According to Rhode Island regulations, assisted living residences for people with Alzheimer’s disease, or related dementia, are required to be certified with the state as having an “Alzheimer Dementia Special Care Unit / Program.” These residences, often called “memory care,” must meet the special requirements described on this page.
The services generally offered in any assisted living home include room and board, meals, housekeeping, and help with activities of daily living (ADLs) like eating and bathing. A residence with an Alzheimer Dementia Special Care Unit / Program must go further, meeting 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 38 memory care homes in Rhode Island. There are also board and care homes, which offer the same services as assisted living, sometimes including memory care, in a smaller house-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 $5,847 per month, which is about $70,164 annually. Rhode Island is one of the more expensive states for memory care; the national average is about $5,000 per month, or about $1,000 more than regular assisted living. In Providence, the average cost of memory care per year exactly matches the state-wide figure of about $70,164. 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, but Connecticut ($7,426 per month) and Massachusetts ($7,174) actually average higher costs than Rhode Island.
All new residents in Rhode Island assisted living homes must be evaluated using the state Department of Health’s Assisted Living Resident Assessment, which assesses health needs, eating ability, how well a person communicates, mobility, and much more. This form must be signed by a registered nurse. Often the RN who assesses new residents works for the memory care community, and the cost of assessing is included in a one-time “community fee” that covers move-in costs including assessing and also deep cleaning and painting a new resident’s room. It may be possible to have someone from your preferred doctor’s office conduct the assessment, at personal expense, but admissions policy is up to the residence itself.
Any potential resident is entitled to a document with 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 Dementia Special Care Units:
– Staffing patterns
– Ratio of staff to residents
– Training for staff
– Description of 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.
And 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.
A room for one person must be at least 100 square feet, and eight feet wide; for two people the rooms must be at least 160 square feet and 10 feet wide. (Those numbers exclude 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 per every eight.
Regulations require memory care communities to be “physically adapted to accommodate the particular needs and behaviors of those with dementia.” This means design elements that have been shown to benefit people with memory loss, including easy-to-navigate layouts, secure outdoor areas for time in the open air, bright lighting and paint colors, and more.
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 except to say that 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) is required around the time of hiring, and then annually. Also upon hiring, all assisted-living staff in Rhode Island must have 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 (unless there’s a life-threatening emergency). The reasons a person can be evicted are:
– The residents’ personal or healthcare needs cannot be met there.
– Resident is dangerous to self or others
– Failure to pay bills after more than 30 days outstanding
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. It’s very important to be clear on their policy before agreeing to a move-in contract, because unfair evictions are a major problem in assisted living around the country. Before signing the contract, ask for a written eviction policy and save that document.
Unlike with 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 $1,212 for a single person. People 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 maximum amount is more than $1,000 per month. Click here for more information, including the required forms. 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, however, cannot be covered by funds from this program. Financial requirements include monthly income less than $2,382 per month in 2021. 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.
Assisted living is among the benefits covered in the Rhode Island Home and Community Care Co-Pay Program, for those who do not qualify for Medicaid, that helps people 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 normal Medicaid, and fewer financial restrictions, though there is an income limit of about $21,600 for an individual. There is no asset limit. For more information, click here. You can apply through the Health Source RI website.
Due to higher rates of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) in those who have seen combat, veterans are statistically more likely to develop dementia. Relevant in all states including Rhode Island is the VA’s Aid & Attendance pension program for veterans and surviving spouses, which is an enhanced monthly benefit added to veterans’ and survivors’ basic pensions. 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, including going toward the cost of memory care. Also, 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 $14,928. Learn more here.
There is also one veterans’ home in Rhode Island, which is a residential care home that provides long-term care for veterans. It is located in Bristol. In addition to nursing home care and assisted living, memory care is 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 are a limited number of beds, contact a home before visiting to see if your loved one is eligible to live there. For more information and contacts, click here.
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 claim your elderly loved one as a dependent). Remember also that medical and dental expenses are deductable, 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.