I. Paying for Memory Care in Indiana

The Cost of Memory Care in Indiana

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.

Residents of Indiana pay an average of $4,100 per month for assisted living, according to data from the 2019 Genworth Cost of Care Survey, which is just $49 more than the U.S. median of $4,051. However, this is $70 lower than the average cost in neighboring Illinois, $239 less than in Ohio and $250 below the costs in Wisconsin. After factoring in an average cost increase of 25% for memory care compared to assisted living, Indiana residents can expect to pay approximately $5,125 per month for residential memory care services.

Average costs for assisted living also vary within the state due to differences between facilities and geographic location. The average monthly price is $Indiana in urban Indianapolis, and it rises to $4,500 heading north to Kokomo and Lafayette. The highest cost of $5,685 is paid to the east in Muncie, while the lowest monthly cost of $2,970 is enjoyed in more southerly Bloomington. Bearing in mind that these averages are for standard assisted living, memory care rates may be up to $1,500 higher each month.

   

Indiana Medicaid Programs for Memory Care

Aged and Disabled Waiver

Indiana Medicaid offers an Aged and Disabled waiver to eligible individuals to allow them live in a residential care setting rather than a nursing home. The waiver provides case management and covers various costs, which may include transition assistance to relocate from a nursing home, personal care, assistance with activities of daily living, transportation, housekeeping and laundry. Prepared meals, nutritional supplements and medical supplies and equipment are also covered.

  • Who Is Eligible: To qualify for the A & D waiver, applicants must meet the personal, functional and financial eligibility requirements for Indiana Medicaid coverage. They must also be assessed as requiring the level of care provided in a nursing facility, but be able to safely live in a less restrictive residential care setting.
  • How to Apply: Individuals not already enrolled in Indiana Medicaid must do so first, and then contact their local Area Agency on Aging to request an assessment for the A & D program.

Non-Medicaid Financial Assistance Programs for Memory Care in Indiana

Residential Care Assistance Program

The Indiana RCAP program is funded by the state Division of Aging and provides financial support for eligible individuals who can no longer live alone but do not need nursing home care. The program provides a daily allowance that may go toward the cost of housing, meals, laundry and care coordination services in state-contracted residential care facilities.

  • Who Is Eligible: Applicants must be blind, disabled or aged 65 or older and live in an approved, licensed housing community in one of 23 participating Indiana counties. Individuals cannot require the level of care provided in a nursing facility and must meet Indiana Medicaid’s financial guidelines, which cap monthly income at 300% of the current Federal Benefit Rate and countable assets at $2,000.
  • How to Apply: Interested seniors must complete an application through the RCAP facility where they plan to reside. More information about the program can be obtained from the Area Agency on Aging serving their region of the state.

Medicare Advantage Plans

Indiana residents who have health care coverage through Original Medicare may choose to enroll in a Medicare Advantage plan instead. These MA or Part C plans are available through Medicare-authorized private insurance companies and include all the services provided by Part A and B coverage. Most MA plans include Part D coverage for prescription drugs along with additional benefits. The specific benefits vary between MA providers and individual plans, but may include dental, vision and hearing services, transportation to medical appointments, wellness services and personal care assistance.

Due to recent updates in Medicare program guidelines, the residential care facility where a beneficiary resides may now be considered their home. With this change, residents may now be reimbursed for personal care and other covered service costs through an MA plan.

  • Who Is Eligible: To be eligible for coverage through an MA plan, an individual must be already enrolled in Original Medicare. Enrollees in Medicare Parts A and B may switch to an MA plan regardless of any preexisting conditions such as an Alzheimer’s or dementia diagnosis. MA plan enrollees must continue to pay monthly Part B premiums, as well as any applicable Part C plan premiums.
  • How to Apply: Medicare provides a plan finder tool that interested seniors can use to select an MA plan from those available through providers in their area of Indiana. They may contact the plan provider directly or call Medicare at 800-633-4227 to learn when and how to apply.

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.

II. Memory Care Laws and Regulations in Indiana

Memory Care Regulation

In Indiana, assisted living facilities are referred to as housing with services establishments and must file a service disclosure form to register with the Indiana Family and Social Services Administration, Division of Aging.

The service disclosure filed by facilities that provide memory care must name an appointed director and include:

  • The philosophy regarding dementia care
  • Admission, retention and discharge criteria and processes
  • How resident care plans are developed, implemented and updated
  • Classifications of staff and staff-to-resident ratios for all shifts
  • Initial and specialized staff training and continuing education requirements
  • Types and frequency of planned activities for residents
  • Any distinguishing features and services that relate to dementia care

Housing with services establishments that provide medication administration or nursing care are categorized as health care facilities. State regulations require that these facilities obtain a license as a residential care facility through the Indiana State Department of Health, Division of Long Term Care.

The ISDH’s Residential Care Facility Licensing Program conducts health surveys of licensed facilities every nine to 15 months to ensure compliance with state regulations. The program also investigates any complaints filed against facilities.

Facility Scope of Care

Housing with services establishments provide room and board to five or more residents and various health-related and supportive services. Facilities must provide residents with three nutritious meals each day, and offer social and recreational programming and/or transportation to community-based activities. Those that provide specialized memory care must offer activities and programming appropriate for individuals with dementia.

