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

Last Updated: November 13, 2022

 

In Wisconsin, there are three types of assisted living residences: community-based residential facilities, residential care apartment complexes and adult family homes. There are differences between them, but they all provide housing, supervision, and support services.

Two of these types of homes may house people with dementia. Community-based residential facilities and adult family homes can have residents with Alzheimer’s disease or another dementia (this type of housing is often called memory care). They must articulate to the state what further steps they offer to serve the specific needs of dementia patients. Community-based residential facilities, for instance, must have daily structured activities that are beneficial for people with memory loss and other symptoms including social withdrawal. Adult family homes must develop a program statement that describes how many people with dementia the home can take in, and how the residence will go beyond normal assisted living to serve their needs.

Residential care apartment complexes cannot admit someone who has difficulty recognizing danger or making care decisions, and this type of housing may only be good for someone in the early stages of Alzheimer’s. Because of this, they are not a good long-term housing solution and should not be considered as memory care. If someone with early-stage dementia does move into a residential care apartment complex, a move into memory care will eventually be necessary because dementia is a progressive disease.

Memory care in Wisconsin is regulated by the Division of Quality Assurance’s Bureau of Assisted Living. There are 60 memory care homes in Wisconsin. There are also more than 1,000 board and care homes, which offer the same services as assisted living (sometimes including memory care) in a smaller, more house-like environment for fewer than 12 residents. For free assistance finding memory care of any size to meet your family’s needs and budget, click here.

 Did You Know? Wisconsin has one of the Top 10 highest rates of Alzheimer’s disease in senior citizens, as about 13% of people over 65 have the disease. The expected rate of increase, however, is one of the country’s lowest. The number of people over 65 with AD is expected to rise from 120,000 in 2020 to 130,000 in 2025, an increase of about 9%. Only three states (Wisconsin, Missouri, and North Dakota) are expecting a five-year increase lower than 10%.

 

How Much Does Memory Care Cost in Wisconsin?

The average cost of memory care per month in Wisconsin is $5,558 which is in line with the national average costing $5,448. Wisconsin’s most expensive place for memory care is in Racine, where memory care costs $6,589 per month. The least expensive city for memory care is in Wausau where it will cost $5,006 monthly. In Milwaukee, the state’s most populated city, memory care costs $6,441 per month.

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

It can be possible for people who live in western Wisconsin to find more affordable memory care outside the state. Minnesota has a slightly less expensive overall average ($5,448 per month) but big savings can be found in a town like Rochester, which is only about an hour from La Crosse, Wisconsin, and costs an average of $5,043. Iowa’s average cost is less than Wisconsin’s, at roughly $5,300 per month, so savings could be found in that state as well. To the south, Illinois’s costs are higher than any of these surrounding states, at about $5,448 per month. Prices can vary so widely, however, that investigating communities in surrounding states is a smart way to potentially save money.

Other Wisconsin cities with memory care costs:

Wisconsin Memory Care / Assisted Living Costs (updated Aug. 2022)
Region / City Daily Cost Monthly Cost
Statewide $183 $5,558
Milwaukee $212 $6,441
Madison $191 $5,816
Green Bay $177 $5,374
Racine $217 $6,589
Eau Claire $174 $5,300
Oshkosh $207 $6,257

 

Wisconsin Assisted Living Laws & Regulations

 COVID-19 Related Measures (updated Aug. 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

Community-based residential facilities may only admit residents who have been assessed and found compatible with the services provided there. A diagnosis of Alzheimer’s is not necessary for a person to move into any memory care in Wisconsin. Assessments are made by a medical professional who works for the residence, usually a nurse, to determine someone’s personal preferences and medical needs so that staff can effectively help and communicate with the resident while also maintaining their health and safety. Specifically, a person’s ability to perform activities of daily living like bathing and eating would be assessed, as well as their stage of dementia.

The cost of the assessment may be included in the residence’s base rate, or there may be a community fee that covers move-in costs including the assessment and also preparing a new resident’s room. Community fees usually run between $1,500 and $3,500.

In adult family homes, new residents must have health assessments within 90 days prior to admittance or seven days after. The process is similar to entering into another facility, where someone working for the residence does the assessing and determines mental and physical abilities to create a detailed service agreement that specifies the following:

– Services that will be provided, with descriptions
– Charges for room and board, services, and any other fees
– Payment method
– Conditions for transfer or discharge

The service agreement must be completed within 30 days of admission to an adult family home.

Residents may not be admitted who are:

– Confined to bed
– Threatening or destructive to property or self
– Physically or mentally abusive (unless facility can ensure protection for others)
– In need of more than three hours of nursing care per week
– In need of restraints (unless a waiver is granted by state)

You can move into a memory care community on short notice, but this is not a good idea. Finding the right home takes multiple visits to different residences and asking lots of questions. You do not want to rush this process. Additionally, your loved one will have more say about where they end up if you begin searching for a home before the move is actually necessary.

