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

Legal Definition of Assisted Living / Memory Care in Washington

In Washington, residences that provide room, board and healthcare services to people with Alzheimer’s disease or dementia are called assisted living facilities with special care units. These facilities offer:

– Housing
– Activities
– Housekeeping
– Meals, including nutritious snacks
– Medication assistance
– Arranging for doctor appointments
– Monitoring
– Emergency response

Special care units for people with dementia, often referred to as memory care, can be a wing of an existing assisted living residence or the entire residence itself. A secure outdoor area must be provided in Washington memory care, because time outside has been shown to benefit people with dementia. There are more assessments required for patients in memory care than in regular assisted living, and staff needs additional training to help people in various stages of dementia.

Assisted living facilities in Washington are regulated by the Washington State Department of Social and Health Services, Aging and Long-Term Support Administration. There are over 500 memory care homes in Washington. There are also over 100 board and care homes, which offer the same services as assisted living for 12 or fewer residents in a smaller, in a house-like residence. For free help finding memory care of any size to meet your family’s needs and budget, click here.

How Much Does Memory Care Cost in Washington?

The average cost of memory care per month in Washington is $7,251. This makes Washington relatively expensive compared to other states, as the national average for memory care is $5,448 per month.

The most expensive place for memory care in Washington is its most populated city, Seattle, where memory care costs $8,171 per month. Spokane’s average memory care costs is $5,926 monthly. The least expensive city for memory care is Walla Walla, costing $3,902 per month.

Residents of western and southern Washington, including the coastal and south Puget Sound regions of the state, might consider Oregon for memory care if cost is their biggest factor. Oregon’s memory care averages monthly $6,110 statewide and $6,037 in Portland. Eastern Washingtonians could consider memory care options in Idaho, where it is also much less expensive averaging $4,638 per month statewide.

Washington Assisted Living Laws & Regulations

Admissions Process & Requirements

An assisted living facility in Washington can only admit a patient if its services will meet that person’s needs. Every memory care community is different, but they all must produce in writing what care and services are provided. This is given on a standardized form. You’ll want to scrutinize it to make sure your loved one is a good fit. For example, policies on Medicaid assistance may differ, and some homes offer intermittent nursing services and medication administration while others do not. It’s a good idea to get these forms from homes you’re considering, and then compare them. The disclosure must include:

– Activities
– Food and diets
– Services related to arranging and coordinating healthcare needs
– Laundry
– Housekeeping
– Level of assistance with activities of daily living
– Intermittent nursing services
– Help with medications
– Transportation services
– Rules related to smoking and pets
– Limitations on end-of-life care
– All charges and costs
– Bed hold policy (whether your spot will be held if an extended hospital stay is required)
– Policy on accepting Medicaid
– Buildings’ fire prevention features
– Security services

Someone who cannot walk without assistance may not be admitted without special permission from the state, along with patients who require full-time nursing care.

A preadmission assessment is required before moving into memory care. Then, a more detailed assessment must be done within 14 days of beginning residence there. These assessments are usually performed by medical professionals who work for the residence. They determine unique needs, including exactly which activities of daily living a new resident needs help with, to make sure the home is a good fit and also prepare a personalized service plan. The plan works like a blueprint that tells staff the best way to help your loved one. The cost of assessment might be included in the base rate, or there may be a community fee, which is a one-time payment at the time of move-in that covers costs like the assessment and also preparing a new resident’s room. Community fees are usually between $2,000 and $4,000.

A person does not need to be diagnosed with dementia to move into memory care in Washington state. Alzheimer’s and dementia are difficult to diagnose without expensive tests like PET brain scans. The assessments will give the residence a good idea of whether your loved one needs memory-care services.

While it might be possible to move into memory care on short notice in Washington, this is not a good idea. Finding the right memory care community is a process. Normally one that takes weeks or months of investigating options by taking tours and asking questions of residents and staff in homes that might suit your needs. Ideally, you would begin searching before a move becomes necessary. The sooner the search begins, the more input your loved one can provide.

Facility / Residence

Bedrooms must be at least 80 square feet for one occupant, and 70 square feet per person for multiple occupants. The maximum number of people per bedroom is two, unless the residence was licensed before 1989. One toilet and sink is required for every eight residents, and one shower or bath is required for every 12. There must be smoke detectors in every room, as well as manual and automatic fire alarms. Emergency lighting and a disaster plan are also required. Facilities that offer memory care must make sure visitors can exit without sounding an alarm, and provide an appropriate outdoor activities area.

