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

Last Updated: November 28, 2022

 

In Montana, assisted living facilities provide health and personal care in a residential or apartment-style setting. There is supervision and security 24-hours per day along with activities for residents. There are three different types of assisted living facilities in Montana that are classified A to C. All three must provide housing, laundry, housekeeping, recreational activities, and help with activities of daily living like eating and dressing. They are defined as:

– Category A homes are for people who can live relatively independently
– Category B is for residents who need full-time nursing care
– Category C is for people with severe cognitive impairment, which include Alzheimer’s disease and related dementias

Category C homes would be considered memory care, with additional requirements including dementia-specific training for staff and appropriate design features like quiet areas with minimal distractions.

Montana assisted living homes are regulated by the Department of Public Health and Human Services’ Quality Assurance Division. There are approximately 25 memory care homes in Montana. It is possible to find smaller, more home-like memory care options. For free help finding memory care to meet your family’s needs and budget, click here.

 Did You Know? Montana has one of the highest percentages of residents 65 and over, translating to 17% of its population being seniors. The mortality rate from Alzheimer’s disease is among the lowest, with only about 29 deaths per 100,000 people.

 

How Much Does Memory Care Cost in Montana?

The average cost of assisted living with memory care in Montana is $5,374 per month. This puts Montana in line with the national average of $5,448 per month for memory care. In Billings, the average cost of memory care is $5,521 per month. Outside the three biggest cities in the state of Billings, Missoula, and Great Falls and in Montana’s more rural areas, the price of memory care falls to $4,822 per month. Missoula’s average costs are $5,632 monthly. Great Falls’s average memory care cost a little less running $5,006 per month.

 Did You Know? Montana residents can receive free assistance to help them locate a memory care home to meet their needs and budgets even if that residence is across state lines. Free assistance is available.

In a state as large and thinly populated as Montana, you may need to look in neighboring Idaho, Wyoming, or the Dakotas for memory care for your loved one. If you live in Missoula, for instance, or the surrounding glacier country, it might be possible to find more affordable memory care in Idaho, whose state average of $4,638 per month for memory care is among the country’s lowest. Wyoming to the south runs $5,043 and North Dakota to the east averages at $4,086 per month. It still may be possible to find the right home for less money if you investigate options. South Dakota could be another option averaging $4,049 monthly.

Montana Memory Care / Assisted Living Costs (updated Oct. 2022)
Region / City Daily Cost Monthly Cost
Statewide $177 $5,374
Billings $182 $5,521
Great Falls $165 $5,006
Missoula $185 $5,632

 

Montana Assisted Living Laws & Regulations

 Covid-19 Measures (updated Oct. 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 medical assessment is required before moving into any assisted living residence. This assessment evaluates the patient’s thinking ability, ability to perform activities of daily living, mood and personality. The assessment is usually conducted by a medical professional who works at the residence, and the cost of the assessment is often covered by a community fee that includes other up-front expenses like deep cleaning or painting a new resident’s room. Community fees typically cost between $1,500 and $2,500. If a memory care community does not have someone to assess a person moving in, then a private doctor may need to complete this step at the resident’s expense, but this should be made clear well before a decision gets made to move in.

Someone in the early stages of Alzheimer’s disease or dementia could move into a Category A or B residence if the disease does not cause disruptive behavior and they require help with less than four activities of daily living. Eventually, a Category C home will become necessary. To move into a Category C assisted living home, or memory care, a resident must:

– Have a severe cognitive impairment that prevents expressing needs or making basic care decisions.
– Be at risk to wander away from the residence.
– Not pose a danger to self or others.
– Not require restraints or confinement.
– Have a written doctor’s order to move into Category C living.

