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Assisted Living vs. Memory Care

In North Carolina, memory care is secured assisted living operating under a Special Care Unit disclosure statement -- not a separate license.

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Memory care regulation in North Carolina. NC requires a Special Care Unit disclosure statement, not a separate certification, before a community can market secured memory care. Read the full explanation →

What physically differs

A designated Special Care Unit adds secured exits, door alarms, staff trained specifically in dementia care, and structured programming built around cognitive and sensory needs -- on top of the same base adult care home license. Standard assisted living has none of that required.

What senior care costs. NC's statewide median is $6,496/month for assisted living, per the 2025 CareScout Cost of Care Survey (formerly the Genworth Cost of Care Survey). No metro-specific or memory-care figure is published. Read the full explanation →

Questions families ask

What should I ask a facility in Smithfield about its 'admission and retention' policy?

Adult care homes operate under 10A NCAC 13F rules governing which residents they may admit and continue to serve based on assessed level of care — facilities are generally required to use a state-approved assessment (commonly the FL-2 medical form completed by a physician) to determine whether a resident's needs fall within what the facility is licensed and staffed to provide, and to discharge or transfer residents whose needs exceed that scope. Ask the facility directly what level-of-care threshold would trigger a required move, since this varies by facility and by whether the resident is in a general unit or a licensed Special Care Unit.

Can I trust glowing online reviews of an assisted living facility in Durham, or should I check something official first?

Online reviews aren't part of North Carolina's regulatory oversight and can't substitute for it — the official sources are DHSR's Regulated Facilities search to confirm licensure and DHSR's ACLS Facility Inspections, Ratings and Penalties search (info.ncdhhs.gov/dhsr/acls/star/search.asp) to review actual inspection findings, corrective action history, and any penalties within the last 36 months. Reviews can supplement that picture but shouldn't replace checking the state's own compliance record.

Will NC Medicaid pay for the room-and-board cost of an assisted living community in Cary?

Not directly — North Carolina does not have a Medicaid HCBS waiver covering room and board in assisted living/adult care homes (there is no 'CAP/AL' equivalent). Instead, eligible low-income residents can receive State/County Special Assistance (SA), a state- and county-funded cash supplement toward room and board, and SA recipients automatically become eligible for Medicaid, which can then cover medical and personal care services layered on top.

What exactly does the CAP/DA Medicaid waiver cover for a parent aging in place in Apex?

The Community Alternatives Program for Disabled Adults (CAP/DA) is North Carolina's Medicaid 1915(c) home- and community-based services waiver for adults 18+ who need a nursing-facility level of care but want to remain at home. It covers up to 18 in-home and community-based services, including adult day health, in-home aide services, home modifications and equipment, meal preparation, respite care, personal emergency response systems, and consumer-directed care that lets the beneficiary hire and supervise their own caregiver.

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