Memory Care in New Mexico

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 Mexico, seniors and families pay $4,100 per month on average for assisted living, which is slightly more than the national monthly average of $4,051. Based on the statewide monthly figure, families should expect to pay between $4,920 and $5,330 per month for residential memory care in New Mexico.

The total monthly cost of memory care varies widely from one region to another within the state. In the capital city of Santa Fe, assisted living costs an average of $4,445 per month and memory care costs roughly $5,556. The most expensive city in the state for assisted living is Farmington, where this level of care costs $4,600 per month and memory care is an estimated $5,750 per month. Albuquerque is a relatively affordable city for senior living, with assisted living averaging $4,050 per month and memory care at $5,063 per month.

New Mexico Medicaid Programs for Memory Care

Centennial Care Community Benefit

Memory care services in New Mexico are covered by Centennial Care, the state’s Medicaid managed care program, via the Community Benefit. This program provides long-term care services for seniors in a residential setting, including their home or a residential care community, allowing them to avoid or delay nursing home placement. It has a self-directed care option in which participants choose their own care providers. In some cases, this includes eligible family members. While this service doesn’t directly pay for assisted living, it covers services received in an assisted living setting. Some services covered by the Community Benefit program include adult day health care, respite care, personal care assistance, private duty nursing and personal emergency response systems.

• Who Is Eligible: To be eligible for the Community Benefit, applicants must be qualified to receive services under Centennial Care. Generally speaking, an applicant must be a U.S. citizen, national, legal alien or permanent resident, and they must be a permanent resident of New Mexico. As of 2020, the annual income limit is $15,801 for a single applicant and $21,307 for a two-person household.
• How to Apply: Those who are interested in enrolling in the Community Benefit should apply online through the Centennial Care website or contact the state’s Human Services Department at 1-800-283-4465. Alternatively, a qualifying senior may receive in-person assistance and submit a paper application at their nearest NM Human Services Department field office.

Non-Medicaid Financial Assistance Programs for Memory Care in New Mexico

Area Agency on Aging

New Mexico has four Area Agencies on Aging that administer, plan and support community-based services at the local level for older adults. This program offers an array of services to support aging in place, combat senior hunger and support caregivers. While the program has no minimum income guidelines, priority is given to minorities with low incomes, those who live in rural areas, those who are not fluent in English, those who have been diagnosed with Alzheimer’s disease or dementia and those who are at risk of nursing home placement. Services vary by region, but common services include adult day health care, respite care, case management, homemaker and chore services, caregiver support, congregate and home-delivered meals and legal services.

• Who Is Eligible: To be eligible for services through AAA, applicants must be at least 60 years old or at least 55 years old and in a tribal program.
• How to Apply: To apply for services, applicants should contact their region’s AAA office.

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 New Mexico, memory care is provided in assisted living facilities for adults. These facilities are licensed and regulated by the New Mexico Department of Health.

In addition to the standard requirements that are met by all assisted living facilities in the state, those that offer memory care services must meet additional conditions. These include requirements relating to care coordination, staffing, training individualized service plans, assessments and re-evaluations, documentation, security and resident rights.

Facility Scope of Care

Memory care facilities in New Mexico are required to provide supervision and assistance to residents as necessary with specified nursing services, including:

• Medication administration or supervising self-administration
• Activities of daily living
• Recreational and social activities
• Laundry and housekeeping
• Transportation
• Around-the-clock comprehensive nursing services are not provided.

Memory care facilities are required to provide three nutritionally balanced meals and evening snacks that are in keeping with recommended daily dietary guidelines.

Admissions Requirements

Prior to admitting a prospective resident with dementia, the assisted living facility must conduct a pre-admission assessment to determine whether the secured environment is needed or if a less restrictive alternative is appropriate. Memory care facilities in New Mexico can accommodate a wide range of residents, but there are some restrictions in place as well. This table outlines who may and may not be admitted or retained.

Care Plan Requirements

Memory care facilities must provide individualized service plans for prospective residents prior to admission to ensure that the facility is equipped to meet their needs. The service plan must provide an outline of the services that will be provided, including when, how and by whom. Residents must be reassessed every six months or after a significant change in their health or abilities.

Residents may contract with third-party agencies, including hospice agencies. The memory care facility must coordinate care provided within the building by these third-party agencies.

Medication Management Requirements

Residents may self-administer their medication with the approval of their physician. If they don’t have physician approval, then they can self-administer medications with the assistance of a facility staff member who has successfully completed a state-approved program in medication administration assistance. Medications may only be administered by a relative of the resident, a physician, a physician extender or a licensed nurse.

Staff members who assist with medication self-administration are responsible for understanding the potential interactions and side effects that may occur with a given medication. Memory care facilities must have a consulting pharmacist on staff who reviews medication lists on a quarterly basis to ensure that records and orders are accurate. The pharmacist must also ensure that the facility is properly storing, labeling, documenting and disposing of medications in accordance with the requirements of the state’s Board of Pharmacy.

Facility Requirements

In New Mexico, apartment-style units in assisted living facilities, including those that offer memory care, are not required. Units may be single or double occupancy. Single occupancy units must be at least 100 square feet, and double occupancy units must have at least 80 square feet per resident, excluding storage space. At least one toilet, sink and bath or shower must be provided for every eight residents.

Memory care facilities must have a secured environment to prevent residents from wandering. This is described by the state as any locked area with fences or doors that restrict access through the use of alarms. Facilities must also have secured outdoor areas for residents to use throughout the year.

Staffing Requirements

New Mexico provides specific guidelines regarding staffing requirements and ratios to ensure that residents receive adequate care. All memory care facilities must have an administrator who is responsible for daily operations. They must also have a sufficient number of direct care staff who are specially trained to meet residents’ needs, and at least one staff member must be awake at all times. The facility must have a licensed nurse who provides medication administration and a licensed nurse or physician extender who reviews health evaluations and ISPs.

Direct care staff must complete 16 hours of supervised training before providing unsupervised care, along with 12 hours of training annually. This training includes fire safety, first aid, resident rights and confidentiality, reporting requirements for abuse, infection control and transportation safety. They must also have at least 12 hours of annual dementia-related training.

Medicaid Policy

In New Mexico, memory care services are covered by Centennial Care, the state’s Medicaid 1115 waiver managed care demonstration program.

Reporting Abuse

Family members, seniors and the general public have two avenues for reporting suspected or observed abuse, exploitation or neglect. They may call the toll-free Health Facility Complaints hotline at 1-800-752-8649. Alternatively, they may print a Health Facility Consumer Complaint Form and fax or mail it to the provided number or address.

Health facilities are required to report all incidents of abuse, neglect, exploitation, injuries of unknown origin or cases of death where abuse or neglect is suspected. Reports are to be made through the state’s Health Facility Reporting System.