An “assisted living residence” in Vermont must provide housing, healthcare, and personal care services for older adults. Assisted living is meant to be home-like, with state requirements including a private bedroom and private bath for every resident, as well as a living space and kitchen. Vermont regulations also state that an assisted living residence must promote self-direction and active participation in decision making. Health monitoring and medication management assistance are also required.
Special approval from the state’s Department of Disabilities, Aging, and Independent Living is required for a residence to admit people with Alzheimer’s disease or similar dementia, in what’s often called “memory care” (or “Alzheimer’s special care units”). The residence needs to show that it can handle the specialized needs of people with dementia, which include a dementia-friendly physical layout, activities, and special training for staff on communicating with people who have Alzheimer’s or a similar disease.
The average cost of assisted living with memory care per month in Vermont is $6,980, which breaks down to about $229 per day and $83,760 annually. Vermont assisted living homes are required to provide a written description of all rates and fees, including for optional services, to anyone considering moving in. Assisted living, without the additional services required for memory care, costs Vermont residents about $5,334 per month and $64,008 annually.
Vermont’s largest city is Burlington, where memory care costs about $6,701 per month and $80,412 per year. In other Vermont areas, memory-care costs average about $7,179 per month and $86,148 annually.
Within 14 days of moving into a Vermont assisted living community, every new resident must be evaluated using the Vermont Resident Assessment Form, which you can see here. This evaluation must be done by a registered nurse.
Prior to moving in, any potential resident in Vermont assisted living must be provided a description of all rates and charges, and an explanation for how those costs might change. There is also a disclosure form that is available from any of these residences if asked for, which must include the following information:
– Services the residence can provide
– Public programs or benefits (see below) that the residence accepts or delivers
– All policies related to eviction
For memory care, the residence must provide a written statement of philosophy and mission, as well as details on how the special needs of people with Alzheimer’s or other dementia are met there.
An assisted living residence cannot admit someone who needs full-time nursing care, or who otherwise requires a level of care that the residence can’t provide. Residents who pose a threat to themselves or others may not be admitted, or may be evicted if they already moved in.
Vermont assisted living homes have size requirements for bedrooms and living units that are larger than most other states. Units must be at least 225 square feet, with a bed, bathroom, living space, kitchen, storage, and lockable door. All units in Vermont are for a single person, unless occupants voluntarily choose to have a roommate.
There are no staff-to-resident ratios in Vermont assisted living, except to say staffing must always be adequate to meet the needs of every resident. All assisted living homes must have a state-certified director who is responsible for the day-to-day management of the residence. Directors must receive 20 hours of continuing education annually, in courses related to the care of residents. Anyone working directly with residents must receive at least 12 hours of training annually, including:
– Residents’ rights
– Fire safety and emergency evacuation
– Emergency response
– Reporting abuse, neglect, or exploitation
– Communicating with residents
– Infection control
– General supervision and care guidelines
Additionally, 24 hours of continuing education is required in courses related to:
– Alzheimer’s disease
– Medication management
– Behavioral management
– Transfers (getting in and out of bed)
– Infection control
Vermont Medicaid’s Global Commitment to Health Waiver provides financial help for costs including assisted living. The goal of the waiver is to keep people who need nursing-home-level care from actually moving into a more expensive nursing home. To receive Global Commitment funds, a person must be Medicaid-eligible—including monthly income under $1,041 if you live outside Chittenden County, and under $1,125 if you live inside Chittenden County. Other programs in Vermont have been wrapped into the Global Commitment to Health program in recent years, including the Choices for Care Waiver and the state’s PACE program. Benefits available to people in memory care include funds to cover the costs of help with activities of daily living, transportation, medical assistance devices, and more. Further information is available here, and you can apply elsewhere on the state’s website. (Vermont Medicaid is also known as “Green Mountain Care.”)
Vermont’s Medicaid recipients who need extra supervision but don’t require full-time nursing care (or can avoid moving into a nursing home with a little extra help) may be eligible for the Assistive Community Care Service program, which provides funds to cover expenses including in assisted living. The benefits include health monitoring, case management, and help with activities of daily living. Consumer direction of services is not available under this program, meaning the state provides guidance on care providers. A person must already be enrolled in Medicaid to receive help under this program. (Enroll here.) Contact your nearest Vermont Agency of Human Services office to apply for ACCS.
This program under Vermont Medicaid (or “Green Mountain Care”) is for people who cannot live alone and need a little extra help staying out of more expensive nursing homes. The Attendant Services Program is meant to keep people in their homes, but the state will consider applicants who live in assisted living communities. Eligibility requirements are considered more lenient for this program than the Medicaid programs above, so someone who makes more than the income limit may still be eligible for benefits, for example. This is a self-directed benefit, so recipients have a say in how they use the funds to cover care. Help with activities of daily living is among the benefits. For more information, click here. To apply, contact the Vermont Department of Disabilities, Aging, and Independent Living.
Veterans are statistically more likely to develop dementia. Relevant in all states including Vermont is the VA’s Aid & Attendance pension program for veterans and surviving spouses, which is money 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 pensions can be used as the recipient wishes, meaning it can go toward the cost of memory care. In addition, the cost of residential care can be deducted from income, effectively reducing the amount of calculable income used to determine the benefit amount. The latest (2020) maximum amount a veteran can receive through A&A is $27,194 per year, and surviving spouses can receive $14,761. Learn more here.
There are also veterans homes in Vermont, which are facilities providing long-term residential care for veterans. In addition to nursing home care, assisted living and memory care may be 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 service. Because there is often a waiting list, contact a home before visiting to see if your loved one is eligible to live there.
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, the reverse mortgage would become due.
Elder care loans are for families to cover 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.