I. Paying for Memory Care in Washington

The Cost of Memory Care in Washington

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.

Assisted living costs in Washington average $5,500 per month, which is substantially more expensive than the national monthly average of $4,051. Based on the assumption that memory care costs an average of 25% more than assisted living, one can anticipate residential memory care expenses in Washington to fall around $6,875 per month.

Senior care costs vary widely throughout the state. In the Spokane area, assisted living averages only $4,000 per month, which is $1,500 less than the state’s average. In the Seattle area, which encompasses Tacoma and Bellevue, the monthly cost of assisted living averages $6,500, well over the state average. With an average monthly assisted living cost of $4,900, Wenatchee lands closer to the midrange of costs for the state. It’s important to remember that these prices are for residential assisted living services. Depending on the location and the individual facility, residential memory care may cost approximately $1,000-$2,000 more per month.

   

Washington Medicaid Programs for Memory Care

Apple Health Long-Term Services and Supports

Through Washington Medicaid, Apple Health LTSS funds memory care and other medical services for low-income residents who demonstrate a need for long-term care. The plan pays for in-home care or services at a Medicaid contracted residential care facility. Seniors who wish to remain at home may qualify for home health aides or in-home skilled nursing care.

  • Who is Eligible: Washington residents aged 18 and older who require long-term care may qualify to participate in Apple Health LTSS. Applicants must meet the program’s stringent income and resource requirements to be eligible. Financial limits are set by law and may change yearly.
  • How to Apply: Applications may be submitted in person, via postal mail or online. An application form can be picked up at, or sent via postal mail from, any local HCS office. The application, which can be found by searching for form 18-005, can also be downloaded and printed. To fill out and submit an application online, visit the Washington Connections website.

The Community First Choice Option

The Community First Choice Option provides attendant care and nonmedical services to seniors who demonstrate a need for an institutional level of care. Qualified applicants can receive assistance at home, in a residential care facility, assisted living program or in an adult family home.

This self-directed care program lets seniors choose their caregiver, which may include a family member. Eligible seniors may qualify for assistive technology, nursing assistance and community transition services. Since this is an entitlement program, it doesn’t employ a waiting list and anyone who qualifies will receive services.

  • Who is Eligible: Applicants must be aged 65 or older and demonstrate a need for an institutional level of care as assessed by Washington’s Department of Social and Health Services. Individuals must also meet strict income requirements. For 2019, the limit for individuals is $2,313 with no more than $2,000 in total assets. Medicaid planning services are available to help potential applicants navigate the rules, exceptions and strategies for eligibility.
  • How to Apply: Seniors who wish to apply for this benefit should do so through their county’s aging services organization. Applications may be filed on paper or electronically, and supporting documentation is required.

The Specialized Dementia Care Program

For individuals who are no longer able to live at home, The Specialized Dementia Care Program helps fund long-term residential care. Enrollees live at Medicaid contracted assisted living facilities, where they receive specialized dementia care. Services are tailored to the individual’s needs, preferences and abilities, and include intermittent nursing services, staff with dementia specific training and access to a secure outdoor area.

  • Who is Eligible: To qualify for the program, an individual must be receiving, or eligible to receive, Medicaid and have a diagnosis of Alzheimer’s Disease or another irreversible dementia. A DSHS assigned case manager must confirm the need for specialized dementia care.
  • How to Apply: Contact Washington State’s Department of Social and Health Services to begin the enrollment process or connect with a participating assisted living facility.

Non-Medicaid Financial Assistance Programs for Memory Care in Washington

Program of All-Inclusive Care for the Elderly

Residents of participating counties in Washington may receive comprehensive medical and social services through the Program of All-Inclusive Care for the Elderly. Services are coordinated through an interdisciplinary team of healthcare professionals and may allow participants to stay in their homes, rather than receive care in residential facilities. PACE takes the place of Medicare or Medicaid benefits for enrollees.

  • Who is Eligible: To qualify for PACE, applicants must be 55 or older and live within the service area of a PACE organization. Applicants must be eligible for a nursing facility, but be able to live safely in a community setting with support. More information on participating communities is available at the Washington State Department of Social and Health Services.
  • How to Apply: Potential applicants can find enrollment guidelines and assistance and may begin the application process at Providence PACE and ICHS PACE.

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.

II. Memory Care Laws and Regulations in Washington

Memory Care Regulation

Washington State defines assisted living facilities as residential settings that are meant to provide housing and basic services, and that take responsibility for the safety and well-being of seven or more residents. This includes facilities that specialize in providing care for individuals with dementia or other memory impairment issues. Licensing is provided by The Washington State Department of Social and Health Services’ Aging and Long-term Support Administration.

During the licensure process, facility owners and other key staff must undergo background checks. The DSHS conducts inspections at least every 18 months to ensure compliance.

