Memory Care in Delaware

Table of Contents

Memory Care in Delaware

Table of Contents

• The Cost of Memory Care in Delaware
• Delaware Medicaid Programs for Memory Care
• Can You Use Medicare To Pay for Memory Care in Delaware?
• More Ways To Pay for Memory Care in Delaware
• Memory Care Laws and Regulations in Delaware
• Free and Low-Cost Resources for Seniors in Delaware
• Delaware COVID-19 Rules for Memory Care Facilities

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.

To predict the cost of memory care, we've taken the cost of assisted living reported in the 2021 Genworth Cost of Care Survey and added 25%. Individual assisted living facilities may cost slightly less or more, depending on factors such as quality of care, location and demand. 

Delaware is considerably more expensive than the rest of the nation when it comes to the cost of memory care. The national average is $5,625 per month, while the average expense in Delaware for memory care is about $7,494. Neighboring states have lower average costs as well. Pennsylvania residents pay $5,125 on average, and the price is higher for Maryland residents at $6,560.

In Dover, the cost for memory care is slightly more than the state's average at $7,591. Prices for cities in surrounding states also vary. Washington, D.C. and Philadelphia, PA are much higher than the national average at $7,435 and $7,106, respectively. Baltimore, MD's memory care costs are slightly more than the U.S. average at $5,938.

Delaware's Medicaid program doesn't cover memory care in assisted living communities and there aren't any available waivers, but the Diamond State Health Plan - Plus does cover some of the costs associated with this type of care. Personal care services, case management, cognitive services, community transition services and transportation are some of the expenses that might be covered for those who are eligible.

This program can certainly be used to pay for many of the companion services needed, but it won't cover room and board at a nursing facility.

• Who Is Eligible: Applicants must first qualify for Medicaid, be over 65 years old and have medical documentation supporting the need for nursing care. There are income caps and asset limits as well, capped at 250% of the federal benefit rate and $2,000 in assets. 
• How To Apply: For the Diamond State Health Plan - Plus, people can visit their local State Service Center or call the Division of Medicaid and Medical Assistance at (800) 996-9969.

Unfortunately, Medicare does not generally cover the cost of Memory Care. Most Memory Care Facilities are considered to be "social settings," so Medicare does not cover the cost incurred in these facilities. The only exception to that is if you are receiving memory care services in a Nursing Home. While this situation is much less common, Medicare would sometimes cover the cost, depending on a number of circumstances.

That being said, Medicare does still cover qualified doctor visits, medications, etc., as it would if you were still at home, but it will not cover the cost of care received at the Memory Care Facility.

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.

Memory Care Regulation

Assisted living facilities that provide memory care are licensed by the Delaware Department of Health and Social Services (DHSS), Division of Long Term Care Residents Protection. The division is responsible for monitoring compliance with federal and state regulations governing long-term care facilities, as well as performing annual surveys and unscheduled inspections. DLTCRP staff also respond to incidents and complaints regarding quality of life, quality of care and violations of residents' rights in assisted living facilities.

An ALF that offers special services, such as memory care, must provide a disclosure document that details the facility's:

• Philosophy of care
• Population served
• Admission and discharge criteria and processes
• Assessment, care planning and implementation procedures
• Staffing and training policies
• Resident activities
• Nutrition and hydration services
• Policy regarding wandering
• Psychosocial services
• Safe storage plan for medication
• Costs

Facility Scope of Care

Assisted living facilities in Delaware provide housing, supervision, personalized assistance and health care and supportive services for individuals who need help with activities of daily living. Facilities must ensure that each resident's care plan is implemented properly and provide all required personal services, arrange access to necessary health care and social services and facilitate or arrange opportunities for leisure activities and social interaction. Residents may receive care from licensed hospice programs and home health care agencies, with prior approval from the ALF's director.

Admissions Requirements

Licensed assisted living facilities in Delaware may accept adults and elderly individuals with a range of conditions, including Alzheimer's disease and other forms of dementia. The following table offers an overview of the conditions and circumstances that determine whether an individual may be admitted or continue receiving memory care in an assisted living facility, based on the applicable rules and regulations.

