TABLE OF CONTENTS
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.
In New Jersey, the average monthly cost of assisted living is $6,400. This is approximately $2,350 higher than the national median of $4,051 per month, but only $365 above the average paid in neighboring Delaware. Other nearby states have significantly lower costs; assisted living averages $4,630 per month in New York, and only $3,913 in Pennsylvania. If the average cost of memory care is 25% higher than the rate for assisted living, New Jersey residents who need residential memory care can expect to pay about $8,000 per month.
Assisted living costs in New Jersey vary considerably, depending on the facility chosen and where it is located. Trenton residents pay the highest average monthly price at $6,750, while those in Vineland pay the lowest rate at $4,600 per month. Costs in Atlantic City and Ocean City are also below the state average, at $5,200 and $4,896, respectively. Additionally, these rates are for assisted living, so it’s important to keep in mind that memory care may cost up to $2,000 more per month.
MLTSS is a New Jersey Medicaid program that provides comprehensive healthcare and support services for qualified individuals. All MLTSS services are coordinated through Medicaid-approved managed care organizations (MCOs). Room and board expenses in assisted living facilities are not covered by MLTSS, but the program does pay for medical services normally covered by Medicaid and supportive services, including care management, assisted living services, personal care, mental health and addiction services and personal emergency response systems.
The state of New Jersey provides a monthly cash State Supplemental Payment to eligible residents, which may be used to cover the cost of memory care in a licensed assisted living facility.
Individuals who qualify for Medicare may opt for coverage through a Medicare Advantage or Part C plan available through approved private insurance companies. In addition to providing Medicare Part A and B services, many MA plans include Part D coverage for prescription drugs, and additional services, such as hearing, vision and dental care, transportation to medical appointments, meals and other benefits.
Medicare recently redefined what’s considered an enrollee’s home to include assisted living settings where memory care is provided, which allows some of the costs residents incur to be covered by MA plans.
In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:
In New Jersey, assisted living facilities (ALFs) that provide residential memory care are regulated and licensed through the Department of Health (DOH), Division of Health Facilities Evaluation and Licensing. ALFs are licensed for a minimum of four residents, but New Jersey regulations do not specify maximum occupancy limits. There are two types of residential ALFs in the state:
Facilities that offer Alzheimer’s and dementia care are required to have admission and discharge guidelines in place and ensure that staff attend a mandatory dementia training program. Additionally, facilities must have a written plan for activities, safety policies and specific procedures relating to memory care residents that can be provided to staff, residents, family members or the public upon request.
To ensure compliance with state regulations and continued quality of care, the Division of Health Facilities Evaluation and Licensing performs unannounced inspections of all licensed facilities every two years, as well as investigative inspections in response to complaints.
ALR and CPCH facilities in New Jersey should operate according to assisted living values that encourage and promote independence, dignity and privacy for residents in a homelike environment. These facilities provide housing along with a coordinated range of 24-hour supportive services to meet the needs of residents. The personal and health-related services offered may be provided by the facility’s staff or arranged through outside providers and may include:
According to New Jersey regulations, assisted living settings are appropriate for those who can respond to their environment, demonstrate independent activity, interact with others and express volition. State regulations allow ALR and CPCH facilities to accept individuals with a wide range of disabilities and frailties. They also stipulate that 20% of a facility’s residents must require a nursing home level of care. The table below provides a general guide on individuals who may and may not be admitted to an ALR or CPCH:
|Residents Who May Be Admitted||Disabled adults aged 18 or older and seniors who:|
|Residents Who May NOT Be Admitted||Those who:|
ALR and CPCH facilities in New Jersey are required to obtain a healthcare provider’s assessment for each resident in the 30 days prior to their admission. This is necessary to verify that the level of care the facility provides is appropriate for the individual’s needs. Details on the person’s nursing requirements, preferences and usual routines should also be obtained from their current caregivers, if applicable.
When a resident is admitted, an initial assessment by an RN is required to determine what services the individual needs, and a general service plan must be developed within 14 days after admission. If the person requires healthcare services based on the initial assessment, an RN must complete an additional assessment. Those diagnosed with Alzheimer’s or other forms of dementia must be assessed to determine their cognitive and functional abilities.
