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Arizona Residential Alzheimer’s Care (Memory Care): Rules, Costs & Financial Help

Last Updated: September 28, 2020

 

Legal Definition of Assisted Living / Memory Care in Arizona

Assisted living communities in Arizona provide a comfortable, homelike living setting (including lodging and meals) for seniors and disabled individuals who need supervision and assistance to live independently. This includes people with Alzheimer’s disease or a related dementia. Because these illnesses are progressive, meaning that symptoms get worse over time, people with dementia almost always need to move into an assisted living home at some point.

In AZ state regulations, “assisted living facilities” (ALFs) is a broad term that includes residential settings of three different sizes and three levels of care. The size categories of ALFs include:

1. Adult foster care: Four or fewer residents
2. Assisted living homes: Up to 10 residents (these are also called “board and care homes”)
3. Assisted living centers: 11 or more residents

Assisted living residences in Arizona are licensed to provide one of three levels of care:

1. Supervisory: the lowest level, with monitoring, medication administration, and emergency services
2. Personal care: assistance with ADLs and occasional nursing services
3. Directed care: the highest level, for residents who are unable to communicate needs or make decisions about their care

Assisted living residences that are designed and staffed specifically for persons with Alzheimer’s and other dementias are often referred to as Alzheimer’s care, dementia care, or memory care. In Arizona, the residences that provide care for persons with such neurological conditions are directed care residences. These types of homes in Arizona differ from traditional assisted living in several ways, including:

– Increased security and supervision
– Additional staff training
– Recreational activities specifically appropriate for people with dementia
– Cost (directed care is more expensive)

A point of distinction should be made that memory care homes are not nursing homes. Generally, these residences are less expensive than nursing homes and offer a more comfortable environment with better quality of life to their residents. If you need help finding a memory care (directed care) home that matches your loved one’s specific needs, free assistance is available at this link.

The Arizona Department of Health Services licenses and regulates assisted living in the state under its Bureau of Residential Facilities Licensing. There are more than 330 memory care homes in Arizona, and more than 1,600 board and care homes.

 

Memory Care Costs in Arizona

 Did You Know? Arizona residents can receive free assistance finding memory care homes that match their needs and budget. Get help here

The average cost of memory care in Arizona in 2020, was about $4,470 per month and $53,640 per year. Memory care communities in Arizona typically include all room and board costs and a defined number of hours of care each month. Therefore, persons with dementia that require greater than average amounts of assistance may pay more than the average cost.

Notably, there are areas within Arizona that are more and less expensive than the statewide average. Areas of Arizona that are less expensive for assisted living and memory care include Maricopa County cities Phoenix and Mesa, where the average monthly cost is $4,150 and $3,856 respectively. The cities in Arizona where memory care is most expensive areFlagstaff and Tucson, where the monthly costs are $5,960 and $5,600, respectively.

While the bordering state of New Mexico has costs that are similar to Arizona’s, assisted living with memory care is less expensive, on average, in Utah. Arizonans who live in the northern part of the Grand Canyon state may want to investigate whether there might be more affordable options on the other side of the state border.

Arizona Memory Care / Assisted Living Costs (updated Sep. 2020)
Region / City Monthly Cost Annual Cost
Statewide $4,470 $53,640
Phoenix $4,180 $50,160
Tucson $5,600 $57,200
Mesa $3,856 $46,272
Flagstaff $5,960 $71,520

 

Arizona Assisted Living Laws and Regulations

Admission Requirements & Process

In Arizona, in order to be admitted to an assisted living residence, including memory care, there are several requirements that one must meet. These include:

● Must not require mental health services
● Must not be confined to bed
● Must not have pressure sores that are stage 3 or 4 in severity
● Must not require ongoing nursing services (exceptions may be made if an independent nurse or hospice care agency is hired)
● Must not require restraints (this includes physical restraints, as well as prescription medications to sedate a resident)

In addition to the above, new residents must be assessed within 14 days of admission and a care plan made. Paying for the appointments to be evaluated is probably the responsibility of the person moving in, but Medicare recipients get an annual free “wellness visit” (also called a “cognitive assessment”) that screens for dementia symptoms, and this is a good way to begin the process of getting evaluated for memory care.

Service plans must be reviewed and revised on a consistent basis: Every 3 months for residents residing in a direct care residence, every 6 months for those in a personal care residence, and once a year for those who are in a supervisory care residence.

The assessment is similar to receiving a diagnosis, because it’s important for your loved one’s new home to know their stage of dementia and the level of care required. Someone in the early to middle stages might not need directed care (see levels of care above) like someone in the later stages. An official diagnosis is probably not required to move into Arizona memory care, but all parties will want as complete an understanding of your loved one’s condition as possible.

Begin the process as soon as you can, before moving becomes necessary, because finding an assisted living home on short notice might not be possible, and your loved one can provide more input in earlier stages. In most cases, a family will spend several weeks deciding which assisted living residence is best. They then will spend several more weeks relocating their loved one and getting him/her settled in. Many assisted living residences have waiting lists, and therefore admission is not always immediate.

 Covid-19-related Admittance Rules
During the pandemic, assisted living homes in Arizona may still admit new residents, but they must have their temperature taken, and be screened for other symptoms of Covid-19 (cough, fever, sore throat, and breathing difficulty).  Because visitations may be severely restricted, new residents will need to ask management whether loved ones can help with moving in.

 

Facility / Residence

In Arizona, memory care homes for persons with dementia must be physically constructed for the safety and wellbeing of persons with the disease. For instance, memory care residences might have an enclosed outdoor area to prevent wandering. In addition, activities specifically geared towards persons with dementia are required (though these have changed during the Covid-19 pandemic, see below), as well as the availability of staff around the clock.

