As more people reach retirement age in Wisconsin, the number of seniors requiring memory care continues to increase. In 2020, Wisconsin reported around 120,000 residents were diagnosed with Alzheimer's. This is expected to grow 8.3% by 2025 to an estimated 130,000 cases. As more people require specialized nursing care for conditions associated with cognitive decline, many families have to deal with the financial toll.
Memory care facilities provide those living with Alzheimer’s and dementia with care that is tailored to their unique needs. Memory care can take place in its own facility, or as part of a designated wing of another residential care community. Staff members of memory care units or facilities undergo specialized training in caring for those with memory impairment, and the facilities often coordinate social activities and schedules specifically for the needs of those living with Alzheimer’s or dementia.
This guide will cover the cost of memory care in Wisconsin, financial assistance options for paying for memory care, free memory care resources in the state, and a directory of memory care facilities in Wisconsin.
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 provide the most accurate estimate, we've added 25% to the cost of assisted living found in the 2021 Genworth Cost of Care Survey when predicting what memory care will cost in the state of Wisconsin. Costs can vary based on demand, region and quality of care.
Compared with neighboring states such as Minnesota and Illinois, the cost of care in Wisconsin is more expensive. The average Illinoisan pays $5,610 per month for memory care, while Minnesotans pay $5,635. In Wisconsin, the average cost of memory care is about $5,750. It can vary widely depending on where you live. Racine has the highest average monthly cost at $6,813 per month, while Milwaukee residents pay an average of $6,655 per month. Memory care in Oshkosh costs an average of $6,446 per month. Wausau has the lowest average cost for care in the state at $5,156, and La Crosse has an average cost of $5,329 per month.
State Medicaid programs offer coverage to those who can't afford medical care as long as they can prove a medical need and meet certain income requirements. Wisconsin's Medicaid program doesn't provide direct coverage for memory care, but it does provide two waiver programs to assist people who can't afford long-term care at an assisted living facility.
IRIS Program
IRIS (Include, Respect, I Self-Direct) is a special needs program that offers assistance to seniors and adults living with disabilities. It works by giving individuals a monthly benefit they can use toward the cost of their private care. Participants use these state-backed funds to pay for skilled nursing care, adult day care services, companion services and transitions from their homes into a care facility.
Family Care Waiver
The Family Care Waiver was meant specifically for individuals who are over the age of 65 and require long-term assisted care. Wisconsin considers long-term care to mean any form of care that includes assisting patients with basic needs, such as personal care, skilled nursing or memory care.
The Medicaid program helps people who can't afford to pay for medical treatment obtain the care they need. To qualify, their income must remain under an income threshold. They also must not have a lot of assets that could otherwise be used to pay for care if sold. Here are the income limits for Wisconsin residents.
2022 Medicaid Income Limits for Seniors in Wisconsin
family size | annual income limits | asset limits |
---|---|---|
Single Person | $30,276 | $2,000 |
Two-Person Household (Single Applicant) | $30,276 for applicant | $2,000 for applicant & $137,400 for spouse |
Two-Person Household (Dual Applicants) | $60,552 | $4,000 |
In addition to meeting these income requirements, the following must also apply:
If a senior is having trouble applying for benefits or doesn't know what programs they qualify for, they can use these resources.
aid.
resource | contact | description |
---|---|---|
Aging and Disability Resource Center | Online | With centers located across the entire state, the ADRC program helps connect seniors with medical services, financial aid and other support services. |
Wisconsin Department of Health Services | 608-266-1865 | The Wisconsin Department of Health Services helps residents find quality medical care, enroll in assistance programs and determine eligibility for services such as Medicaid. |
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:
In Wisconsin, assisted living facilities that are permitted to care for those with memory impairment fall under the category of community-based residential facilities (CBRFs). The Wisconsin Department of Health Bureau of Assisted Living regulates these facilities and handles licensing and registration.
As part of the licensing process for CBRFs that provide care for people with dementia, the facilities must have a detailed description of the special care services they will offer these residents. To ensure continuous quality, the licensing department conducts unannounced inspections every two years and in response to complaints.
CBRFs may provide care, treatment, and other assistive services beyond room and board to residents. The level of care is limited to intermediate nursing care, and no more than three hours of nursing care may be administered to an individual resident per week. CBRFs are permitted to admit and provide services to those with dementia, but not those who require around-the-clock or advanced nursing services.