In Category C residences, the following must be made available in writing to anyone considering moving in:

– Overall philosophy and mission of caring for people with dementia
– Processes for move-in, transfer and discharge
– Process for move-in assessment
– Explanation for how to update health-care plan
– Staff training and education
– Physical environment and design features that are appropriate for people with cognitive impairment
– Level of involvement allowed for families
– Any costs of care or fees

Someone has the following issues may not move into or remain in a memory care facility in Montana:

– If their needs cannot be met there
– If they presents a threat to themselves or others
– If they cannot respond to verbal instruction
– If they have a complex medical condition that cannot be treated there
– If they fail to pay within a reasonable amount of time after appropriate notice

A note from your loved one’s primary care doctor is required to move into memory care in Montana, but this is not the same as an official diagnosis. Someone does not need a diagnosis to enter memory care. Alzheimer’s and related diseases including frontotemporal, vascular, and Lewy body dementias are difficult to diagnose and distinguish because symptoms change and vary. It’s important to match a home to your loved one’s unique needs, not a specific disease.

While it is possible to move into memory care on short notice in Montana, this is not a good idea. Finding the right home is a long process that involves looking at every option and asking questions of residents and staff. Additionally, your loved one will be able to provide more input the sooner the search begins. It is best to start looking before moving becomes necessary.

 

Facility / Residence

Residents’ living units must be at least 100 square feet for one person, and 80 square feet per person if there is more than one. Four residents are the maximum allowed in one living unit. This does not include bathrooms or closets. There must be one toilet for every four patients, and a shower for every 12.

The physical environment or design must be appropriate for people with dementia. This usually means a simple layout with clear sight lines and landmarks that make it easy to navigate, quiet rooms with minimal distractions, and special locks to prevent wandering. Regulations do not require a secure outdoor space, but this is something to look for because being outside has been shown to benefit people with dementia.

 

Staff & Training

A licensed administrator with state-approved education and work experience must be employed at every Montana assisted living residence. The administrator is responsible for day to day operations. Sixteen hours of continuing education annually are required for administrators. Additionally, in category C residences (memory care), eight hours of annual training must be dementia-specific. There are no required staff-to-resident ratios in Montana. An employee with CPR training must be awake and on-duty at all times. All staff receive training relevant to the needs established in residents’ service plans, and in category C residences this includes:

– Helping residents who cannot perform activities of daily living
– Techniques for minimizing dementia-specific behaviors including wandering, hallucinations, and delusions
– Therapies to promote social and emotional stimulation
– Encouraging dignity, independence, privacy and choice
– Managing medications
– Strategies for managing incontinence

 

Evictions & Discharges

Montana does not have statewide regulations about evictions from assisted living. The rules say that a resident must be transferred if they cannot receive adequate care. No one may stay at an assisted living home that is not equipped to handle their condition. For people with dementia, this would mean that as activities of daily living like eating and dressing get harder, staff must have adequate training to help your loved one stay as safe and healthy as possible.

One of the items required to be included in a written resident agreement is the criteria for transfer or discharge. This means the home must explain, in writing, the reasons someone can be evicted. Be sure you understand this document and that it is as specific as possible, because unfair evictions can be a problem in memory care nationwide. File it in case the issue comes up later. For guidance on what to do next if you receive an eviction notice, click here.

 

Financial Assistance for Residential Alzheimer’s Memory Care

Big Sky Home and Community Based Services Program

Montana’s Big Sky waiver is a Home and Community Based Services waiver under the state’s Medicaid program that can help cover costs in assisted living. Funds through Big Sky cannot pay for room and board, but the costs of care in assisted living (personal care assistance, counseling, therapies, laundry, food, etc.) may be covered. Transportation and medical equipment is also covered. People receiving this benefit must be Medicaid-eligible. Requirements in 2022 include monthly income under $2,523 per month for a single individual. Medicaid Planning professionals may be able to help get benefits for needy people who aren’t quite eligible. For more information, click here.

 

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 three veterans’ homes in Montana. They are:

– Columbia Falls Montana Veterans’ Home. They are in the Flathead Valley near Glacier National Park and have a 15 bed memory care unit.

– Southwest Montana Veterans Home in Butte which is along the Continental Divide.

– Eastern Montana Veterans Homes in Glendive. This is in the eastern, central part of the state. They have a 16 bed special care wing.

These facilities provide long-term residential care for veterans. In addition to nursing home care, assisted living and memory care are provided. Neighboring states also have veterans’ homes. Your loved one might consider looking there for more options as there are no requirements that one must live in the state. For example, Idaho has three veterans’ homes statewide. Additionally, North Dakota, South Dakota and Wyoming all have one facility apiece. 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.