Memory Care in Utah

Table of Contents

Memory Care in Utah

Table of Contents

• The Cost of Memory Care in Utah
• Utah Medicaid Programs for Memory Care
• Can You Use Medicare To Pay for Memory Care in Utah?
• More Ways To Pay for Memory Care in Utah
• Memory Care Laws and Regulations in Utah
• Free and Low-Cost Resources for Seniors in Utah
• Utah 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 calculate the cost of memory care, we added 25% to the assisted living cost as reported by the 2021 Genworth Cost of Care Survey. 

Memory care in Utah costs an average of $4,375 per month, which is almost $1,000 less than the national median of $5,625. Communities in Utah generally charge lower fees than those in the neighboring states of Arizona, Colorado and Wyoming, where the average costs are $5,000, $5,938 and $5,211, respectively. Prices are similar across the border in Nevada, where the average senior pays $4,688 for memory care.

Costs of memory care are fairly similar throughout Utah, with the most expensive option being Provo at $4,619 and the most affordable option being Logan, which is $494 cheaper per month at $4,125. Seniors in the state capital of Salt Lake City pay around $4,138, while those in the southern border city of St. George pay $4,375 each month.

Medicaid does not cover the costs of memory care in Utah. However, seniors can apply for the New Choices Waiver Program, which may cover some of the expenses incurred in a residential memory care program. To apply for the waiver, seniors will first need to qualify for Medicaid coverage.

• Who Is Eligible: Seniors over the age of 65 years who meet certain medical and financial requirements may apply for Medicaid. All applicants must be U.S. citizens or legal residents and reside in Utah.
• How To Apply: Interested seniors can apply online on the Utah Department of Health Medicaid website.

New Choices Waiver Program

The program pays for some of the care services provided in assisted living facilities and other residential communities. The program aims to ensure seniors receive the care services they need without living in a nursing home. Services covered by the program include rehabilitation services, personal care, behavioral therapies, specialized medical equipment and nonmedical transport. The waiver doesn't cover room and board expenses.

• Who Is Eligible: This waiver program is available to seniors over the age of 65 who are residents of Utah. Seniors must qualify for Medicaid to apply. Applicants are required to undergo an evaluation to show they require nursing home level care. In addition, applicants must currently be long-term care facility residents.
• How To Apply: To request information and begin the application program, seniors can call the New Choices Waiver Program offices at (800) 662-9651.

Medicaid Eligibility for Seniors in Utah

Applicants must demonstrate that they meet certain financial, medical and residential requirements to qualify for Medicaid in Utah. Single applicants are limited to an annual income of $30,276, and married applicants have a yearly income limit of $60,552 ($30,276 per spouse). The asset limits are $2,000 for single applicants and $4,000 for married couples. 

2022 Medicaid Income Limits for Seniors in Utah

To apply for Medicaid, seniors must provide the following documents to prove that they meet the specified requirements:

• Birth certificate
• Proof of citizenship or legal resident status
• Proof of current address
• Proof of current income
• Bank statements
• Title deeds of any property owned
• Power of attorney
• Copies of burial arrangements
• Copies of insurance policies

How To Get Help Applying for Medicaid in Utah

The Utah Department of Health offers online, telephonic and in-person assistance to people applying for Medicaid in Utah. 

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 the state of Utah, residential facilities that offer care services to seniors are known as assisted living facilities (ALFs). Depending on the level of care provided to its residents, an ALF is either classified as a Type I or Type II facility. ALFs can be further classified as large, small or limited capacity facilities, depending on the number of residents they can accommodate. Only Type II ALFs are permitted to admit residents with Alzheimer’s disease or other dementias.

Both Type I and Type II ALFs are licensed by the Department of Health, Facility Licensing and Certification. All ALFs must renew their license to operate on an annual basis. The state’s Office of Long Term Care conducts a comprehensive survey of ALFs every 18 months. These inspections may be planned or unannounced.

Facility Scope of Care

Both Type I and Type II ALFs are required to provide residents with personal care services, housekeeping, laundry, maintenance, scheduled activities and assistance with medication administration. The facility must provide residents with three daily meals and snacks. Staff members are also required to coordinate medical services and dental care for residents. While not required, facilities may provide nursing services, such as assessments, health monitoring and routine tasks.

In addition to these services, Type II ALFs must also provide a high level of assistance with daily living tasks, including bathing, dressing and toileting, as well as daily supervision and nursing services. Facilities are required to have individual service plans for each resident, detailing their specific nursing care, medication and support needs to help promote their independence. Staff members must be available on-site 24 hours a day.

