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

Last Updated: November 13, 2022

 

In Maryland, communities that offer a place to live with full-time care and support services for people with Alzheimer’s disease or dementia, are called assisted living facilities with an Alzheimer’s special care unit. Another common term for these is memory care. Residents in assisted living are given housing, supervision, support, and health-related services including help with activities of daily living like eating and dressing.

Assisted living facilities in Maryland offer three levels of care: low, moderate, or high. Someone in the late stages of Alzheimer’s will obviously need to live in a high-level residence, while a person in the early or middle stages will live in low or moderate. Assisted living facilities may not legally house someone whose health needs cannot be met there. Because Alzheimer’s is progressive, meaning it gets worse over time, your loved one in low or moderate memory care will eventually need to move somewhere offering more care, like a high-level residence or a nursing home.

Any assisted living residence housing people with dementia must submit the following to the Office of Health Care Quality, which regulates assisted living under the direction of the Maryland Department of Health:

– Description of the unit (memory care facilities are typically built with special considerations, including secure outdoor areas and special locks on bedroom units)

– Statement of philosophy or mission

– Staff training and titles

– All procedures that go beyond the treatment provided in normal assisted living

There are approximately 240 memory care communities in Maryland. There are also 150 board and care homes, which offer the same services as assisted living (often including memory care) in a smaller house-like setting, typically with fewer than 12 residents. For free help finding the perfect memory care home to meet your family’s needs and budget, click here.

 

How Much Does Memory Care Cost in Maryland?

The average cost of memory care per month in Maryland is $5,926. The state’s most expensive place for memory care is Cumberland, where memory care costs $6,368 per month. The least expensive city for memory care is Hagerstown, for about $5,595 monthly. In the Baltimore area, including the state’s second-largest city Columbia, memory care costs $5,742 per month.

 Did You Know? Maryland residents are entitled to free assistance finding memory care residences regardless of whether the residence they chose is in or out-of-state. Get help here

If you live in northern Maryland, it’s possible to find more affordable memory care out-of-state in Pennsylvania, where average costs are $4,969 per month. Delaware, Virginia, and West Virginia all average higher memory care costs than Maryland. Washington D.C. is much more expensive than its neighbors, at an average monthly cost of $8,429.

Maryland Memory Care / Assisted Living Costs (updated Aug. 2022)
Region / City Daily Cost Monthly Cost
Statewide $195 $5,926
Baltimore $189 $5,742
Cumberland $209 $6,368
Hagerstown $184 $5,595
Salisbury $198 $6,037

 

Maryland Assisted Living Laws & Regulations

 Covid 19-Related Measures (updated Aug. 2022)
Residents – Their temperatures are checked and patients are also tested regularly.
Visitors – Can visit loved ones, must wear a mask and temperature is checked upon entry.
Staff – Have temperatures checked upon entry and are regularly tested.

Admissions Process & Requirements

Within 30 days before admission, a resident must be assessed using the Residential Assessment Tool to gauge health, function, and emotional and social well-being. This assessment is provided by the residence and performed by a medical professional. Based on the results, the memory care home will create a resident’s service plan that outlines what your loved one needs and how those needs will be met.

The cost of the assessment is typically included in a community fee charged when your loved one moves in. The community fee generally costs between $1,500 and $3,000, and covers move-in expenses as well as deep cleaning and painting a new resident’s room.

Assisted living homes in Maryland may not admit someone if they:

– Require full-time nursing care
– Have stage III or IV skin ulcers
– Require a ventilator
– Have an acute and fluctuating medical condition that requires monitoring, and frequent medication and treatment changes
– Have an illness that requires isolation from other residents
– Present a danger to self or others

A home may request a waiver (an exception to the above rules), so that your loved one would be allowed to move in or stay. A diagnosis of Alzheimer’s disease is not required to move into memory care in Maryland.

 

Facility / Residence

Bedroom units must be at least 80 square feet of space for a single-person room, and 120 square feet per person if there are multiple occupants. The maximum number of people allowed in a bedroom is two. There also must be one toilet for every four residents and one shower or bathtub for every eight. Smoke detectors are required in every bedroom and outside the rooms within their vicinity. A plan for fire evacuation must be posted on every floor, and fire drills are required four times per year.

