Memory Care in Oregon

Table of Contents

Memory Care in Oregon

Table of Contents

• The Cost of Memory Care in Oregon
• Oregon Medicaid Programs for Memory Care
• Can You Use Medicare To Pay for Memory Care in Oregon?
• More Ways To Pay for Memory Care in Oregon
• Memory Care Laws and Regulations in Oregon
• Free and Low-Cost Resources for Seniors in Oregon
• Oregon COVID-19 Rules for Memory Care Facilities

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.

To determine the cost of memory care in Oregon, we added 25% to the assisted living costs reported in the Genworth 2021 Cost of Care Survey.

Memory care in Oregon costs around $6,306 per month, which is $681 less than the national average of $5,625. Idaho and Nevada seniors pay some of the lowest costs in the region at $4,798 and $4,688 per month, respectively. In California, memory care costs an average of $6,563, and seniors in Washington state pay some of the highest fees at $7,500.

The cost of memory care also varies widely within the state. The lowest costs are found in Corvallis at $5,606, and seniors in Eugene pay the highest rates in the state at $7,029 per month. Memory care costs in Portland and Salem average $6,219 and $6,875 per month, respectively, and seniors in Bend pay $6,044 monthly.

Oregon’s Medicaid service will cover memory care indirectly through two separate waiver programs. These programs are the Aged and Physically Disabled Waiver and the Oregon K Plan.

The Aged and Physically Disabled Waiver

The Aged and Physically Disabled Waiver, also known as the 1915 waiver, helps qualified Oregon seniors pay for home and community-based services in long-term care. This wavier covers services such as personal care, housekeeping, transportation and meals.

• Who Is Eligible: Eligibility for the Aged and Physically Disabled Waiver includes seniors aged 65 and older and those 18 and older with a disability. Seniors must also require a nursing home level of care and meet all income and asset eligibility requirements for Medicaid.
• How To Apply: Seniors can contact any local Seniors and People with Disabilities Office to apply.

Oregon K Plan

The Oregon K plan provides home and community-based services to seniors who require a nursing home level of care but prefer to receive services at home or in a community setting of their choice. Services covered by the Oregon K Plan include dressing, bathing, feeding, cooking, housekeeping and memory care.

• Who Is Eligible: Seniors must be eligible for regular Medicaid and require an institutional level of care.
• How To Apply: Seniors can complete an online application or contact a local agency.

Medicaid Eligibility for Seniors in Oregon

In Oregon, Medicaid applicants must meet financial requirements to be eligible for benefits. The maximum annual income from all sources must not exceed $30,276 for a single applicant. In a two-person household with both individuals applying, the income requirements are no more than $60,552 or $30,276 per spouse. Asset limits are $2,000 per applicant or $4,000 per couple. In a two-person household with only one person applying, the asset limit can reach $137,400, which makes it possible to retain homeownership.

2022 Medicaid Income Limits for Seniors in Oregon

To qualify for Medicaid, seniors must also:

• Be aged 65 or older
• Be an Oregon resident
• Be a U.S. citizen, permanent resident or legal alien
• Require a nursing home level of care

How To Get Help Applying for Medicaid in Oregon

Fortunately, there are several resources that can help Oregon seniors apply for benefits and answer their questions about coverage amounts, payments and billing. These programs may also provide information on additional services that can help cover memory care costs.

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:

• 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.

Memory Care Regulation

In Oregon, memory care is provided in communities licensed through the Oregon Department of Human Services. These mostly include residential care facilities but can also include assisted living and nursing facilities. Each licensed facility must meet state requirements, serve individuals displaying behavioral symptoms and ensure each staff member is trained in dementia care. Licenses expire every two years, and department staff members conduct facility inspections at least once in a two year period to ensure facilities adhere to all regulations and in response to complaints. All facilities providing memory care for residents with dementia must obtain an official endorsement on its license.