Based on these assessments, the facility is required to develop a personalized care plan for the individual during their first 14 days of residency. The service and care plans for each resident must be reviewed quarterly and revised as needed to reflect changes in their physical and/or cognitive condition.
New Jersey has specific rules regarding the administration of medications in ALR and CPCH facilities, including injections of pre-drawn insulin, disposable insulin pens and epinephrine. A facility may designate staff to provide supervision and assistance to residents who self-administer medications. These staff members must receive training from the facility’s RN or a licensed pharmacist.
Alternatively, facilities may designate trained, supervised staff, including certified home health aides and nurse aides to administer medication. These staff members must complete a medication aide course, pass an exam to become certified and be supervised by an RN. It is also required that facilities use a unit-dose drug distribution system for the delegated administration of medications.
ALRs and CPCH facilities in New Jersey may offer single- or double-occupancy accommodations, with a maximum of two residents per room. ALRs must provide apartment-style units that have a lockable entry door, kitchenette and private bathroom with a toilet, bathtub/shower and sink. Rooms in CPCH facilities may have shared bathrooms, and kitchenettes are not required. However, each room must have a lockable entry door.
The amount of living space required in a unit depends on the type of facility:
Assisted living facilities in New Jersey are required to have sufficient professional and unlicensed staff on duty to provide the basic care, assistance and supervision residents require, based on assessments of each resident’s needs. ALRs and CPCHs must appoint an administrator who holds a valid New Jersey assisted living or nursing home administrator license, and employ personal care staff who are certified homemaker/home health aides, certified nurse aides or have passed a personal care assistant training course.
There is no minimum staff-to-resident ratio required in ALRs and CPCHs, but state regulations include specific staffing guidelines for these facilities:
ALRs and CPCHs are also required to provide personal care staff with orientation training before they begin working with residents. This training should cover assisted living concepts, care of residents with physical impairments, pain management and infection prevention and control, as well as abuse and neglect, resident rights and emergency procedures.
Ongoing training is also required for all direct-care staff members:
Additionally, facilities that offer memory care services must provide training in dementia and Alzheimer’s care for all staff members directly involved in the care of memory-impaired residents.
New Jersey Medicaid covers the cost of services provided in ALR and CPCH facilities for eligible enrollees through the Managed Long Term Services and Supports program. However, those who qualify for the program are responsible for paying the room and board portion of the monthly fees charged by their facility.
The New Jersey Long-Term Care Ombudsman is authorized through the Older Americans Act to investigate, resolve or refer complaints involving residents of ALRs and CPCHs. Concerned parties can file anonymous complaints regarding neglect, abuse, bodily injuries, exploitation or crimes by contacting the ombudsman’s office at 877-582-6995. Complaints about treatment or care in facilities licensed through the New Jersey DOH may be made by calling the department’s Division of Health Facilities Evaluation and Licensing complaint hotline at 800-792-9770.
|Statewide Respite Care Program|
|877-222-3737||The New Jersey Statewide Respite Care Program provides a range of free or reduced-rate respite assistance alternatives for unpaid caregivers of frail elderly and functionally impaired individuals, including those with Alzheimer’s and dementia.|
|Alzheimer’s New Jersey|
|888-280-6055||Alzheimer’s New Jersey provides community education, care consultations, support groups and wellness/respite care programs for individuals suffering from dementia and their families. The organization’s website offers a wealth of informational resources and its helpline is available 24-7.|
|Alzheimer’s Adult Day Services Program|
|877-222-3737||This state-run program provides subsidized adult day care services for those with Alzheimer’s and other forms of dementia. Services are offered at 32 ADC centers in 19 counties but are available to eligible applicants statewide.|
|Alzheimer’s Association – South Jersey|
|800-272-3900||The Alzheimer’s Association’s Delaware Valley Chapter South Jersey office provides dementia sufferers and their families with a range of local and online support services and educational resources, as well as a 24-hour helpline.|