Additionally, CBRFs are required to provide certain services unrelated to health care, including:
CBRFs may admit a wide range of residents, but there are certain restrictions as well. 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:
CBRFs must assess each individual person’s abilities, physical and mental condition, and care needs prior to admission. These assessments must be completed, at minimum, once per year, or anytime a resident’s needs or abilities change.
Immediately upon admission, CBRFs must develop a temporary, individualized service plan, and a comprehensive, long-term service plan must be developed within 30 days of admission. The plan must include which services a resident will receive, and at what frequency.
Residents of CBRFs are permitted to administer their own medications unless they have been found incompetent to do so by their physician. When necessary, medications may be administered and/or directed by a registered nurse, nurse practitioner, or pharmacist. Certain medications, including nebulizers, injectables, and medications administered rectally or vaginally must always be administered by a nurse.
CBRFs may have both private and double-occupancy rooms with shared bathrooms. All facilities must have, at minimum, one toilet, one sink, and one tub or shower for every 10 residents.
Residents’ rooms must be clean and odor-free, and all residents who wish to do their own laundry must have access to a laundry facility.
CBRFs must have resident care staff who are responsible for directly caring for residents, as well as an administrator, who oversees the resident care staff and the day-to-day operation of the facility. There are no minimum staff ratios, but facilities must have enough employees present to meet residents’ needs on a 24-hour basis.
All resident care staff must undergo training prior to performing any job duties. The training must include, at minimum, a Department of Health approved training in medication management, first aid, fire safety, and standard precautions. Facilities must ensure additional, adequate trainings in resident rights, reporting abuse, and, for some, development of service plans and provision of personal care. All staff of CBRFs that offer memory care must undergo training in managing the physical and psychological needs of persons with dementia within 90 days of employment.
Additionally, facility administrators and resident care staff must receive 15 hours of continuing education annually.
Standard Medicaid does not cover room and board in CBRFs. However, Wisconsin has two Medicaid waiver programs- Family Care and IRIS- which people with dementia may use to cover the cost of certain memory care services that they receive while living in a CBRF.
Anyone with a concern or complaint about the quality of care or treatment of residents in a CBRF should contact the Office of the Long-Term Care Ombudsman. The ombudsman may also be reached by phone at 800-815-0015.
In addition to state and federal programs, many charitable organizations and public programs provide support services for little to no cost. From early diagnosis to support groups that help caregivers adjust to the realities that come with caring for a loved one with cognitive decline, the following organizations offer vital resources.
resource | contact | description |
---|---|---|
Memory Screening | 608-266-1865 | Memory screenings help Wisconsin residents identify the early onset of conditions such as dementia so they can delay the progression of the condition with proper care. |
Dementia-Capable Wisconsin | 608-266-1865 | The Dementia-Capable program helps caregivers of people living with Alzheimer's or dementia by providing resources and support. |
Alzheimer's Association Wisconsin Chapter | 800-272-3900 | The Alzheimer's Association connects families with support systems, care facilities and community assistance. The association also advances medical research to help improve care outcomes. |
Alzheimer's and Dementia Alliance of Wisconsin | 608-232-3400 | The Alzheimer's and Dementia Alliance of Wisconsin strives to improve the lives of everyone living with or taking care of someone who suffers from cognitive decline. |
Music & Memory Program | 608-266-1865 | Music provides a great creative outlet to help people in the early onset of dementia. This program is run by the state and serves patients in nursing homes and care facilities across Wisconsin. |
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.
question | answer |
---|---|
Am I allowed to visit my loved one in person? | Yes (Conditions Apply) |
Is my loved one required to quarantine after I visit him or her? | No |
Am I required to wear a mask if I visit my loved one in person? | Yes |
Are visitors screened for elevated temperatures? | Yes |
Are residents allowed to leave the facility at-will? | Not Available* |
Are residents of senior living facilities who leave required to quarantine when they get back? | Not Available* |
Are staff members and contractors checked for elevated temperatures? | Yes |
Are staff members and contractors tested for COVID-19? | Yes (Conditions Apply) |
Do staff members have to regularly screen residents for COVID-19 symptoms? | Yes |
Do staff members have to regularly check residents for elevated temperatures? | Yes |
Do staff members have to regularly test residents for COVID-19? | Yes (Conditions Apply) |