Illinois Residential Alzheimer’s Memory Care: Rules, Costs & Financial Help

Legal Definition of Assisted Living / Memory Care in Illinois

In Illinois, assisted living provides full-time care for people with medical issues including dementia patients. Assisted living facilities care for at least three adults over 55 years old who are not related and need help with activities of daily living including bathing, eating, and walking from room to room. Staff is available 24 hours per day.

Illinois also has shared housing facilities which have 16 or fewer residents, mostly 55 or older and who need assistance with activities of daily living. Shared housing homes also provide 24-hour care. A key difference between assisted living and shared housing is the number of patients per room. Assisted living residents have private, one-person apartments unless the resident chooses to have a roommate, in which the maximum occupancy per room is two people. In comparison, there may be more than one or two people per room in shared housing. Shared housing is also called board and care homes.

Both types of residences can house people with Alzheimer’s disease or a related dementia. These types of homes are often called memory care, Alzheimer’s care, or dementia care. To obtain this distinction, they must:

– Register its Alzheimer’s program with the Illinois Department of Public Health

– Designate a representative for each resident

– Ensure safety for those who wander or need supervision, and can help during an evacuation

– Enable communication between the resident, a representative, family members, and anyone else (like a doctor) designated in the resident’s service plan

– Provide stimulating and appropriate activities to encourage brain health

– Provide a minimum of 1.4 hours of service per resident per day

The state requires all assisted living homes to provide: three meals per day, housekeeping, laundry, security, and an emergency communication response system. Additionally, every resident must have a doctor’s assessment within 120 days of moving in and it must be updated annually.

Assisted living facilities and shared housing establishments in Illinois are regulated by the Department of Public Health, Division of Assisted Living. Illinois has over 300 memory care homes and 90 board and care homes that may serve residents with dementia. For free help finding memory care of any size to fit your family’s needs and budget, click here.

How Much Does Memory Care Cost in Illinois?

The average cost of memory care per month in 2024 in Illinois is $5,884. Pricing varies widely depending on where you live. The most expensive areas for memory care in the state are to the north in Rockford, in the state capitol in Springfield, and Bloomington. These pricey cities for care range from $6,877 to $6,758 monthly.

The least expensive place for memory care is Carbondale in southern Illinois, where costs are about $4,612 monthly. People looking for memory care in western and southern Illinois might want to go across the state border into Missouri and Kentucky, which both have less expensive memory care. Missouri is one of the least expensive states in the entire country for memory care, with average rates of $3,936 per month. Kentucky’s average is a bit higher, costing $4,492 monthly. Other major cities include:

Illinois Assisted Living Laws & Regulations

Admissions Requirements & Process

To move into a memory care facility in Illinois, an assessment needs to be completed within the first 120 days by a doctor. This evaluation looks at a person’s physical, cognitive, and psychosocial condition. This means they want to know how strong your loved one is physically, mentally, how easy (or difficult) it is to relate to others and function within the residence. A doctor must also confirm that your loved one has no contagious infections. Beyond the required evaluation, residences are given the freedom to create their own admissions standards. For example, some residences don’t charge for an assessment while others require it be completed by an outside doctor. If completed independently, the resident would be responsible for paying for it. It’s very important to ask the home what their policy is for admissions, including the assessment.

Someone cannot be accepted as a resident in assisted living, memory care, or shared housing if:

– The desired residence cannot give the proper level of care for the specific resident, or isn’t licensed to fit the person’s medical needs

– The staffing levels are not appropriately high enough to add a new resident

– The new resident is dangerous to themselves or others

– The new resident needs total help with more than two activities of daily living

Residents may not receive full-time medical care in assisted living. Limited, or intermittent care is allowed and outside medical professionals are allowed to enter residences to help patients. If your loved one needs to be under the care of an outside doctor on a consistent basis, you need to be clear on whether that care can be provided before moving in.

Facility / Residence

Assisted living (including assisted living with memory care) is required to provide single-person rooms to all residents except those who choose to be with a roommate. The maximum number of people per room in assisted living is two. In shared housing, there is no rule about how many residents are allowed per room. Also, there is no square footage requirement in Illinois regulations for rooms. Take care to inspect where your loved one would live to make sure the rooms are big enough to fill your needs. Every room in assisted living must have a private bathroom with a toilet, sink, ventilation or window, and any equipment upgrades detailed in the resident’s service plan. You’ll also want to be sure the design is dementia-friendly, meaning the layout is easy to navigate and hallways don’t run into dead ends. Outdoor space is also ideal for people with dementia, but not required in regulations.

