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

Last Updated: November 13, 2022

 

In Tennessee, there are two kinds of memory care homes for people with Alzheimer’s disease or other dementias. There are “assisted care living facilities” and “residential homes for the aged”. Both types of residences provide room and board for people who need help with activities of daily living like bathing or eating. Assisted care living facilities are allowed to provide medical care for residents and part-time nursing care as well as various therapies. Residential homes for the aged cannot provide nursing or medical care.

Both types of residents can house people with dementia in secured wings. A difference is that someone in the late stages of dementia may live in assisted care living facilities, while regulations say that residential homes for the aged may only house someone with dementia during the early stages of the disease. A person with Alzheimer’s or dementia who lives in a residential home for the aged must be assessed quarterly to be sure individual needs can continue to be met by the facility.

Assisted living in Tennessee is overseen by the Department of Health’s Division of Health Care Facilities. There are approximately 160 memory care residences in Tennessee, ranging in size from large apartment-complex style communities to smaller more home-like settings caring for 12 or fewer people. For free help finding memory care of any size to meet your family’s needs and budget, click here.

 Did You Know? In Tennessee about 12% of people over 65 have Alzheimer’s. The number of people with the disease is expected to increase from 120,000 in 2020 to 140,000 in 2025.

 

How Much Does Memory Care Cost in Tennessee?

The average cost of memory care per month in Tennessee is $4,969. Tennessee is one of the less expensive states for memory care, with costs below the national average of $5,448 monthly.

The state’s most expensive place for memory care is Chattanooga, where memory care costs $5,116 monthly. The least expensive city for memory care is in Clarksville $3,902 per month. In Nashville, memory care costs $4,969 monthly. The cost in Memphis is $5,080 monthly.

 Did You Know? In Tennessee, free assistance is available to help families locate a memory care home to meet their needs and budgets. Get help here.

People who live near a bordering state may be able to find more affordable memory care outside Tennessee. To the east, North Carolina has a lower average monthly cost for memory care $4,859. Additionally, bordering states average less for memory care than Tennessee, so Tennesseans looking for affordable memory care can look outside the state for more options. Kentucky costs $4,159 monthly, Arkansas runs $4,564, Mississippi is $4,233, Alabama is at $4,233, and Georgia averages $4,270 monthly.

Other cities and costs:

Tennessee Memory Care / Assisted Living Costs (updated July 2022)
Region / City Daily Cost Monthly Cost
Statewide $163 $4,969
Nashville $163 $4,969
Memphis $167 $5,080
Chattanooga $168 $5,116
Clarksville $128 $3,902
Jackson $168 $5,116

 

Tennessee Assisted Living Laws & Regulations

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

Assisted care living facilities must complete an assessment of every resident before they enter, and no later than 72 hours prior to admission, making sure the fit is appropriate and care needs can be fulfilled there. For memory care in residential homes for the aged (which may only admit someone in the early stages of dementia) a medical team must determine that the home can adequately manage the disease, and the person must be reassessed quarterly. Assessments are also a way for these communities to record specific details about your loved one’s abilities, needs, personalities, and much more. These details are used to create an individualized care plan that helps staff manage a person’s daily needs. For example, an assessment would help determine the best way to engage with your loved one for more open communication, and would list exactly which activities of daily living they cannot do themselves.

Assessments are conducted by medical professionals who work for these residences. The cost of assessing may be included in the base rate, or residences sometimes charge a one-time community fee. This is meant to cover move-in costs like the assessment, deep cleaning and painting a new resident’s room. Community fees usually run between $1,500 and $2,500.

Assisted care living facilities may not admit a patient with:

– Stage III or IV decubitus ulcer or exfoliative dermatitis
– Requires continuous nursing care
– Has an active sickness that requires isolation
– Poses a behavioral threat to self or others
– Requires physical or chemical restraints
– Has needs that cannot be safely met by the assisted care living facility

Residential homes for the aged may not admit a person with the following medical issues:

– Cannot self-administer medications
– Requires full-time nursing care
– Poses a danger to self or others
– Cannot safely evacuate within 13 minutes
– Requires physical or chemical restraints

In Tennessee, it is not required that a person be diagnosed with dementia before moving into memory care. Alzheimer’s and related dementias require expensive tests like PET scans for a doctor’s diagnosis, as symptoms can change and vary over time. The important factor in finding the right home is that staff there can support your loved one’s unique needs and provide a safe and comfortable environment.

