I. Paying for Memory Care in West Virginia

The Cost of Memory Care in West Virginia

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.

Based on the average cost of assisted living as reported by the 2019 Genworth Cost of Care Survey, memory care in West Virginia will cost seniors and their families an average of $4,687 a month. This includes the costs associated with board and care, supervision and some dementia-specific services, such as meal assistance. The West Virginia average is less than the average cost across the United States, which is approximately $5,063 based on the average cost of assisted living, which is $4,051 per month.

The urban areas in West Virginia vary widely in their average monthly costs for memory care. Beckley, in the southern part of the state, is one of the most affordable areas, with an average cost of $4,062 a month for memory care. This is $1,500 a month less than the most expensive area, Weirton, where care costs $5,625 a month. Charleston, the state capital, stays close to the national average cost, at $5,056 a month. These figures are based on the average cost of assisted living in these areas, and adding 25% to account for the price difference often seen between assisted living and memory care.

  • West Virginia: $4,687
  • United States Average: $5,063
  • Wheeling: $4,237
  • Charleston: $5,056
  • Weirton: $5,625
  • Morgantown: $4,963
  • Beckley: $4,062
  • Huntington: $4,418
   

West Virginia Medicaid Programs for Memory Care

Medicaid Personal Care Program (MPCP)

Medicaid beneficiaries in West Virginia can get help paying for the cost of a personal caregiver through the Medicaid Personal Care Program (MPCP). This program issues payments to the caregiver of a senior’s choice, who can be a family member or friend. Caregivers assist with activities of daily living, plus personal care and some chores around and outside of the home. The program also pays some of the cost of medical supplies.

MPCP services may be provided to seniors with a medical need for assistance, as recommended by a personal physician. Services are open to seniors who live in their own homes, in the homes of relatives or friends, and for seniors in some facilities, such as assisted living and residential care homes.

Who is Eligible: Program beneficiaries must be eligible for Medicaid and have a demonstrated medical need for caregiver support. Single seniors are limited to a maximum monthly income of $771. Applicants are limited to a maximum of $2,000 in countable assets.

How to Apply: Seniors can apply for MPCP directly, through a local Area Agency on Aging, or by calling 866-767-1575 for an application packet. Most new applications are subject to a 60-day waiting period before benefits are available.

Home and Community Based Services Waiver (HCBSW)

The West Virginia Bureau for Medical Services administers the Home and Community Based Services Waiver (HCBSW) to help seniors get necessary services at an appropriate care level. Multiple waivers are included in the HCBSW program, including:

  • Aged and Disabled Waiver (ADW)
  • Traumatic Brain Injury Waiver (TBIW)
  • Intellectual and Developmental Disabilities Waiver (IDDW)

These waivers pay many of the costs of caregiver assistance and medical supplies, as well as skilled nursing and transportation services. Friends and family members may be designated as caregivers under an HCBS waiver, and services are open to seniors who live at home, with family or in a residential care setting, such as assisted living or memory care facility.

Who is Eligible: To qualify for long-term Medicaid, seniors in West Virginia must be aged 65 or over and have a medical need for residential care services. Income limits range between 100% and 300% of the Federal Benefit Rate, or between $771 and $2,313 a month for single adults applying for themselves. Seniors are limited to countable assets of no more than $2,000, not counting the applicant’s household items, personal vehicle and up to $585,000 in home equity.

