According to the latest statistics from the Alzheimer's Association, 26,000 New Hampshire residents aged 65 and older currently have this devastating disease. By 2025, that number is expected to grow to 32,000, an increase of 23.1%. Alzheimer's and related dementia disorders claimed the lives of close to 500 New Hampshire seniors in 2018, making it the state's sixth-leading cause of death. In 2019, the per capita cost of dementia care was $25,147 in New Hampshire alone, and related Medicaid expenditures for the nation as a whole are expected to total over $305 billion in 2020.
Memory care facilities provide those living with Alzheimer's and dementia with care that is tailored to their unique needs. Memory care can take place in its own facility, or as part of a designated wing of another residential care community. Staff members of memory care units or facilities undergo specialized training in caring for those with memory impairment, and the facilities often coordinate social activities and schedules specifically for the needs of those living with Alzheimer's or dementia.
This guide will cover the cost of memory care in New Hampshire, financial assistance options for paying for memory care, free memory care resources in the state, and a directory of memory care facilities in New Hampshire.
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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.
We added 25% to the cost of assisted living as reported in the 2021 Genworth Cost of Care Survey to calculate the cost of memory care.
Seniors in New Hampshire pay an average of $7,566 per month for memory care. This amount is almost $2,000 more than the national average of $5,625. Communities in nearby Maine charge a similar amount at $7,331, while those in Massachusetts are far more costly at around $8,125 per month. Vermont is the most affordable state in the vicinity, with an average monthly cost of $6,563.
Data is only available for one city in New Hampshire: Manchester, with a monthly average cost of $10,076. Across the state border in Boston, MA, seniors pay significantly less at around $8,524 each month. In Portland, ME, the costs are similar to those in Boston at an estimated $8,156 per month.
The New Hampshire Medicaid Program is designed to assist low-income seniors and chronically ill adults with receiving the medical care and services they require. It doesn't cover memory care services in an assisted living community or home-based environment. The Choices for Independence Waiver Program may cover some of the costs and make memory care an affordable option.
Choices for Independence Waiver Program
The Choices for Independence Waiver Program is aimed at seniors who are eligible for Medicaid and medically qualify for nursing home care. The program is designed to delay or prevent the move to a nursing home by providing the required care services to seniors in a less restrictive environment such as an assisted living community. Benefits are provided on a case-by-case basis and may include nonmedical transportation, intermittent skilled nursing care, personal care services, physical therapy, occupational therapy and specialized medical equipment.
Seniors applying for Medicaid in New Hampshire are required to meet certain income guidelines to qualify for coverage. Single applicants have a monthly income limit of $2,523, while married couples must receive less than $5,046 or $2,523 per spouse. The asset limit in New Hampshire is $2,500 for single applicants and $5,000 for dual applicants.
2022 Medicaid Income Limits for Seniors in New Hampshire
|family size||annual income limits||asset limits|
|Two-Person Household (Single Applicant)||$30,276 for the applicant||$2,500 for the applicant, $137,400 for the non-applicant spouse|
|Two-Person Household (Dual Applicants)||$60,552||$5,000 ($2,500 per spouse)|
Additional requirements for eligibility include being a citizen of the United States or a legal resident and being a resident of New Hampshire.
Documents that may be required for the application include:
Services are available to assist seniors and their loved ones in the application process.
|NH Easy Gateway to Services||844-275-3447||The NH Easy Gateway to Services website offers an online quiz to see if a person is eligible for Medicaid. It explains different health care options and provides a step-by-step guide through the application process. A helpline is available for those requiring additional assistance.|
|Service Link||866-634-9412||ServiceLink Centers are located throughout the state. Seniors can apply for Medicaid in person at one of the offices or ask any questions about the program.|
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:
In New Hampshire, the Department of Health and Human Services Health Facilities Administration is responsible for licensing and inspecting assisted living facilities, including those that offer memory care. The administration performs routine inspections to ensure compliance with state rules and regulations and conducts unscheduled inspections in response to complaints. New Hampshire has two types of licensed AL facilities: supported residential health care facilities (SRHCFs) and residential care facilities (RCFs).
State regulations do not include special requirements for facilities that provide memory care, other than prohibiting the use of mechanical constraints and stipulating that staffing must be adequate to meet the needs of residents.
SRHCFs and RCFs must provide necessary services to ensure the health and safety of residents and limit the likelihood of injuries and accidents. At a minimum, the scope of care must cover:
SRHCFs must also ensure that residents have access to nursing, rehabilitation and behavioral health care services if required.
New Hampshire regulations allow RCFs and SRHCFs to accept individuals with various conditions who require assistance with activities of daily living and instrumental activities of daily living, including those with cognitive impairment. An overview of the circumstances that determine whether a person may reside in an RCF or SRHCF is provided in the following table.
Residents Who May Be Admitted By RCFs And SRHCFs
Seniors and adults who have:
Residents Who May Be Retained By SRHCFs
Residents who required ongoing nursing or medical care and whose needs may be met by the facility's staff or a licensed home health care provider.
