In Rhode Island, assisted living residences provide care and support for people with Alzheimer’s disease or related dementia. These facilities are required to be certified by the state as having an Alzheimer’s Dementia Special Care Unit / Program. In addition, these residences, often called memory care, must meet other special requirements.
Assisted living homes offer room and board, meals, housekeeping, and help with activities of daily living like eating and bathing. A residence with an Alzheimer’s Dementia Special Care Unit has additional requirements including a physical layout that is dementia-friendly (like circular hallways and simple layouts), activities that are specifically good for people with dementia, and training for staff that covers how to communicate with and care for people with the distinct challenges posed by dementia. Memory care homes must also employ a full-time registered nurse.
Assisted living in Rhode Island is regulated by the state’s Department of Health, Center for Health Facility Regulation. There are approximately 38 memory care homes in Rhode Island. There are also board and care homes, which offer the same services as assisted living, in a smaller home-like setting, usually for fewer than 12 residents. For free help finding memory care of any size to meet your family’s budget and needs, click here.
The average cost of assisted living with memory care in Rhode Island is $8,245 per month. Rhode Island is one of the more expensive states for memory care; the national average is $5,448 per month. In Providence, the average cost of memory care per month is $7,325. Because the state is so small, there is not a lot of cost variance. Prices in Cranston, Warwick, and Pawtucket all match the state averages.
New England is unfortunately an expensive area for memory care. Rhode Islanders might be able to find more affordable options in the surrounding states. Connecticut costs $7,426 per month and Massachusetts is $7,174.
All new residents in Rhode Island assisted living homes must be evaluated using the state Department of Health’s Assisted Living Resident Assessment. This assesses health needs, eating ability, ability to communicate, mobility, and more. This is normally done by a registered nurse who works for the memory care community. The cost of the evaluation is included in a one-time community fee that covers move-in costs like the assessment and also deep cleaning and painting a new resident’s room. Any potential resident is entitled to the following information before moving into an assisted living home in Rhode Island:
– Residence’s owner and operator
– Level of licensure, with an explanation of what the levels mean
– Rules for admissions and evictions
– All services available
– Costs including all fees and deposits
– Details of residency agreements, including residents’ rights and admissions standards
– Contact information for the state’s Department of Health (which regulates assisted living), the Medicaid Fraud and Patient Abuse Unit, the state ombudsperson, and local police
Importantly for people in memory care, the residence must also disclose the following to people moving into Alzheimer’s Dementia Special Care Units:
– Staffing patterns
– Ratio of staff to residents
– Training for staff
– Description of the physical layout
– Dementia-friendly activities
Unlike many other states, regulations in Rhode Island say a person needs to have been diagnosed with dementia to move into memory care. Unfortunately, Alzheimer’s and related diseases are difficult to diagnose; the process usually requires expensive tests including PET brain scans. For this reason, it is possible to move in without a literal diagnosis if a person exhibits all the signs of dementia. The residence may be able to help with diagnosing, as well, during the assessment process without those additional costs that would come with the tests.
While it might be possible for someone to move into memory care in Rhode Island on short notice, this is not a good idea. Finding the right home takes months of investigating residences and asking questions of staff and others who live there. Ideally, you would begin searching for memory care before a move becomes necessary. The sooner you begin investigating options, the more input the person with dementia can have on the decision.
In Rhode Island, a room for one person must be at least 100 square feet and eight feet wide, and for two people the spaces must be at least 160 square feet and 10 feet wide. That does not include the bathrooms and closets. The maximum number of people allowed in one room is two. Residences need one tub or shower for every 10 people and one toilet for every eight.
Regulations require memory care communities to be “physically adapted to accommodate the particular needs and behaviors of those with dementia.” This means using design elements that are dementia friendly and have been shown to benefit people with memory loss. This usually means a simple layout with clear sight lines and landmarks that make it easy to navigate, quiet rooms with minimal distractions, special locks to prevent wandering, secure outdoor areas for time outside, bright lighting, and soft paint colors.
