Memory Care in Kentucky

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.

Kentucky seniors pay an average of $3,497 per month for assisted living — $554 less than the national average. Neighboring states also average higher than in Kentucky, with West Virginia about $250 more per month and Tennessee just over $400 more. Indiana and Illinois both exceed the national average, so Kentucky seniors can expect to save approximately $600-670 per month compared to the state’s northern neighbors. With the additional cost of memory care, seniors can expect to pay somewhere between $4,196 and $4,546 monthly for residential memory care in Kentucky.

Geographic area can play an important role in determining actual costs. For example, Kentucky seniors living in Owensboro might pay as little as $2,166 per month for assisted living, while costs in the Lexington Area average $4,297. The monthly average cost in the Elizabethtown area is $3,400, almost $100 less than the state average, while the monthly cost in Louisville and Jefferson Counties is closer to the national average at $4,073. These prices are for standard assisted living care. The cost of memory care might be around $430-$1,290 more, depending on the area and the amenities offered at a facility.

Kentucky Medicaid Programs for Memory Care

Home and Community Based Waiver

The Home and Community Based Waiver is a Medicaid program designed to help those over the age of 65 and those with a qualifying disability remain in the community. It offers a variety of support services and long-term care options, such as attendant care, meal delivery and home modifications. It may also cover adult day care and respite care in a residential facility. In-home memory care may be an option under this waiver program. Participant directed services are an option under this waiver, allowing seniors to hire a caregiver for many of their daily activities. A caregiver might be a neighbor, friend or family member.

• Who is Eligible: To qualify for the Home and Community Based Waiver, a senior must be at least 65 years old, meet the requirements for nursing home admission and meet the financial qualifications for Medicaid. Special financial rules apply to this waiver program. To qualify with no share of the cost, seniors must earn no more than $2,369 per month. Those who earn more may retain up to $2,349 per month to pay for personal needs, spousal/family maintenance or health expenses. Any remaining income goes to the waiver program under these special financial rules.
• How to Apply: If interested in a Home and Community Based Waiver, seniors can apply online or call 844-784-5614.

Kentucky Transitions

Seniors currently living in a nursing home may be eligible for the Kentucky Transitions waiver program. This Medicaid waiver is designed to help seniors move back into their own homes or another private residence. A program coordinator helps assess a senior’s needs for medical and personal care, along with social activity. Then, the coordinator and senior work together to create a plan to meet those needs in a residential setting. For seniors without a home of their own, the program offers assistance in finding safe and affordable housing. Seniors who qualify for Kentucky Transitions may also qualify for services under the Home and Community Based Waiver program.

• Who is Eligible: To qualify for Kentucky Transitions, a senior must have been a nursing home resident for at least 90 days and have the ability to live safely in the community with the right support services. Seniors must also be enrolled in Medicaid and receiving Medicaid-paid services.
• How to Apply: To apply for Kentucky Transitions, seniors can call 502-564-0330 or send an email to [email protected]

Non-Medicaid Financial Assistance Programs for Memory Care in Kentucky

Adult Day Care and Alzheimer’s Respite Program

The Adult Day Care and Alzheimer’s Respite Program is designed to assist seniors and their families with the financial costs of providing primarily in-home care. Those with Alzheimer’s or other types of dementia may be eligible for adult day services that include social, medical and personal care, delivered at the adult day care center. Meals and healthy snacks are provided, along with access to activities and medication reminders. Transportation may also be coordinated through the service provider. Seniors are typically enrolled for a minimum of four hours per day, at least three days per week.

• Who is Eligible: Seniors who are able to respond to program activities and participate in a manner that does not pose health and safety hazards to other program participants may apply. A diagnosis of Alzheimer’s, dementia or other disability is required. Services are provided on a sliding scale basis, and participants are typically charged a percentage of the total allowable rate for adult day care.
• How to Apply: This program is administered by local Area Development Districts. To locate your office, find the ADD serving your county.

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.

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.

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.