California Residential Alzheimer’s Care (Memory Care): Laws, Costs & Financial Help

Legal Definition of Memory Care in California

In California, assisted living residences for seniors, including those with dementia, are officially called Residential Care Facilities for the Elderly (RCFEs) and they are licensed by the California Department of Social Services, Community Care Licensing Division. These are facilities where 75% of the residents are 60 or older and varying levels of care and supervision are provided, including assistance with the Activities of Daily Living (mobility, bathing, dressing/grooming, eating, toileting).

RCFEs may only accept residents with dementia if the facility has met the statutory and regulatory requirements. These facilities have enhanced supervision and safety requirements, appropriate activity programs and specially trained staff. They may also use personal egress alert devices, delayed egress design and locked facility doors and perimeters.

Assisted Living Laws & Regulations

Admissions Requirements & Process

California residents must be assessed before being admitted to a Residential Care Facility for the Elderly (RCFE). The assessment will evaluate their functional capacity, mental condition and social factors. This evaluation must be updated once a year, or if there is any significant change in their condition, whichever comes first. This assessment can be performed by staff at the residence. While there is no standard form, a Functional Capability Assessment is available here.

RCFE applicants must also complete a medical assessment, signed by a physician, to be admitted. This medical assessment must be updated annually, or more frequently if there is a significant change in a resident’s medical condition.

Applicants will not be admitted if they have or meet any of the following conditions:

• Active communicable tuberculosis
• Stage 3 or 4 pressure injury
• Gastrostomy tubes
• Nasogastric tubes
• Staph infection
• Depend on others for help with all Activities of Daily Living
• Require 24-hour skilled nursing or immediate care
• The primary need for care is due to ongoing behavior caused by a mental disorder that would upset the general resident group
• Have dementia, unless the RCFE has met the statutory and regulatory requirements

RCFEs are required to provide residents with an admission agreement no later than seven days days following admission. This agreement must include all services, rates, payment provisions, and conditions that would allow for refunds. It must explain billing and payment procedures and the conditions that could cause rates to increase. Any factors that could lead to eviction must also be listed.

Because it can take months between picking a residence and moving in, you’ll want to start looking as soon as possible. Your loved one will also be able to provide more input the sooner you start your search. It is possible to move into memory care on short notice, but the longer you spend investigating options, the more likely you are to find a home that’s a good fit. This is especially true because some residences have extended waitlists for admissions.

Scope of Care

RCFEs in California provide supervision and care for its residents, including assistance with the Activities of Daily Living, observation and, when appropriate, self-releasing postural supports. Residents who require the following services or have the following needs may also reside in an RCFE as long as the relevant statues and regulations are followed and services are administered by a properly trained professional:

• administration of oxygen
• bedridden
• catheter care
• colostomy/ileostomy care
• contractures
• dementia care
• diabetes
• enemas/suppositories
• hospice care
• incontinence
• injections
• intermittent positive pressure breathing machines
• medication management
• stage 1 and 2 pressure injury
• wound care

Staff & Training Requirements

There is no specific staffing ratio that must be met in California, though staffing “must be sufficient” for the number of residents throughout the day and night. An administrator or manager who is certified and at least 21 years old must be on the premises 24 hours per day. All other staff in residential care facilities must be at least 18 years old, with on-the-job training. Additionally:

• Initial training in the first month of hiring is 40 hours total. 20 hours must be done before they can work with patients and 12 hours must be focused on dementia care.
• Staff who work directly with residents need 20 hours of training annually, including eight hours of dementia-care training.
• First aid training is also required. Someone trained to do CPR must be working at the residence at all times.
• All training for every employee must be documented by the facility.
• Residences must train staff to recognize elder abuse.
• Residents with specialized health conditions, like diabetes, must be cared for by staff with training from a licensed professional that meets the specific need.
• Staff who handle medications must meet training requirements that vary depending on the number of residents.

