Memory Care in Colorado

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.

Assisted living facilities in Colorado have an average monthly cost of $4,095, as reported in the 2019 Genworth Cost of Care Survey, which is just slightly above the national average of $4,051. Based on this average, families can expect to pay about $5,000 for memory care in Colorado, although prices vary from region to region.

Prices for assisted living vary substantially within the state of Colorado. Boulder is at the high end with an average of $4,750 per month, while the most affordable is Pueblo with an average of $3,800. Denver’s average cost is more than 10% higher than the state overall at $4,500, and Colorado Springs is slightly more affordable than average at $4,000. Greeley and Fort Collins also have below average assisted living costs at $3,988 and $3,848 per month, respectively.

Colorado Medicaid Programs for Memory Care

Elderly, Blind or Disabled (EBD) Waiver

The EBD waiver provides access to services that aren’t covered by the Colorado state Medicaid program (Health First Colorado). This additional coverage includes what are known as home and community-based services, which have the intent of keeping seniors out of nursing homes by providing care elsewhere. Most importantly for those seeking memory care, the EBD waiver covers the cost of care received in assisted living facilities, although residents are still required to pay for room and board. This waiver also covers many other services, such as homemakers, home modifications, respite and adult day care.

• Who is Eligible: Applicants below age 65 must have a physical disability or blindness. Applicants above age 65 must have a functional impairment that requires the type of long-term support usually received in a nursing facility. They must also be within the income and asset limits for Colorado Medicaid and be a legal resident of the state. As of 2020, an individual is allowed an annual income of $16,612 and countable assets of $2,000.
• How to Apply: Members of Health First Colorado (Colorado Medicaid) can apply for the EBD waiver through the closest Single Entry Point Agency. Residents who aren’t already a member can apply online, at a local office or by mail.

Non-Medicaid Financial Assistance Programs for Memory Care in Colorado

Home Care Allowance (HCA)

The Colorado Department of Human Services provides monthly cash payments to eligible seniors and people with disabilities via the Home Care Allowance program. The HCA is intended to help residents stay in their own home, or that of a caregiver, by funding their purchase of in-home care services from approved providers. In-home services include hygiene and mobility assistance, cooking and cleaning, money management and shopping, as well as other activities of daily living.

• Who is Eligible: Applicants can be of any age and must be legal residents of Colorado. Seniors must be receiving a minimum of $1 in federal Supplemental Security Income (SSI) payments, or, if under 65, be eligible for the Aid to the Needy Disabled – State Only (AND-SO) program. Eligibility and payment amount are also based on the applicant’s functional ability and how often they need assistance.
• How to Apply: Residents can apply for the HCA program by contacting their local Single Entry Point. Staff will schedule an assessment to determine the appropriate payment level, followed by annual reassessments. These agencies are responsible for answering questions, processing applications, performing assessments and developing care plans.

Supplemental Security Income (SSI) and the Colorado Supplement

The federal government provides monthly payments to eligible residents via the Supplemental Security Income (SSI) program. Most states contribute a small amount of additional funding, known as the optional state supplement, which is intended to help pay for personal care services required by the applicant. As of 2020, the federal SSI payment is $783 per month for an individual. Colorado’s supplement is $25 per month for those living independently or in the home of another. However, the supplement increases to $551 when living in an adult foster home, and can be as high as $475 if receiving home care that is keeping the recipient out of a nursing facility.

• Who is Eligible: Applicants for SSI must be 65+ or blind or disabled. They must also be a legal U.S. citizen or national and meet the income and asset limits. Applicants for the Colorado Supplement must be receiving SSI and currently in an approved living arrangement (federal code A or B), which can include the applicant’s own home.
• How to Apply: Residents can download an application form and submit it online or by mail. Applications can also be made in person with the assistance of staff at various locations around Colorado, which can be found using the application assistance map.

