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Colorado Residential Alzheimer’s Care (Memory Care): Laws, Costs & Financial Help

Last Updated: October 06, 2020

 

“Assisted Living Residences” (ALR) provide a place to live for older adults who cannot stay in their homes, including people with dementia. In Colorado, assisted living offers room, board, and meals to three or more adults, as well as providing security, supervision, personal care, and social services. Care and services include transportation to appointments and help with activities of daily living (ADLs) like eating or getting dressed. Someone who needs 24-hour nursing care typically may not reside in an assisted living residence, but ALRs may provide memory care for people with Alzheimer’s disease, or related dementia, in the entire residence or in a secured wing.

An ALR with memory care (also called “Alzheimer’s care” or “dementia care”) must go further, offering the following:

– A detailed assessment to determine the resident’s personal needs (see below)
– Secured spaces with special locking devices
– Enhanced monitoring to ensure safety indoors and outside
– Specialty services like activities to strengthen memory and encourage socialization

There are about 200 memory care communities in the state, and more than 380 board and care homes, which are smaller house-like residences that offer similar services including memory care. Free assistance is available to help families locate a residence that works for their loved one. Get help here.

Assisted living in Colorado is regulated by the Department of Public Health and Environment.

 

How Much Does Memory Care Cost in Colorado?

The average cost of memory care per month in Colorado is $4,910, which breaks down to about $58,920 annually. Remember to fully research the costs at any memory care home, asking for a complete list of fees and charges including any potential add-ons. The state’s most expensive place for memory care is Boulder, where it costs about $5,670 per month and $68,040 annually. Memory care is less expensive in Colorado’s rural areas, outside its cities, at about $4,070 per month and $48,840 annually.
Anyone who lives in Colorado and is looking for more affordable memory care might want to check prices just across the state borders. Wyoming, Utah, and Nebraska are all bordering states whose memory costs are, on average, lower than Colorado’s. Northern Coloradans could look in Wyoming, where the average is $4,510 per month; people on the Colorado Plateau along the western end of the state could potentially go to Utah, where the cost is about $4,070 per month; and residents in the northeastern plains area might find less expensive memory care in Nebraska, for an average of about $4,580 per month. (New Mexico’s costs are almost identical to Colorado’s.)

 Did You Know? Coloradoans with dementia can receive free assistance locating memory care residences that meet their needs and budget. Start here.  

Other Colorado cities and their memory-care prices include:

Coloado Memory Care / Assisted Living Costs (updated Oct. 2020)
Region / City Monthly Cost Annual Cost
Statewide $4,910 $58,920
Denver $5,380 $64,560
Colorado Springs $4,800 $57,600
Fort Collins $4,580 $54,960
Pueblo $4,540 $54,480

 

Colorado Assisted Living Laws & Regulations

Admissions Requirements & Process

It might be possible to move into Colorado memory care on short notice, but a pre-admission assessment is required for all residents in assisted living. This assessment must be updated at least annually, because ALRs may not admit someone whose needs cannot be met by the services provided therein. The screening must determine:

– Physical, health, and social needs
– Preferences (cultural, religious, etc.)
– Ability to self-care

An example of the assessment form is provided here, and can be filled out by the resident or a representative (including family members). This means that if you understand your loved one’s capabilities, particularly if you are a caregiver, you can help determine whether a home is the right fit. The assessment still calls for a “comprehensive physician report,” however, and the cost of this report from your loved one’s doctor is unlikely to be covered by the residence (though make sure to ask). If your loved one is on Medicare, an annual free “wellness visit,” or “cognitive assessment,” screens for dementia symptoms and can be part of the process of getting what you need to move into memory care.

You do not need to be diagnosed with Alzheimer’s disease or related dementia (like vascular, frontotemporal, or Lewy body dementia) to move into memory care in Colorado. It is difficult to diagnose dementia and memory care is for people who need specially trained staff to care for them, not for people with official diagnoses. The symptoms, in other words, are more important than knowing the specific disease.
The following information must be provided from the residence to anyone moving into a Colorado ALR:

– Right to receive CPR (residents may refuse to be resuscitated)
– Minimum staffing levels (see below)
– Policy on whether ALR has staff awake during nighttime hours
– Emergency alert devices and evacuation plan
– Individualized care plan
– Smoking prohibitions
– On-site location of latest inspection report
– Upon request, a copy of most recent licensing rules

Someone who requires regular 24-hour medical or nursing care may not be admitted into an ALR, and neither can a person with a history of conduct that poses a danger to self or other residents.

 Covid 19-Related Rules for Admissions
During the pandemic, the state has advised assisted living communities to halt admissions if anyone there tests positive for Covid-19.
New residents may be admitted if there has not been an instance of Covid, but the state requires every individual residence to submit a plan about the virus, and these plans may include admissions requirements including a mandatory quarantine period (usually 14 days) in a secluded wing of the residence before moving into the general area. This plan should be made available to anyone considering moving in.

 

Facility / Residence

A single-person living unit or bedroom must be at least 100 square feet, not including bathroom and closet areas, and a two-person unit must be at least 120 square feet. Two people is the maximum allowed in one room, unless the residence was built before 1986. One bathroom with a sink, toilet, and shower must be provided for every six residents. Alarm systems and fire detection including sprinklers and smoke alarms must be up to building codes.