Facility Scope of Care

In Washington State, assisted living facilities are allowed, but not required, to provide supportive health services, nursing care or assistance with the activities of daily living. If a facility opts to provide these services, they must offer at least the minimal level of assistance with eating, bathing, dressing, mobility and other personal hygiene tasks. Facilities may also provide services, such as glucose monitoring and mental health care. They must supply three meals daily, and accommodate physician prescribed special diets.

Facilities that are contracted with the state to provide dementia care must tailor care, supervision and activities to the individual needs of residents, which includes coordinating with family members to honor preexisting routines and preferences. Intermittent nursing services, medication assistance and personal care support must also be provided.

Admission Requirements

Residents who may be admitted:
  • Individuals whose needs can safely be met by the facility’s staff and through reasonable accommodations as provided for by state and federal law
Residents who may not be admitted:
  • Individuals who require nursing or a nursing facility level of care (unless an RN is available on-site)
  • Individuals who need frequent evaluation by a nurse (excluding residents who are suffering from a short-term illness or receiving hospice care)
  • Individuals who jeopardize the safety of other residents

Care Plan Requirements

Prior to admission, the ALF must obtain a thorough assessment of each resident’s needs and preferences. Upon move-in, the facility must complete an initial resident service plan based on residents’ needs. A full evaluation of the individual’s functional and health needs must be performed within 14 days of the move-in. Additional limited assessments will be required if a resident’s condition changes.

Medication Management Requirements

Residents of Washington based assisted living facilities may either self-administer medication or have medication administered via nurse delegation, depending on their negotiated service agreements. If their license permits, the facility may also let a resident’s family member administer prescribed treatments or medication as long as a written medication or treatment plan is provided.

Facility Requirements

For facilities licensed after July 1, 1989, up to two residents may share an apartment. For dual occupancy living spaces, there must be a mutual agreement to share a sleeping room. Facilities licensed prior to that date may accommodate four residents to an apartment. Facilities with common-use bathrooms must supply at least one toilet and one sink for every eight residents, and one bathing fixture for every 12 residents. All floors that have sleeping rooms must also have a toilet room.

Facilities that provide state approved dementia care must also supply residents with a safe outdoor space that includes walking paths.

Staffing Requirements

All ALFs must employ an administrator and sufficient staff to provide the care and services needed by each resident, as defined in the negotiated service agreement. Facilities that admit residents who require a nursing-home level of care must have a registered nurse on-site at all times.

Administrators and long-term care workers must complete a two-hour DSHS approved orientation. Staff training must include 70 hours of DSHS approved basic training, three hours of DSHS approved safety training and two hours of HIV/AIDS training. Staff and administrators must also complete 12 hours of continuing education annually. Administrators and long-term care staff must complete CPR and first aid certification, and maintain a valid card for the duration of their employment. At least one staff member aged 18 or older with CPR and first aid certification must be present and available at all times.

Staff who are responsible for nurse delegation or diabetic care tasks must be a certified home care aide or a certified RN assistant. Prior to accepting nurse delegation tasks, these individuals must complete nurse delegation or core diabetes training with DSHS contracted community instructors.

In addition, facilities that offer dementia care services must employ 24-hour awake staff. Administrators and staff caring for dementia patients are required to complete specialty training within 120 days of beginning patient care services. Training is outcome based and includes the skills and core knowledge needed to safely and effectively care for special needs residents. Direct supervision is required until the staff member completes all training modules successfully.

Medicaid Policy

Through Washington Medicaid, qualified individuals can receive residential care services in state contracted assisted living facilities. Residents of ALFs may be eligible for personal care and other services through specific Medicaid waiver programs.

Reporting abuse

Any suspected abuse should be reported online through DSHS or by phone at 800-562-6078. Complaints can include failure to provide care, unsafe or unclean facilities, improperly prepared food and patient neglect. Reports may be made anonymously.

Complaints about elder abuse can also be reported to a county Long-Term Care Ombudsman. The state Long-Term Care Ombudsman can be reached by telephone at 800-562-6028.

III. Free Memory Care and Alzheimer's Resources in Washington

ResourceContactDescription
Alzheimer’s Association — Washington State Chapter

 

800- 272-3900The Alzheimer’s Association’s Washington State Chapter offers education, support groups and care consultations for individuals living with dementia and their caregivers. The chapter also offers early stage memory loss programs to help individuals who have recently been diagnosed with the disease.
Dementia Support Northwest

 

360- 671-3316Dementia Support Northwest supports, educates and empowers individuals living with Alzheimer’s through support groups and technology designed to help find seniors who’ve wandered from home.
University of Washington — Alzheimer’s Disease Research Center

 

206-744-0588In addition to engaging in cutting edge research, the Alzheimer’s Disease Research Center provides Washington residents with dementia related information and opportunities to participate in clinical studies for disorders, such as Lewy Body dementia, frontotemporal degeneration and vascular dementia. The center also arranges public talks and events.