A Department of Health-certified administrator must be hired to be responsible for operations and safety at all times. There are no staff-to-resident ratios, there must always be enough employees to meet the needs of every resident, and an employee with CPR training must be on-site at all times. All staff who have contact with residents must have a background check, and a registered nurse must visit the assisted living home at least once every 30 days, to make a review of the residence. Staff working with residents with dementia must have at least 12 hours of dementia-specific training annually.
Ten hours of training on topics including age-related behaviors, helping with activities of daily living, and transferring (such as from a bed to a chair) are required when hired and then done again annually. Also upon hiring, all assisted-living staff in Rhode Island must have an orientation that includes these topics:
– Fire prevention
– Recognizing and reporting abuse and neglect
– Assisted living philosophy (goals or values like dignity, choice, etc.)
– Residents’ rights
– Emergency procedures
– Infection control
Thirty days’ notice is required before a person can be evicted from assisted living. The only exception is if there is a life-threatening emergency. The reasons a patient could be evicted are:
– The residents’ personal or healthcare needs cannot be met there.
– Resident is dangerous to themselves or others
– Failure to pay bills 30 days after they are dues
A person being evicted from assisted living in Rhode Island must receive written notice containing the following information from the evicting residence:
– Date of termination
– Reason for eviction
– How to appeal
– State ombudsperson’s contact information
The ombudsman advocates for residents in long-term care and can assist with appeals or investigations regarding an eviction.
If the resident is being asked to leave because of nonpayment, Rhode Island regulations require that a good-faith effort be made to work out the finances.
Residences may have other, more specific criteria for how they decide whether a person can be asked to leave after moving in. Before signing the contract, ask for a written eviction policy and save that document. 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.
Unlike Medicaid programs, money from Rhode Island’s Supplemental Security Income Assisted Living Program can go directly toward the costs of room and board in an assisted living home, including one with memory care. Applicants must meet requirements including monthly income less than approximately $1,300 for a single person. Patients with needs that require nursing-home-level care are not eligible. The amount of money provided by the program depends on the level of care needed, but the current maximum amount is more than $1,000 per month. To apply, contact Rhode Island’s Aging and Disabilities Resource Center, “The Point,” at 401-462-4444.
The Rhode Island Global Consumer Choice Compact Medicaid Waiver is for people who need health or personal care services, including residents in assisted living and memory care. Benefits include personal care and housekeeping in assisted living, as well as case management and physical therapy. Room and board in assisted living, are not paid for by funds from this program. Financial requirements include a monthly income of less than $2,742 per month in 2023. More information is available from the state’s Office of Health and Human Services. To apply, contact the Rhode Island Division of Elderly Affairs at 401-462-3000. There may be a waiting list, and people who need a higher level of care are prioritized. Full RI Medicaid eligibility criteria are available, and candidates can take a quick, online Medicaid eligibility test.
Assisted living is among the benefits covered in the Rhode Island Home and Community Care Co-Pay Program. This program is designed for those who do not qualify for Medicaid, supporting patients who cannot leave their houses or assisted living communities without significant help or need assistance with activities of daily living like dressing and bathing. There are more covered benefits under the Co-Pay Program than standard Medicaid and fewer financial restrictions. There is an income limit of about $21,600 for an individual and no asset limit. For more information, click here. You can apply through the Health Source Rhode Island website.
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 and different pension types.
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
There is one veterans’ home in Rhode Island. It is a residential care home that provides long-term care for veterans. The Rhode Island Veterans’ Home in Bristol is located about thirty minutes southeast of Providence. They have a special care unit that has 36 beds. In addition to nursing home care and assisted living, memory care is provided. This is a facility that provides 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, Massachusetts has two veterans’ homes statewide. Additionally, Connecticut has one facility. More info.
1) Eldercare 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.