Private living units (bedrooms) must be at least 80 square feet for one person, and 120 square feet for two people. Two is the maximum number of people allowed in a single living unit. There must be one bathroom with a bath or shower for every eight residents.

 Covid-19-related Facility/Residence Rules
The Arizona Department of Health Services has recommended that all group activities in assisted living residences, including memory care, be cancelled during the pandemic. Residents should be restricted to their rooms as much as possible, the state says, and receive their meals there rather than eating in groups.

 

Staff & Training

All assisted living facility employees must be CPR and first aid certified. Those who provide resident care assistance (formally called caregivers) must be a minimum of 18 years old and have 3 months of experience in the healthcare field. Assistant caregivers need only be 16 years old.

For all positions, staff must undergo training specific to the level of care (supervisory, personal, or directed) provided at the residence in which one is employed. Employees working with persons with Alzheimer’s disease and related disorders in directed care residences must have training specific to working with this population. All ALFs must have a manager overseeing operations. Managers must be at least 21 years old with an assisted living facility manager certification.

Required number of hours of initial staff training is as follows: 20 hours for supervisory care, 50 hours for personal care, and 62 hours for directed care. Remember, memory care facilities usually offer directed care. Managers require additional training, which comes to a total of 69 hours. Annual training is also required for all staff (6 hours per year). Those who work in a residence that provides a personal care services level of care must take another 2 hours of training on an annual basis, and those who work in a directed care services residence must take another 4 hours of training each year.

Arizona does not have a set staff-to-resident ratio for assisted living residences. Said another way, residences are given the flexibility to decide the number of staff that is required to meet the needs of the residents. Residences that cater to persons with dementia require more staff than residences that serve people with less demanding needs.

 Covid-19-related Staff Rules
During the Covid-19 pandemic, all staff in Arizona assisted living must wear masks during their entire shifts, and every shift must begin by checking for respiratory symptoms and fever. There must also be staff training for putting on and taking off personal protective equipment (PPE).

 

Evictions

In Arizona assisted living, a resident can be evicted if their needs exceed the level of care provided there. Because Alzheimer’s disease and related dementias are progressive, it’s likely that someone admitted into a personal care-level home would eventually need directed care (see levels of care above). In this case an eviction would be necessary, and your loved one would need to find a new home. Residences can probably assist with relocation, and free help to find the right memory care home is available at this link.

Someone whose behavior gets so bad that physical or chemical restraints are required could also be evicted. Unlike many states, there is not a rule in Arizona requiring 30 days notice before a resident has to leave if evicted.

There are not rules that say someone can be evicted for nonpayment, but residences may have their own policies concerning what to do when someone doesn’t pay their bill. When moving into an assisted living home, you should ask for the specific reasons a person can be evicted, and get this answer in writing. For tips on what to do if you receive an eviction notice, click here.

 

Financial Assistance for Residential Alzheimer’s / Memory Care

While the cost of memory care can be quite expensive, financial assistance is available for low-income persons who need it.

Medicaid

Medicaid is a jointly funded federal and state program, and in Arizona, it is called the Arizona Health Care Cost Containment System (AHCCCS). However, the program that provides long term home and community based services via AHCCCS is the Arizona Long Term Care System (ALTCS). While many states offer home and community based services (HCBS) via HCBS Medicaid waivers that limit the number of program participants, services and supports via ALTCS are available to all eligible applicants. In addition to covering the cost of nursing home care, ALTCS will cover the cost of supportive services in a variety of settings, such as one’s home, adult foster care, and assisted living. To be clear, this program will not cover the cost of room and board in assisted living facilities (or memory care units for persons with dementia), but will offer assistance for care services. More on Medicaid eligibility.

 

Home and Community Based Services (HCBS) Program

While Arizona’s Home and Community Based Services Program does not help to cover the cost of assisted living (or care services in assisted living), it is beneficial for persons with dementia who require assistance with daily living activities and would otherwise be able to continue to live at home, or with family, if care assistance were provided. A collaboration between the Arizona Department of Economic Security and local Area Agencies on Aging offices, a variety of supportive services are available, which includes meal delivery, housecleaning, personal care assistance, adult day care, and respite care. For more information, including how to apply, click here.

 

Veteran’s Affairs (VA)

While not limited to Arizona, the VA offers an Aid & Attendance (A&A) pension for veterans and surviving spouses who receive either the basic VA pension or the basic survivor’s VA pension. Applicants must be at least 65 years of age or disabled and require assistance with completing activities of daily living, such as mobility, transferring, eating, and bathing. The monthly cash assistance received from these pensions can be used as the recipient sees fit, which means it can go towards the cost of memory care. In addition, the cost of residential care can be deducted from one’s income, effectively reducing one’s countable income when determining one’s pension benefit amount. In 2020, veterans can receive as much as $27,194 per year, and surviving spouses can receive as much as $14,761 per year that can be put toward the cost of memory care. Learn more here.

 Did You Know? Officials estimate that only one out of seven veterans eligible for Aid & Attendance money have applied for it. Apply soon if you’re eligible, because it takes about nine months to be approved.

There are also state Veterans homes, which are residential care facilities that provide long-term care for veterans. In addition to nursing home care, assisted living and memory care may be provided. Payment is made directly from the VA to the facility. Arizona has two of these homes, in Phoenix and Tucson (click here for more information).

 

Other Options

Other options may be available to help pay for memory care, including tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you can claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that may include some assisted living costs.

A reverse mortgage may be a good option for a married person moving into memory care, if their spouse continues to live in the home. Should the spouse move from their home, the reverse mortgage would become due.

Elder care loans are for families to cover initial costs of moving into memory care, if you need a little help at first but can afford costs after the initial payments. For example, if one is waiting for a VA pension to be approved or waiting to sell a home.