In Nevada regulations, assisted living residences are called “residential facilities for groups” and offer room and board, help with activities of daily living (ADLs), protective supervision, meals and snacks, and housekeeping for people who are older or have physical disabilities.
To admit people with dementia in what’s often called “Alzheimer’s care” or “memory care,” a residential facility for groups must have been inspected and approved by the state’s Division of Public and Behavioral Health. Significantly more training is required for staff in memory care than in assisted living without dementia residents. (For more on staff training, see below.)
There are 54 memory care communities in Nevada. These range in size from large, apartment-complex-style residences to homes that are smaller, for between four and 12 people with dementia (smaller memory care homes are sometimes called “board-and-care homes”). For free help finding memory care in Nevada to fit your family’s needs and budget, click here.
The average cost of memory care per month in Nevada is $4,233, which breaks down to about $50,796 annually. These figures put Nevada below the national average for memory care, which runs about $5,000 per month.
The state’s most expensive city for memory care is Carson City, on Lake Tahoe in western Nevada, where the average cost is $5,488 monthly and $65,856 annually. The least expensive city is nearby Reno, for $4,412 monthly and $52,944 per year. The state’s biggest city is Las Vegas, where memory care costs about $4,161 per month and $49,932 annually.
It might be possible for people who live near the Nevada border to find more affordable memory care outside the state. In the northeast, for example, more affordable options might be available in Twin Falls, Idaho, which is very near the border and has memory care costs around $3,700 per month. If you live in the southeast, look at St. George, Utah, where memory care runs about $4,000 per month. States east of Arizona (Utah and Oregon) have lower overall average monthly costs than Nevada, whereas its neighbors to the west (California and Oregon) are more expensive, with costs that average more than $5,400 per month.
New residents must be assessed for COVID-19 and tuberculosis signs and symptoms, as well as their need for help with activities of daily living (ADLs) upon admission. This needs assessment and a financial assessment are required for every new resident. The needs assessment helps create a service plan covering unique personal and healthcare needs; the financial assessment determines whether Medicaid assistance is necessary (see below). These assessments are completed by a medical profession who works at the home, or by a third party contracted to make assessments. The cost of assessments may be included in the basic rate, or may be part of a “community fee” that covers move-in and up-front costs including assessments but also deep cleaning a painting a new resident’s room. Community fees are usually between $1,500 and $2,500.
There should never be surprises in billing because anyone considering a Nevada assisted living home is entitled to the following information in writing:
– Rates for services and schedule for payment
– All services included in the basic rate
– Any additional or optional services not included in the basic rate
– The policy on refunds
Someone with the following issues may not be admitted into assisted living in Nevada (without a medical exemption):
– Is bedridden
– Requires physical or chemical restraints
– Requires skilled 24-hour nursing care
– Requires gastronomy care
– Has a serious infection
The residence may evict someone who does not pay a bill within five days of the due date. Someone whose needs exceed the care provided in an assisted living home may not live there.
Your loved one does not need an official diagnosis of Alzheimer’s, or related disease like frontotemporal, vascular, or Lewy body dementia, to be admitted into memory care in Nevada. Dementias are difficult to diagnose, with symptoms that change and vary, so it’s important to match a home with your specific needs rather than any specific type of dementia.
An apartment or living unit must be at least 80 square feet if it’s a single, and 60 square feet per person if there are multiple occupants. Three is the maximum number of roommates allowed. There must be one toilet for every four residents and a tub or shower per every six. Unlike many other states, Nevada does not have regulations requiring secure outdoor areas or dementia-friendly indoor design features at memory care residences. This means you need to take extra care when considering a community for your loved one. Look for clear sightlines with an easily navigated layout, soft paint colors, and room to walk around without encountering a dead end, as these have been shown to benefit people with dementia.
Nevada has specific staffing ratios for memory care: no more than six residents for every direct-care staff member during waking hours, with at least one person awake and on duty through the night. Within 40 hours of hiring, memory care staff members must have two hours of training in providing care, including in an emergency, specifically to a person with dementia. Within three months of hiring, they must receive at least eight hours of further training on providing care to someone with dementia. At least eight hours of continuing education is required annually. Administrators in Nevada memory care homes must have at least three years of experience caring for populations with Alzheimer’s or a related dementia.
Unlike many other states, there is not a rule in Nevada regulations requiring advanced notice before a resident can be discharged or evicted. In Nevada, someone can be evicted from memory care for:
– Non-payment of a bill within five days of due date
– Not following rules or policies of the residence
– The residence can no longer meet the person’s medical needs
Because regulations lack specificity, and unfair evictions are a major problem in assisted living nationally, it’s important to be very clear on a memory care home’s specific policies for how and why a person is evicted. Each home should have its own guidelines, and be able to provide them in writing. Get this information before signing a contract to move in. Tips on what to do next if you receive an eviction notice.
Nevada Medicaid’s HCBW-FE program is for non-medical care services like case management, meal preparation and housekeeping costs for people who want to remain in their home or assisted living or memory care community rather than moving into more expensive nursing care. For more information, click here. To apply, contact your local office of the Nevada Aging and Disability Services Division.
Nevada Medicaid’s HCBS-PD is another waiver similar to the HCBW-FE above, but provides services for people of all ages, with benefits including covering costs of assistance with activities of daily living (ADLs). For more information and to apply, contact the Division of Healthcare Financing and Policy.
Risk factors from military service, especially traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD), make veterans statistically more likely to develop dementia. Relevant in all states including Nevada 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 also known as the “enhanced monthly benefit” or 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 two veterans’ homes in Nevada, which are residential care facilities that provide long-term care for veterans. They are the Southern Nevada State Veterans Home in Boulder City, 25 minutes south of Las Vegas, and the Northern Nevada State Veterans Home in Sparks, just east of Reno. In addition to nursing home care, assisted living and memory care are 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. Click here for contacts and more information on the Southern NV VA, and here for the Northern NV VA.
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.