Residents Who May NOT Be Admitted or Must Be Discharged By RCFs:
New residents of SRHCFs and RCFs must be evaluated by a trained assessor using an HFA-approved tool. Assessments must be conducted every six months and after any noted change in a resident's condition. If indicated, a nursing assessment must be performed that covers a resident's vital signs; medication use; clinical services and physical, behavioral, cognitive and mental status. Qualified facility staff must develop a care plan for each resident based on their assessment results.
Residents of SRHCFs and RCFs may self-administer medications and verbally self-direct staff to help, if necessary. SRHCF staff may supervise self-administration by residents but may not handle medications. A licensed nurse may delegate the administration of oral medications to unlicensed staff members, who may also administer enemas, glycerin suppositories, topical products and medicinal baths/shampoos with direction. In RCFs, medications may be administered by a licensed nurse or a medication nursing assistant.
Per state regulations, licensed SRHCFs and RCFs are not required to provide private apartments. Resident accommodations may be single or double occupancy and should include a sink and toilet. Facilities must have one bathtub or shower for every six residents. SRHCFs that offer memory care should be equipped with a wander prevention system, a locked security system or an alarmed system that locks automatically when a resident wearing an electronic sensor approaches. RCFs with 16 or fewer residents must have a wander prevention system installed if awake staff is not on duty at night.
SRHCFs and RCFs must employ an administrator to handle daily operations, sufficient direct care staff to provide residents with personal care assistance and a licensed nurse to administer medications. In SRHCFs, the on-staff nurse must also oversee health services and assist with resident assessments, and they may also delegate medication administration to a certified nursing assistant.
There are no minimum staffing ratios in New Hampshire assisted living facilities. Instead, administrators determine personnel requirements according to their facility's size and the service needs of its residents. SRHCFs and RCFs must have at least one awake staff member on duty around the clock. Overnight staffing is not required in facilities with less than eight beds that are equipped with electronic communication systems.
Regulations require facility administrators to complete 12 hours of continuing education on relevant topics each year. Direct care personnel must receive a comprehensive orientation and initial training within one week of being hired, and they must be provided with ongoing training during their employment.
New Hampshire Medicaid only provides coverage for care received in a nursing home as an entitlement. The plan does offer the Choices for Independence Waiver program, which can help defray monthly expenses for seniors who wish to live in a less restrictive assisted living setting. Assistance is capped at 80% of the cost of care in a nursing facility, but the waiver does cover a variety of services that may benefit memory care residents.
Incidents of resident neglect or abuse in a New Hampshire SRHCF or RCF facility should be reported to the Office of the Long-Term Care Ombudsman. Complaints may be made by email, by calling 800-442-5640 or by completing and faxing a facility initial report form to 603-271-5574. Alternatively, a completed report form may be mailed to:
Office of the Long-Term Care Ombudsman Office of the Commissioner NH Department of Health and Human Services 129 Pleasant Street Concord, NH 03301
A number of resources are available to guide and assist seniors and their caregivers along the difficult journey that is Alzheimer's. These resources provide information, education and support along the way to ensure seniors enjoy the best quality of life possible.
|Alzheimer's Association Massachusetts and New Hampshire Chapter||800-272-3900||The Alzheimer's Association Massachusetts and New Hampshire Chapter provides a central resource for seniors and their caregivers regarding Alzheimer's and other dementia-related conditions. The organization runs support groups and educational programs across both states. The association offers a helpline that's available 24/7.|
|Alzheimer's Impact Movement New Hampshire||603-969-9155||The Alzheimer's Impact Movement New Hampshire advocates on behalf of seniors. The organization aims to improve government awareness regarding Alzheimer's and increase government investment in research projects and support services.|
|ActivMed Memory Screening||978-655-7155||This medical practice has offices across the state. It offers free memory screening tests to determine if there's an issue that should be investigated further. These tests are repeated on an annual basis to look for cognitive changes.|
|Memory Cafes New Hampshire||Multiple locations with contact information online||There are a number of memory cafes across the state of New Hampshire. These cafes offer a welcoming environment for seniors with memory loss disorders and their caregivers. Each cafe offers different activities and social engagement time for seniors. In addition, they provide a space of mutual support for caregivers and seniors.|
|Justice in Aging Project||888-353-9944||The Justice in Aging Project provides free legal services for seniors aged 60 and over. Seniors with memory loss disorders may experience a particular set of legal issues, and the project will protect and assist them. Problems faced by seniors may include financial exploitation and disputes with senior care facilities.|
Note: The following information was compiled and most recently updated on 2/10/2022. 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.
|Am I allowed to visit my loved one in person?||Yes (Conditions Apply)|
|Is my loved one required to quarantine after I visit him or her?||No|
|Am I required to wear a mask if I visit my loved one in person?||Yes|
|Are visitors screened for elevated temperatures?||Yes|
|Are residents allowed to leave the facility at-will?||Yes|
|Are residents of senior living facilities who leave required to quarantine when they get back?||No (Conditions Apply)|
|Are staff members and contractors checked for elevated temperatures?||Yes|
|Are staff members and contractors tested for COVID-19?||Yes (Conditions Apply)|
|Do staff members have to regularly screen residents for COVID-19 symptoms?||Yes|
|Do staff members have to regularly check residents for elevated temperatures?||Yes|
|Do staff members have to regularly test residents for COVID-19?||Yes (Conditions Apply)|