Memory Care in Georgia

Table of Contents

Memory Care in Georgia

Table of Contents

• The Cost of Memory Care in Georgia
• Georgia Medicaid Programs for Memory Care
• Can You Use Medicare To Pay for Memory Care in Georgia?
• More Ways To Pay for Memory Care in Georgia
• Memory Care Laws and Regulations in Georgia
• Free and Low-Cost Resources for Seniors in Georgia
• Georgia 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 determine the cost of memory care in Georgia and its surrounding areas, we've increased the assisted living costs provided by the Genworth 2021 Cost of Care Survey by 25%.

Other states within the area are also less expensive than the U.S. average. Alabama is the least costly at $4,379 per month, while in Florida ($5,000), South Carolina ($4,515) and Tennessee ($5,131), seniors can expect to pay just a bit more than in Georgia. 

The cost of memory care can vary depending on where in the state a facility is located, but when looking at the statewide average, Georgia's monthly expense for memory care is more than $1,000 below the national median at $4,419. Cities throughout the state range from $3,438 in Warner Robins to as much as $6,625 in Brunswick. In larger cities, such as Atlanta ($4,806) and Columbus ($5,279), seniors pay a little more than the statewide average.

Although Medicaid doesn't directly cover memory care services in Georgia, it does provide some services that may be offered within a memory care setting, including skilled nursing and physical therapy. Those who require comprehensive coverage to afford memory care services may also apply to one of the state's waiver programs, which amend the coverage offered by regular Medicaid to include additional services tailored to seniors and long-term care residents. 

• Who Is Eligible: Medicaid is open to seniors aged 65 and older, as well as to those who are legally blind, disabled or in need of nursing care. Seniors applying for Medicaid must also meet income and resource limits, which require a monthly income that doesn't exceed $2,523 and a maximum of $2,000 in countable assets or $3,000 in assets for couples.
• How To Apply: Seniors can visit the Georgia Medicaid website to start their application.

Community Care Services Program

The Community Care Services Program (CCSP) is a Home and Community-Based Services (HCBS) waiver that helps eligible seniors avoid nursing home placement. It provides personal care services either in the home or within state-licensed assisted living and memory care facilities, as well as personal support services, emergency response systems and respite care, when necessary.

• Who Is Eligible: Medicaid-eligible seniors can qualify for the CCSP if they have a functional impairment or are determined by a physician to require a nursing home level of care. 
• How To Apply: Seniors can apply for the CCSP by contacting their nearest Area Agency on Aging or calling (866) 552-4464.

Service Options Using Resources in a Community Environment

This program, known as SOURCE, is one of Georgia's Elderly and Disabled waivers. It covers services such as assisted living and memory care, as well as some in-home services, for seniors who would require a nursing home level of care if it wasn't for the support provided by this program.

• Who Is Eligible: Seniors who are financially eligible for Medicaid and are determined to require nursing home-level support may qualify for this program.
• How To Apply: Those who want to apply for this program can contact their local Georgia Aging and Disability Resource Connection office.

Medicaid Eligibility for Seniors in Georgia

Seniors who wish to qualify for Medicaid waivers in Georgia must meet specific annual income limits, as listed in the table below. Regardless of household size, a single applicant is subject to an annual personal income limit of $30,276. In a two-person household where both members are applying, the annual household income limit is doubled to $60,552. Assets for single applicants are limited to $2,000, while dual applicants can retain up to $3,000 in countable assets.

2022 Medicaid Income Limits for Seniors in Georgia

Beyond these income and asset limitations, seniors applying for Medicaid must also prove:

• Aged 65 or older or in need of nursing home care
• U.S. citizenship or permanent residency
• Full-time residency in Georgia

How To Get Help Applying For Medicaid in Georgia

Resources are available in Georgia to help seniors better understand and navigate the complex process of applying for Medicaid coverage.

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

In Georgia, facilities that provide residential memory care services include assisted living communities with 25 or more residents, and personal care homes for two or more residents. These facilities are licensed and regulated by the Department of Community Health (DCH), and must meet specific requirements for admission thresholds, provided services, facility standards, and medication management. Facilities offering memory care services must provide secure surroundings for residents and meet additional requirements.

All facilities in Georgia must undergo an on-site inspection to be granted their initial license. Thereafter, facilities are subject to both announced and unannounced inspections, reviews and examinations by DCH representatives.

Facility Scope of Care

Assisted living communities in Georgia are required to provide residents with personal care, medication administration by a certified aide, and assisted self-preservation in the event of an emergency situation. Personal care homes are required to offer housing, meals, personal care services, social activities, and assistance or supervision with medication administration.

In both of these settings, memory care units must offer activities appropriate to residents' abilities or adapt activities so memory care residents are able to participate. These activities must be available on a weekly basis, with therapeutic activities available daily. Programming may include motor-focused activities such as exercises, dancing, and gardening; self-care, including bathing and grooming; social activities; and activities that support sensory enhancement.

Admissions Requirements

The state of Georgia has restrictions on who may be admitted to assisted living communities and personal care homes. The table below outlines the requirements for acceptance to one of these facilities.