Evictions

The admission agreement signed when moving in must include information about evictions, including all the reasons a person can be asked to leave the residence. An eviction notice can be issued that gives someone 30 days to move out, for the following reasons:

• Nonpayment within 10 days of the due date
• Illegal behavior
• Not following the residence’s policies
• Resident’s health needs have changed and the residence can no longer safely provide care

If a resident’s behavior is considered threatening to anyone in the residence, it’s possible that the state’s Department of Social Services would approve a three-day eviction notice, rather than the usual 30 days. A judge’s order is required to remove someone who doesn’t leave voluntarily after receiving an eviction notice. Help with relocation must be made available to someone being evicted. For general information on what to do if you receive an eviction notice in memory care, click here.

California Memory Care/Assisted Living Costs

Because of California’s large size, there can be a vast difference in the cost of assisted living and memory care depending on what part of the state you are in. The table below lists the 2025 median monthly costs of both assisted living and memory care facilities in different regions of the state, and it includes the statewide median as well as the median for non-metropolitan areas. Individuals who are in the early to mid stages of dementia may be best suited for assisted living facilities, which are less expensive than memory care, while those with more severe symptoms or who are in the late stages of dementia will likely need memory care.

With high monthly prices statewide, it is possible to find more affordable memory care in neighboring states. For example, if you live to the east in the San Joaquin Valley, memory care in both Nevada and Arizona is less expensive.

Assistance for Memory Care in California

There are several sources of financial assistance and care support for qualified California seniors with Alzheimer’s disease and other dementias who reside in assisted living facilities or specialty care assisted living facilities. They include Medi-Cal Home and Community Based Services (HCBS) Waivers, the Program of All-Inclusive Care for the Elderly (PACE), Veterans Affairs (VA) pensions and Supplemental Security Income (SSI), as well as elder loans, tax credits and reverse mortgages.

Medicaid Long-Term Care

Medi-Cal (California Medicaid) will not cover room and board costs for Residential Care Facilities for the Elderly (RCFEs), but it will cover long-term care services and supports for seniors who live in RCFEs through the following programs:

Medi-Cal Assisted Living Waiver
The Medi-Cal Assisted Living Waiver (ALW) covers long-term care services and supports for California residents age 65 and over who need a Nursing Facility Level of Care but live instead in a Residential Care Facility for the Elderly (RCFE), an Adult Residential Facility or in public subsidized housing. ALW benefits include skilled nursing visits, meal delivery, homemaker services and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing/grooming, eating, toileting).

In addition to needing a NFLOC, applicants for the ALW have to meet an income limit, which is $1,836/month for an individual, effective April 2026 through March 2027, and an asset limit, which is $130,000 for an individual in 2026. The ALW is currently available in the following counties – Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara and Sonoma.

It’s important to note that there is a state-wide waitlist for the ALW that had 17,513 people on it as of Nov. 2025. To find out waitlist information and if there are any available spots in your area, contact the relevant Care Coordination Agency.

California Advancing and Innovating Medi-Cal
This program provides Enhanced Care Management and Community Supports for several high-needs groups, including seniors who are at risk of nursing home placement who live in Residential Care Facility for the Elderly (RCFE). California Advancing and Innovating Medi-Cal (CalAIM) also serves seniors who are in nursing homes but wish to transition back to the community, including to a RCFE.

CalAIM’s Enhanced Care Management allows the beneficiary and their families or representatives to participate in the care planning, and it provides assistance with  in finding physicians, scheduling medical appointments, managing medications, and locating and applying for needed community-based services and supports. CalAIM’s Community Supports include home modifications for safety and accessibility, homemaker services, personal care assistance and Assisted Living Facility Transitions, which helps program participants access assisted living.

