Memory Care in Indiana

Table of Contents

Memory Care in Indiana

Table of Contents

• Indiana Medicaid Programs for Memory Care
• Can You Use Medicare to Pay for Memory Care in Indiana?
• More Ways to Pay for Memory Care in Indiana
• Memory Care Laws and Regulations in Indiana
• Free and Low-Cost Resources for Seniors in Indiana
• Indiana 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.

We calculate memory care costs by adding 25% to the average assisted living costs as listed by Genworth’s Cost of Care Survey 2021. Indiana seniors spend $5,354 per month for memory care. 

This monthly charge is $271 lower than the national median of $5,625 and compares favorably with neighboring states. Older adults in Indiana spend less per month than those residing in Illinois ($5,610) and Michigan ($5,313), while Ohio seniors pay the highest rate in the region at $5,794 per month. The most affordable memory care is in Kentucky, where communities charge $4,310.

Memory care costs vary across Indiana. Seniors living in the north pay the cheapest rates, with those in Michigan City spending $4,521 and South Bend residents paying $4,135, one of the cheapest rates in the state. Costs rise in central Indiana, with communities charging $5,598 and $5,826 in Indianapolis and Columbus, respectively. Prices are highest in the west of the state, with seniors in Lafayette paying $6,569 per month.

The Cost of Memory Care in Indiana

Indiana Medicaid helps low-income seniors pay for nursing home care but doesn’t cover the costs in residential environments, such as memory care communities. Seniors looking for financial assistance to help pay for memory care in a residential facility could be eligible for Medicaid waivers or other programs.

Aged and Disabled Waiver

Indiana’s Aged and Disabled Waiver program helps those who require memory care and nursing home placement but can live safely in a less supportive environment. It covers several expenses associated with living in a residential care community, such as assistance with activities of daily living, housekeeping, meals and medical supplies.

• Who Is Eligible: Seniors must meet the same financial and personal criteria needed to enroll in Indiana’s Medicaid program. In addition, applicants must be 65 years or older or deemed permanently disabled and require nursing home placement but be able to live safely in a less restrictive community.
• How To Apply: Applicants must have Indiana’s Medicaid coverage before applying. To request an assessment to enroll in the waiver program, contact the local Area Agency on Aging.

Medicaid Eligibility for Seniors in Indiana

Eligibility for Medicaid in Indiana is dependent on the levels of annual income and assets held by seniors. Each person applying must have an income of less than $2,523 per month. For married applicants applying together, this becomes a household limit of $5,046.

Assets are also considered and are limited to $2,000 for a single person. If both partners in a two-person household jointly apply for Medicaid, their asset cap is $3,000. When just one spouse is making an application, the asset limit is $2,000 for the applicant and $137,400 for their partner.

2022 Medicaid Income Limits for Seniors in Indiana

In addition to being characterized as low income and meeting the income and asset limits, Indiana Medicaid applicants must also fall under the following criteria:

• Be resident in the state of Indiana.
• Be a U.S. national, permanent resident, citizen or legal alien.
• Require health care or insurance assistance

How to Get Help Applying for Medicaid in Indiana

Seniors who require assistance navigating the Medicaid system in Indiana can find guidance and help with applications.

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 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 Admitted

Seniors 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 Admitted

Those 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.

Indiana seniors affected by Alzheimer’s and other forms of dementia, their caregivers and family members can find support, information and assistance from several resources.

Note: The following information was compiled and most recently updated on 2/8/2022. 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.