Residents Who May Be Admitted

Older adults and people with:

• Dementia
• Mental health conditions
• Developmental disabilities
• Physical disabilities
• AIDS
• Traumatic brain injuries
• A desire to live in a memory care unit without having a probable diagnosis of Alzheimer's disease, who waive their right to live in another type of environment

Residents Who May NOT Be Admitted

Those who:

• Require continuous medical or nursing care and services as determined by their required physical examination
• Have active tuberculosis
• Have a behavioral condition that requires physical or chemical restraints, isolation or confinement
• Are bedridden
• Require care beyond what a facility is permitted to provide

Care Plan Requirements

Facilities are required to complete a residential assessment within 48 hours of a senior moving in, and after that, on a yearly basis or following any significant health change. A licensed health professional must also determine if a senior is able to self-administer medication or requires assistance. Additional assessments may be conducted for residents with medical, psychological, developmental, or intellectual impairments.

Residents are also allowed to contract with third-party providers, such as a licensed hospice agency, certified home health agency, or mental health agency, if they feel they could benefit from additional services.

Both assisted living communities and personal care homes require residents to undergo an assessment to determine their functional capacity for completing activities of daily living, as well as their physical care needs, medical requirements, and any cognitive or behavioral impairments. Facilities also need to determine an individual residents' personal preferences in regard to the care services they receive and whether they have access to family supports.

The results of these assessments must be written up in the form of a care plan with findings updated on an annual basis. Memory care units are required to review residents' care plans each quarter, making adjustments as needed based on changes in their needs.

Medication Management Requirements

Residents of assisted living communities who have the capacity to self-administer medications must be allowed to do so. Staff must assist with medication administration if requested, including providing help with storage, applying topical medications or administering EpiPens. Staff must be licensed to provide this assistance unless the medication is packaged in individual doses.

If medication administration is provided by a facility, it must be performed by a certified medication aide. These services include administering physician-ordered medications, insulin or epinephrine, conducting finger stick blood glucose tests, or administering a commercially prepared enema. Quarterly drug regimen reviews must be conducted by a licensed pharmacist.

The same requirements are in place for self-administration and assistance by staff in personal care homes, however, these facilities are not permitted to administer medications and are not required to undergo pharmacist reviews.

In memory care units, both assistance with self-administration and the administration of medications must be provided by a licensed registered nurse (RN) or a licensed practical nurse working under the supervision of a licensed physician or RN. A proxy caregiver employed by the facility may also be permitted to administer these services.

Facility Requirements

In both assisted living communities and personal care homes, apartment-style units are required, so seniors may reside in either private and shared rooms. A minimum of one toilet and sink must be provided for every four residents, and at least one room for bathing/showering for every eight residents. Fully accessible bathrooms are required if a facility serves residents who rely on wheelchairs or walkers. Living units in personal care homes can house up to four residents, and residents are permitted to share a living space if the request is made in writing.

Memory care units are required to provide a homelike environment with features such as multipurpose rooms for dining and activities, secured outdoor spaces that are wheelchair accessible, lighting that minimizes shadows, and personalized entrances to resident rooms so seniors can readily identify their own space. Facilities must also have a communication system in place that allows staff to communicate with other team members and emergency service workers.

Staffing Requirements

Assisted living facilities and personal care homes in Georgia are required to have a full-time administrator to deal with daily operations, as well as a team of direct care staff to assist with personal care services. Certified medication aides must be employed to administer medication in assisted living facilities. Staffing at a facility must reflect the needs of its residents. The minimum staff-to-resident ratio is 1:15 during waking hours, and 1:25 at night, and at least one staff member must be on-site 24 hours per day.

All staff members are required to undergo training within 60 days of employment on topics such as residents' rights, infection protocols, and emergency preparedness. Direct care staff must receive training in the medical and social needs of residents, assistance with medication, and emergency first-aid. All hands-on staff members are required to participate in 24 hours of continuing education in their first year of employment and 16 additional hours on an annual basis.

Memory care units are required to have enough specialized dementia care staff to adequately serve their residents' needs, including certified medication aides, with one awake staff member on-site at all times. Dementia care staff must undergo special training in the areas of philosophy of care and facility policies, including dementia-specific care needs, behavioral problems, communication skills and therapeutic activities specific to those with dementia.

Medicaid Policy

While Georgia Medicaid does not cover room and board expenses, it offers the CCSP and SOURCE waiver programs to help seniors cover the cost of care in assisted living communities and personal care homes, including the services provided in memory care units.

Reporting Abuse

Family members or anyone with concerns about resident neglect or abuse in an assisted living community or personal care home should contact the Department of Community Health's Healthcare Facility Regulation division at 800-878-6442. Concerns and complaints may also be submitted online by filling out a protective services report.

Seniors throughout Georgia can access various resources that offer help with common issues that face seniors. Some of these resources provide support and training for caregivers as well as access to important resources that offer programs tailored to the unique needs of dementia patients. Additionally, the resources listed below exist to ensure the safety and quality of life for seniors living with Alzheimer's disease and those who reside in long-term care. 

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.