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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.
Genworth Financial’s 2019 Cost of Care Survey shows that the average cost of assisted living in Rhode Island is $5,199 per month. While this is considerably more expensive than the U.S. median of $4,051, it is near the lower end of the price spectrum in neighboring states, which ranges from a high of $7,021 in New Hampshire to a low of $4,630 in New York. In Connecticut, assisted living costs an average of $4,880, while rates in Massachusetts average $5,640 per month. Adding 25% to the average for assisted living in Rhode Island puts the expected cost of memory care at $6,498 per month.
The monthly cost of assisted living in Rhode Island’s largest city, Providence, is on par with the state average. This is about midrange between the costs in neighboring Boston, Massachusetts, and Norwich, Connecticut, where the monthly averages for assisted living are $6,442 and $4,247, respectively. Bearing in mind that the $5,199 monthly average mentioned previously is for standard assisted living only, and seniors seeking memory care in Rhode Island may pay up to $675 more per month.
The Rhode Island Medicaid Global Consumer Choice Compact Waiver offers funding to help seniors who need memory care remain in a community setting, such as an assisted living facility. The waiver provides a number of benefits, including case management, assistance with activities of daily living, personal care, medication management and physical therapy. Approved participants are responsible for paying their room and board fees, which are not covered by this program.
The Department of Elderly Affairs administers the SSI Enhanced Assisted Living program to help cover assisted living room and board costs for eligible Rhode Island residents, including those receiving memory care. This program augments the monthly amount of Supplemental Security Income an individual receives, and it also provides an allowance for personal needs.
The Rhode Island Department of Human Services manages the Home and Community Care Co-Pay program. This non-Medicaid program provides eligible seniors with funds to offset the cost of assisted living and memory care, so they can avoid placement in a nursing home. The amount of assistance a participant receives is based on their income, which also determines the amount of the co-pay they must contribute each month.
Rhode Island residents currently enrolled in Original Medicare Parts A and B may choose to switch to a Medicare Advantage plan to recoup some of the expenses incurred in a memory care facility. Also referred to as Medicare Part C, these plans are offered by private insurance companies under contract with the Centers for Medicare and Medicaid Services. The CMS requires that MA plans cover all the basic services provided by Medicare Part A and B, and many also include Part C prescription drug coverage. MA plans may also offer a range of extra benefits, which can include vision and dental services, personal emergency response systems, wellness programs, personal care assistance and nonmedical transportation.
Due to recent CMS rule changes, the coverage options for MA have expanded to include certain services provided in assisted living facilities, and seniors may now use the facility where they receive memory care as their address of record with an MA insurer. This makes it possible for enrollees to be reimbursed for eligible memory care-related expenses through specific plans, such as the United Healthcare assisted living plan. Coverage varies between plans and providers in Rhode Island, so seniors should verify that a particular plan meets their needs before they enroll.
In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:
Rhode Island assisted living facilities are licensed and regulated by the state’s Department of Health, Center for Health Facility Regulation. The type of license a facility requires is based on the following fire code and medication administration classifications:
Assisted living facilities that provide dementia care must have an F1-M1 license. Facilities must also obtain a dementia special care unit license if:
The CHFR inspects all licensed facilities annually to ensure compliance with state regulations and investigates complaints.
The care services provided in Rhode Island assisted living facilities and dementia special care units should include:
Rhode Island assisted living facilities and dementia special care units may admit adults and seniors with various care requirements and conditions, including Alzheimer’s disease and related disorders. The following table provides an overview of the criteria that affects admittance to an assisted living facility, according to state regulations:
|Residents Who May Be Admitted and Retained By ALFs and Dementia Special Care Units||Seniors and adults who:|
|Residents Who May NOT Be Admitted or Must Be Discharged:||Individuals who:|
Each new resident admitted to assisted living facilities and dementia special care units must be evaluated by a registered nurse to determine the individual’s health, social, physical, cognitive and functional needs. The written evaluation must be completed using the DOH’s Assisted Living Resident Assessment form and signed by the RN conducting the evaluation. A care plan must be developed for each resident based on their assessment within a reasonable period after admission.
In M1 facilities that provide memory care, registered nurses, licensed practical nurses and registered medication aides may administer topical and oral medications and monitor related health indicators. Unlicensed staff members must complete four hours of RN-administered training and pass an exam to be registered as medication aides. Schedule II medications may only be administered by licensed staff.
Assisted living facilities that offer memory care and dementia special care units must have security features to ensure resident safety and quality of life, such as locking mechanisms and secured perimeters. Facilities may offer single rooms and shared rooms that accommodate no more than two residents. Single rooms must be at least 100 square feet in size, and shared rooms must provide at least 160 square feet of usable space. Rooms must have lockable storage areas for the safekeeping of residents’ personal possessions. Facilities are required to have at least one toilet for every eight beds and a shower or tub for every 10 beds, at a minimum.
Licensed facilities must employ a DOH-certified administrator who is responsible for its proper and safe operation. There are no mandated staff ratios, but facilities are required to have sufficient staff on duty to provide the necessary care and ensure the physical and mental well-being of residents. Dementia special care units must have trained and experienced registered nurses on staff to manage residents’ dementia-related health and behavioral issues.
Direct care staff members who work with residents with dementia must receive four hours of initial training on relevant topics and two hours of ongoing training annually. New staff in dementia care units must complete 12-hours of orientation and training that covers understanding the various types of dementia, effective communication and behavior management.
The Rhode Island Medicaid program does not cover memory care or assisted living services as entitlements. However, it does offer the Global Consumer Choice Compact Waiver, which may provide financial aid for eligible seniors who receive memory care in an assisted living facility.
Concerned parties can report suspected resident neglect or abuse in an assisted living facility or dementia special care unit by contacting the Department of Elderly Affairs Protective Services Unit at 401-462-0555.
|Alzheimer’s Association Rhode Island Chapter||For assistance, call the 24-hour helpline at 800-272-3900||The AA’s Rhode Island Chapter offers information, education and support to individuals living with dementia and their caregivers. The chapter also participates in research fundraising efforts in cooperation with the national AA organization.|
|Alzheimer’s Impact Movement – Rhode Island||Complete the online form to join AIM, or sign up to become an advocacy volunteer||AIM is a nonpartisan organization that advocates with federal and state lawmakers to enhance public policies and investments in dementia research, care and support.|
|Alzheimer’s Disease and Related Disorders Program||For more information, email Nancy Sutton||The Rhode Island Department of Health’s ADRD program provides education about dementia prevention, diagnosis and treatment and promotes improvements in care, support and available resources for those living with memory loss. The program also maintains and makes annual updates to the State Plan for Alzheimer’s Disease and Related Disorders.|
|Memory Cafes||Find a memory cafe in your area of Rhode Island||Memory cafes in various Rhode Island communities offer monthly support group gatherings for local seniors living with memory loss and their family members. Events may include a meal and refreshments, information sharing and therapeutic and interactive activities.|
|Rhode Island Pharmaceutical Assistance for the Elderly Program||To apply, contact the Department of Elderly Affairs at 401-462-3000 or the Rhode Island ADRC hotline at 401- 462-4444||The RIPAEP program provides prescription discounts for elderly and disabled state residents who are enrolled in a Medicare Part D plan. The program can provide cost savings ranging from 15% to 60%, depending on participants’ income, and it covers drugs used to treat Alzheimer’s disease and dementia.|