Massachusetts Residential Alzheimer’s Care (Memory Care): Rules, Costs & Financial Help

Legal Definition of Assisted Living / Memory Care in Massachusetts

Assisted living residences in Massachusetts offer housing, meals, security and personal care for adults who need help with activities of daily living like housekeeping and dressing. For people with Alzheimer’s disease or dementia, there are special care residences. Known as memory care, these units can be an entire community or a special wing of assisted living.

Every memory care residence is required to provide a philosophy and mission statement that shares its goals for supporting residents. These mission statements can be generic, often stating that the community is “committed to fulfilling the needs of residents”.  They’re part of a longer, more specific list of disclosure items you’ll want to ask for when considering a memory care community. The list will tell you about services, activities, and policies at the residence, as well as costs, meals, and how visits are handled.

Memory care staff must have additional training in serving the needs of people with dementia. Other requirements specific to special care residences include a secure outdoor area for residents who may be prone to wandering.

Assisted living in Massachusetts is regulated by the state’s Executive Office of Elder Affairs. There are approximately 180 memory care homes in the state as of 2024. There are also 10 board and care homes, which offer the same services as assisted living, often including memory care. These are a house-like setting for 12 or fewer residents. For free help finding a memory care home to meet your family’s needs and budget, click here.

How Much Does Memory Care Cost in Massachusetts?

There can be significant differences in the cost of assisted living and memory care depending on what part of Massachusetts you are in. The table below lists the median monthly cost of both assisted living and memory care facilities in different regions of the state as of 2025. 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.

For context, the median cost of assisted living across the country in 2025 was $6,200/month, while it was $9,600/month in Massachusetts in 2025.

Massachusetts Assisted Living Laws & Regulations

Admissions Process & Requirements

Before moving in, a resident must be assessed by a nurse who works for the residence. The price of this assessment is usually covered by a community fee that also includes move-in costs like deep cleaning the new resident’s room. The assessment determines:

– Patient’s needs and preferences
– The resident’s ability to perform activities of daily living
– The resident’s cognitive status (stage of dementia) and its how it impacts on functional abilities
– Whether the resident can self-administer medication

All this information goes into an individualized service plan. This details medications, allergies, dietary needs, and a behavioral history. There is no time frame during which the assessment must be completed but families should expect this to occur within the few first weeks of a move.  A diagnosis of dementia is not required to move into memory care in Massachusetts. Dementia is difficult to diagnose as symptoms change over time.

Before a residency agreement can be signed and any money can be paid, the following information must be provided in a disclosure statement:

– The number and type of units the residence operates
– The number of staff per shift
– A list of residents’ rights
– An explanation of any additional costs that may go beyond the base agreement
– Medication management policy
– Explanation of any limitations on services provided, including whether staff cannot help with activities of daily living
– Number and duties of nurses employed by the home
– Process for resident assessment prior to move-in
– Explanation of CPR policies (how many staff are qualified to perform CPR and under what circumstances)
– Explanation of eviction policies
– Explanation of physical design features
– Example of a service plan and explanation of reviews, revisions, and signatures required
– Explanation of types of diets available
– List of activities for residents
– Security policy
– Disaster and emergency preparedness plan
– Policy on family members’ participation at the residence

Someone who needs full-time nursing care may not be admitted into assisted living in Massachusetts, unless the care is provided by someone certified to work within the residence.

It is possible to find a memory care home on short notice, but this is not a good idea. The sooner you begin searching, the more input your loved one can provide and the more likely you are to find a perfect fit.

Facility / Residence

Massachusetts regulations do not require bedrooms to be a certain number of square feet. Regulations do state that single- or double-occupancy rooms must have lockable entry doors and either a kitchenette or access to an area for cooking. Two is the maximum number of people allowed in a bedroom unit. Every living unit or bedroom must have its own toilet, sink, and bathtub or shower.

Memory care units must provide a secure outdoor area, where residents can walk safely. Regulations do not specify other rules about how the facilities should be physically designed. Looking for design features that are dementia-friendly when touring a potential home for your loved one is important to keep in mind. These would include easily navigated spaces, hallways that run circular so people with dementia avoid dead ends, and softer paint colors.

Staff & Training

There are no required staff-to-resident ratios in Massachusetts. Residences must be sufficiently staffed at all times, with at least two employees awake throughout the night. No one convicted of a felony related to theft or selling controlled substances may be employed at an assisted living facility in Massachusetts. Administrators must be at least 21 years old, with relevant experience. Five hours of training are required for managers, not including training related to assisting someone with dementia.

Seven hours of orientation is required for staff who prepare meals or work with residents, and 10 more hours of relevant training is required annually. Fifty-four hours of training are required for staff who help residents with activities of daily living. All memory care staff must receive two hours of training annually on assisting people who have Alzheimer’s or a related dementia.