The services offered must meet the needs and preferences of a facility’s residents and may include:

  • Personal care
  • Assistance with activities of daily living
  • Assistance with self-administration of medications
  • Housekeeping
  • Personal laundry
  • Assistance handling personal funds
  • Scheduling medical and health care services
  • Arranging social services

Trained staff of licensed RCFs may also provide nursing care and medication administration. Unlicensed housing with services establishments may contract with a licensed home health agency to provide these services. Residents may also contract with their choice of home health agencies to receive on-site health care, personal care or hospice services.

Admissions Requirements

Assisted living facilities in Indiana may accept residents with a range of care needs, and state regulations are in place that limit who may and may not be admitted. The following table provides insight into the conditions that determine whether an individual may live in this type of care setting:

Residents Who May Be AdmittedSeniors and adults with:

  • Chronic, stable illnesses
  • Mental health conditions
  • Physical, intellectual or developmental disabilities
  • Alzheimer’s disease and related dementias
  • Controlled behavioral issues
Residents Who May NOT Be AdmittedThose who:

  • Are medically unstable
  • Require 24-hour comprehensive nursing oversight or care
  • Pose a danger to themselves or others
  • Require rehabilitative care, oversight or therapies but have no licensed provider
  • Require complete assistance with eating, transferring or toileting

Care Plan Requirements

Indiana regulations stipulate that housing with service establishments and residential care facilities evaluate a prospective resident prior to their admission to ensure the facility is capable of providing the care a person requires. This evaluation should cover an individual’s:

  • Physical, mental and cognitive status
  • Abilities to perform activities of daily living
  • Ability to self-administer medication

Based on the completed evaluation, a care plan must be developed that details the scope, type, and frequency of services an admitted resident will receive, along with their preferences. Each resident must be reevaluated at least twice per year, or when any significant change in their condition occurs, and their care plan updated accordingly.

Medication Management Requirements

Indiana housing with services establishments not licensed as residential care facilities may not administer medications. However, staff may assist residents with self-administration if requested by providing cues or reminders, opening containers or steadying a resident’s hand during the application of eye drops.

Licensed RCFs must have orders from a resident’s doctor to administer medication. Administration, which includes the preparation and distribution of medications, must be performed by licensed nursing staff or by qualified medication aides under the supervision of a licensed nurse.

Facility Requirements

Residential care facilities that provide services under the Indiana Medicaid Aged and Disabled waiver program are required to offer individual wheelchair-accessible residential units consisting of a living area, kitchenette, bedroom and private bath. Half of all units must have roll-in showers.

In other facilities licensed prior to 1984, resident rooms are limited to four beds, and there must be one toilet and sink for every eight residents, and between one and six baths/showers depending on the facility’s occupancy. Residential units in facilities licensed after 1997 must have private baths with a sink, toilet and tub or shower.

Facilities are also required to have two gender-specific bathrooms per floor that are equipped with wheelchair-accessible fixtures.

Staffing Requirements

RCFs in Indiana must employ an administrator who holds a comprehensive care or residential care facility administrator’s license. Administrators are required to complete 40 hours of continuing education every two years.

Regulations also require that facilities have a sufficient number of qualified, trained staff to meet the scheduled and unscheduled needs of residents 24 hours per day. At least one awake staff member with first aid and CPR certifications must be on the premises at all times. RCFs that provide medication administration or nursing care are required to have a minimum of one nursing staff member for every 50 residents on-site around the clock.

Directors of memory care units must have at least 12 hours of initial training in dementia care, and six months of continuing education annually. Staff who provide direct care to residents are required to have six hours of initial dementia-specific training, and three hours of continuing education each year.

Medicaid Policy

Indiana Medicaid does not cover the cost of services or room and board in adult family homes and residential care facilities. However, the state does offer the Aged and Disabled waiver program to help eligible residents living in participating facilities pay for some provided services and necessary supplies, but it excludes room and board fees. Because the A&D is a waiver program rather than a Medicaid entitlement, enrollment is capped and qualified applicants may be placed on a waiting list based on availability.

Reporting Abuse

Resident neglect or abuse in a residential care facility may be reported to the Indiana Attorney General’s Patient Abuse and Neglect program. Concerned parties may submit details of the incident via the program’s online report form, or call the AG’s Abuse and Neglect toll-free hotline at 800-382-1039. Concerns about conditions or care received in a licensed residential care facility may be reported to the ISDH by calling 800-246-8909 during regular business hours, or by submitting a completed complaint form by email or fax.

III. Free Memory Care Resources in Indiana

ResourceContactDescription
Alzheimer’s Association of Greater Indiana800-272-3900The Greater Indiana Chapter of the Alzheimer’s Association provides an array of supportive services and educational resources for Alzheimer’s sufferers and their families. The chapter also works in tandem with the national organization to promote and fund research and brain health initiatives.
Dementia Friends Indiana317-254-5465Dementia Friends Indiana is part of a nationwide movement to advance dementia awareness and education at the community level. The goal is to make navigating life easier for individuals with dementia and their loved ones by providing support and resources needed to make practical changes.
Indiana Alzheimer’s Disease Center317-963-7556A National Institute on Aging-designated research center, the Indiana Alzheimer’s Disease Center is on the cutting-edge of dementia research. Along with hosting clinical studies open to Indiana residents, the center provides education and training in the diagnosis and treatment of Alzheimer’s disease and related dementias.
Family Caregiver Support Program800-986-3505The Family Caregiver Support Program provides eligible caregivers of those with Alzheimer’s and other forms of dementia with information and assistance accessing resources and services. Counseling, training, group support, supplemental services, and respite care assistance are made available to caregivers through individual Area Agencies on Aging throughout Indiana.