Assisted living residences, including memory care homes with “special care units” for people with Alzheimer’s disease or another related dementia, are classified in Minnesota as “housing with services.” These homes must provide sleeping units and health-related services to their residents, as well as the following:
– Access to an on-call registered nurse
– A system to check on every resident daily
– A means for residents to request assistance
– 24/7 emergency response
– Two meals per day
– Weekly housekeeping and laundry
– Assistance with self-administered medications
– Assistance with three or more activities of daily living (ADLs) including bathing, dressing, eating and grooming
Further, memory care or special care units cannot be provided by an assisted living residence unless it offers a written document to residents, or potential residents, that lists the following:
– A statement of overall philosophy specifically addressing the needs of residents with dementia
– Criteria for deciding who may live in memory care
– The process for assessment and creation of a resident’s service plan
– Staffing credentials, duties, and training
– Description of physical environment including features that address the needs of residents with dementia
– List of programs and activities
– Explanation of family involvement and availability of family support programs
– Statement that resident will be given 30-day notice prior to any fee changes
There are close to 250 memory care communities in Minnesota, but only five board and care homes, which offer the same services as assisted living in a more house-like setting. That’s fewer than most other states, but smaller memory care communities are still an option if your loved one doesn’t want to live in a residence that feels like an apartment complex. For help finding memory care that meets your family’s needs and budget, click here.
Assisted living in Minnesota is regulated by the state’s Department of Health.
The average cost of memory care per month in Minnesota is $4,540, which breaks down to about $54,480 annually. Remember that a Uniform Consumer Information Guide is required to be given to any resident or prospective resident, and must include all costs and potential fees. Therefore, there should be no billing surprises.
The state’s most expensive place for memory care is its biggest city, Minneapolis, where memory care costs about $5,700 per month and $68,400 annually. Those numbers encompass the whole of the Twin Cities, so St. Paul averages about the same, as do the surrounding suburban areas within The Metro, including Bloomington, Brooklyn Park, and Plymouth. The least expensive city for memory care is Rochester, for about $3,560 per month and $42,720 per year.
While Minnesota’s memory care costs are lower than the national average of about $5,000 per month, it may be possible to find more affordable assisted living in surrounding states. Western Minnesota residents could look in the Dakotas, which both average a little more than $4,000 per month for memory care. Specifically, Grand Forks, on the North Dakota border with Minnesota, only costs about $2,330 for memory care. Sioux Falls, on the southern part of the border between South Dakota and Minnesota, costs roughly $4,000 per month for memory care. Iowa and Wisconsin, Minnesota’s other neighbors, are both slightly more expensive, but there still may be opportunities for savings. La Crosse, Wisconsin, for example, is on the border with Minnesota and only costs about $3,090 per month for memory care.
Regarding of the location in which one is looking for memory care, Minnesota residents are entitled to free assistance finding residences. Get help here.
A person can live in a housing with services establishment only if the residence meets that person’s specific health needs. For people with Alzheimer’s or related dementia, this probably means there must be a special care unit with services appropriate for someone in your loved one’s stage of dementia, and as your loved one’s dementia worsens, it may become necessary to find more appropriate housing for someone advancing into later stages.
An assessment by a registered nurse who works for the residence is required within five days of moving in. The cost of the assessment is usually covered by an assessment fee or “community fee” that covers all move-in costs including the assessment and readying a new resident’s living unit. (Community fees are usually between $1,500 and $2,500.) Monitoring and a reassessment are then required within 14 days of move-in. If your loved one needs help with medication management, this requires another assessment by a registered nurse. When considering a memory care home, be sure to ask specific questions about the assessment process, to be crystal clear on what appointments need to be made and how they are paid for. Documents spelling out what happens step-by-step leading up to move-in should be provided to any prospective resident.