How to Apply: Seniors in West Virginia can apply for an HCBS waiver by calling 866-767-1575, or by mail at:

Bureau of Senior Services (BoSS)
Arlene Hudson, Director of Medicaid Operations
1900 Kanawha Blvd., East
Charleston, WV 25305

Non-Medicaid Financial Assistance Programs for Memory Care in West Virginia

Legislative Initiative for the Elderly (LIFE)

The Legislative Initiative for the Elderly (LIFE) program is a West Virginia state project to comply with the federal Older Americans Act and provide needed non-medical and non-personal care services for seniors with unmet needs. LIFE does not pay caregivers for assistance with daily living, but it does pay for up to 60 hours a month in extra services to help seniors who live alone, with family or in a residential care setting, such as a memory care facility or assisted living community. Provided services include:

  • Shopping assistance
  • Housekeeping and laundry service
  • Transportation and standby service during medical appointments
  • Medication management and administration assistance
  • Meal delivery and/or preparation

Who is Eligible: The LIFE program is open to seniors aged 60 and over who meet their county’s eligibility criteria. These vary from county to county and by the year, but they often include financial and need-for-care assessments.

How to Apply: Seniors can apply for LIFE benefits at a local senior center. Applications and requests for program information may also be submitted to the state central office by calling 877-987-3646, or by mail at:

West Virginia Bureau of Senior Services
1900 Kanawha Blvd. East
Charleston, WV 25305

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 West Virginia

Memory Care Regulation

The West Virginia Department of Health and Human Resources (DHHR), Bureau for Public Health, Office of Health Facilities Licensure and Certification regulates memory care facilities as Alzheimer’s/dementia special care units, which must obtain a special license. These facilities provide services 24 hours a day that include specialized memory care programs for a state-specified number of hours a day. The department splits facilities into three categories: residential care homes can house up to three seniors with dementia, small facilities house between 4 and 16 residents, and large facilities house 17 or more residents. Seniors admitted to a residential care home must have a placement recommendation from the department. Facilities of all sizes are subject to inspection and regulation.

Facility Scope of Care

Memory care facilities in West Virginia may provide board and care, as well as routine caregiver services for their residents. In addition to basic services, facilities may also provide limited nursing care from a staff or visiting nurse. Residents who need more intensive nursing care may remain in the residential care facility for up to 90 days, provided their condition is temporary and expected to improve.

Other types of non-medical care may be provided for residents of special care units. These services include transportation outside of the facility, meal service in the community dining area and leisure activities, including memory-specific activities relating to dementia care.

Admission Requirements

The State of West Virginia imposes restrictions on who can and cannot be admitted to a facility that provides memory care services. Guidelines are issued by the DHHR, and provided to all licensed care facilities, regardless of the level of care provided.

Residents Who May Be AdmittedSeniors with a medical condition that imposes a disability requiring 24-hour care, including:

  • Alzheimer’s disease/dementia
  • Developmental disabilities
  • Traumatic brain injury
  • Mental health conditions
Residents Who May NOT Be AdmittedChildren under the age of 18, as well as those adults who:

  • Require nursing care in a dedicated post-acute facility or nursing home
  • Have medical conditions outside of the scope of a residential care facility
  • Demonstrate disruptive, violent, self-harming or other behaviors that cannot be managed with medication and non-medication interventions
  • Cannot self-evacuate in case of fire or other emergency

Care Plan Requirements

Incoming residents at all West Virginia memory care facilities must be provided with a detailed care plan prior to admission. Care plans must include an exposition of all likely and continuing costs, as well as an explanation of extra services and the expenses they add to the cost of care. Care plans are drafted in consultation with the resident’s physician, who includes specific diagnoses and plans for continuing physical and mental health therapy services. Special care units must also include written policies relating to the facility’s pre-admission screening process and procedures for admission, transfer and discharge. The written care plan must also include an explanation of the level of care the facility’s license permits. Included in the terms must also be a written statement describing the conditions under which the resident may be transferred or discharged.

Medication Management Requirements

Alzheimer’s/dementia special care units may administer medication as needed within their licensure category. Facilities must follow the published state guidelines for administering psychotropic and behavior-modifying medications. Guidelines must also be followed for non-medical behavior modification strategies. Before administering behavior-modifying medications, the facility must ensure that the resident’s diagnosis justifies the use of the medication and that daily checks are performed for adverse side effects that must be reported to the resident’s physician. Dosage amounts must be based on age recommendations and measures must be taken to gradually reduce the amount of medication needed over time. Residents who receive medication must be evaluated on a monthly basis by a practitioner-level health provider, and a doctor must review the care plan at least once every six months.

