Since July 1, 2026, an assisted living community in Washington cannot operate a memory care unit without DSHS certification — and the new rules hand families a staffing disclosure that is the most useful document on a memory care tour.
By Patricia Nguyen, CDP · October 24, 2026
Washington quietly handed families one of the strongest memory care consumer-protection tools in the country. Under a 2025 law (Engrossed Second Substitute Senate Bill 5337), no one may operate or maintain a memory care facility or unit in this state without certification from the Department of Social and Health Services as of July 1, 2026. The requirement sits on top of the regular assisted living license and applies to communities that run a secured dementia unit or that market memory or specialized dementia care.
The teeth are real. DSHS can impose civil penalties of up to $10,000 on a current or former licensee operating an uncertified memory care unit, can suspend or revoke certification or order a stop placement, and operating without certification is treated as an unfair or deceptive act under the Washington Consumer Protection Act. DSHS is also required to maintain a public register of certified facilities and units, so certification status is a matter of public record rather than something you have to take on faith.
What this means practically: if you are touring a secured memory care unit anywhere from Bellevue to Everett to Tacoma this fall, certification is now a baseline question, not a nicety. Some long-standing providers are operating under case-by-case conditional exemptions DSHS may grant to avoid displacing residents — that is legitimate, but you are entitled to know which situation you are looking at.
The most valuable thing in the new rules is not the certificate on the wall. It is the additional disclosure form a certified community must give prospective residents and their representatives. That form has to describe staffing coverage — including the number of overnight awake staff and direct-care staffing per bed.
Those two numbers are what families have spent years trying to pry out of marketing directors. A 48-bed secured unit with two awake caregivers overnight is a very different place at 3 a.m. than one with four, and no brochure will tell you which you are standing in. Ask for the disclosure form in writing, read the overnight line, and do the arithmetic yourself.
The rules also require that residents and their representatives be told of significant staffing changes within 30 days. If your parent is already living in a Puget Sound memory care unit, that notice is your early-warning system for a quiet cut in overnight coverage.
Certification sets a floor, and knowing the floor tells you what to verify. A certified community must have awake staff 24 hours a day, and where residents live in separate buildings or cottages — a common layout on the Eastside and in Snohomish County — at least one awake staff member must be physically present in each building. It must have permanent infrastructure designed for dementia care, including elopement prevention, and written policies for residents who wander, for missing residents, and for obtaining behavioral consultation.
On the ongoing side: a full assessment of each specialized-care resident at least every six months; at least six hours a year of dementia-related continuing education for every direct-care worker; daily access to independent, individual, and group activities adjusted to a resident's mood and energy, including programming for residents who are awake at night; a residential atmosphere in which residents can reach their own rooms at any time without staff help; and a disaster preparedness plan that specifically addresses residents with dementia.
The outdoor requirement is unusually detailed and worth seeing with your own eyes. The enclosed area must be reachable without staff assistance, fenced or walled high enough to prevent typical elopement, shaded and protected from rain, surfaced with slip-resistant material suitable for wheelchairs and walkers, furnished, planted with non-toxic plants, and monitored or restricted in extreme weather. In a region where it rains eight months a year, covered outdoor access is the difference between a garden that gets used and one that photographs well.
Here is the distinction that trips families up. The certification law applies to assisted living facilities, which Washington defines as serving seven or more residents under RCW 18.20. Adult family homes — licensed for up to six residents under RCW 70.128 — are not covered by it.
That is not a reason to skip them. Adult family homes are Washington's signature care setting, and in Tacoma, Lynnwood, Kent, and Everett a well-run AFH with a dementia-experienced provider often delivers more consistent one-to-one attention than a large secured unit, at roughly $4,500–$7,000 a month against $7,500–$9,500 for memory care. It does mean the new certification is not the screening tool there.
For an AFH, verify a different set of things: the license and any dementia specialty on the DSHS lookup at fortress.wa.gov/dshs/adsaapps/lookup, the full inspection and enforcement history, what dementia-specific training the provider and resident managers have completed, who is awake overnight, and what the home's written plan is if your parent begins trying to leave. Ask what happens when care needs exceed what six beds and one or two caregivers can absorb — the honest answer is a referral out, and you want to hear it before move-in.
Two Washington programs sound alike and are easy to confuse. Certified memory care is a licensing requirement that applies regardless of how the stay is paid for. The Specialized Dementia Care Program (SDCP) is an Apple Health (Medicaid) benefit delivered in a small number of assisted living facilities that hold a contract with DSHS.
SDCP eligibility has three parts: a diagnosis of Alzheimer's disease or another irreversible dementia such as vascular dementia or Lewy body dementia; receiving or being eligible for Medicaid; and an assessment by a DSHS case manager finding a need for specialized dementia care. The service package includes tailored care and activities, dementia-specific staff training, awake staff 24 hours a day, a secure outdoor area, intermittent nursing, and medication and personal care support. Because DSHS contracts with a limited number of buildings, bed availability — not eligibility — is usually the binding constraint in King, Pierce, and Snohomish counties.
If your parent may need Apple Health within a year or two, screen for both at once: ask whether the community is certified for memory care and whether it holds an SDCP contract. A community that is certified but private-pay only means a second move later, which is the single hardest thing to put a person with dementia through. Start with your Area Agency on Aging — Aging and Disability Services in King County, Homage in Snohomish, Aging & Disability Resources of Pierce County — and request a CARE assessment through DSHS Home and Community Services.
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