Regulations do not require that a person be diagnosed with Alzheimer’s disease, or a related dementia like vascular, frontotemporal, or Lewy body dementia, in order to be admitted into memory care in Minnesota. Dementia is difficult to diagnose and symptoms can change and vary over time. It is important to match your loved one’s unique needs, rather than specific symptoms, to their new memory care home.
Unlike many other states, Minnesota does not define the size of bedroom units in assisted living, how many bathrooms per resident, or how many occupants may live in one bedroom, except to say compliance with state and local building codes is required.
Minnesota memory care residences must also be built with design and security features that are good for people with dementia. What this specifically means is not defined in regulations, but dementia-friendly features usually include special locks to prevent wandering, a secure outdoor area, softer paint colors, and an easily navigated layout with hallways that run circular so residents with more advanced dementia do not encounter dead ends.
There is no staff-to-resident ratio in Minnesota, though there must at all times be enough people working to fulfill the needs of every person living there. Dementia-specific training is required for people who work in memory care. Supervisors must have eight hours of dementia-care training within 120 working hours of their employment start dates, and two hours of annual additional training. Employees who work directly with residents must have eight hours of initial training and two hours of annual additional training.
Dementia-care training must include:
– An explanation of Alzheimer’s disease and related dementias (vascular dementia, frontotemporal dementia, Lewy body dementia, etc.)
– Helping with ADLs
– How to deal with challenging behaviors
– Best ways to communicate
The residence must provide a description of training for employees, including the frequency of training. Besides the dementia-specific training guidelines above, employees in all assisted living residences in Minnesota must receive an orientation and eight hours of in-service training annually. Managers and supervisors must have 30 hours of continuing education every two years.
Minnesota regulations say that 30 days notice is required before a residence can end the health- and personal care assistance received by someone living there. The regulations separately require 30 days notice to terminate housing. Thirty days notice, at least, is therefore required before a person can be evicted from memory care, and a condition that requires as much assistance as advanced dementia would not allow for someone to continue living in memory care without health- and personal care.
When picking a community, it’s a good idea to ask: What are the exact reasons a person can be evicted? Can your loved one be told to leave for nonpayment or aggressive behavior? The answer may depend on the residence. Some states require detailed eviction rules to be provided in writing, but not Minnesota. Ask for this document before agreeing to move in, because unfair evictions are a big problem in memory care. Evictions are legal, even if the person has Alzheimer’s disease, unless the residence is violating its own admissions and retention policy, so keep a copy of that policy on file. More information on what to do after receiving an eviction notice.
This program helps pay for home and community-based services (HCBS) for people over 65 who live at home or in assisted living. Participants can have a designated caregiver manage their healthcare, or it can be managed by the state. To receive benefits, a person must be enrolled in Medicaid, whose qualifications include monthly income under $2,349 (from 2020 through July 2021). There may be exceptions for people designated as “medically needy.” Though this program is available state-wide, there may be waiting lists. Apply as soon as possible by clicking here or contacting your local county health office.
Designed to help people who may need nursing-home-level care to remain in their homes or assisted living communities, the Community Access for Disability Inclusion waiver is a statewide program that covers costs including nursing services and specialized medical equipment. Recipients must be certified as disabled by the Social Security Administration or a state medical review team. Income and asset limits may apply, though professional Medicaid planners can be useful in making this determination. For more information, click here. To apply, contact your local Department of Human Services agency.
Veterans are statistically more likely to develop dementia. Relevant in all states including Minnesota 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. A&A is part of the military’s Disability and Death Pension Program, and is also referred to as the Enhanced Monthly Benefit and the Income Improvement Pension. 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 (2021) maximum amount a veteran can receive through A&A is $27,540 per year, and surviving spouses can receive as much as $14,928. Learn more here.
There are also five veterans’ homes in Minnesota, which are residential care facilities that provide long-term care for veterans. They are located in: Minneapolis; Hastings, southeast of St. Paul; Silver Bay, on the north shore; Luverne, in the southeast corner by Sioux Falls, South Dakota; and Fergus Falls, along the western state line. 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.
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.