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.
The average monthly cost of assisted living in Maryland is $4,300, which is almost $250 more than the national monthly average of $4,051. Assuming the cost averages 25% more than assisted living, seniors can expect to pay around $5,375 each month for memory care in Maryland.
Within the state, costs can vary widely. In Cumberland, assisted living costs an average of $3,750 per month, which is the most affordable area of the state. In California, the cost rises to $6,263 per month, which is more than $2,500 higher than the rate in Cumberland. Costs in Maryland’s largest city, Baltimore, are close to the average, at $4,225 per month. These prices are for standard assisted living; depending on the area and facility, memory care may cost $1,000-$2,000 more each month.
The Community Personal Assistant Services program is designed to help people who wish to remain in their homes but require some assistance with activities of daily living. Providers may be self-employed and chosen by program participants, or agency-employed providers whose services are arranged by the program administration. Services can include personal assistance, nurse monitoring and support planning.
Community First Choice aids people who wish to stay in the community but need assistance to avoid nursing home admission. Services provided by the program include assistive technology, nurse monitoring and personal assistance services. These services can be provided in the enrollee’s home or an adult foster care or assisted living facility. Assistance provided is based on an individual’s needs and is generally self-directed. The program allows family members to be hired as caregivers.
The Community Options Waiver is for people who need nursing home level care but wish to receive care in their home or a group living community. A group living community may include assisted living facilities, but not all assisted living facilities participate in the program. Services provided can include behavior counseling, respite care and environmental modifications. Applicants may be added to a waiting list in some counties.
Seniors in Maryland can use the Medical Day Care Services waiver to access daytime supervision in a licensed day care center. This provides respite to primary caregivers and allows seniors to participate in social activities. The program also provides participants with meals, medication monitoring and a nursing assessment.
The Increased Community Services Program is designed to help elderly people in nursing homes move back into their own home, the home of a relative or an assisted living facility. It provides assistance with transitioning to a new living arrangement and long-term support to help individuals live in the community. This includes personal assistance, medical alert systems and adult day care.
The Senior Care Services Program aids residents at risk of entering a nursing home and allows them to stay in their own home or the home of a caregiver. A major focus of the program is care coordination, and other services available include respite care, home modifications and personal care.
The Assisted Living Subsidy provides financial assistance to Maryland seniors to help pay for the cost of assisted living. The subsidy is only available in limited counties and at facilities participating in the program. Communities in the program are small, accommodating no more than 16 residents. Waiting lists for this program may apply.
Group homes in the Congregate Housing Services Program receive money directly from the program to provide residents with services such as meals, housekeeping, medication reminders and some personal assistance. The program is designed for people who require less care than what is offered in a traditional assisted living facility, but who cannot live independently. The program is only available in certain communities.
In-Home Aide Services are available to Maryland residents 18 years and older who require help to stay in their homes. The program provides case management, self-training and assistance with activities of daily living. Services are provided at a reduced rate based on the participant’s income. A waiting list exists for the program and those with the highest need are given priority.
Project Home assists people who can’t live alone but can live in a foster care environment. The program provides meals and accommodation and may include transportation, social activities and some assistance with activities of daily living. Participants are asked to pay program fees, but financial assistance may be available for those unable to afford them. Waiting lists do exist for Project Home and priority is given to those most in need.
In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:
Assisted living facilities in Maryland that are licensed to care for individuals with memory impairment are considered assisted living programs (ALPs) and are regulated by the Department of Health. There are three types of licenses available based on the level of care provided. The department or their delegates conduct facility inspections every 15 months, or more often if required.
ALPs must complete an assisted living disclosure form, and facilities with an Alzheimer’s special care unit must include details regarding the unique design features and activities provided to meet the needs of residents with dementia.
All ALPs must provide three nutritious meals daily and snacks throughout the day. They must also aid in coordinating health services, provide assistance with two or more ADLs and offer occasional assistance in accessing recreational services. Programs can provide minor interventions to manage disruptive behavior and occasional psychological episodes.
Facilities with level two licenses provide a higher level of support with ADLs and can assist with frequent disruptive behaviors or psychological episodes. Level three programs also provide ongoing access to comprehensive health services, frequent assistance with ADLs and intensive supervision to manage behaviors that may disrupt or harm the resident or others. They must also monitor and manage psychological episodes that may require immediate intervention.
There is a wide range of residents who can be admitted to ALPs, but facilities must meet certain restrictions as well. This table gives an overview of who may or may not be admitted.
|Residents Who May Be Admitted||Older adults and people with:|
|Residents Who May NOT Be Admitted||Those who require:|
And those who:
Individuals must be assessed to identify the level of care they require to meet their medical, cognitive and psychiatric needs. The assessment also determines their treatment requirements, ability to self-administer medication and their ADL and risk factor management needs. Any problematic behaviors are noted. The assessment must be reviewed every 6 months, and a full assessment must be performed after a non-routine hospitalization or significant change in condition.
Level one programs can assist with self-administration of medications, while level two and three programs can administer medication and monitor the effects of medications and treatments. Each resident’s ability to self-administer must be reviewed by a licensed health care professional at least quarterly. Health professionals must also review individual’s regimes within 14 days of admission, and a licensed pharmacist must conduct an on-site review at least every six months for any resident receiving nine or more medications.
ALPs can have a maximum of two residents per unit, although this limit may be waived if programs have previously received a waiver. There must be at least one toilet for every four residents. A minimum of one bathtub or shower is required for every four residents in facilities with eight or fewer residents. Larger facilities must have one for every eight residents.
Facilities must have enough staff available to make sure residents’ scheduled and unscheduled needs can be met. A waiver to use electronic monitoring instead of awake overnight staff can be granted when a physician or nurse determines residents don’t require overnight assistance.
Each facility must have a manager to direct daily operations and an alternate nominated for periods when the manager is unavailable. There must be a registered nurse available to provide nursing services, and medication technicians and direct care staff must also be available. Initial training is required and individuals who perform personal care must demonstrate competence to the delegating nurse. Managers must complete 20 hours of continuing education every 2 years.
Room and board in ALPs is not covered by standard Maryland Medicaid. Waiver programs, including the Community Options Waiver, do assist with the cost of some care services provided by level two and three ALPs. Services in level one programs are not covered by any Medicaid waivers.
Maryland has a range of reporting options for anyone with concerns or complaints about the treatment of residents in ALPs. Both Adult Protective Services and the Office of Health Care Quality investigate complaints. Residents with Medicaid insurance can report concerns to the Medicaid Fraud Control Unit of the Maryland Attorney General’s office. In addition, the Maryland Department of Aging, Long-Term Care Ombudsman Program investigates and attempts to resolve complaints made by residents of assisted living facilities.
|Johns Hopkins Memory and Alzheimer’s Treatment Center||410-550-6337||In addition to evaluation and treatment, the Johns Hopkins Memory and Alzheimer’s Treatment Center has family and patient resources available, including a social group. Individuals may be able to participate in the center’s research trials.|
|Alzheimer’s Association of Maryland||800-272-3900||The Alzheimer’s Association has information and support available to people with Alzheimer’s disease and their families. Support groups are also available around the state.|
|Family Caregiver Support Program||410-767-1100||The Family Caregiver Support Program provides information and assistance to family members looking after individuals of any age who have Alzheimer’s disease or a related condition. Respite care and supplemental services are also available.|