Evictions & Discharges

The documents that are provided by the home to anyone moving in include an explanation of what would cause a facility to decide to evict a resident. Regulations are not specific about what can get a resident evicted, so the community is able to determine that for itself. Grounds for eviction or discharge usually include nonpayment, aggressive or dangerous behavior, damage to property, or a medical condition that cannot be safely treated there. Memory care homes can make their own eviction policies but they must tell you about them before you move in.

It’s important to be clear on the eviction policy, and to get the specifics in writing. Unfair evictions are a problem in assisted living, and having your own document that covers this issue will help protect against an unexpected notice of eviction.

If you do receive an eviction notice, there are steps you can take in the process of fighting the decision or finding a new home. For more on what to do next, click here.

Financial Assistance For Residential Alzheimer’s Memory Care

MassHealth Personal Care Attendant

In Massachusetts, Medicaid is called MassHealth. The MassHealth Personal Care Attendant program is meant to keep people with acute medical needs out of nursing home care, enabling them to remain in their own houses or assisted living. Benefits have a set budget and are determined by an individual’s need and on a case-by-case basis. The main benefit is personal care assistance with the Activities of Daily Living (mobility, bathing, dressing/grooming, eating, toileting), but they can also include medication administration and transportation.

To qualify for the Personal Care Attendant program, applicants must meet two financial requirements – an asset limit ($2,000 for an individual in 2026) and an income limit ($1,735/month in 2026) – as well as the medical requirement of needing help with two of the Activities of Daily Living.

Group Adult Foster Care Program

The Group Adult Foster Care Program (GAFC) helps low-income Massachusetts residents with the cost of group adult foster care, which can include assisted living if the program has been approved by the residence. Adult foster care homes are smaller group homes. The program offers benefits that can cover long-term care services such as assistance with activities of daily living, light housekeeping, and medication management but cannot pay for living costs like room and board. The Supplemental Security Income Assisted Living Benefit (SSI-G), however, does cover room and board and can be combined with group adult foster care program benefits. To qualify for GAFC, applicants must meet two financial requirements – an asset limit ($2,000 for an individual in 2026) and an income limit ($1,330/month in 2026) – as well as the medical requirement of needing help with one of the Activities of Daily Living.

Frail Elder Home & Community-Based Services Waiver

Frail Elder Home & Community-Based Services Waiver (FEW) is a state-run Medicaid program designed to help individuals live independently in their community and not need to move into a nursing home. Benefits extend to those living in their own home, that of a loved one, or an adult foster care home (not in assisted living or memory care). Benefits are based on an individual’s need and can include respite care, assistance with activities of daily living, transportation, home modifications, assistive technology devices, meal delivery, and assistance with household chores. To qualify for FEW, applicants must meet two financial requirements – an asset limit ($2,000 for an individual in 2026) and an income limit ($2,982/month in 2026) – as well as the medical requirement of needing a Nursing Facility Level of Care (NFLOC). It’s important to note that a dementia diagnosis does not automatically equate to a NFLOC designation.

Adult Day Health Care

Adult Day Health Care (ADH) is a program that offers long-term care benefits in the form of adult day care to qualified applicants. This program is meant to offer extra supportive services enabling one to live independently and not need to move into a nursing home. ADH allows enrollees to live in their own home, that of a loved one, in adult foster care, or assisted living (so long they are not receiving MassHealth benefits from another program). Benefits can include respite care, case management, dementia care, assistance with activities of daily living, skilled nursing, and transportation. To qualify for ADH, applicants must meet two financial requirements – an asset limit ($2,000 for an individual in 2026) and an income limit ($1,330/month in 2026) – as well as the medical requirement of needing adult day care (with a physician’s note attesting to that fact), plus the need for daily skilled nursing or the need for significant assistance with one of the Activities of Daily Living.

Veterans Affairs (VA)

Qualified Massachusetts veterans (or their surviving spouses) with dementia 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. 1, 2025 – Nov. 30, 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 other and one qualifies for A&A and one 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 Housebound and the other for A&A: $38,350

Veterans Homes

There are also two veterans’ homes in Massachusetts, called Soldiers Homes, which are residential care facilities that provide long-term care for veterans. They are located in Holyoke, in central Massachusetts near Springfield, and Chelsea, across the Mystic River from Boston. In addition to nursing home care, assisted living and memory care are provided. There are only 14 beds for memory care in the Soldiers Home in Chelsea and none in Holyoke. Neighboring states have more veterans’ homes, so a loved one might consider looking there for more options as there are no requirements that one must live in the state. For example, New York has five statewide and the other surrounding states (Connecticut, Rhode Island, Vermont and New Hampshire) all have one apiece. More info.

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 a VA pension to be approved 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.