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

Last Updated: November 28, 2022

 

Missouri defines their memory care facilities as full-time care homes that offer services for people with Alzheimer’s disease or related dementia. Generally, these are called assisted living facilities or residential care facilities. Memory care may be an entire residence or a special, secure wing of their community.

While assisted living and residential care must provide full-time security, supervision, and meals, their special care units for people with dementia offer even more. Among the requirements for memory care in Missouri is a written disclosure to anyone considering becoming a resident. This must explain how its special care unit is different from regular assisted living. It also includes:

– Its philosophy and mission on fulfilling the needs of residents with dementia
– The process for assessment and how it establishes an individualized care plan
– Staff training
– Architectural design features that are dementia friendly
– The types and frequency of activities
– Family support programs and how families stay involved
– The costs of care and any additional fees
– Safety and security information

The main differences between assisted living and residential care in Missouri are:

– People in residential care must be able to evacuate without assistance.
– Assisted living must build its care services around a social model.
– Assisted living must have a physician on duty who can supervise residents’ care.
– Assisted living is required to provide help with activities of daily living (like cleaning, dressing, and going to the bathroom), while they are not part of the required care in residential care facilities

Because of these differences, special care units (or memory care) in assisted living facilities are better for someone in the later stages of Alzheimer’s, while residential care facilities can be a great option for someone in the early stages.

Memory care residences are regulated by the Missouri Department of Health and Senior Services. There are roughly 300 memory care homes in Missouri. There are also almost 200 board-and-care homes, which offer the same services as assisted living (often including memory care) in a smaller house-like setting for 12 or fewer people. Missourians can receive free assistance locating memory care homes to meet their loved ones needs and budget. Click here for more information.

 Did You Know? Roughly 120,000 people in Missouri have Alzheimer’s disease, and that number is expected to reach 130,000 by 2025. This projected 18% increase over five years is one of the Top 5 lowest figures for any state.

 

How Much Does Memory Care Cost in Missouri?

The average cost of memory care per month in Missouri is $3,644 . This is one of the most affordable rates in the U.S., and well below the national average of $5,448 per month. In Kansas City memory care is the most expensive statewide, costing $5,558 monthly. Those average costs encompass that whole area, including Independence and Lee’s Summit. The least expensive city for memory care is in Jefferson City where it will cost $2,503 monthly.

 Did You Know? Missourians can receive free assistance locating memory care homes to meet their needs and budget. Get help here.

Neighboring states, like Kansas, average care costs are much higher, running $5,558 per month. Prices obviously vary widely, and anyone who lives in southern Missouri might consider looking in Arkansas, another of the more affordable states for memory care at about $4,564 per month. Other Missouri cities with costs:

Missouri Memory Care / Assisted Living Costs (updated Aug. 2022)
Region / City Daily Cost Monthly Cost
Statewide $120 $3,644
Kansas City $183 $5,558
St. Louis $163 $4,969
Springfield $129 $3,938
Columbia $111 $3,386
Jefferson City $82 $2,503
St. Joseph $154 $4,675

 

Missouri 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

A patient cannot be admitted into an assisted living facility if:

– Their behavior threatens to harm themselves or others
– They require physical or chemical restraints
– They require skilled nursing care the residence cannot provide
– They require more than one person to help with activities of daily living (except bathing and transferring)
– They are bed-bound

An assisted living resident must be able to exit the building unassisted in the event of an emergency  evacuation. Assisted living facilities must screen residents to ensure an appropriate fit. That is done through multiple physical exams. Generally within five days a community-based assessment must be conducted (and then reviewed semi-annually), and someone admitted into a residential care facility must also have a physical examination within 10 days of moving in. These assessments are conducted by a doctor working for the residence. The cost of assessing is typically included in a community fee at the time of move-in. Community fees cover the assessments and other up-front costs like painting a new resident’s room, and normally run between $1,500 and $2,500.

Someone does not need a diagnosis of dementia to move into memory care in Missouri. Dementias are difficult to diagnose, with varying symptoms that change over time. It’s much more important to match your loved one with a home that fits their unique needs, rather than a home that specializes in a specific disease.

 

Facility / Residence

Resident units in assisted living and residential care facilities must be at least 70 square feet per person, and the maximum number of people allowed per unit is four. One toilet and sink must be provided for every six residents, and one shower or tub for every 20.

In memory care, the environment must be designed with dementia friendly features. This usually means spaces to wander without encountering a dead end, special locking mechanisms and other security features that won’t trap or harm someone who is disoriented, and a comfortable outdoor area.

 

Staff & Training

Staff in Missouri memory care facilities must have at least three hours of dementia-specific training during their orientation. A program of dementia-specific ongoing training must be instituted by all memory care facilities.

In assisted living, there must be one staff person for every 15 residents during the day, and one employee for every 20 residents at night. Regulations state that this ratio is the minimum, and communities must have enough staff on hand at all times to meet the needs of every resident. Residential care facilities have similar ratio requirements, though they must also have a licensed nurse on staff who works eight hours per week per every 30 residents. Facilities must have a licensed administrator who takes at least 40 hours of relevant training every two years.

 

Evictions & Discharges

Thirty days notice is required before a resident in a Missouri assisted living facility can be evicted. Special exceptions are possible if a resident is considered dangerous. The reason for the discharge must be documented in detail. Generally, your loved one can be evicted if:

– The resident’s health or personal needs cannot be met by the residence
– The resident poses a danger to other residents
– The resident does not pay their bill

Before moving into an assisted living community, ask for the specific reasons for eviction in writing because they can vary. Can they kick someone out for payment that’s a week or two late? Unfair evictions can be a nationwide problem in memory care. For more on what to do next if you receive an eviction notice, click here.

 

Financial Assistance for Residential Alzheimer’s Memory Care

Supplemental Nursing Care

Financial assistance for memory care is available through the MO HealthNet (Medicaid) program called Supplemental Nursing Care. This is a cash benefit to help people with significant health issues cover the price of assisted living. Payments vary depending on the type of residence; people in assisted living residences receive almost twice as much as those in residential care facilities. A facility does not need to be Medicaid certified for a resident there to receive this benefit. Among the eligibility requirements is a monthly income limit of $963 in 2022. To apply, contact your local Missouri Department of Social Services. If you’re not sure if your loved one qualifies for MO HealthNet, click here for eligibility requirements, or take a fast and simple Medicaid Eligibility Test.

 

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 are seven veterans’ homes in Missouri that provide long-term care for veterans. In addition to nursing home care, all seven homes have special dementia care units. They are located in Mexico, just north of Columbia and Jefferson City; Cape Girardeau, along the big river in the Lowlands; St. Louis; Cameron, less than an hour north of Kansas City; Warrensburg, an hour east of Kansas City; Mt. Vernon, in the southwest; and St. James, an hour-and-a-half west of St. Louis in Phelps County. In addition to nursing home care, each home has a secured dementia unit with a dining room, activity area, and enclosed courtyard. Neighboring states have 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, Illinois has four Veterans homes statewide and some are located relatively close to their shared border. Additionally, Arkansas and Kansas both have two 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.