Every active Missouri DHSS license in the City of St. Louis and St. Louis, St. Charles, Jefferson and Franklin counties — 146 facilities, with license numbers, beds and inspection records.
Missouri DHSS lists 146 active assisted living and residential care licenses in the City of St. Louis and St. Louis, St. Charles, Jefferson and Franklin counties, with 9,211 licensed beds between them.
That count is 101 Option 2 assisted living facilities, 12 Option 1, 16 Residential Care Facility II and 17 Residential Care Facility I licenses. 70 of them have disclosed an Alzheimer's special care unit.
| County | Licenses | Licensed beds | With Alzheimer's unit |
|---|---|---|---|
| City of St. Louis | 21 | 907 | 1 |
| St. Louis County | 64 | 4,745 | 40 |
| St. Charles County | 29 | 2,248 | 19 |
| Jefferson County | 13 | 580 | 3 |
| Franklin County | 19 | 731 | 7 |
These are among the largest, best-known communities in the metro. Each profile has the full license record, itemized DHSS inspection findings and tour questions.
Filter by county:
Assisted living is a DHSS license level; memory care is an Alzheimer's special care unit or program that a licensed facility discloses to DHSS. Missouri has no separate memory care license.
| Assisted living (ALF / RCF) | Memory care (Alzheimer's special care unit) | |
|---|---|---|
| What it is | A DHSS-licensed residence giving 24-hour care, services and protective oversight under a social model of care. | A unit or program inside a licensed facility that has been disclosed to DHSS as suited to people with Alzheimer's or dementia (RSMo 198.510). |
| What it isn't | Not skilled nursing: a resident can't need hospitalization or skilled nursing placement (19 CSR 30-86). | Not a separate Missouri license. DHSS licenses the building (usually an Option 2 ALF); the special care unit is a disclosure on top of it. |
| Evacuation rule | RCF residents must reach safety unassisted; Option 1 ALFs may serve residents needing minimal help; Option 2 ALFs may serve residents who can't evacuate alone, with added staffing and individual evacuation plans. | 70 of the 70 metro assisted living licenses with a special care unit are Option 2. |
| What to ask for | The license level and the most recent Show Me LTC inspection. | The written Alzheimer's special care disclosure the facility filed with DHSS. |
| Who pays | Medicare doesn't pay for either. Missouri's Aged and Disabled Waiver can cover personal care for eligible residents, but not room and board. | |
Every listing comes from the Missouri DHSS LTC Directory (updated October 5, 2026) and links to a record page with the facility's Show Me Long Term Care inspection history.
We don't accept payment for placement on this list, and we don't rate facilities. Click any name for the license number, capacity, operator and inspections; full profiles add the requirements DHSS cited.
Residents of a Residential Care Facility (RCF I or II) must be able to reach safety on their own; an Assisted Living Facility may serve residents who need help to evacuate.
Option 1 ALFs may keep residents who need minimal help; Option 2 ALFs may keep residents who can't evacuate safely, with extra staffing and an individualized evacuation plan.
Data source + refresh cadence
Licenses, levels of care, capacity, Alzheimer's special care unit flags, operators and administrators come from the Missouri Department of Health and Senior Services (DHSS) LTC Directory, published for the Section for Long-Term Care Regulation (file updated October 5, 2026). Inspection and complaint-investigation history comes from DHSS Show Me Long Term Care.
Listings are active licenses only. We re-pull both sources quarterly. Last updated: October 23, 2026 · Last verified: October 2026.
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STL Senior Advisor