Washington regulations do not include a requirement that buildings be designed with other dementia-friendly features like easy-to-navigate layouts with clear sightlines, or bright lighting and paint colors. Studies have shown that the right dementia-care design can improve mood and encourage participation in activities. As you look at options for your loved one, keep an eye on whether they’ll be comfortable and able to thrive within the spaces.

Staff & Training

There is not a required staff-to-patient ratio, but memory care homes must ensure that they have adequate staff at all times to meet the needs of every resident. Fingerprint-based background checks are required of all employees. Memory care homes must provide special training for staff to meet the needs of people with dementia. Orientation and safety training are also required before someone can begin work in assisted living. Twelve hours of training is also required every year.

An assisted living administrator must be at least 21, with education, training, and experience that meet the residence’s state-approved requirements. Continuing training and education on state statutes related to assisted living is also required.

Evictions & Discharges

A resident of Washington memory care can be evicted if the residence cannot meet their medical needs. For example, if someone develops a condition that requires long-term nursing care then they would need to leave. That is because continuous nursing care is beyond the scope of what’s offered in Washington memory care. Nursing care is only allowed for up to 14 days in some residences. Another reason for eviction can be if the patient becomes non-ambulatory (loses the ability to walk), and the residence is not approved to admit people who cannot walk.

Washington regulations do not provide details on the process of eviction. It’s important to be clear on these rules before agreeing to a move-in contract, because unfair evictions can be a nationwide problem. If you are considering a facility, ask specifically why and how a person can be evicted. What is the time between receiving an eviction notice and needing to move out? Thirty days is standard. How do you appeal? Can someone be kicked out for late payment of bills, or aggressive behavior? Get the answers in writing, so you’re prepared if a dispute comes up about your loved one being asked to leave. If you receive an eviction notice in a Washington memory care home and need to know next steps, click here.

Financial Assistance for Residential Alzheimer’s Memory Care

Medicaid Personal Care

Commonly called Apple Health, this program will not cover room and board in assisted living, but will help with costs associated with activities of daily living like bathing, dressing, and eating. Nursing services can also be covered, including assessments and skilled treatment. Eligibility rules are stricter than typical Medicaid, including an income limit of $841 in 2022 for an individual. For more information, visit the state’s Washington Medicaid Personal Care website or click here for an easy to read overview of the program.

Community First Choice Option

Community First Choice Option is another Medicaid program that helps pay for services that are not room and board. A key difference between Community First Choice Option and the Medicaid Personal Care is that eligibility guidelines are not as strict under this program. Enrollees use the financial assistance to pay for help with activities of daily living like bathing, dressing, and eating. Meal preparation, medication assistance, and some nursing care are also covered. Someone enrolled in Community First Choice Option can receive assistance from other Medicaid programs in Washington. More information is available here.

Community Options Program Entry System

Community Options Program Entry System is a Medicaid waiver in Washington to help people who need nursing-home-level care stay in their own homes or assisted living residences. The funds provided by this program may also be used to pay costs of moving into assisted living. In order to be accepted into the Community Options Program Entry System you must qualify for Medicaid. Many of the benefits are similar to Medicaid Personal Care and Community First Choice Option above, but eligibility requirements differ. This program enrollment is limited, so there may be a waiting list. For more information and to apply, click here.

New Freedom Program

Residents of King and Pierce counties (which include Seattle, Tacoma, and Bellevue) may be eligible for the New Freedom Medicaid waiver. This can help cover costs for someone who requires full-time nursing care but wants to stay at home or in assisted living. This program is an alternative to those listed above and offers more flexibility. The state works with the person in need to determine expenses which might be appropriate for coverage, including assistive technology and preventative medical care. Recipients must be Medicaid-eligible. For more information, click here.

Nurse Delegation Program

Washington’s Nurse Delegation Program is a Medicaid program that trains caregivers (who must be licensed with the state as a nursing assistant) how to administer nursing-home-level care. The goal of the Nurse Delegation Program is to keep people in their houses. The program can also apply to someone in assisted living. A trained RN will periodically check in with the caregiver to make sure tasks are being performed correctly and their loved one’s health remains stable and predictable. To learn more, 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

Veterans Homes

There are also four veterans’ homes in Washington, which are residential care facilities that provide long-term care for veterans. They are the Washington Veterans Home in Port Orchard, Washington Soldiers Home & Colony in Orting (near Mount Rainier), Spokane Veterans Home and the Walla Walla Veterans Home. Currently, all four homes are assisted living facilities that extend to nursing home care, and do not have memory care units. 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, Oregon has two veterans homes and Idaho has three facilities 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.