Facility Requirements

Facilities may provide private and shared rooms. No more than two residents are allowed to occupy a room together. Facilities must have at least one sink and toilet for every six residents and one bathtub or shower per floor, or for every 10 residents.

All licensed facilities must provide personal care services and help with administration of prescription medication. Staff must be able to assist residents follow planned diets and activity regimens. Facility staff are responsible for booking medical and dental appointments for residents as needed. Alzheimer’s and dementia care units must also provide behavior management services tailored to the needs of each resident in order to prevent self-harm and harm to other residents.

Staffing Requirements

Special care units are required to employ both administrators and caregiver staff. If nursing care services are provided at the facility, the establishment is required to employ a registered nurse. The state of West Virginia does not mandate specific caregiver-to-resident ratios, but all facilities are required to employ enough full-time staff to take care of residents’ physical and therapeutic needs. Facilities with more than four residents that provide memory care services must have at least one member of staff awake and ready to respond 24 hours a day.

Medicaid Policy

West Virginia does not provide Medicaid funds for any type of residential care or memory care services. Supplemental payments are not generally available, though a special benefit is available for seniors who qualify for SSI but cannot, for whatever reason, receive SSI benefits. State benefit amounts can be as high as $879.90 a month for eligible seniors, plus an additional $1,122.32 a month to eligible residential care facilities.

Reporting Abuse

Suspected cases of elder abuse or neglect can be reported to local law enforcement. Call 911 if an emergency is in progress. West Virginia Adult Protective Services may be reached by phone at 800-352-6513, or by mail at:

350 Capitol Street,
Room 730
Charleston, WV 25301

III. Free Memory Care and Alzheimer's Resources in West Virginia

ResourceContactDescription
West Virginia Alzheimer’s Association800-272-3900The West Virginia chapter of the Alzheimer’s Association provides no-cost educational resources, referrals for care and home support services for seniors with dementia. The association also helps families with community resources and supports funding and research efforts that include medical trials for seniors with Alzheimer’s disease and other forms of dementia.
Area Agencies on Aging877-987-3646West Virginia’s four Area Agencies on Aging coordinate across the state to provide free and low-cost services for seniors with dementia and other seniors aged 60 and over. Services provided by AAA chapters include transportation and nutrition services, vouchers for food and clothing and monitoring for program and financial compliance among other nonprofit organizations.
West Virginia Aging & Disability Resource Network (ADRN)304-558-3317The West Virginia Aging & Disability Resource Network (ADRN) provides no-cost professional services to assist medically and financially needy seniors in West Virginia find adequate residential care. Office staff research potential residential care facilities and maintain lists of nonprofit community resources for seniors who need therapeutic and social assistance. Other provided services include:

  • Personal care
  • Nutritional support
  • Transportation for medical and personal trips
  • Adult day care
  • Respite care
  • Hospice services
  • Memory screenings
  • Caregiver training
  • Dementia-friendly community events
F.A.I.R. Alzheimer’s & Dementia ProgramContact a local senior centerThe West Virginia Bureau of Senior Services administers the Family Alzheimer’s In-Home Respite (FAIR) Program for West Virginia families and caregivers looking after seniors with Alzheimer’s and dementia. The program provides a home visit from skilled caregivers to provide in-home respite care, as well as assistance developing activity plans and community events for seniors with dementia.
Memory Assessment Center at Chestnut Ridge304-598-4214The Memory Clinic program at Chestnut Ridge offers free screenings for Alzheimer’s disease and low- or no-cost memory care health services for seniors located throughout West Virginia. Facility staff include a geriatric neurophysiologist, and services include medical and mental health screenings, nutrition screenings and other needed medical services for seniors with dementia.