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

Legal Definition of Assisted Living / Memory Care in Oregon

Assisted living homes in Oregon for people with Alzheimer’s disease or dementia, are called Endorsed Memory Care Communities. These communities offer more specialized care than assisted living and residential care facilities, in care units that are apart from other residents who do not have dementia. The state requirements say that these communities must offer:

– Person-directed care
– Resident protection
– Staff training specifically for dementia
– Physical design and environmental requirements that are dementia friendly

All assisted living and residential care homes in Oregon, including memory care, must assist residents with activities of daily living like eating and bathing, and meet whatever health and social needs residents require to thrive. Other requirements that all care facilities must offer are:

– Three nutritious meals daily, plus snacks, from menus made with input from residents
– Social and recreational activities daily
– Help with medications
– Household services (like laundry)

The Oregon Department of Human Services oversees assisted living communities in the state. There are approximately 250 memory care communities in the state. There are also about 75 board and care homes, which offer the same services as assisted living (sometimes including memory care) in a smaller more home-like setting, usually for fewer than 12 people. For free help finding memory care to meet your family’s needs and budget, click here.

How Much Does Memory Care Cost in Oregon?

The average cost of memory care per month in 2024 in Oregon is $6,599. Oregon is one of the more expensive states for memory care. The national average for monthly costs is $5,884. The state’s most expensive place for memory care is Eugene, where memory care costs $7,355 per month. The most affordable place in Corvallis, for an average cost of $5,844 per month. In the Portland area, including Hillsboro and Gresham, memory care costs $6,520 per month.

Since Oregon’s memory care costs are above the national average, it may be possible to find more affordable long-term care in neighboring states. For example, while California’s overall costs are a bit higher, running $6,877 monthly, but relatively close to their border the city of Redding costs $5,804 per month. To the north, just over the border in Washington, the city of Walla Walla memory care costs are $4,213 per month.

Other cities in Oregon and their memory care costs:

Oregon Assisted Living Laws & Regulations

Admissions Process & Requirements

Assisted living homes in Oregon (including those with memory care) are required to provide a disclosure form to anyone who asks. The disclosure must include the following:

– Policies including possession of firearms and ammunition

– Payment details including basic rental rate and what that includes, cost of all additional services, billing method, due dates, deposit, and which fees are non-refundable

– Method for evaluating residents’ needs

– Policies for changes to costs

– Refund conditions

– Description of the total scope of services (what staff can provide)

– Philosophy on healthcare and help with activities of daily living

– Statement of residents’ rights and responsibilities

– Medication policies including administration and pharmacy choice

– Details including actions and circumstances that will result in an eviction

– Staffing plan

– Notice that the Department of Human Services may examine residents’ records when evaluating the residence

There are also four requirements particularly for people moving into memory care:

– Philosophy of care and services for people with dementia

– Admission, discharge, and transfer criteria

– Staff training topics and amount, and names of trainers

– Number of direct-care staff assigned to the memory care unit during every shift

An evaluation of a resident’s needs must be made before move-in, and then quarterly (four times a year) thereafter. The evaluation must include:

– Resident’s specific routines and preferences

– Physical health condition

– Communication ability

– Ability to perform activities of daily living

– Ability to perform instrumental activities of daily living

– Skin condition

– Nutrition needs

– Weight

– Medical treatments required

– Nursing needs

– Risk indicators

The residence is responsible for these evaluations, which are used to make a personalized service plan that details how exactly a person will be cared for. A medical professional working for the home performs the assessment. If the cost of assessing isn’t included in the base rate, then there may be a one-time move-in fee, called a community fee, that covers up-front expenses including the assessment and also things like deep cleaning and painting a new resident’s room. Community fees usually run between $1,500 and $2,500.

Someone with the following issues may not be admitted into (or may be evicted from) memory care in Oregon:

– Care needs exceeding the residence’s abilities

– Behavior that interferes with the rights, health, and/or safety of others

– Complex or unstable medical condition that the home cannot properly address

– Unable to evacuate during an emergency

– Poses a danger to self or others

– Commits a crime

– Fails to pay

There is not a rule requiring that a person be diagnosed with dementia in order to move into memory care in Oregon. Many people with Alzheimer’s or a related disease are never officially diagnosed because symptoms can vary widely and the process involves expensive tests like PET brain scans.