While it is possible to find memory care on short notice in Tennessee, it’s not a good idea. The process of finding the right home includes inspecting multiple residences and asking questions of staff and people who live there. Once you’ve narrowed your choices, make repeated visits to participate in meals and activities before signing a contract. Ideally, you should begin looking for memory care before the move is necessary. Your loved one will be able to provide more input the sooner you begin looking.

 

Residence / Facility

Living units must provide at least 80 square feet per resident, and there must be at least 15 square feet per resident in the dining area. No bedroom may have more than two beds. There must be one toilet, sink, and bath or shower for every six residents. Sprinkler systems and smoke alarms must be state-approved, and fire drills are conducted at least four times per year.

One important consideration for memory care homes is that the buildings are designed with dementia-friendly features. Tennessee does not require easily navigated layouts, circular hallways (so wandering residents don’t encounter dead ends), bright lighting and paint colors, and secured outdoor areas to give residents a safe space for spending time outdoors. These are the types of physical details you should look for when investigating options for your loved one; keep an eye on whether a person with dementia will feel comfortable within the spaces.

 

Staff & Training

There is no staff-to-patient ratio in Tennessee memory care; regulations say staffing must be adequate to serve the needs of every resident. In either type of memory care home, an attendant who is at least 18 years old must be on-duty (and awake) at all times. Administrators must complete 24 hours of continuing education every two years, covering healthcare, nutrition, and financial management. Assisted care living facilities must have a qualified dietician on staff.

 

Evictions & Discharges

Residential homes for the aged may only admit someone with dementia in the early stages, and a new assessment must be made by medical staff about every three months to make sure their needs can be met there. This is important to consider when looking for memory care because dementias are progressive, meaning they get worse over time, and that means transfer to an assisted care living facility with memory care for middle and later stages will eventually be necessary. Regulations say that someone being discharged because their needs cannot be met should be transferred to a more appropriate community.

In Tennessee, if you are signing a contract for your loved one to receive memory care in a residential home for the aged, make sure to get the details (in writing) about how transfers work when their dementia advances into later stages. A good memory care home will have steps in place.

A resident in an assisted care living facility can be evicted for the following reasons:

– Stage III or IV decubitus ulcers

– Continuous nursing care becomes necessary (though exceptions are possible if arrangements are made between the residence, resident, and outside healthcare professionals)

– Verbal or physical aggression becomes dangerous

– Physical or chemical restraints are required

– Resident cannot evacuate within 13 minutes

Generally, someone in assisted living cannot remain in the community if their needs cannot be met there. Residences may also have their own rules about evictions and discharges. It’s important to have those rules in writing before agreeing to a move-in contract, because unfair evictions are a nation-wide problem. If you have received an eviction notice in assisted living and need to know next steps, click here.

 

Financial Assistance for Residential Alzheimer’s Memory Care

TennCare CHOICES (Medicaid)

Medicaid is a jointly funded federal and state program, and in Tennessee the program that provides long-term care and support is called TennCare. Medicaid generally never pays for room and board in assisted living homes, but under the CHOICES program a person can get financial help for services intended to keep someone out of a nursing home. CHOICES is meant to help someone stay in their house or assisted living community by paying for personal care services that assist with activities of daily living and instrumental activities of daily living like bathing, dressing, and grocery shopping. Assistive technologies, like grabbers and devices that help stimulate memory, may also be covered.

To enroll in TennCare CHOICES, a person must be Medicaid-eligible, including monthly income under $2,742 in 2023. For more information on CHOICES, visit the TennCare website here.

 Not sure if your loved one qualifies for TennCare (Medicaid)? See TennCare eligibility requirements or take a Medicaid Eligibility Test

 

OPTIONS for Community Living

OPTIONS is a non-Medicaid program for Tennesseans older than 18 who need help with activities of daily living and instrumental activities of daily living. Anyone with cognitive disabilities, including Alzheimer’s disease and related dementias, can apply through their local Area Agency on Aging. Benefits include case management, homemaker services, personal care assistance, and meal delivery. There are no income requirements, but there may be a cost depending on someone’s monthly income. Click here for more information.

 

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 also four veterans’ homes in Tennessee, which are residential care facilities that provide long-term care for veterans. They are located in Humboldt (northwest Tennessee), Murfreesboro (Upper Cumberland), Knoxville (eastern), and Clarksville (Mid Cumberland). In addition to nursing home care and assisted living, memory care is provided in all four residences. Neighboring states have more 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, Missouri has seven homes and both Alabama and Kentucky have four homes statewide.  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.