Program of All-Inclusive Care for the Elderly
California residents age 55 and over who require a NFLOC can have all of their healthcare coverage, including Medicaid and Medicare, streamlined into one plan with the Program of All-Inclusive Care for the Elderly (PACE). PACE also offers vision, dental and hearing care, and PACE day centers provide day-time supervision, meals, social activities and regular health checkups for program participants. Being enrolled in Medicaid and/or Medicare is not a requirement for PACE, but it is free for Medi-Cal Aged, Blind and Disabled (ABD) beneficiaries.

California’s PACE programs are located in Commerce (AltaMed PACE), Eureka (Redwood Coast PACE), Fresno (BoldAge PACE Fresno, WelbeHealth Fresno), Garden Grove (CalOptima Health PACE), La Quinta (WelbeHealth Inland Empire), Long Beach (WelbeHealth Long Beach), Los Angeles (InnovAge Crenshaw, myPlace Greater LA PACE), Merced (Central Valley PACE), Napa (Providence PACE), Newport Beach (Innovative Integrated Health), Oakland (Center for Elders’ Independence), Pasadena (WelbeHealth Pasadena), Reseda (Brandman Centers for Senior Care), Redlands (Loma Linda University Health PACE), Riverside (Neighborhood Healthcare PACE), Rohnert Park (AgeWell PACE), Sacramento (Sutter SeniorCare PACE and InnovAge California PACE – Sacramento), San Bernardino (InnovAge California PACE – San Bernardino), San Diego (St. Paul’s PACE and Family Health Centers of San Diego PACE), San Francisco (NEMS PACE and On Lok PACE), San Jose (WelbeHealth San Jose), San Marcos (Gary and Mary West West PACE), San Ysidro (San Diego PACE), Stockton (WelbeHealth Stockton), Victorville (High Desert PACE) and Visalia (Family HealthCare Network (FHCN) PACE.

Nursing Home Medicaid and Money Follow the Person
California’s Nursing Home Medicaid will cover all nursing home expenses, including room and board, for all eligible applicants. To qualify, applicants must require a Nursing Facility Level of Care and meet an asset limit ($130,000 for an individual as 2026). There is no income limit for Medi-Cal’s nursing home coverage, but beneficiaries are required to give most of their income to the state to help cover the cost of care. And, after the beneficiary passes, all of the assets in their estate (unless otherwise protected) are subject to Medicaid Estate Recovery, which is legally obligated to try and collect reimbursement for any long-term care expenses paid by Medi-Cal.

California Nursing Home Medicaid beneficiaries who want to leave the nursing home and return to a small group home with no more than four unrelated residents (or their own home or the home of a relative) can receive assistance with the transition through California Community Transition (CCT), which is a the Money Follows the Person program. The assistance can include paying for moving expenses, utility set-up fees, essential furniture and appliances, as well as long-term care coverage in the new residence.

Veterans Affairs (VA)

Qualified California veterans (or their surviving spouses) can also receive financial assistance through a Veterans Affairs (VA) Pension that they could use to pay for assisted living or memory care. There are three levels of VA Pensions – Basic, Aid & Attendance (A&A) and Housebound. To qualify for any of them, veterans or their surviving spouses need to meet a net worth limit of $163,699 (effective Dec. 2025 – Nov. 2026), which is calculated by adding the total of their assets to their annual income. Some assets are exempt, like a primary home, primary vehicle and household furniture and appliances. VA Pension applicants also have to meet an income limit to be eligible – their income must be less than the VA Pension they are applying for in order for them to qualify. And veterans must meet a military service requirement, which includes not having received a dishonorable discharge.

To qualify for A&A, veterans or their surviving spouses must also meet a medical requirement, which is one of the following must be true:

• They need help to perform the Activities of Daily Living (mobility, bathing, dressing/grooming, eating, toileting) OR
• They have to stay in bed for at least a large portion of the day due to illness OR
• They are in a nursing home due to loss of mental or physical abilities OR
• Their eyesight is extremely limited (5/200 or less in both eyes even with glasses or contacts; or concentric contraction of the visual field to 5 degrees or fewer)

To qualify for Housebound, veterans must spend most of their time in their home due to a permanent disability.