Colorado regulations do not require dementia-friendly building designs in memory care, like circular hallways and easy-to-navigate layouts. For this reason, be sure to fully inspect the entire community before moving in, keeping an eye on whether your loved one will be able to easily move around.

 Covid 19-Related Visitor Rules
During the pandemic, visits to loved ones in Colorado memory care communities must take place outside, and all visitors must wear a mask.
A separate outdoor area must remain available for residents who are not having visitors.

 

Staff & Training

There is no required staff-to-resident ratio in Colorado, except that staffing must be adequate to meet the needs of every resident on-site, and at all times there must be at least one person working who has CPR and first-aid certification. Every employee or volunteer at an ALR must have an orientation to start the job including:

– care and services provided at the specific residence
– residents’ rights
– overview of state regulations
– infection control
– emergency response
– reporting requirements

Administrators must go through a background check and be at least 21 years old, with experience including one year supervising administration of personal care services such as help with activities of daily living like eating and dressing. Forty-five hours of care-related training is required for administrators, and 40 hours of administrator training are also required.

 Covid 19-Related Rules for Staff
During the pandemic, employees in Colorado assisted living homes must wear personal protective equipment including masks at all times, and be trained on how to use PPE properly. Staff must also be trained on screening for the signs of Covid-19, including symptoms like fever and shortness of breath, and check residents daily.

 

Eviction Rules

A Colorado assisted living residence is not required to give any notice before someone can be evicted. This means your loved one can be discharged on short notice for reasons including not paying the bill in a timely manner. Regulations say, however, that this must be spelled out in the resident agreement signed at admissions. Look carefully at your agreement for rules about evictions and you can probably negotiate 30 or even 60 days notice.

Residents may also be evicted if their medical condition cannot be managed at the home. Because dementias including Alzheimer’s disease are progressive, you need to be sure that as your loved one’s condition worsens, the community is prepared to handle more severe symptoms.
Bottom line: Get specific details from the residence about what it would take to evict your loved one, and how that process works, before moving in. Click here for more.

 

Financial Assistance for Residential Alzheimer’s Memory Care

Medicaid Waiver for the Elderly, Blind, and Disabled

This waiver provides financial assistance for people who may need nursing-home-level care but want to stay in their residence of choice, including ALRs. Services covered do not include room and board, but additional costs of assisted living like laundry, housekeeping, and medical help may be covered. Among the eligibility requirements for Colorado residents is income (for one person) under $2,349 per month in 2020. This program’s full name is the Home and Community-Based Services Waiver for Persons Who Are Elderly, Blind and Disabled (HCBS-EBD). The waiver is available state-wide but enrollment may be capped, so eligibility doesn’t guarantee availability. This means there might be a significant wait time to receive benefits. More information is available on the state’s website here. To apply, contact the Colorado Single Entry Point Agency in your area.

 Not sure if your loved one qualifies for Medicaid? See Colorado Medicaid eligibility requirements or for a Medicaid “Eligibility Test,” click here.

 

Colorado Old Age Pension (OAP)

Elderly, low-income Colorado residents may be eligible for financial help with costs including services in assisted living. The Old Age Pension is meant to bridge the gap between a person’s monthly income and a reasonable cost of living. Someone in the program can receive more than $800 per month, depending on income and enrollment in other programs like Social Security. To apply, contact your County Department of Human Services office here.

 

Adult Foster Care Program

Someone in the early stages of dementia may be eligible for financial assistance through the Adult Foster Care Program. Adult foster care homes are for people who can live more independently in a family-like environment. This is not appropriate for memory care, but someone with early-stage dementia who is still relatively independent and functional may benefit. Among the costs covered are meals, transportation, and help with activities of daily living. To apply, contact your local County Department of Human Services here.

 

Veterans Affairs (VA)

Veterans are statistically more likely to develop dementia. Relevant in all states including Colorado is the VA’s Aid & Attendance pension program for veterans and surviving spouses, which is an amount of money added to veterans’ and survivors’ basic pensions. Applicants must be at least 65 years old (or disabled) and require assistance with activities of daily living (ADLs) like eating, bathing, and mobility. The cash assistance from these pensions can be used as the recipient wishes, meaning it can go toward the cost of memory care. In addition, the cost of residential care can be deducted from one’s income, effectively reducing the amount of calculable income used to determine the benefit amount. The latest (2020) maximum amount a veteran can receive through A&A is $27,194 per year, and surviving spouses can receive as much as $14,761. Learn more here.

There are five veterans’ homes in Colorado, which are residential care facilities that provide long-term care for veterans. The homes are located in Aurora (near Denver), Monte Vista (in the southern part of the state), Florence (near Pueblo), Rifle (in western Colorado), and Walsenburg (off Interstate 25 in southern Colorado). In addition to nursing home care, assisted living and memory care may be provided. Payment is made directly from the VA to the facility. State veterans’ homes are typically reserved for veterans whose need for care stems at least 70 percent from their military service. Because there is often a waiting list, contact a home before visiting to see if your loved one is eligible to live there.

 Did You Know? Colorado is a relatively young state, with only 13% of its residents over 65, one of the lowest rates in the country. And of those, only about 10% have Alzheimer’s disease, which is also low compared to other states.

 

Other Options

Other ways to help pay for memory care include 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.