Massachusetts State surveyors are scrutinizing the environment and training expectations for facilities who have a registered “Specialty Dementia Unit” in their facility. The focus on the physical environment during survey proves to be a deep dive into very specific parameters. In reading the guidelines, they may appear to be general in nature, but when surveyors are on site the attention to environmental standards is very specific. All Providers, regardless of the presence of a Specialty Unit in the facility, should read the Licensing for Long Term Care Facilities, Section 150.029, Physical Environment for Dementia Care Units, to prepare for Regulatory survey with this special focus population in mind. Dementia Focused Survey is not far down the road as a standard of practice, so these guidelines will allow facilities to expand the measures taken to promote safety and functional performance at the highest practical level.