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

Last Updated: November 13, 2022

 

Pennsylvania’s regulations say that facilities that provide care for dementia patients fall under two categories: personal care homes and assisted living residences. There are about 1,200 personal care homes in Pennsylvania and fewer than 50 assisted living residences.

The difference between the two types of facilities is in the amount of care provided. Assisted living residences provide full-time nursing-home care and personal care homes are for people who do not require 24-hour nursing care. Someone with dementia, particularly in later stages, requires care and round-the-clock supervision from trained staff, but not necessarily full-time nursing. Homes that cater to people with Alzheimer’s are often called memory care.

Personal Care Homes may assist with activities of daily living like eating and bathing, and administering medications, but their regulations aren’t as strict as assisted living. Assisted living must provide the following:

– 24-hour supervision, monitoring and emergency response
– Nutritious meals
– Laundry
– Housekeeping
– Activities encouraging socialization
– Basic cognitive support services
– Transportation and medication assistance

An assisted living residence is also required to enable supplemental care, so employees there will connect residents to outside medical help including physical therapy, hospice, and more general needs like dental and vision appointments. Personal care homes, on the other hand, do not need to coordinate with outside healthcare.

Personal care homes and assisted living residences are regulated by the Pennsylvania Department of Human Services. There are 390 memory care homes in Pennsylvania and 275 board and care homes, which offer the same services as assisted living and personal care homes, sometimes including memory care, in a smaller house-like environment for 12 or fewer residents. For free help finding memory care of any size to meet your family’s budget and needs,  click here.

 Did You Know? The number of people over 65 with Alzheimer’s disease in Pennsylvania is increasing by 14.3%. It is expected by 2025, 320,000 Pennsylvanians will have the disease.

 

How Much Does Memory Care Cost in Pennsylvania?

The average cost of memory care per month in Pennsylvania is $4,969. Pennsylvania is one of the country’s most populated states and pricing varies widely depending where you live. The most expensive place for memory care is in the southeast part of the state in Reading at $6,920 per month. The least expensive cities are Scranton at $3,497 monthly and Pittsburgh costing $3,938 per month.

 In Pennsylvania, free assistance is available to help families locate memory care homes that meet their needs and budgets. Get help here.

Pennsylvania is in the lower half of states’ average memory care costs; the national average is about $5,000. If you live in western Pennsylvania, it might be possible to find more affordable memory care in Ohio, but the prices there are generally higher at about $5,595 per month. Northern Pennsylvanians could look in New York, where costs average $5,558 monthly. Prices vary widely, so it still may be possible to find savings in neighboring states.

Other Pennsylvania cities with memory care costs:

Pennsylvania Memory Care / Assisted Living Costs (updated June 2022)
Region / City  Daily Cost Monthly Cost
Statewide $163 $4,969
Philadelphia $226 $6,883
Pittsburgh $129 $3,938
Erie $183 $5,558
Reading $227 $6,920
Scranton $115 $3,497
Lancaster $220 $6,699
Harrisburg $192 $5,853

 

Pennsylvania Assisted Living Laws & Regulations

 COVID-19 Related Measures (updated June 2022)
Residents – Their temperatures are checked and patients are 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

In Pennsylvania, there are a number of conditions a person must meet in order to be admitted to a personal care home or assisted living residence. A person with special needs may live in a personal care home so long as the home demonstrates it can adequately address those needs. Personal care homes are not allowed, for instance, to admit someone who needs full-time nursing-home care.

Assisted living may not admit anyone with the following medical needs without approval from the Department of Human Services:

– Ventilator dependency
– Vascular ulcers that are not healing
– Continuous intravenous fluids
– Infectious diseases requiring isolation
– Physical restraints

Both types of residences require every resident to have a written program describing the specific needs of the person and the services the residence intends to provide. Among the issues assessed are:

– Mobility
– Medications
– Thinking ability
– Physical limitations
– Personal interests

An assessment must be completed within 15 days of admission for personal care homes, and implemented within 30 days of moving in. In assisted living, the assessment must be made within 30 days of moving in.

For people with dementia, personal care homes are required to have an additional cognitive assessment by a doctor or geriatric assessment team within 72 hours of admission to a dementia care unit. Memory care residents must be reassessed annually. Assisted living residences must follow those same guidelines for memory care residents. In assisted living, a support plan must be developed within 72 hours of preadmission, and this plan must be revised quarterly.

Assessments are made by medical professionals who work for the memory care communities, not your personal doctor. The cost of assessing is often included at no additional cost when a new resident signs a contract, but this is not always the case; some residences charge a “community fee” that covers move-in costs including the assessments. Community fees are usually between $1,500 and $2,500.

An official diagnosis of dementia is not required to move into memory care in Pennsylvania. Diagnosing dementia is difficult and involves expensive tests like PET brain scans. If your loved one has dementia symptoms, the screening and assessments will be able to determine whether a home is appropriate for their stage of dementia.

 

Facility / Residence

Room size regulations are different for personal care homes and assisted living residences. Personal care home living units must be at least 80 square feet. If there are multiple occupants, there must be 60 square feet per resident. A bedroom for people with mobility needs (who can’t move around without assistance) must be at least 100 square feet per resident, and allow total access. In assisted living, on the other hand, a room must be at least 225 square feet, or 300 square feet for two occupants. Two occupants is the maximum allowed in one room in an assisted living residence, whereas in personal care homes up to four people can be roommates. Personal care homes require one toilet and sink for every six residents, and one tub or shower for every 10. Assisted living regulations say there must be a toilet, sink, and tub or shower in every living unit.