Facility / Residence

Regulations in Oregon differentiate between assisted living and residential care facilities, both of which may have a separate wing for memory care. Assisted living facilities provide apartment-style living, with a kitchen and bathroom, and these units must be at least 160 square feet (220 square feet if newly constructed). Residential care facilities have bedrooms built around a centrally located bathroom, and the bedrooms must be at least 80 square feet excluding closets and bathrooms. No more than two people may live in one room.

The physical design of a building must be beneficial for people with dementia. This means clear sight lines and a layout that’s easy to navigate, soft paint colors, bright lighting, and secure outdoor spaces. Hallways that run circular to avoid dead ends have been shown to allow for wandering without a person becoming agitated. Special locks or security are also necessary to prevent a wandering resident from getting outside.

Staff & Training

There is no staff-to-resident ratio requirement in Oregon memory care. However, there must be adequate staff to meet the needs of every resident at all times. Every residence must establish a system (defined in writing) to decide how many caregivers and staff are working at a time.

An administrator must be on-site 40 hours per week, and is responsible for making sure staffing is adequate for the health needs of the residents. Administrators must be at least 21 years old and have relevant experience and education. Administrators must also attend a state-approved training program for at least 40 hours before beginning the job. All administrators must have 20 hours of additional training annually, and administrators in memory care must have 10 additional hours of dementia-specific training.

All regular staffers must complete orientation before they can start work, including education on residents’ rights, community-based care, abuse and reporting requirements, standard precautions for infection control, and fire safety and evacuation procedures.

Specific dementia-care training must include:

– Education in the dementia disease process, including behavioral symptoms in early, middle, and late stages
– Techniques for understanding and managing symptoms
– Strategies for encouraging socialization and providing meaningful activities
– Addressing pain
– Providing proper nutrition
– Preventing wandering

Evictions & Discharges

A resident must be given 30 days notice before getting evicted. That requirement can be waived if there is an urgent situation involving health and safety. Before an eviction, the memory care community must try to resolve the issue or otherwise demonstrate that the discharge is a last resort. A resident can be asked to leave if:

– Care needs can no longer be met at the memory care community, normally due to a change in medical condition
– There is dangerous behavior
– Unable to evacuate in an emergency
– There is drug use or other criminal activity
– Non-payment of bills occur

Memory care communities in Oregon may have their own guidelines on what can get a person evicted. It’s very important to ask exactly how and why a person can be evicted before agreeing to a move-in contract, because unfair evictions can be a major problem in assisted living. Get the answers in writing. If you’ve received an eviction notice in an Oregon assisted living home and need to know next steps, click here.

Financial Assistance for Residential Alzheimer’s Memory Care

K Plan / Community First Choice Program (CFC)

Also called the K Option, or the Community First Choice option, this program is meant to provide financial help to people who may need nursing home level care but wish to remain in their house or assisted living community (including in memory care). Benefits are in the form of home and community-based services that include benefits that cover medical devices and assistive technology, help with activities of daily living, and behavioral support. To be eligible, your loved one must qualify for Oregon’s Medicaid program. In 2024 that includes a monthly income less than $2,829, countable assets less than $2,000, and a documented medical need for a nursing home level of care. For more information, visit the state’s website. Apply through your local Area Agency on Aging.

Aged and Physically Disabled Medicaid Waiver

The Aged and Physically Disabled waiver provides financial help for people who live in a nursing home to move back into their community. This can include transitioning into an assisted living facility, memory care residence, or the home of a family member. The benefits are slightly different from the K Plan above, and recipients can be enrolled in both programs. Benefits include money to move out of a nursing home into assisted living, case management, housing services, and welfare assistance. Applicants must be eligible for Oregon Medicaid. In 2024 that includes income under $2,829 per month, countable assets less than $2,000, and a documented medical need for a nursing home level of care. Waitlists can occur because there is a limit as to how many participants the program can accept and APD currently has 39,360 enrollees. To apply, follow this link for an online application or contact your local Area Agency on Aging.

