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

Last Updated: October 20, 2020

 

Legal Definition of Assisted Living / Memory Care in Florida

In Florida, assisted living facilities provide a comfortable, homelike living setting for seniors and disabled individuals who require supervision and assistance to live independently. Room and board, as well as noncontinuous nursing and / or personal care services, such as assistance with activities of daily living (ADLs) like bathing, dressing, and mobility (getting up from a chair / bed, walking, etc.) are provided. Social activities, supervision, transportation assistance (either arranging or offering rides), and help with scheduling appointments are also provided. Please note: Some services may be provided at an additional cost above and beyond the regular monthly fee.

Assisted living residences that are designed and staffed specifically for persons with Alzheimer’s and other dementias are formally referred to as Special Care Units (SCU). However, SCU is more of a legal term; these residences are more commonly called memory care or Alzheimer’s care homes (though they’ll also board people with related dementias including vascular, frontotemporal, and Lewy body dementias). These types of homes in Florida differ from traditional assisted living in several ways, including:

– increased security and supervision
– additional staff training
– recreational activities specific for persons with dementia
– cost (see below)

A point of distinction should be made that memory care homes are not nursing homes. Generally, these residences are less expensive and offer a better quality of life to their residents. Some medical care may be provided, but not at the full-time-nursing level.

 There are close to 2,000 assisted living and board & care homes in Florida. Seniors and family members can receive free assistance researching residences that meet their needs and budgets. Get help here

Both memory care homes and assisted living residences can be non-profit or for-profit. They can be standalone buildings, wings/sections of buildings, private homes, homes for the aged, boarding homes, etc. These facilities can be licensed to accommodate just a single resident or up to several hundred residents. However, residents cannot be related to the administrator or owner of the ALF. All assisted living in Florida is regulated by the state’s Agency for Health Care Administration’s Bureau for Health Facility Regulation.

 

Florida Memory Care / Residential Alzheimer’s Care Costs

Due to the added level of security and supervision of special care units in Florida, memory care costs between $900 – $1,200 more each month than traditional assisted living. In 2020, that statewide average cost of memory care is $4,180 per month and $50,160 annually.
Given Florida’s vast size, there is considerable cost variation. In fact, even in the same geographic areas, the cost of memory care may go up or down by 20% depending on amenities and the occupancy rate of the specific residence. To put it another way: Pensacola in the Panhandle costs about the same as Port St. Lucie in the Southeast, and Miami (the Keys) costs about the same as Tampa (West Peninsula). If cost is a concern, it can be worthwhile to visit and negotiate with multiple residences. In fact, Florida residents can even receive free assistance to help find the right memory care home for their budget and needs.

The most expensive city in Florida for memory care is Tallahassee, for about $5,700 per month and $68,400 annually. In Florida’s largest city, Jacksonville, memory care costs about $5,090 per month and $61,080. The most expensive city for memory care in Florida is The Villages, an age-restricted community near the middle of the state that spans 30 square miles and has a population of more than 50,000. In The Villages, memory care costs about $6,430 monthly and $77,160 per year. The least expensive place for memory care is Sebring, for about $3,380 monthly and $40,560 annually.

If you live near Florida’s border with Alabama and Georgia, it might be a good idea to search for memory care in one of those states, which both have less expensive (on average) memory care costs than Florida. Georgia costs about $4,000 per month, and Alabama memory care runs about $3,890 per month. Mobile, Alabama, for instance, is about 60 miles from Pensacola, and memory care in Mobile is less expensive than Pensacola by more than $500 per month.  Other notable cities and average costs:

Florida Memory Care / Assisted Living Costs (updated Oct. 2020)
Region / City Monthly Cost Annual Cost
Statewide $4,180 $50,160
Jacksonville $5,090 $61,080
Miami $3,890 $46,680
Tampa $3,890 $46,680
Orlando $5,120 $61,440
Port St. Lucie $4,180 $50,160
Cape Coral $4,800 $57,600
Tallahassee $5,700 $68,400


Assisted Living Laws & Regulations

Admissions Requirements & Process

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

-Be a minimum of 18 years old
-Does not display symptoms of any type of contagious disease
-Is able to perform daily living activities (bathing, grooming, eating, etc.) with supervision or assistance.
-Is able to take medication (with or without assistance)
-Must not require around-the-clock care from a mental health professional
-Must not be confined to bed
-Must not have pressure sores that are stage 3 or 4 in severity
-Residents of limited nursing home facilities or limited mental health facilities must not have certain nursing needs, such as assistance with feeding tubes or handling of drainage tubes following surgery

In addition to the above, residents must undergo an initial physical exam within a defined period of time, to be completed by a doctor or nurse practitioner who works for/with the residence. The cost of this assessment should be included in the price of admission. (It is possible you’ll need to use your own doctor for this assessment and need to cover the cost yourself, but it’s usually part of moving in). This timeframe for the initial exam is between 60 days prior to admission to 30 days after admittance. After the initial exam, a physical must be performed every 3 years to ensure residents continue to meet the requirements of assisted living facility residency in Florida.

While this may seem obvious, residents of special care units must have Alzheimer’s disease or some form of dementia. This does not mean an official diagnosis of dementia is required. Alzheimer’s and related diseases are difficult to diagnose, and the important consideration is that the symptoms and needs of your loved one match the level of care provided in special care units (memory care).

In most cases, a family will spend several weeks deciding which assisted living residence is best for their loved one. They then will spend several more weeks relocating their loved one and getting him / her settled in. Please note: Many assisted living residences have waiting lists, and therefore, admission is not always immediate. Another reason to begin the process early is that dementia worsens over time, and you want as much input as possible from the person actually making the move before decision-making becomes affected.