Safety regulations are similar in both personal care homes and assisted living. There must be two exits on every floor, smoke detectors within 15 feet of every room, and monthly fire drills, with a nighttime fire drill required every six months. Personal care homes are not allowed to have key-operated locks; all locks must be magnetic and able to automatically open if the fire alarm sounds. In assisted living, standard key locks are allowed with permission from the Department of Labor and Industry.

Pennsylvania does not have a requirement that memory care homes be designed with dementia-friendly features. For this reason, keep a close eye on the physical spaces when investigating options for your loved one. People with dementia have been shown to benefit from time spent in open air, so look for a secure outdoor area. Clear sight lines, a simple layout, circular hallways that don’t run to dead ends, bright lighting, and soft paint colors have all been demonstrated by studies to help people with Alzheimer’s disease or dementia. Additionally, people with dementia will eat more when the dining area has bright lighting.

 

Staff & Training

Personal care homes and assisted living residences are not required to maintain a specific staff-to-patient ratio. Rather, the rules state there must be enough staff to adequately meet the needs in every resident’s support plan (see Admission Requirements above). Regulations do say that for every 50 residents there must be one staffer at all times trained in CPR and first aid. In assisted living, there must be one CPR and first-aid-trained person, present at all times, for every 35 residents.

Direct-care staff in personal care homes must be at least 18 years old, with a high school diploma or GED. In assisted living, an administrator must be on-hand for 36 hours or more per week. A licensed nurse must be available at all times. In personal care homes, an administrator must be on-hand at least 20 hours per week. Assisted living residences must also have a dietician on staff.

In both personal care homes and assisted living residences, direct-care staffers must be at least 18 years old with a high school diploma or GED. Their training must include:

– Orientation on topics including fire safety, emergency preparedness, residents’ rights, and reporting abuse.
– Training and competency programs for assistance with activities of daily living.

Personal care homes require 12 hours of training annually for staffers. In assisted living residences, 16 hours of training are required annually and a minimum of two hours of dementia-specific training.

 

Evictions & Discharges

A residence in Pennsylvania has to give someone 30 days notice before evicting them. If an eviction becomes necessary, there are other requirements as well: The home must provide a reason for the eviction, the name of a new residence or location the evicted resident can relocate to, and the method for appealing the decision to evict.

A home cannot allow someone to live there if staff cannot meet their needs. The screening process should determine appropriateness before a move-in, but if a resident’s health were to suddenly change an eviction might become necessary. If a home cannot accommodate residents who are non-ambulatory, for instance, then a person who loses the ability to walk would not be able to keep living there. If full-time nursing care becomes necessary, then your loved one may need to transfer into a nursing home. Keep in mind, however, that special accommodations are allowed by the state if the home contracts with outside medical professionals to help keep a person in their memory care community.

It’s very important to be clear on eviction policy before moving your loved one into a memory care community. This is because unfair evictions can be a problem in assisted living communities nationally. Ask what can get someone evicted (Aggressive behavior? Non-payment of bills?) and what the next steps are. Get answers that are as specific as possible in writing. If you received an eviction notice and need to know next steps, click here.

 

Financial Assistance for Residential Alzheimer’s Memory Care

Department of Aging Waiver (Medicaid)

Medicaid is a jointly funded state and federal program that helps cover healthcare costs. In Pennsylvania, Medicaid generally will not cover room and board costs in assisted living or personal care homes. People who are at least 60 years old, and have been evaluated as needing some nursing-home level care but reside in assisted living or at home, may be eligible for the Department of Aging Waiver in Pennsylvania. The waiver is a Home and Community Based Services that offers financial assistance for transportation, meals, personal care, case management and more. Determine eligibility or get more information here.

 

Pennsylvania’s Domiciliary Care

Pennsylvania’s Domiciliary Care services, called PA Dom Care, is an alternative to assisted living and personal care homes. Someone who lives in the home of a caregiver is eligible, and the program is meant to incentivize staying in a household-style environment for longer periods of time. The caregiver being paid through the program cannot be a relative. The home is certified by Area Agencies on Aging, and payments are paid through Social Security. A single person receives $1,275.30 per month in 2022, and $1,047.10 goes to the caregiver, with the rest ($228.20) kept as a needs allowance. Couples receive a little less than twice as much. Apply through your local Area Agency on Aging (click here). For a list of Dom Care guidelines, click here.

 

Supplemental Security Income Program

Pennsylvania has a Social Security supplement that pays a maximum of $1,261 per month to qualified individuals living in personal care homes or in Domiciliary Care. To qualify, a person must have very little income and resources. For more information, including how to contact the Social Security Administration, 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 six veterans’ homes in Pennsylvania, which provide long-term care for veterans. They’re located in Hollidaysburg, Erie, Spring City, Scranton, Pittsburgh, and Philadelphia. In addition to nursing home care and assisted living, memory care is provided in all six homes. Neighboring states also 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 instance, New York has 5 homes, Ohio has 3, West Virginia has 2 and New Jersey has 3 facilities. 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.

 

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.