State plate · MO
Assisted living in Missouri
Missouri licenses assisted living through DHSS, Section for Long-Term Care Regulation, under the license types Residential Care Facility (RCF, RCF*); Assisted Living Facility (ALF, ALF); Alzheimer's special care unit. The state's own list, as of October 24, 2026, counts 600 licensed facilities with 27,901 beds; 459 of them have 20 or more, the smallest size HUD's Section 232 program insures. HUD's active-loan file shows 8 FHA-insured assisted living loans in Missouri with $113.7 million outstanding as of September 30, 2026.
Licensing
- Licensing agency
- DHSS, Section for Long-Term Care Regulation
- License types
- Residential Care Facility (RCF, RCF*); Assisted Living Facility (ALF, ALF); Alzheimer's special care unit
- Official program page
- health.mo.gov
- Facility list
- CSV (2026-10-05)
Licensing details checked against each agency's site on 2026-10-24. HUD requires a Section 232 assisted living project to be licensed or regulated by the state and have at least 20 beds.
Licensed supply, from the state's list
| Facilities on the list | 600 |
|---|---|
| Licensed beds | 27,901 |
| Facilities with 20 or more beds | 459 (77% of facilities, 94% of beds) |
| Homes with 6 or fewer beds | 1 |
| Median size | 39 beds |
| Memory care | 4,725 Alzheimer's special care unit capacity in 161 facilities |
Covers: Residential care and assisted living facilities. Source: data.mo.gov, as of October 24, 2026.
CDC survey profile (2020)
The National Post-acute and Long-term Care Study, run by CDC's National Center for Health Statistics, estimates residential care communities with four or more beds. 2020 is its latest wave with state figures, so these numbers differ from the state's own list.
| Measure | Missouri | US |
|---|---|---|
| Communities | 450 | 30,600 |
| Beds | 22,500 | 1,197,600 |
| Average beds per community | 50 | 39 |
| For-profit | n/a% | 81.9% |
| Chain affiliated | 72.6% | 61.4% |
| Medicaid certified | 49.6% | 43.6% |
| Dementia-only communities | n/a | 10.5% |
| Dementia-only or with a dementia unit | 27.7% | 20.5% |
| Residents 85 and older | 46.9% | 49.9% |
| Residents with Alzheimer disease or other dementias | 34.1% | 42.1% |
Source: CDC/NCHS, Biennial Overview of Post-acute and Long-term Care (data.cdc.gov). Percentages are of communities, except the resident rows.
HUD Section 232 assisted living loans
- Active FHA loans
- 8
- Outstanding
- $113.7 million
- Median note rate
- 2.96%
- Endorsed since FY2001
- 17
Since fiscal 2001 HUD has endorsed 17 FHA-insured assisted living loans in Missouri for $317.4 million of original principal, 9 of them for new construction or substantial rehabilitation, and 3 since fiscal 2021. 1 of today's active loans carry a note rate of 5% or more. The active file also lists 1 board and care loans in the state.
| Property (HUD name) | City | Units | Endorsed | Rate | Balance | Matures |
|---|---|---|---|---|---|---|
| Mcknight Place Assisted Living & Memory CareFHA 08543107 | St Louis | 135 | Aug 2021 | 2.95% | $53,919,190 | Sep 2061 |
| Pare ProvenceFHA 08543103 | Creve Coeur | 232 | Feb 2020 | 2.98% | $29,538,493 | Nov 2056 |
| The Fountains of West CountyFHA 08522106 | Ellisville | 57 | May 2022 | 3.30% | $11,449,775 | Jun 2057 |
| Les MaisonFHA 08522088 | Creve Coeur | 44 | Apr 2016 | 3.10% | $5,326,113 | May 2051 |
| Twin Oaks at Heritage PointFHA 08543083 | Wentzville | 50 | Apr 2009 | 2.65% | $4,639,580 | Oct 2050 |
| Oak Tree VillasFHA 08522055 | Jefferson City | 102 | Feb 2012 | 2.67% | $4,154,833 | Jan 2044 |
| Dolan Residential CareFHA 08522085 | St. Louis | 41 | Aug 2014 | 2.95% | $3,537,423 | Sep 2049 |
| Autumn Place of JoplinFHA 08422018 | Joplin | 36 | Jun 2009 | 5.65% | $1,138,144 | Jul 2039 |
Active loans: HUD FHA insured mortgages, active, as of September 30, 2026. Endorsements: HUD Office of Healthcare Programs database, data run July 8, 2026. Facility type comes from HUD's endorsement records.
Own or are buying an assisted living or memory care building in Missouri? See what HUD, Fannie Mae and Freddie Mac would lend against your NOI.
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ALF Atlas is operated by Janover Capital LLC and is not affiliated with HUD, FHA, CDC or any state agency. Methodology.