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

Memory care is generally provided in residential care facilities, commonly known in Colorado as assisted living residences and alternative care facilities. The Colorado Department of Public Health and Environment is responsible for the regulation and licensing of assisted living. The state requires facility administrators to be certified in the scope of care provided, such as having a background curriculum that covers Alzheimer’s for an administrator of a memory care facility. New staff members must also receive training related to the specific needs of the resident population.

Facility Scope of Care

In Colorado, assisted living residences and alternative care facilities aren’t permitted to provide a high level of nursing care on a full-time basis, such as the level of care in a nursing facility. However, residents can receive short-term and moderate nursing care if needed while remaining in the facility. This allows memory care to be provided in an assisted living setting for the majority of people.

Residents of ALRs and ACFs are entitled to:

• All meals and assistance with activities of daily living
• Medication administration and homemaker services
• 24/7 security, social care and supervision

Admissions Requirements

Each facility sets its own admission requirements, and management is required to produce a copy upon request. For example, alternative care facilities (ACFs) are certified to accept Medicaid members, while other facilities are specialized in nature and only accept people who benefit most from the services provided, such as people with Alzheimer’s.

Care Plan Requirements

Colorado’s regulations require an initial assessment to be performed on each new resident of an assisted living facility, and this is used to formulate a care plan for the individual. This plan must be worded clearly, using terminology that the general public understands, and it must be made available to the resident, family members or authorized agents upon request. Residents with a specific health issue, such as Alzheimer’s disease, must be placed on a care plan that provides appropriate services and amenities, and this includes an appropriate set of activities for the resident’s physical and cognitive function.

Medication Management Requirements

Prescription and nonprescription medication must be ordered by an authorized practitioner, clearly labeled with the individual’s full name and stored on-site in a secure location. By default, residents of assisted living facilities are entitled to keep and manage their own medication, which is known as self-administration, although this is less likely in a memory care situation due to declining cognitive function. Residents who are assessed as unable to self-administer must be assisted or have their medication administered by a nurse or qualified medication administration person (QMAP). If a resident cannot self-administer and the facility has no QMAP, the resident must be discharged.

Facility Requirements

State regulations require that assisted living facilities be properly and safely maintained, which includes the exterior grounds, resident areas, staff rooms and storage spaces. Facilities must also maintain an ability to properly serve the resident population, such as having at least two wheelchair-accessible entry and exit points if there are any residents using wheelchairs and having handrails on all staircases. Common areas and dining rooms must meet accessibility standards. Private bedrooms must be at least 100 square feet or 60 square feet per occupant in a shared bedroom, and the maximum occupancy is two. There must be a minimum of one bathroom for every six residents, with at least one bathroom for every floor that houses residents.

Staffing Requirements

The Code of Colorado Regulations states that an assisted living residence must have at least one staff member on duty at all times who is capable of performing CPR. Beyond this minimum, the facility administrator must devise a plan for routine staffing levels that takes into account the number of beds, the health condition and needs of residents, as well as the set of services outlined in the resident agreement and care plan. The appropriate routine staffing level is assessed and ultimately determined by state regulators.

Medicaid Policy

In Colorado, Alternative Care Facility (ACF) is a term used specifically for assisted living facilities that are certified for Medicaid reimbursement by the Department of Health Care Policy and Financing. In most cases, a resident of an ACF who is enrolled in Medicaid will be covered for all personal care services received in the facility, such as mobility assistance, hygiene or help getting to appointments. However, the cost of room and board isn’t covered by Colorado Medicaid or its waiver program.

Reporting Abuse

Colorado has strict policies and severe penalties for facilities, staff and administrators who abuse residents, whether emotionally or physically, or create unsafe environments for residents and other staff. Management must report any allegation of abuse against a resident to their family or emergency contact within 24 hours. Members of the public who wish to report an issue in an assisted living facility should contact the Health Facilities Department at (303) 691-4045 or submit a complaint form online. Fax, email and postal options are also available. Criminal allegations should be followed up with the police.