Independent Choices Program (ICP)

The Independent Choices Program promotes independent living by providing additional care benefits. Designed to prevent the need to move into an institutionalized nursing home setting, enrollees are given a monthly stipend to spend on care needs and services. Covered benefits include assistance with activities of daily living, home modifications, chore service, and laundry. The benefit of this program is that participants can self-direct their care and hire the caregiver of their choosing. Qualified caregivers can be hired including one’s spouse, friend, or relative. Enrollees must live in their own homes or that of a loved one. Benefits include assistance with activities of daily living, meal prep, grocery shopping, and laundry. To qualify, participants must meet the eligibility requirements in Oregon. In 2024 that includes a monthly income of less than $2,829 per month, countable assets of less than $2,000, and a medical need for a nursing home level of care. A waitlist can apply because there is an annual cap of about 2,600 enrollees. More information about ICP is available here. Call (800) 282-8096 to apply or visit your local Area Agency on Aging.

Consumer-Employed Provider Program (CEP)

A Medicaid program that aids those who need additional care benefits to not need to move into a nursing home. Those enrolled in the program can self-direct their care by hiring the caregiver of their choice. Benefits include assistance with activities of daily living, meal prep, chore service, and medication management. Depending upon an individual’s need, participants are given a maximum of 40 hours of care per week. To qualify, eligibility requirements in 2024 include a monthly income of less than $2,829, countable assets of less than $2,000, and a documented medical need for a nursing home level of care. Call (800) 282-8096 to apply or visit your local Area Agency on Aging.

Spousal Pay Program

The Spousal Pay Program promotes independent living by hiring an enrollee’s spouse as a caregiver. Caregiver benefits include assistance with activities of daily living, shopping, meal prep, laundry, and housework. Participants can self-direct their care and must reside in their own homes or that of a family member. To qualify, the Medicaid requirements in 2024 are a monthly income under $2,829, countable assets less than $2,000, and a medical need for a nursing home level of care. Call (800) 282-8096 to apply or visit your local Area Agency on Aging. Click here for more information about the Spousal Pay Program.

State Plan Personal Care (SPPC)

The State Plan Personal Care is part of the regular Medicaid program that helps facilitate independent living and prevent the need to move into a nursing home. Qualified participants receive benefits in the form of care hours that provide additional long-term care service. Depending on what an individual needs, a maximum of 270 care hours per year that range from assistance with activities of daily living to laundry, medication management, and meal prep. Enrollees must live in their own homes or that of a family member. Other eligibility requirements for Medicaid in 2024 include a monthly income of less than $943, countable assets of less than $2,000, and the medical need for assistance with activities of daily living. For information about SPPC can be found here. To apply, go to your closest Area Agency on Aging or call the Department of Human Services at (800) 282-8096. Click here to see if your loved one qualifies for Medicaid by taking a fast and non-binding 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 2023 to December 2024. 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 $16,551

– Veterans with dependent spouses or children up to $21,674

– Surviving spouses without dependent children up to $11,102

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 $27,609

– Veterans with dependent spouses or children a maximum of $32,729

– Surviving spouses without dependent children a maximum of $17,743

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 $20,226

– Veterans with dependent spouses or children a maximum of $25,348

– Surviving spouses without dependent children a maximum of $13,568

Veterans Homes

There are two veterans’ homes in Oregon. They are residential care facilities that provide long-term care for veterans. They are:

– The Oregon Veterans Home located in Dalles. It is along the Columbia River and the state’s northern border. They currently have a 25 bed Alzheimer’s Unit.

– The Edward C. Allworth Oregon Veterans’ Home located in Lebanon. It is less than an hour south of Salem.

In addition to nursing home care and assisted living, memory care is provided. 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, California has eight veterans’ homes statewide and one is located relatively close to their shared border. Additionally, Washington has four facilities statewide with one close to its border. 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.