Memory Care in Kentucky

Table of Contents

Memory Care in Kentucky

Table of Contents

• The Cost of Memory Care in Kentucky
• Kentucky Medicaid Programs for Memory Care
• Can You Use Medicare To Pay for Memory Care in Kentucky?
• More Ways To Pay for Memory Care in Kentucky
• Memory Care Laws and Regulations in Kentucky
• Free and Low-Cost Resources for Seniors in Kentucky
• Kentucky 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 Kentucky and surrounding states, we added 25% to the average monthly cost of an assisted living facility based on the survey numbers from Genworth’s 2021 Cost of Care Survey.

Memory care in Kentucky averages $4,310 per month. Compared to the national average, this type of care is $1,315 less. To the south in Tennessee, the median cost is $5,131 per month, and to the north in Indiana and Ohio, seniors can expect to pay around $5,354 and $5,794, respectively. Virginia residents pay one of the highest costs in the area at $6,563.

Location within the state can play a factor in the cost of memory care. In Kentucky, this costs ranges from $3,860 in Owensboro to $5,710 in Lexington. Elizabethtown seniors pay around $4,031 per month, while those in Bowling Green and Louisville average the same at $4,375.

Kentucky Medicaid is a state and federal program that helps low-income individuals pay for health care and receive medical services they otherwise couldn’t afford. Medicaid doesn’t cover the cost of assisted living and memory care directly, but it does offer one home and community-based waiver program that helps pay for personal care.

Home and Community-Based (HCB) Waiver

The HCB waiver provides financial help to the elderly and to adults and children with disabilities to help them remain in the community as long as possible. The waiver covers a variety of services, including attendant care, home adaptions, meals and respite care.

• Who Is Eligible: Seniors age 65 and older or those with a disability are eligible to apply for the HCB waiver. Individuals must meet the requirements to be admitted into a nursing home and meet the financial requirements for Medicaid.
• How To Apply: To apply for an HCB waiver, file an application online through kynect or call the Department for Community Based Services at (855) 306-8959. Applications can also be submitted in person at any DCBS office.

Medicaid Eligibility for Seniors in Kentucky

For Medicaid eligibility, the total income limit for applicants can’t exceed 300% of the federal poverty level or $30,276 per year per applicant. Asset limits for a single applicant can’t be more than $2,000. In a two-person household, the asset limit for the non-applicant is $137,400, which allows the spouse to maintain ownership of their home and other belongings.

2022 Medicaid Income Limits for Seniors in Kentucky

Additional eligibility criteria include:

• Kentucky residency
• U.S. citizen, permanent resident or legal alien
• 65 years of age or older
• Require health care or insurance assistance

How to Get Help Applying for Medicaid in Kentucky

Seniors in Kentucky can choose local or statewide help when applying for Medicaid. The following resources can provide application assistance and answer questions about benefits, claims, billing and additional services.

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 can 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.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 loan will need to be paid back after the sale of the home. The most commonly used type of reverse mortgage 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 can 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 Kentucky, assisted living facilities and personal care homes are regulated by separate government entities. The Kentucky Department for Aging and Independent Living certifies all assisted living communities, while personal care homes are licensed by the Kentucky Cabinet for Health Services, Office of Inspector General, Division of Health Care.

As part of the licensing process for long-term care homes that provide memory care, facilities (both personal care home and assisted living communities) must provide a comprehensive document that details special services, staff training programs that specialize in dementia care, placement processes, family care expectations and any costs associated specifically with memory care services. Barring a complaint, inspections are carried out every two years to ensure compliance and recertification at an assisted living facility and annually for licensing at a personal care home.

Facility Scope of Care

Assisted living facilities offer services that include assistance with all seven activities of daily living, help with housekeeping or other chores, transportation assistance and help with self-administered medication. These facilities are also expected to offer scheduled activities and social opportunities, along with meals and snacks.

Personal care homes, another residential option, provide a range of health-related services, along with continuous monitoring and supervision. A personal care home is also required to offer social and recreational activities that stimulate and engage residents to the best of their ability.

Admissions Requirements

Long-term care facilities work with a wide variety of residents who need different levels of care; however, not all seniors can be safely and adequately cared for in these communities. The table below lists some of the reasons why a senior might be denied for placement in an assisted living facility.

Residents Who May Be Admitted

Older adults and people with:

• Dementia
• Disabilities
• Mobility or physical disabilities who can still navigate the facility with limited assistance
• Mental health conditions
• Intellectual or developmental disabilities

Residents Who May NOT Be Admitted

Those who:

• Can’t walk or transport themselves using a mobility assistance device, unless the condition is temporary
• May be a danger to themselves, other residents or staff members
• Require nursing care or other health services (some facilities may allow contracted service through a third-party company)

Care Plan Requirements

According to the Louisiana Administrative Code, ARCPs must perform and document an initial assessment of the resident’s needs. The screening must include information on the resident’s physical and mental status as well as the need for assistance with ADLs and IADLs. The ARCP must use this assessment in devising the resident’s care plan within 21 days of admission. The care plan has to be reviewed at least annually and revised, as necessary, by the staff involved in the resident’s care.

Medication Management Requirements

Staff with documented training can supervise the self-administration of medications and assist with reminders, opening containers, pouring medication and bringing it to residents. Staff administration of medications is allowed in all ARCPs in accordance with residents’ care plans. Medications can only be administered by a person currently licensed by the appropriate state agency. Intravenous therapy may be administered by staff under the supervision of a licensed practitioner in level 4 facilities only. The resident, the resident’s representative or the ARCP may contract with another individual or agency to administer medications

Facility Requirements

ARCPs may house up to two residents per resident unit. Level 1 and 2 facilities must have one bathroom for every four residents; level 3 and 4 facilities must have a separate, complete bathroom in each apartment. Facilities that accept residents with dementia or exit-seeking behaviors must provide an enclosed area adjacent to the facility so the residents may go outside safely.

Staffing Requirements

Louisiana doesn’t impose staffing ratios. Each ARCP must have at least a director, a designated activities coordinator and a direct care staff person. Employees who work directly with residents who have dementia must obtain at least eight hours of evidenced-based dementia training within 90 days of employment in addition to eight hours of such training annually. Staff who have regular contact with residents must obtain a minimum of four hours of dementia training within 90 days of employment as well as two hours of dementia training annually.

Medicaid Policy

Medicaid reimburses assisted living facilities for services rendered to seniors covered by Medicaid waivers or enrolled and receiving personal care coverage. These individuals must be eligible for institutional level of care. The reimbursement includes coverage of assistance with ADLs.

Reporting Abuse

The Elderly Protective Services in the Governor’s Office of Elderly Affairs investigates and intervenes appropriately in cases of abuse, neglect and exploitation involving Louisiana residents aged 60 years and older. The office can be reached at 1-833-577-6532 or by mail at: Governor’s Office of Elderly Affairs, P.O. Box 61, Baton Rouge, LA 70821-0661.

Louisiana’s Health Standards Section provides a complaint form for filing grievances against any health care facility licensed by the Department of Health. Once completed, the form should be mailed to: Health Standards Section, P.O. Box 3767, Baton Rouge, LA 70821. The HHS can be reached at 225-342-0138.

Residents of Kentucky can get information on programs and services that seek to improve their quality of life. These services range from online information to personal care services for older adults and families.

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.