Memory Care in Arkansas

Because of the specialized staff training and resources required to provide high-quality memory care, memory care typically costs more than other types of residential care. On average, memory care will cost 20-30% more than assisted living.

In Arkansas, the average cost of assisted living is $3,175 per month, which is much less expensive than the U.S. national average of $4,051. Memory care tends to cost around 25% more than assisted living, so seniors in Arkansas can expect to pay about $4,000 per month for these services.

However, costs do vary across the state depending on the location of a facility. The most affordable region for assisted living is the Pine Bluff area, which costs an average of $2,651 per month. While some cities such as Fort Smith and Jonesboro have averages close to the state median, costs can climb as high as $4,000 in Hot Springs and $4,783 in Little Rock. It’s also important to remember that these averages are for assisted living services, and memory care is likely to add another $600-$1,200 to the monthly cost.

• Little Rock: $4,783
• Fayetteville: $3,611
• Fort Smith: $2,925
• Jonesboro: $3,200

Arkansas Medicaid Programs for Memory Care

Living Choices Assisted Living Waiver

Under the Living Choices Assisted Living Waiver program, the state of Arkansas covers assisted living services in licensed ALFs, including facilities with Alzheimer’s special care units. The program is administered by the Arkansas Department of Human Services’ Division of Aging, Adult and Behavioral Health Services and Division of Provider Services and Quality Assurance. It’s designed for seniors in need of 24-hour personal care and supervision, and covers supportive services such as homemaking, household chores, attendant care, companionship, transportation and medical oversight. The waiver does not cover room and board.

• Who Is Eligible: This waiver program is available to all residents of Arkansas aged 65 and older who require the level of care offered in an ALF, and have a medical need for assistance with at least one of the provided services. An applicant’s income cannot exceed 300% of the Social Security Income Federal Benefit Rate, which is $2,349 as of 2020. Individual applicants can have a maximum of $2,000 in countable assets, and couples are allowed up to $3,000.
• How to Apply: Seniors who wish to apply should contact their local DHS county office or the Choices in Living Resource Center.

Personal Care Program

Part of the state Medicaid program, Arkansas’ Personal Care Program is designed to benefit seniors in need of long-term services and supports. The program allows seniors and their families to self-direct the care and services they receive while living at an assisted living facility with a licensed Alzheimer’s special care unit. It helps to cover the cost of hands-on daily assistance provided by trained caregivers, including activities such as basic hygiene, bathing, dressing and toileting.

• Who Is Eligible: Applicants can be of any age, so long as their doctor deems this level of care necessary, and must be residents of the state of Arkansas. Seniors aged 65 and older must not have an income that exceeds 100% of the SSI Federal Benefit Rate, which as of 2020 is $783 per month. A married couple’s income is capped at $1,175 per month. If a memory care community is enrolled as a provider with the state Medicaid program, residents in ASCUs can apply.
• How to Apply: Eligible seniors should contact their local DHS county office or the Choices in Living Resource Center to complete an application.

More Ways to Pay for Memory Care

In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:

• Long-Term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It’s best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.
• Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This can be a good way to fund memory care in the short-term, but the loans will need to be paid back after the sale of the home. The most commonly used type of reverse mortgages for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.
• Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs such as memory care. More information about these programs can be found on the VA website.
• Life Insurance: Some life insurance policies allow policyholders to cash out their policy before a qualifying death. There may be some downsides to accessing a life insurance benefit early, so be sure to read more about the process.

Memory Care Regulation

In the state of Arkansas, specialized units that are designed to provide care services for seniors with Alzheimer’s and other types of dementia are known as Alzheimer’s special care units (ASCUs). Both assisted living and nursing facilities can house ASCUs. Per state regulations, ASCUs must be housed in a separate and distinct unit from the rest of the facility.

The Arkansas Department of Human Services, Division of Medical Services, Office of Long Term Care is responsible for licensing and regulating these facilities. To operate, a facility must offer assisted living services for at least three adult residents on a 24-hour basis.

