Memory Care in Michigan

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.

Michigan’s assisted living facilities have an average cost of $4,000 per month, according to the 2019 Genworth Cost of Care Survey, which is $51 below the nationwide average. Memory care services generally cost 25% more than assisted living, which raises the expected cost of memory care in Michigan to $5,000 per month.

The cost of care in a facility is also greatly influenced by its location in Michigan. For example, the average cost for assisted living in Jackson is $3,000 per month, and this climbs to $5,300 per month just 55 miles away in Monroe. Detroit’s monthly cost is above average at $4,625, while Grand Rapids and Lansing are more in line with Michigan’s average at $4,240 and $4,000, respectively. However, it’s important to remember that memory care in Michigan is generally at least $1,000 per month more expensive than the prices quoted for assisted living.

Michigan Medicaid Programs for Memory Care

MI Choice Waiver Program

Michigan Medicaid has a waiver program, MI Choice, which allows the state to direct more funding toward seniors who aren’t living in a nursing facility. The purpose of this waiver is to prevent nursing home placement by providing the necessary care and services in the individual’s own home, an adult day health care center or other residential setting. MI Choice covers the cost of personal care, such as hygiene and mobility assistance, but doesn’t pay for room and board. Residents who are currently in a nursing facility can receive assistance with transitioning back to their home, an assisted living facility or elsewhere in the community.

• Who is Eligible: Applicants must be aged 65 or older, assessed as requiring the level of care provided in a nursing facility and able to live safely in the community. They must also meet the eligibility requirements for Michigan Medicaid, including having a maximum annual income of $16,612 and $2,000 in non-exempt assets. Couples are allowed an annual income of $22,491.
• How to Apply: Local agencies are responsible for managing intake and care coordination for the MI Choice waiver. Visit the Michigan HHS website to view the waiver region map and begin the application process.

Non-Medicaid Financial Assistance Programs for Memory Care in Michigan

Optional State Supplement (OSS)

Residents who receive federal benefits through Supplemental Security Income (SSI) may also receive additional monthly payments via the Optional State Supplement program administered by Michigan’s Department of Human Services. The OSS payment levels are based on the applicant’s marital status, living arrangement and countable income. As of 2020, the maximum supplement for an individual living in a home for the aged is $179.30 per month. This payment is intended to help pay for the cost of personal care services. The OSS also includes a monthly allowance for incidental costs.

• Who is Eligible: Applicants must be eligible for SSI at the federal level, and meet the income and asset limits. If an applicant is residing in a medical facility, it must be certified for Medicaid.
• How to Apply: Applicants or their designated representatives can call the Social Security Administration at (800) 772-1213 to arrange an appointment, or use the office locator tool to find a nearby location to begin the process. In some cases it’s possible to apply for the SSI benefits online.

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 Michigan, assisted living facilities are licensed as homes for the aged (HFA) or adult foster care (AFC) homes. Any adult may receive AFC services, whereas HFAs are licensed for those aged 55 and older. Most adult foster care facilities have 20 or fewer residents, and most homes for the aged have 21 or more.

Individuals with Alzheimer’s and other dementias may receive memory care in either an AFC or HFA, and both types of facilities must provide a certain set of services and accommodations as described in the licensing rules and statutes for each category of facility.

Facility Scope of Care

Residents in Michigan’s homes for the aged and adult foster care homes may receive intermediate or temporary nursing care, but these facilities aren’t licensed for full-time nursing. Facilities offering memory care must provide a written description of their overall philosophy, assessments, care plans, staff training and other issues related to Alzheimer’s.

HFA and AFC facilities are required to provide:

• Housing and meals, supervised personal care and protection
• Staffing that’s appropriate and qualified to handle the facility’s needs
• Activities that are appropriate for people with various physical, social and behavioral needs

Admissions Requirements

Homes for the aged and adult foster care facilities in Michigan have different purposes and treatment options, and the policy for admission is based largely on those factors. See below for a general outline, and request the admission policy in writing from individual facilities.

Care Plan Requirements

Licensed facilities in Michigan are required to conduct assessments on potential residents before they’re admitted, which are then used to form a personalized care plan. This plan must incorporate the physical and cognitive needs of the individual, and it must clearly describe the amount of care and services needed, as well as the itemized costs.

Residents and their family members or designated representatives can be involved in the formulation of the plan, which must be updated at least annually, and the facility is required to maintain and produce copies upon request.

Medication Management Requirements

Medication, dietary supplements and special medical procedures must be prescribed by a physician or dentist, and kept in the original container in a secure location. Residents are generally permitted to administer their own medication, often with supervision from staff, unless otherwise stated by a health care professional. According to Michigan’s medication management requirements, the supervisory staff member is responsible for making sure the resident takes the correct medication at the dosage and timing indicated by a licensed physician or dentist.

Facility Requirements

All facilities must have a maximum of four beds per room, one sink and toilet for every eight residents on each floor and one bath or shower for every 15 residents. There are no regulations requiring an HFA or AFC to provide an environment specifically for people with dementia. However, as noted in the facility scope of care section, any facility that offers memory care services is required to fulfill the particular needs of residents with Alzheimer’s and other dementias. As a result, it’s advisable to ask whether a facility does provide memory care.

Staffing Requirements

Michigan’s regulations require that all homes for the aged and adult foster care facilities have an administrator who is responsible for facility operations. Facilities must also have one staff member on duty for each shift to serve as the resident care supervisor, who’s responsible for maintaining the respectful and kind treatment of residents, as well as their safety during an emergency situation.

There is no minimum ratio of staff to residents, although facilities are required to have an adequate number of sufficiently trained staff on duty and awake at all times.

Medicaid Policy

Michigan Medicaid doesn’t directly cover the costs of homes for the aged or adult foster care facilities. However, the Michigan Medicaid State Plan does cover the cost of personal care services received by enrolled members, such as assistance with bathing or mobility issues. Preventive services aimed at delaying placement in a home are also available through the Medicaid MI Choice waiver, but room and board costs aren’t covered.

Reporting Abuse

Complaints related to Michigan’s homes for the aged and adult foster care facilities are processed by the Bureau of Community and Health Systems. Individuals can submit a report using the online complaint form, print and mail a paper form to the Complaint Intake Unit or call (866) 856-0126. Reports must allege that a facility is in violation of state regulations, which are available to view online. In the case of alleged serious criminal activity, rather than a breach of regulations, contact the police and file a report.