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.
The average monthly cost of assisted living in Pennsylvania is $3,913, almost $140 less than the national monthly average of $4,051. This means that the approximate cost of memory care in the state is $4,891. This figure assumes that memory care will cost an average of 25% more than assisted living.
Costs can vary significantly throughout the state. In the Philadelphia area, the cost of assisted living averages $4,875 a month, but in Pittsburgh, seniors can expect to pay $3,265. Lancaster has the highest assisted living in Pennsylvania at $5,097 a month, and the Scranton Area is the most affordable at just $2,546. These are prices for assisted living, and memory care costs can be $1,000-$2,000 more each month, depending on the area and facility.
The Community HealthChoices Waiver provides support to older adults and people over 21 who have a physical disability. The program is specifically aimed at helping eligible adults remain in their homes. CHC provides medical coverage and long-term support services such as assistive technology, home modifications and service coordination to increase the independence of participants. Nursing care and assistance with activities of daily living can also be provided. The benefit may be used to pay for in-home memory care and nursing home care; however, it does not cover residence in an assisted living facility. The program replaced the Pennsylvania Department of Aging Medicaid Waiver, and people living in assisted living facilities under the old program may be able to keep their benefits in the new system.
The Living Independence for the Elderly (LIFE) program is a managed care program that helps older Pennsylvanians receive the services and support they need to live independently. The program provides a comprehensive and all-inclusive suite of medical and supportive services that includes nursing care, personal care and physical, speech and occupational therapies. The program provides in-home supportive care, which may include memory care services, but can only be provided to people who are able to be safely served in the community.
The PA Domiciliary Care Program is more commonly known as Dom Care and operates similarly to adult foster care. It is an alternative to assisted living that lets the person in need of care move into the home of a caregiver. Caregivers, called Dom Care Providers, must meet background checks and other requirements. Participants receive personal care and assistance with activities of daily living and providers are also responsible for other services including transport, medication management and recreational activities. Providers cannot be related to their residents, but elderly people can move into the home of a friend, as long as the friend meets the other provider criteria.
The OPTIONS Program lets older adults receive support and services in their homes. A wide range of benefits are available to individuals, including personal assistance, home modifications and transportation. Support can also be provided to caregivers, such as adult day care and respite services. Participants in the program are assessed to determine their health and physical abilities, and the funding and services available to them are based on this assessment. Some services are self-directed, so participants can choose their provider. OPTIONS is not an entitlement, so waiting lists may apply. Participants are also expected to pay for a share of the services based on their income.
In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:
In Pennsylvania, assisted living facilities have two levels of licensing. These are assisted living residences (ALRs) and personal care homes (PCHs). PCHs are not available to residents who require a nursing home level of care. Both levels of facilities are permitted to care for those with memory impairment and are licensed by the Pennsylvania Department of Human Services.
Facilities offering memory care must detail how they care for people with dementia, including their philosophy, staff training and the activities designed to meet the needs of people with Alzheimer’s disease. Facilities are inspected annually and in response to complaints.
Both types of facility provide services beyond room and board to residents. For residents who don’t require assistance with activities of daily living (ADLs), services include laundry and cognitive supports. Other residents receive assistance with ADLs, transportation and medication assistance.
Facilities that have a secure dementia care unit are required to provide certain services on a weekly basis, including:
Resident participation in these activities must be voluntary.
There is a wide range of residents who may be admitted into ALRs and PCHs. There are some restrictions on who can be admitted, but facilities can request an exception from the licensing agent under certain conditions. The below table gives an overview of who may or may not be admitted.
|Residents Who May Be Admitted||Older adults and people with:|
|Residents Who May NOT Be Admitted||Those who require:|
In addition, PCHs cannot admit or retain any residents who require a nursing home level of care.
A medical evaluation is required prior to admission to an ALR. This must be conducted by a physician, physician’s assistant or nurse practitioner. The evaluation determines if the individual can be safely served in the facility and also helps develop a service plan. A further assessment is conducted within 30 days of admission to determine the support plan, with reassessments conducted yearly. Support plans are updated after a significant change in condition or at the Department’s request.
PCHs must also conduct an assessment prior to admission. This determines if the facility can meet the applicant’s needs. A support plan that takes into consideration the resident’s communication abilities, mobility, medication administration needs and cognitive functioning must be written and implemented within 30 days.
Both facility types must assess individuals within 72 hours of their admission to a secured dementia care unit. Memory care residents must be reassessed annually to determine if they need continuing residency.
Both facility types must provide assistance with self-administration of medication, if required. This assistance includes remembering medication schedules, storing medication and offering medication at the correct time. Medication administration services must be provided to residents who have been assessed as needing them and those who choose not to self-administer. These services must be provided by licensed professionals or staff that have completed and passed approved medication administration training.
Secured dementia care units in both ALRs and PCHs cannot have more than two residents occupying a living space. Facilities must also provide both indoor and outdoor exercise space. Each facility must detail how they will enhance environmental awareness, minimize stimulation and maximize independence for memory care residents. Doors equipped with locking systems may be installed with written approval from the Department.
ALRs must have direct care staff to provide personal care assistance to residents, and there must be direct care staff awake at all times. Each mobile resident must receive at least one hour of assisted living services each day, and those with mobility needs must receive at least two hours of care daily. Administrators must also be present in the residence for an average of at least 36 hours a week. While there are no minimum staffing ratios, there must be enough staff to meet the needs detailed in residents’ care plans.
Both administration and direct care staff must complete and pass the licensing agency-approved training. Administrators must complete 24 hours of continuing education each year, and direct care staff must complete 16 hours of annual training relating to their job responsibilities. Staff working with memory care residents must complete an additional eight hours of dementia-specific training within 30 days of being hired and at least eight hours of dementia training annually.
PCHs also have no minimum staff ratios. There must be at least one direct care staff person awake whenever residents are present. In addition, the administrator must be present for an average of at least 20 hours each week. PCH administrators must have 24 hours of annual training relating to their job responsibilities, and direct care staff must complete 12 hours of annual training. Direct care staff working with memory care residents must complete at least six hours of dementia-specific training in addition to other prescribed annual training.
Pennsylvania does not have any programs that cover residents in assisted living residences or personal care homes. However, Medicaid covers those residing in nursing home facilities.
The Pennsylvania Department of Aging has a 24-hour hotline for the reporting of elder abuse, whether the person lives at home or in a care facility. Reporters can remain anonymous and have legal protection from retaliation. The Department of Aging can be reached by phone on 1-800-490-8505.
|Penn Memory Center||215-662-7810||The University of Pennsylvania Memory Center has a wide range of classes and support for people with Alzheimer’s and their caregivers. Some services may have a small cost involved, but many are free. People may also be able to participate in clinical trials the center conducts.|
|University of Pittsburgh Alzheimer Disease Research Center||412-692-2700||The Alzheimer Disease Research Center conducts free memory evaluations for people with suspected Alzheimer’s disease or other types of dementia. The center also conducts research and trials that regularly need participants.|
|Alzheimer’s Association Greater Pennsylvania||800-272-3900||The Alzheimer’s Association Greater Pennsylvania has support and services for caregivers and people with Alzheimer’s available both online and in person. This includes support groups and education.|