New Jersey regulations distinguish between assisted living residences and comprehensive personal care homes, but both are generally considered “assisted living,” where room and board is provided with personal and healthcare services for people with special needs. These residences tend to be apartment-style, where everyone has a bedroom unit with a private bathroom and kitchenette. All assisted living must have dining and stimulating activities for residents, as well as nursing services for residents who need nursing-home-level care.
Assisted living for people with Alzheimer’s disease or a related dementia is often called memory care, and these communities are required to have written policies and procedures that take into account the specific needs of people with dementia. Additionally, staff must have specialized training and the facility must provide caregivers a list of activities that specifically benefit residents with dementia. (More in Laws & Regulations below.)
People who require specialized long-term care, like respirators or ventilators, or people with severe behavior management problems, cannot be admitted. An assisted living residence may not admit someone whose needs are greater than the services provided.
Assisted living residences and comprehensive personal care homes are regulated under the New Jersey Department of Health’s Division of Health Facilities Evaluation and Licensing. There are 201 memory care homes in New Jersey. The size of these homes varies, from large apartment-complex-style communities to smaller house-like residences (called board and care homes) with fewer than 12 people. For free help finding memory care to meet your family’s needs and budget, click here.
The average cost of memory care per month in New Jersey is $7,856, which breaks down to about $94,272 annually. This is more than most neighboring states, and higher than the national average of about $5,000.
The most expensive place for memory care is Trenton, which costs about $8,825 per month and $105,900 annually. The least expensive is Ocean City, for $5,847 per month and roughly $70,164 annually. Generally, memory care in the south of the state is more affordable than in the north.
It is possible for people in New Jersey to find less expensive memory care in surrounding states. Western New Jersey residents should consider looking in Pennsylvania, where Philadelphia’s average memory care monthly cost is about $6,500 per month (the state average is below the national average, at about $4,663). For northern New Jersey residents, New York City averages about $7,000 per month for memory care, but costs can vary widely and it is worth investigating options there. To the south, Delaware’s state average is about $7,890, but within that are more affordable options, like memory care homes in Dover that run about $5,800 per month. Regardless of state, persons with dementia can receive assistance finding memory care homes. Start here.
Two assessments are required after admission: the first is a general assessment to determine specific medical needs; the second is a more comprehensive healthcare assessment by a registered nurse. The assessments are required within 14 days of admission. Then a service plan is created, with a program for meeting the new resident’s medical and personal needs. Medications and ability to perform ADLs like eating and bathing will be defined on the service plan, as well as personal issues like tastes and favorite activities. The assessments are conducted by medical professionals who work for the residence, and the cost could be included in the basic rate or the residence may charge a “community fee.” Community fees cover up-front move-in expenses like assessments and deep cleaning and painting a new resident’s room. Community fees usually run between $1,500 and $2,500.
Among the documents all new residents are entitled to in New Jersey assisted living homes are a statement of resident’s rights and the home’s policies on Medicaid (for more on Medicaid, see below).
Someone who requires specialized full-time care such as respirators or ventilators cannot live in New Jersey memory care homes.
An official diagnosis of dementia is usually not required to move into memory care, because Alzheimer’s and related diseases like vascular, frontotemporal, and Lewy body dementia are difficult to diagnose as symptoms vary and change. New Jersey regulations allow a home to establish its own admissions rules, however, so it’s possible a diagnosis is part of moving in. Check with staff to be sure.
Bedrooms in New Jersey assisted living must have at least 150 square feet of floor space for one resident, and 230 square feet of space in a room for two residents. Two is the maximum number of people allowed per bedroom. Every bedroom (or living unit) needs to have a bathroom with a sink, toilet, and shower and bath. Additional bathrooms with toilets must be provided elsewhere. Smoke detectors are required in all bedrooms, living rooms, and common areas, with an automatic fire suppression system throughout the building.