 

Facility / Residence

In Florida, special care units for persons with dementia must be physically constructed for the safety and wellbeing of those with such neurological disorders. While it isn’t specifically stated exactly what this entails, one example is that memory care facilities might have an enclosed outdoor area to prevent wandering. In addition, activities specifically geared towards persons with dementia are required, as well as the availability of staff around the clock. Private resident units (bedrooms) must be at least 80 square feet for one person or 60 square feet per person if there is more than one. Four is the maximum number of roommates allowed in one unit. There must be one toilet and sink for every six residents, and one bath or shower for every eight.

 Covid 19-Related Visitor Rules
During the pandemic, Florida assisted living homes, including those with memory care, must follow additional visitor guidelines. Check with your loved one’s residence about specifics, but generally:
– Visitors must be scheduled, and screened for symptoms
– Masks and social distancing (six feet) are required throughout visits
– Designated visitation areas must be cleaned and disinfected between visits

 

Staff & Training

Prior to employment, all staff must undergo a background investigation, including a fingerprint check by the FBI and the Florida Department of Law Enforcement. Training of staff varies depending on the position and what services are provided. That said, all employees who have not completed core training must attend an orientation prior to interacting with residents. This training must be a minimum of 2 hours and cover topics that pertain to the needs and safety of the residents. All ALFs must have an administrator who has taken a 26-hour training course that covers a variety of subjects, including dementia. Upon completion of the course, the individual must pass a test.

Employees working with persons with Alzheimer’s disease and related disorders (abbreviated as ADRD in Florida) in special care units must have dementia-appropriate training. Staff who have interaction daily with individuals with ADRD, but aren’t responsible for directly caring for them, must undergo 4 hours of dementia training in the first 3 months of being employed at the facility. Staff who directly care for persons with dementia must undergo 4 more hours of training within 9 months of being hired.

For assisted living residences that house a minimum of 17 residents, at least one staff member who is trained in CPR must be on duty at all times. If the ALF offers administration of medications to its residents, an employee must be licensed to give it according to the physician’s order or the instructions on the medication’s label. ALF employees that aren’t licensed to give medications are still able to assist for self-administration of medications. However, some training is required in order to do so: an initial 6 hours of training on medication assistance and an additional 2 hours of training each year.

Florida uses a minimum staff-to-resident ratio staffing approach, which means the required number of staff hours is based on the number of residents in the facility. For instance, a facility with up to 5 residents must have a minimum of 168 staff hours per week, a facility with 26 to 35 residents must have at least 294 staff hours per week, and a facility with 56 to 65 residents must have a minimum of 416 staff hours per week.

 Covid 19-Related Rules for Staff
Additional training on infection prevention and control (sanitizing, etc.) is required for assisted living staff in Florida during the pandemic. Employees must also demonstrate competency putting on and removing personal protection equipment (PPE) including masks and gloves.

 

Evictions

Regulations say that a person must be discharged or evicted if the residence can no longer meet their care needs. Because dementia is progressive, meaning symptoms get worse over time, you need to be sure that the home is equipped to care for your loved one as the disease advances from early to middle and later stages.

There is no specific policy about the process for eviction. The residence will have its own policy. Can someone be evicted for nonpayment? Does aggressive behavior cause a person to be thrown out of a residence? These are important questions that should be answered before signing a contract to move in.

 

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.

Statewide Medicaid Managed Care

Medicaid is a jointly funded federal and state program, and in Florida, the program that provides long-term care and supports is the Statewide Medicaid Managed Care Long-Term Care Program. Abbreviated as SMMC LTC, this program began in 2013, and prior to this, home and community based services (HCBS) were provided via HCBS Medicaid waivers. In addition to covering the cost of nursing home care, the SMMC LTC program will cover the cost of supportive services in a variety of settings, such as one’s home, adult day care, 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 special care units for persons with dementia), but will offer assistance for care services. More on Florida Medicaid Eligibility.

 

Florida’s Optional State Supplementation (OSS)

OSS provides cash assistance to be applied towards the cost of room and board at an assisted living residence, adult foster care home, or a mental health treatment facility in Florida. At the time of this writing, the maximum cash assistance available for a single applicant is $78.40 / month.

 

Veteran’s Affairs (VA)

While not limited to Florida, the VA offers an Aid & Attendance (A&A) pension (monthly cash assistance) for veteran’s 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. Examples include assistance with mobility, transferring, eating, and bathing. The cash assistance received from these pensions can be used as the recipient wishes, 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 $27,195 / year, and surviving spouses can receive as much as $14,742 / year that can be put toward the cost of memory care. Learn more here.

There are also eight state veterans’ homes in Florida, 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. State veterans’ homes are typically reserved for veterans whose need for care stems at least 70% from their military service. Veterans’ homes are located in Port St. Lucie, Lake City, Panama City, Charlotte, Daytona Beach, Land-O-Lakes (Pasco County), Pembroke Pines, and St. Augustine. There are a limited number of beds in these homes, so reach out about available space and waiting lists before visiting. For help finding the right veterans’ home for your loved one who served, contact the Florida Department of Elder Affairs.

 

Alzheimer’s Disease Initiative (ADI)

Worth noting, Florida also has a program called the Alzheimer’s Disease Initiative. While this program does not help pay for residential memory care, financial assistance may be provided to help care for a loved one with dementia. For example, respite care, both at home and in adult day care, is available to give caregivers a break from their caregiving duties.

 

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.