There is no medical requirement for VA Basic Pensions.

Qualified veterans or their surviving spouses are entitled to their Maximum Annual Pension Rate (MAPR) minus their annual income. The following MAPRs are effective from Dec. 1, 2025, to Nov. 30, 2026.

VA Basic Pension MAPRs

• Veterans without spouses or children: $17,441
• Veterans with dependent spouses or children: $22,839
• Surviving spouses without dependent children: $11,699
• Surviving spouses with dependent children: $15,311
• Two veterans married to each other: $22,839

VA Aid & Attendance MAPRs

• Veterans without spouses or children: $29,093
• Veterans with dependent spouses or children: $34,488
• Surviving spouses without dependent children a maximum of $18,697
• Surviving spouses with dependent children: $22,304
• Two veterans married to each other and one qualifies for A&A: $33,548
• Two veterans married to each and one qualifies for A&A and the other for Housebound: $38,350
• Two veterans married to each other and both qualify for A&A: $46,143

VA Housebound MAPRs

• Veterans without spouses or children: $21,313
• Veterans with dependent spouses or children: $26,710
• Surviving spouses without dependent children: $14,298
• Surviving spouses with dependent children: $17,902
• Two veterans married to each other and one qualifies for Housebound: $26,710
• Two veterans married to each other and both qualify for Housebound: $30,580
• Two veterans married to each other and one qualifies for Housebound and the other for A&A: $38,350

Veterans Homes
There are eight Veterans Homes of California that are operated by CalVets. They offer four levels of care – memory care, skilled nursing, assisted living and independent living.

The memory care units specialize in supporting residents with dementia, memory loss and other cognitive impairments. The available services in memory care units are designed to engage veterans with dementia and promote mental health in a safe setting. CalVet’s Skilled Nursing Facilities provide 24/7 supervision and support from licensed nurses and certified nursing assistants. Veterans in early stages of dementia may be able to live in assisted living units, which offer personal care assistance with the Activities of Daily Living (mobility, bathing, dressing/grooming, eating, toileting), but do not specialize in dementia care.

The Veterans Homes in Fresno, Redding, West L.A. and Yountville all offer memory care units, as well as skilled nursing and assisted living. The other four Veterans Homes are located in Barstow (skilled nursing only), Chula Vista (independent living, assisted living, skilled nursing), Lancaster (assisted living only) and Ventura (assisted living only).

Supplemental Security Income

Dementia patients age 65 and over with limited income and assets may qualify for Supplemental Security Income (SSI). These funds can be used to pay for the cost of assisted living or memory care. As of 2026, the maximum SSI benefit for an individual is $994/month and for a married couple it’s $1,491/month.

To qualify for SSI, applicants must be age 65 and over or have a significant disability, and they must meet an income limit and an asset limit. As of 2026, individuals may meet the SSI income limit if they earn less than $2,073/month OR they get less than $1,014/month from non-work sources, like Social Security benefits or pension payments. They may meet the SSI asset limit if they have $2,000 or less in countable assets. For couples, the income limit is $3,067/month in work income or $1,511/month in non-work income, and the asset limit is $3,000.

Other Options

1) Elder care loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for Medicaid approval or waiting to sell a home. More on bridge loans for memory care.

2) Some tax credits and deductions can provide financial relief for seniors with dementia and their families. Seniors with limited financial resources can claim the Credit for the Elderly and/or the Disabled, as long as no one can claim them as a dependent. If someone (like an adult child) can claim the senior as a dependent, they can utilize the Child and Dependent Care Credit, and they can deduct any medical or dental expenses they paid for the senior.

3) A reverse mortgage loan can be a viable option for some senior homeowners who are in need of extra income to help pay dementia care. However, reverse mortgages are not recommended for every senior homeowner who needs extra income, so it’s important to consult with a professional before taking out one of these loans.