Staff and Training

Regulations on staff-to-resident ratios are vague, saying that assisted living homes must have an appropriate number of staff for its residents. At least one member of the staff must be awake and on duty at all times, and that person must have CPR training. Ongoing employee training programs are required in all Illinois assisted-living residences. Multiple orientations are required for every employee within 30 days of beginning work in a residence. They cover topics like residents’ rights, abuse prevention, reporting requirements and training to assist with activities of daily living appropriate to the needs of each resident.

Managers must be at least 21 years old, and complete eight hours of training every year. The ongoing education must cover:

– Promoting resident dignity, independence, self-determination, privacy, choice, and resident rights
– Procedures in case of disaster
– Hygiene and infection control
– Medication management and assisting residents with self-administering
– Abuse and neglect prevention
– Reporting requirements
– Assisting residents with activities of daily living

Memory care facilities has additional requirements for employees and managers. For residences who house people with Alzheimer’s or related dementia, managers and supervisors must:

– Have a college degree including coursework specific to dementia
– One year of hands-on experience working with people with dementia
– Two years of management experience working with people with dementia
– Six hours of specifically dementia-related training is required annually

For staff in memory-care facilities, they must additionally:

– Complete four hours of dementia-specific training before beginning the job, including techniques to minimize disruptive behavior, communicate, and identify safety risks for someone with Alzheimer’s

– Have 16 hours of on-the-job training and orientation covering assistance with activities of daily living, how to evacuate people with dementia in case of emergency, minimizing challenging behavior, how to work with families and cope with caregiver stress, and communicating with someone with dementia.

– Complete 12 hours of dementia-specific training annually

Evictions

There are no regulations that say a patient must be given advance notice before being evicted for nonpayment, inappropriate behavior, or another reason. Homes will have their own criteria, and it’s important to be clear on eviction rules before agreeing to move in. Knowing exactly why a person can be evicted, and how that process works is vital before moving into an assisted living home. By knowing these answers ahead of time, you can prevent an unfair eviction of your loved one. For more on memory care evictions, click here.

Financial Assistance For Residential Alzheimer’s Memory Care

Medicaid Supportive Living Program

Medicaid is a jointly funded federal and state program. In Illinois, there is help that pays for care in assisted living through the Illinois Supportive Living Program (SLP). To be eligible, your loved one must be accepted to reside in an assisted living facility that works with the program and must go through the preadmission screening. The Supportive Living Program will cover the cost of services in assisted living like laundry, meals, security, and transportation, and provide a $90 monthly personal allowance. The resident would still need to pay for room and board. The goal of this program is to prevent a premature move to a nursing home. The Supportive Living Program requires participants to have a minimum income. The Supportive Living Program requires an income equal to or more than the Supplemental Security Income monthly benefit of $943 as of 2024 with no more than $17,500 in assets. More on Medicaid is available here and click here for Illinois Medicaid eligibility requirements. Take a Medicaid eligibility test here.

Choices for Care

This state program sends care coordinators to evaluate Illinois residents over 60 and determine what needs must be met and whether there is a progressive medical issue like dementia that would require placement in assisted living. Coordinators assess what the best living options are for your loved one. Whether that be staying at home or moving into assisted living, memory care, or a nursing facility. Choices for Care also works with families to identify financial assistance a person is eligible to receive. Screening consultations are free. For more information, find Care Coordination Services in your area here, or visit the Choices for Care program page.

HCBS Waiver for the Elderly

Also known as the Persons Who Are Elderly Waiver, this home and community-based services waiver is a Medicaid program whose goal is to help provide extra support and assistance to individuals so they do not have to make an early move into a nursing home. Benefits can include adult day care, emergency home response equipment, light housework, household chores, and meal delivery. Program eligibility requirements include a monthly income of less than $1,215 in 2024 and assets of less than $17,500. Additionally, your loved one must demonstrate a nursing home level of care. Click here for more information on the program. Click here for Illinois Medicaid eligibility requirements or take a Medicaid eligibility test here.