Residents Who May Be Admitted To and Retained in ALFs:

Seniors and adults who:

• Require lodging, meals and assistance with personal care, medication administration and activities of daily living
• Suffer from stable chronic illnesses
• Have physical, intellectual and developmental disabilities
• Have controlled behavioral issues
• Require intermittent or short-term nursing care for no longer than 90 days

Residents Who May NOT Be Admitted or Must Be Discharged:

Individuals who:

• Require skilled testing, treatments or monitoring
• Require monitoring of an unstable or chronic medical condition
• Are bedridden for longer than 14 days
• Are dependent on a ventilator
• Wander in excess of the facility staff's supervisory abilities
• Pose a threat to themselves or other residents
• Exhibit socially inappropriate or unmanageable behavior

Care Plan Requirements

Prospective ALF residents must have a medical evaluation and RN assessment completed 30 days before admission, and a reassessment must be conducted within 30 days of move-in. Based on these assessments, a service plan must be developed to meet the individual's care needs. This plan should detail the services to be provided and address all aspects of their care, including:

• Nutrition and hydration
• Personal care
• Psychosocial and emotional care
• Licensed nursing services
• Rehabilitative services
• Interpretive services
• Assistive technology
• Durable medical equipment
• Environmental services

Medication Management Requirements

The rules regarding ALF staff providing assistance with medication self-administration are contained in the state Board of Nursing regulations. The rules require that within 30 days of a new resident's admission, an RN must assess their ability to self-administer medication and determine whether they need assistance. An RN must also conduct regular reviews to ensure that medications have been received, are properly labeled and stored and are not causing any adverse side effects. Only aides who have passed an exam may assist residents with self-administering medications.

Facility Requirements

Delaware assisted living facilities, including those that offer memory care, may offer private rooms, as well as shared rooms for no more than two residents. Private rooms must provide at least 100 square feet of living space, and shared rooms must offer 80 square feet of living space per resident. Facilities may feature private bathrooms accessed from individual resident rooms or shared bathrooms that serve no more than four residents. If in-unit bathrooms do not contain a tub or shower, such facilities must be provided in a readily accessible location. ALFs must provide residents with in-unit kitchen facilities or access to a central kitchen. State regulations stipulate that facilities providing memory care must detail any specialized physical environment and design features in their disclosure documents.

Staffing Requirements

ALFs in Delaware must have a sufficient number of trained staff on duty to provide adequate care for all residents. Staff employed by facilities that offer memory care must be properly trained and hold appropriate certifications and licenses to ensure the needs of residents are met.

Delaware regulations include minimum requirements for ALF management staff, based on the size of the facility.

• Facilities with up to 24 beds may employ a part-time administrator and must have an RN director of nursing on duty for 20 hours per week, at a minimum.
• Facilities with 25 or more beds must have a full-time administrator and RN director of nursing.

Newly hired care staff must receive a comprehensive orientation on state-mandated topics, which include residents' rights, the health and psychosocial needs of residents being served, infection control, first aid and the facility's fire, life safety and emergency disaster plans. Staff members must also receive at least 12 hours of ongoing training annually.

Medicaid Policy

Delaware Medicaid administers the Diamond State Health Plan – Plus, a managed long-term care entitlement program that covers services in assisted living facilities for eligible state residents, including those who require memory care.

Reporting Abuse

Concerned parties can report witnessed or suspected abuse, exploitation or neglect of an assisted living facility resident by calling the Division of Health Care Quality's 24-hour, toll-free report line at 877-453-0012. Alternatively, individuals may complete and submit an online complaint form.

There is plenty of assistance available for Delaware residents through community programs and charitable organizations. For further assistance, contact the organizations listed below.

Note: The following information was compiled and most recently updated on 2/3/2022. Since COVID-19 is a rapidly evolving crisis, be sure to contact your Memory Care Facility or local Area Agency on Aging for the most up-to-date information.