All ALFs are required to renew their licenses on an annual basis. A comprehensive survey is conducted by the Office of Long Term care every 18 months, which may be planned or unannounced.

Facility Scope of Care

All ALFs are staffed by 24-hour caregivers to respond to residents’ immediate needs and assist with activities of daily living. Facilities should offer mobility assistance, grooming, bathing, dressing and incontinence care, as well as medication assistance. Along with providing personal care services, facilities must host social and recreational activities for residents, and provide supportive services such as housekeeping and transportation to appointments. ALFs are also required to provide residents with three balanced meals, snacks and fluids each day. Additionally, facilities with ASCUs must offer services and programming specific to the needs of memory care residents.

Admissions Requirements

A wide range of residents are eligible for admission to an ASCU, but there may be restrictions. This table acts as a guideline for the types of residents who may or may not be granted admission.

Care Plan Requirements

Prior to moving in, prospective residents must be assessed to determine the level of care and services they need, and a personalized care plan drawn up to meet their needs. Reassessments are required to be conducted on an annual basis, or more frequently if a resident’s needs or condition changes. Residents must also sign a compliance agreement that outlines how the facility will respond in situations or conditions involving risk.

Medication Management Requirements

Residents of CBRFs are permitted to administer their own medications, unless they have been found incompetent to do so by their physician. When necessary, medications may be administered or their administration directed by a registered nurse, nurse practitioner or pharmacist. Certain medications, including nebulizers, injectables and those administered rectally or vaginally, must always be administered by a nurse.

Facility Requirements

All apartment units in an ALF must be large enough for residents to carry out daily functions and activities, such as sleeping, dressing, personal hygiene, eating food and entertaining visitors, and must be accessible for residents who use a wheelchair or other mobility aid. Bathroom and kitchen areas must be separate from other living areas, and the unit must include a small refrigerator and microwave oven. For resident safety, each room must feature a lockable door and 24-hour call system. In a Level I facility, there can be no more than two residents residing in a single unit. All units in Level II facilities are single-occupancy, with exceptions made for married couples, and adults who have requested to reside together.

ASCUs must be located in a separate unit of an ALF that is specifically designed to accommodate the needs of memory care residents.

Staffing Requirements

In Arkansas, ALFs are required to have enough personnel on-site at any given time to adequately support the health and safety of its residents. Staffing ratios for ASCUs are based on the number of residents in the ASCU only, not the ALF as a whole. Both Level I and Level II ALFs must have at least one full-time administrator, on-site manager or responsible staff member available and awake 24 hours per day. Level II ALFs must also be staffed with at least one registered nurse, licensed practical nurses, certified nursing assistants and a consulting pharmacist. Personal care aides may also be employed to provide direct care services.

When hired, all ALF staff must be trained on topics such as building safety, emergency protocols, incident reporting and the residents’ bill of rights. Staff members are required to complete further training within the first six months of their employment on topics such as medication assistance and monitoring, dementia and cognitive impairment, communication skills and disability sensitivity. Six hours of ongoing education are required on an annual basis.

In addition to general ALF training requirements, dementia care staff must undergo 30 hours of training on subjects including facility policies, the treatment of dementia, stages of Alzheimer’s disease and behavior management. Staff must also complete two hours of in-service training each quarter on an ongoing basis, covering topics such as therapies, environmental modifications and developments in the field.

Medicaid Policy

Arkansas’ State Medicaid plan covers the cost of personal care services for seniors, whether those services are provided in an individual’s own home or a residential care setting. Services in ALFs are covered under the Living Choices Assisted Living waiver program, as long as the facility is licensed as a Level II facility.

Reporting Abuse

Family members of residents or anyone concerned about the abuse or neglect of residents in an ALF should contact the Arkansas Department of Human Services, Office of Long Term Care. Complaints can be submitted via phone, fax, email or letter. Investigations are confidential and can be made anonymously, though a name, address and phone number or email address is needed if an individual wishes to be contacted when the investigation is complete.

The Arkansas Long Term Ombudsman Program is also available to assist residents and their family members.