Unlike many other states, New Jersey does not require residences with memory care to be built with features that are specifically designed to benefit people with dementia. Examples of dementia-friendly designs include circular hallways (so someone walking avoids a dead end), clear sight lines, soft paint colors, and a secure outdoor space to spend time in the open air. This makes it important you inspect any home you’re considering with an eye on whether your loved one with Alzheimer’s disease or related dementia will be comfortable within the spaces.
An administrator or designated alternative must be on-site at all times in facilities with 60 or more beds, and half-time in facilities with less than 60 beds. At least one awake personal care employee and another awake employee are required at all times, and a registered nurse must also be available 24 hours per day.
Administrators must be at least 21 years old with a high school diploma or GED, and must be licensed in New Jersey as a nursing home or assisted living administrator. Thirty hours of training on assisted living issues is required every three years for administrators.
For other staff, an orientation and education plan is required at every facility. Annual training is required in these fields:
– Providing services and assistance to residents with physical impairments
– Emergency plans and procedures
– Infection prevention and control
– Resident rights
– Abuse and neglect
– Care of residents with Alzheimer’s and related dementia
Anyone who assists with personal care (including activities of daily living) must fulfill a relevant and approved training program. Twenty hours of additional training on issues related to assisted living residents is required every two years. Anyone who assists with medication administration must have 10 hours of training on that subject every two years.
An assisted living residence in New Jersey must evict (“mandatory discharge” in regulations) anyone whose health gets so bad that they require specialized long-term care, including being put on respirators or ventilators. A resident who needs severe behavior management, for aggression or actions that put themselves or others in danger, can also be evicted.
No one may stay in a home that cannot meet their medical needs. Beyond that, it is up to community management to define what can get someone evicted. Other examples that are listed in regulations:
– Becomes bedridden for more than 14 consecutive days
– Needs 24-hour nursing supervision
– Needs help for four or more activities of daily living (ADLs)
– Has a stage III or IV pressure sores
New Jersey regulations do not require advance notice before a person can be evicted, whereas many other states say someone must be given 30 days. This means your loved one can be evicted suddenly, and the residence does not necessarily need to help find a new home. For this reason, be sure to familiarize yourself with a memory care community’s eviction policy before moving in. Ask how a person is evicted, for what specific reasons, and get the answer in writing because unfair evictions are a major problem in assisted living.
If you receive an eviction or mandatory discharge notice, do not just move out if you think it’s unfair. Click here for next steps.
An assistance program for people with low incomes, New Jersey’s Medicaid Managed Long Term Services and Supports is money from the state’s Medicaid FamilyCare program that can help cover the costs of assisted living. Note that Medicaid can only cover the cost of care services in assisted living / memory care; Medicaid cannot pay for room and board costs. Recipients who are Medicaid-eligible can choose their own providers for services including behavioral therapy and assisted living. For more, visit the state’s MLTSS page.
I Choose Home – NJ is for people with Medicaid who want to move from a nursing home into their own house or into assisted living. Also called Money Follows the Person, this program works with your loved one to come up with a care plan that gets a person out of nursing-home care and into a program that’s most suitable, which might include memory care. ICH-NJ claims to have transitioned more than 29,000 people out of nursing-home care, and saved $35 million. For more, click here. Check eligibility using the link above.
Service-related medical issues like traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) make veterans statistically more likely to develop dementia. Relevant in all states including New Jersey 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 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 income improvement 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 three veterans’ homes in New Jersey, which are residential care facilities that provide long-term care for veterans. They are:
– Veterans Memorial Home in Vineland, in the southern coastal plain
– Menlo Park Veterans Memorial Home, in Edison, in the Piedmont region about an hour outside New York City
– Paramus Veterans Memorial Home, in Paramus in the northern highlands
In addition to nursing home care and assisted living, all three of these homes have “Special Needs Units” for veterans with dementia. 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. For contacts and more information, click the links above.
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 their 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.