Medicaid Managed Long Term Services and Supports

The Medicaid Managed Long Term Services and Supports (MLTSS) is a unique managed care program offered to participants who are both Medicaid and Medical eligible. This program offers home and community-based services to individuals who need extra assistance and support care services so that they do not need to make a premature move into a nursing home. This can help individuals living in their homes, that of a loved one, or in assisted living. Benefits are dependent on what a person needs and can range from assistance with activities of daily living to transportation, respite care, meal service, light chore work, and adult daycare. Benefits are streamlined through a managed care organization so that participants have an easier time getting access to what they need. Illinois Medicaid Eligibility requirements in 2024 are income no more than $1,215 monthly and assets more than $17,500. Click here for Illinois Medicaid eligibility requirements or take a Medicaid eligibility test here. To get further program details, click this link for more information about the Medicaid Managed Long Term Services and Supports Waiver.

Illinois Medicaid-Medicare Alignment Initiative

The Illinois Medicaid-Medicare Alignment Initiative (MMAI) is a program open to individuals who qualify for both Medicaid and Medicare. This program is also similar to the Medicaid Managed Long Term Services and Supports Waiver in that it provides home and community-based services to qualified participants who need additional support services so they do not need to move into a nursing home early. This program enables enrollees to live in their home, that of a relative, or in assisted living. Support services and benefits can include assistance with activities of daily living, transportation, household chores, meal delivery service, home modifications skilled nursing, dental appointments, hospice care, medical equipment, doctor’s appointments, and prescription medication. Among the eligibility requirements for Illinois Medicaid are income under $1,215 in 2024, assets less than $17,500, and a need for a nursing home level of care. Click here for Illinois Medicaid eligibility requirements or take a Medicaid eligibility test here. Click here for more information about the Illinois Medicaid-Medicare Alignment Initiative. 

Veterans Affairs (VA)

Veterans are statistically more likely to develop dementia. Among the reasons for this is that traumatic brain injuries and posttraumatic stress disorder lead to a higher probability of developing the condition. The VA offers many benefits for Alzheimer’s and dementia as well as different pension types.

VA Pensions

There are three types of VA Pensions available. The benefits change annually and are valid from December 2023 to December 2024. The benefits (and their maximum allowance) are as follows:

1) Basic Pension – This benefit is also known as a death pension. It is for veterans and surviving spouses who are aged or disabled. The qualifying disability does not need to be related to their military service. On an annual basis, the Basic Pension pays:

– Veterans without spouses or children up to $16,551

– Veterans with dependent spouses or children up to $21,674

– Surviving spouses without dependent children up to $11,102

2) Aid & Attendance – Abbreviated as A&A, this is an important program for veterans and their surviving spouses who require assistance with activities of daily living. This means they need assistance with activities like bathing, dressing, and eating. A&A is particularly helpful for people with dementia, especially in the middle and later stages of the disease, when the need for more assistance becomes necessary. A&A is intended to help with the long-term care costs of adult day care, in-home care, assisted living, memory care, and skilled nursing. Based on an individual’s need and the progression of the disease, most of these additional services that support your loved one will become necessary. Annually, the A&A pays:

– Veterans without spouses or children a maximum of $27,609

– Veterans with dependent spouses or children a maximum of $32,729

– Surviving spouses without dependent children a maximum of $17,743

3) Housebound – For veterans and surviving spouses who are permanently disabled and unable to leave their homes, making them require additional assistance. The definition of “home” can include assisted living, memory care, and nursing home. The Housebound pension, like the A&A pension, is meant to help cover long-term care costs. Annually, the Housebound pays:

– Veterans without spouses or children a maximum of $20,226

– Veterans with dependent spouses or children a maximum of $25,348

– Surviving spouses without dependent children a maximum of $13,568

Veterans’ Homes

Veterans’ homes 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. There are also four veterans’ homes in Illinois. They are in Anna, Lasalle, Manteno and Quincy. Neighboring states have more veterans’ homes, so a loved one might consider looking there for more options as there are no requirements that one must live in the state. For example, Missouri has almost twice as many VA homes coming in at seven statewide, Kentucky has four and Wisconsin has three. Click here for more info.

Other Options

1)Elder care loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for a VA pension to be approved or waiting to sell a home. More on bridge loans for memory care.

2) 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 can include assisted living costs.

3) A reverse mortgage can be an option for a married person moving into memory care, if their spouse continues to live in the home. However, if the spouse moves from their home, the reverse mortgage becomes due.