 

Facility / Residence

Two residents are allowed in a single bedroom unit in either community-based residential facilities and adult family homes. The square footage requirements are slightly different. A community-based residential facilities bedroom must be between 60 and 100 square feet, depending on whether the resident is ambulatory, semi-ambulatory, or non-ambulatory (how well your loved one can move around). An adult family home bedroom must be 80 square feet for one person and 120 square feet for two. If an occupant is in a wheelchair, the unit must be at least 100 square feet. Every community-based residential facility must have a toilet, sink, and bathtub or shower for every 10 residents. In adult family homes it’s those same facilities for every eight residents. The doors of every adult family home bathroom must unlock from the outside in case of emergency. Grab bars must be around the toilets and baths in adult family homes. Smoke detectors must be in and around all rooms in assisted living residences in Wisconsin.

Wisconsin regulations do not specifically call for dementia-friendly architectural features in memory care communities. Examples of design elements that have been shown to benefit people with dementia include clear sightlines and layouts, a secure outdoor area, and bright lighting and paint colors. Watch for these while taking tours of potential memory care homes, keeping an eye on whether your loved one will feel comfortable within the spaces.

 

Staff & Training

There are no staff-to-resident ratios in Wisconsin assisted living; they must be adequately staffed to meet the needs of every person there. One employee must be awake at all times. In community-based residential facilities with memory care, staff must receive dementia-specific training within 90 days of hiring. The training must specifically address the needs of people with dementia and include the following:

– Residents’ physical, social, and mental health needs
– Medications or treatments
– Program services to help people with dementia
– Meeting needs of someone with dual diagnoses
– Maintaining or increasing social participation, self-direction, and self-care

That sounds somewhat general, but facilities must specifically identify the types of residents they can serve and create a on going educational plan to support their needs.

Administrators in either type of facility must be at least 21 years old. At a community-based residential facility, the administrators are required to have had relevant educational or professional experience. Administrators don’t need to meet the same experience benchmarks in adult family homes, but do need a clean criminal background check.

 

Evictions & Discharges

Someone being evicted from memory care in Wisconsin must be given 30 days notice before they need to leave. No one may continue living in any type of assisted living home if the staff cannot handle their medical condition. Someone who develops a need for 24-hour nursing care, for instance, cannot remain in memory care and would need to be transferred to a nursing home or hospital. Additionally, if a residence cannot admit people who are non-ambulatory and a resident loses the ability to walk would need to find a new home. Behavior that is dangerous to one’s self or others can also justify being discharged from memory care.

These are general regulations, however, and individual homes should have their own specific rules. It is very important that you fully understand the reasons a person can be evicted, and what the process is, before agreeing to a move-in contract. This is because unfair evictions can be a problem in assisted living. Ask all the questions you can and get answers in writing. If your loved one in Wisconsin memory care receives an eviction notice and you need to know next steps, click here.

 

Financial Assistance for Residential Alzheimer’s Memory Care

  The first 3 programs below are Medicaid programs. See Wisconsin’s complete Medicaid eligibility requirements or take a Medicaid Eligibility Test to see if your loved one qualifies.

Wisconsin Family Care

This program is designed to help people live more independently, outside of a hospital or nursing home. For people who live in their own homes, funds from the program may be spent on hiring a caregiver, but in assisted living (regardless of type) Family Care benefits can apply to costs that come up day-to-day, like medical equipment, occupational therapy, and personal care. Two former Medicaid waivers have been folded into this program: the Community Options Program Waiver and the Community Integration Program II. Eligibility requirements are the same as Medicaid, with income under $2,742 in 2023. For more information, visit the program’s website here. To enroll, contact your nearest Aging and Disability Resource Center. They will visit your loved one and fill out a Long Term Functional Screen that determines your loved ones needs and the benefits available to them. Family Care has expanded to be available state-wide.

 

Medicaid Personal Care

Also called Medical Assistance Personal Care, Wisconsin Medicaid Personal Care is a program in which a person’s needs are assessed by a state agent who visits their home (which can include a bedroom unit in assisted living) and determines what costs the state can help cover to keep someone as independent as possible. Personal care is generally defined as assistance with activities of daily living. To be eligible, your loved one must be enrolled in Wisconsin Medicaid. The application to apply can be downloaded here, or you can apply through the state’s ACCESS website.

 

Include, Respect, I Self-Direct Program

This Wisconsin Medicaid program is a home and community-based services waiver that helps someone remain in their home or assisted living residence for as long as possible. Benefits are given by a caregiver who works with a Medicaid representative to form a long-term service and support plan that outlines health goals for your loved one. A budget is then allocated, and the caregiver is responsible for putting funds toward fulfilling the plan. Enrollees must be Wisconsin Medicaid recipients. Visit the program’s website for more information, and to sign up for Medicaid contact your local Area Agency on Aging.

 

SSI Exceptional Expense Supplement (SSI-E)

Eligible recipients, who have been found to require 40 hours weekly of supportive services or in-home care, can receive $95.99 (or $345.36 for couples) on top of their regular Wisconsin Supplemental Security Income benefit. People in assisted living are eligible. To apply, contact your local office for the Department of Health Services. For more information, 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

 More information on VA Pensions’ eligibility criteria, payment rates and the application process is available here.

Veterans Homes

There are also three Veterans’ homes in Wisconsin, which are residential care facilities that provide long-term care for veterans. They are located in King (west of Oshkosh), Union Grove (south of Milwaukee), and Chippewa Falls (outside Eau Claire). In addition to nursing home care and assisted living, memory care is provided. 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, Minnesota has five Veterans homes statewide and several are located relatively close to their shared border. Additionally, Illinois has four facilities and Iowa has one facility 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.