Designing supportive care for persons with Alzheimer's disease and related dementias in residential care is one of the most challenging issues facing researchers, policymakers, and facility administrators. To gain a better knowledge of the types of special care offered by adult care residences (ACRs) and assisted living facilities, the results of a survey of all licensed ACRs in the state of Virginia are presented. Examined are the facilities with special care units (SCUs) and special programs (SPs), the organizational characteristics of facilities that offer special care, the characteristics of existing SCUs and SPs, and the opinions of owners/operators on the elements needed for establishing these units and programs. The discussion focuses on improvements needed within special care and the implications of the views of owners/operators about special care.