Facility Scope of Care

In Oregon, there are no overarching restrictions to the levels of care residential care and assisted living facilities may offer. Facilities must provide residents with the following services:

• Three nutritious meals per day served from preprepared menus that allow for resident input and offer modified special diets and meal substitutions
• Assistance with activities of daily living
• Housekeeping and laundry services
• Medication administration
• Daily recreational programming and activities
• Transportation and ancillary services, whether provided directly or arranged, for medical and other supportive services
• Printed information provided by the Long-Term Care Ombudsman

Admissions Requirements

Prior to admitting a new resident, a facility must perform an initial screening process to identify the potential resident’s preferences and needs and confirm their ability to meet those needs. Facilities may admit individuals with all levels of needs but may also request that residents move out for certain reasons.

Residents Who May Be Admitted

Older adults and people with:

• AIDS
• Dementia
• Developmental disabilities
• Mental health conditions
• Physical disabilities
• Traumatic brain injuries

Residents Who May Be Admitted

Those who:

• Have ADL or health needs that exceed the facility’s capabilities as stated in the facility’s disclosure statement
• Exhibit behaviors that interfere with the safety or rights of others or pose a danger to themselves or others
• Are unable to evacuate the facility in accordance with Fire and Life Safety regulations
• Engage in illegal drug use or conduct potentially harmful criminal acts
• Have unpaid charges

Care Plan Requirements

Facilities endorsed as a memory care community must provide residents with individualized nutritional and activity plans. Before a resident’s admission, these communities must provide residents and their family members with a state-designated uniform disclosure statement that details their policies along with their philosophy of care, information on how they provide services, staff training information, the number of direct care staff working each shift and the facility’s admission, transfer and discharge procedures.

Medication Management Requirements

Specially trained facility staff members over 18 years old may administer medication. All facility-administered medications must be reviewed by a registered nurse or pharmacist every 90 days. Antipsychotic medications have additional administration requirements:

• Prescribing physicians must consult with a resident’s primary care doctor.
• The facility must perform an assessment to show any potential nonpharmacological interventions they could administer to lessen the need for antipsychotic medications.
• The facility must demonstrate that it employed the determined interventions before the antipsychotic prescription and will continue to employ the interventions while administering the prescribed medication.

Facility Requirements

Assisted living facilities must meet the following requirements:

• Not including the bathroom, private resident units in newly constructed buildings must be at least 220 square feet and include a kitchen and a bathroom. Units in renovated buildings must be at least 160 square feet, not including the bathroom.
• Shared units may only exist for couples or individuals who wish to cohabitate.

Units in residential care facilities must:

• Be at least 80 square feet, not including closets and bathrooms, and permit at least 3 feet between beds.
• Open to a temperature-controlled hallway or common area if a bedroom unit.
• House a maximum of two residents per unit.
• Have at least one toilet for every six residents without a private toilet in their own unit.

Additionally, all facility buildings must have smoke detectors, automatic sprinkler systems and manual and automatic fire alarms. Endorsed memory care communities should meet specific occupancy and lighting requirements and have a secure, enclosed space for outdoor recreation.

Staffing Requirements

Endorsed memory care communities must adhere to licensing requirements and sufficiently meet residents’ scheduled and unscheduled needs. All staff members must be trained in dementia-specific topics within 30 days of hire and before providing any resident services. Annually, staff must also obtain 12 hours of training to meet licensing requirements and four hours of dementia-specific service training. Administrators must obtain 20 hours of continuing education annually, 10 of which must be dementia-specific.

All facilities must have an employed, full-time administrator on-site 40 or more hours per week. They must also have a defined system in place to ensure the number of staff on-site and available is sufficient to meet residents’ needs at all times.

Medicaid Policy

Through the Oregon K Plan, or Community First Choice, Medicaid covers assisted living and residential care services through a tiered reimbursement system.

Reporting Abuse

Complaints against facilities or suspicions of abuse should be reported to Adult Protective Services via the abuse reporting hotline at 1-855-503-7233. Suspicions that a facility is violating state regulations may be reported to the Community-Based Care Licensing Complaint Unit at 1-844-503-4773.

Oregon seniors can get help from a variety of organizations throughout the state to improve their quality of life and address a variety of needs. For memory care residents, these organizations can help provide support and answer questions concerning care.

Note: The following information was compiled and most recently updated on 2/13/2022. 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.