Maryland memory care communities are not specifically required to have physical designs that are dementia-friendly. People with Alzheimer’s disease and related dementias are more comfortable in homes with easily navigated spaces, circular hallways that don’t run to dead ends, and outdoor spaces that allow for time in the open air. Be sure to thoroughly inspect any home you are considering for your loved one, checking whether they can be comfortable in the space.

 

Staff & Training

There are no staff-to-resident ratio requirements in Maryland, though regulations say staffing must at all times be adequate to serve the needs of every resident. Assisted living communities in Maryland must have a contract with a registered nurse. Managers must be at least 21 years old, with a high school diploma and sufficient training to fulfill the role of running an assisted living community. For a community offering high-level care, the manager must have a four-year college degree, two years’ experience in health care, and at least one year of experience in assisted living. An 80-hour assisted living training program must also be completed.

Staff must be at least 18 years old, and must complete five hours of training on cognitive impairment and mental illness within 90 days of starting work. An orientation and ongoing education are also required.

 

Evictions & Discharges

Unfair evictions can be a problem for families with a loved one in assisted living. Maryland does not have rules outlining why a patient may be evicted from memory care. Whether or not a resident can be discharged for nonpayment, aggressive behavior, or some other reason is up to the specific residence. When considering a memory care community, ask the specific reasons someone can be evicted and get the answers in writing. Click here for what to do if you receive an eviction notice.

 

Financial Assistance for Residential Alzheimer’s Memory Care

Medicaid Community Options Waiver

Services for someone in memory care in Maryland may be paid for by the Community Options Waiver. This waiver is for people who qualify for Medicaid, including monthly income below $2,742 in 2023, and stay in a moderate- or high-level assisted living facility. The goal of the program is that someone who needs expensive nursing-home level care can stay in their house or memory care community. Medicaid funds can be used to cover intermittent nursing care, nutritional services, case management, and behavioral counseling. The program is popular, so there may be a waiting list; depending which part of Maryland you live in, enrollment could take years. To apply, contact your local Area Agency on Aging.

  Not sure if your loved one qualifies for Medicaid? To see state-specific Medicaid eligibility requirements, click here. For a Medicaid “Eligibility Test,” click here.

 

Increased Community Services

Increased Community Services provides support for people in nursing homes who want to transition back to their own houses or into assisted living. Services covered for Medicaid-eligible Marylanders include help with activities of daily living, which is part of living in memory care. The benefits are similar to the Community Options Waiver program but the income requirements are different. This program is available for people who have a higher level of income, as long as their monthly income does not exceed the cost of care. To apply, contact the Maryland Department of Health at 410-767-1739.

 

Community First Choice

This is another Medicaid program designed to keep people who need nursing-home-level care out of a nursing home and in their own houses or assisted living. Community First Choice also has the added bonus of applicants never going on a waiting list. Some of the eligibility requirements are needing assistance with two activities of daily living and monthly income under $2,742 in 2023. Apply through the state’s Medicaid program.  A slightly outdated fact sheet is available here.

 

Senior Assisted Living Group Home Subsidy Program

This program provides money to recipients to help cover the costs of assisted living. The income requirements are different from Medicaid. This program is not available in all counties in Maryland, and there may be a waiting list. For more information, visit the Department of Aging website. To apply, contact your local Area Agency on Aging.

 

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 2022 to December 2023. 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 $16,073

– Veterans with dependent spouses or children up to $21,001

– Surviving spouses without dependent children up to $10,756

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 $26,751

– Veterans with dependent spouses or children a maximum of $31,713

– Surviving spouses without dependent children a maximum of $17,191

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 $19,598

– Veterans with dependent spouses or children a maximum of $24,562

– Surviving spouses without dependent children a maximum of $13,145

 More information on VA Pensions’ eligibility criteria, payment rates and the application process is available here.

Veterans Homes

There is one veterans’ home in Maryland, a residential care facility that provides long-term care for veterans. The Charlotte Hall Veterans Home in Charlotte Hall offers assisted living, skilled nursing, and memory care for more than 450 veterans at a time. 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, Pennsylvania has 6 Veterans homes statewide and several are located relatively close to their shared border. Additionally, Virginia and West Virginia both have 2 facilities statewide. 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.