Admissions Requirements

While ALFs are able to serve a wide range of residents, there are some restrictions to those who may be admitted. The table below serves as a guideline for the types of residents who may or may not be admitted to a facility in Utah.

Residents Who May Be Admitted

Older adults and people with:

• Dementia
• Mental health conditions
• Developmental disabilities
• Physical disabilities
• AIDS
• Traumatic brain injuries
• Stable health
• A need for assistance with two or more ADLs

Residents Who May NOT Be Admitted

Those who:

• Are totally dependent in ADLs
• Require inpatient hospital care
• Require long-term nursing care
• Are suicidal
• Are aggressive and could pose a danger to themselves or others
• Have active tuberculosis or any another communicable disease that could be transmitted to other residents

Care Plan Requirements

Prior to moving into an ALF, seniors are required to have an assessment to determine their condition and care needs. A licensed health care professional must review and sign this assessment. Within seven days of admission, the facility must develop a personalized care plan for each new resident that supports their unique cognitive, medical, physical and social needs. The plan must outline the services that will be provided, how often they will be provided and who will provide them. Residents are permitted to arrange their own personal care and medical care providers with an outside agency if they wish. Follow-up assessments must be conducted at least every six months, and service plans can be updated as needed.

Medication Management Requirements

There are four types of medication administration assistance permitted at ALFs in Utah: residents can self-administer medications; self-administer medications with minor assistance, including reminders and opening containers; have a family member administer medications or have a facility staff member administer medications. A licensed health care professional conducts an assessment on each resident to determine which of these types of assistance is best suited to their needs. All medications must be reviewed every six months by a licensed pharmacist or health care professional.

Facility Requirements

In Utah, all ALFs are required to provide separate living units for each resident. Up to two residents are permitted to share a unit if they both express that they wish to do so in writing. Each unit must have a space for living and sleeping, as well as a bathroom. Units may also offer a kitchen area. Facilities must offer apartment-style units for Medicaid waiver program participants.

Type I ALFs must have at least one toilet and sink on each level of the facility for every six residents and at least one bathtub or shower for every ten residents. If resident units in Type II ALFs do not offer a private bathroom, the facility must provide a toilet and sink for every four residents and a bathtub or shower for every ten residents. Showers must be able to accommodate residents and wheelchairs.

If a facility offers a memory care unit, it must be secure and have an emergency evacuation plan in place.

Facility licenses are valid for a period of two years. The department conducts surveys of ALFs when possible or in the event that a formal complaint is filed.

Staffing Requirements

Type I ALFs are required to have a full-time administrator on staff to recruit, employ and train the facility’s care staff. The facility must also employ direct staff to provide personal care services to residents, as well as a licensed nurse to provide health monitoring and care coordination. A registered nurse must be available for residents who require assistance with medication management. While there are no minimum staff to resident ratios, a facility must have an adequate number of staff members on-site 24 hours a day to care for the needs of its residents.

Type II ALFs must also have an administrator on staff to manage the facility’s staffing and training. Additional staffing requirements include certified nursing aides to provide personal care services and a licensed nurse for health monitoring and delegating tasks. There are no minimum ratios, though at least one certified nursing aide must be on-site 24 hours a day, and a registered nurse must be available to provide assistance and care as needed. If the facility offers memory care services, at least one staff member with Alzheimer’s and dementia training must be present at all times.

Both types of facilities require their employees to go through an orientation to familiarize themselves with specifics of their job description, ethics, residents’ rights, emergency plans and the facility’s policies and procedures. Staff members must also complete in-service training that’s specifically tailored to their job duties, which may include nutrition and meal preparation, housekeeping, personal and social care, medication assistance, first aid and accident prevention.

Medicaid Policy

Adult residential services in ALFs are covered by the state of Utah under the Medicaid New Choices 1915(c) Waiver program. While the state does not provide a Supplemental Security Income payment to cover services in ALFs, residents may receive family supplementation to help cover the costs of room and board.

Reporting Abuse

Residents’ family members or anyone who has a concern with a situation of abuse or neglect in an ALF should immediately contact the Utah Adult Protective Services’ abuse hotline at 800-371-7897 or make a report online.

Concerned individuals may also register a complaint with the Long-Term Care Ombudsman (LTCO).

Utah seniors and their loved ones have access to numerous support systems and programs that cater to the specific needs of those affected by Alzheimer's and other dementia-related disorders.

Note: The following information was compiled and most recently updated on 2/15/2022. 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.