Assisted living residences, including memory care homes with “special care units” for people with Alzheimer’s disease or another 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 without providing a written disclosure to residents, or potential residents, that includes 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
Assisted living in Minnesota is regulated by the state’s Department of Health.
The average cost of memory care per month in Minnesota is $4,986, which breaks down to about $164 per day and $59,832 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. Assisted living, without the additional services required for memory care, costs Minnesota residents about $3,810 per month and $45,720 annually.
The state’s most expensive place for memory care is its biggest city, Minneapolis, where memory care costs about $6,262 per month and $75,144 annually. The least expensive city for memory care is Rochester, for about $3,909 per month and $46,908 per year.
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. This also means that as your loved one’s dementia worsens (Alzheimer’s is a progressive disease with no cure), it may become necessary to find more appropriate housing for someone advancing into later stages. An assessment by a registered nurse is required within five days of moving in. 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.
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.
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
– 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 inservice training annually. Managers and supervisors must have 30 hours of continuing education every two years.
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 (in 2020). 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. 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 also veterans homes in Minnesota, 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 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.