Every active Missouri DHSS long-term care license in the City of St. Louis and St. Louis, St. Charles, Jefferson and Franklin counties, plus Medicare-certified home health and hospice.
Missouri DHSS licenses 272 long-term care facilities in Greater St. Louis — 146 assisted living and residential care, 126 nursing homes — and 94 of them have disclosed an Alzheimer's special care unit.
| County | DHSS licenses | Licensed beds | With Alzheimer's unit |
|---|---|---|---|
| City of St. Louis | 34 | 2,571 | 2 |
| St. Louis County | 143 | 15,631 | 59 |
| St. Charles County | 44 | 3,852 | 22 |
| Jefferson County | 25 | 2,056 | 4 |
| Franklin County | 26 | 1,420 | 7 |
CMS adds 35 Medicare-certified home health agencies and 32 hospices with offices in the metro.
Every DHSS ALF (Option 1 and 2), RCF I and RCF II license in the metro.
Browse →94 listingsLicenses with a disclosed Alzheimer's special care unit.
Browse →126 listingsSkilled nursing and intermediate care facilities, with Care Compare links.
Browse →35 listingsMedicare-certified home health agencies.
Browse →32 listingsMedicare-certified hospice providers.
Browse →See all 146 assisted living licenses →
Assisted living is a DHSS license level; memory care is an Alzheimer's special care unit or program 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. | |
It lists every active state license, not just paying communities, and every record links back to the official DHSS data and inspection history.
We don't sell placement on these pages and we don't publish star ratings. Featured profiles are chosen by size and how often St. Louis families ask about them.
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. Home health and hospice listings come from the CMS Provider Data Catalog.
Listings are active licenses only. We re-pull both sources quarterly. Last updated: October 23, 2026 · Last verified: October 2026.
Free and online, no pressure. We work for families, not facilities.
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STL Senior Advisor