Memory Care in Wyoming

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 for assisted living in Wyoming is $3,780, which is somewhat lower than the national monthly average of $4,051. Going with the estimate that memory care costs 20-30% more than assisted living, seniors can expect to pay $756-$1,134 per month extra for memory care in Wyoming.

Costs vary within the state, with the largest cities having higher rates than the state average. Cheyenne, the largest city in Wyoming, has an average monthly cost of $4,540 for assisted living, while the second largest city, Casper, has an average cost of $4,425 per month. Bearing in mind that these costs are for standard assisted living, seniors should be prepared to pay more for memory care in any part of the state.

Wyoming Medicaid Programs for Memory Care

Community Choices Home and Community Based Services Waiver

Wyoming’s Community Choices Waiver program includes several previously separate waivers that provided financial assistance to Medicaid-eligible seniors, including the Assisted Living Facility Waiver, Long Term Care Waiver, Comprehensive Waiver and Supports Waiver. This expanded Medicaid Home and Community-Based Services program allows the state to waive certain Medicaid requirements to offer additional services to eligible applicants, because Medicaid doesn’t pay for the cost of room and board in assisted living. Covered services may include daily care services, personal care, skilled nursing and other services, such as those needed for memory care.

• Who is Eligible: To qualify for the Community Choices Waiver, Wyoming residents must be aged 65 or older, or younger with a qualifying disability, require a nursing facility level of care and meet the financial eligibility guidelines to participate in the Medicaid program. As of January 1, 2020, the waiver’s maximum income standard is $2,349 a month per individual.
• How to Apply: Those interested in applying for the waiver can contact the Wyoming Department of Health, Division of Healthcare Financing Community Based Services Unit at 1-855-203-2823.

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.

Memory Care Regulation

The Department of Health, Office of Healthcare Licensing and Surveys regulates and licenses assisted living facilities, including facilities with secured units and those dedicated to the care of people with Alzheimer’s disease or other forms of dementia. State surveyors conduct an unannounced health survey as part of the licensing process, and perform periodic surveys for license renewal and as needed to investigate complaints. The department may also place a monitor at the facility, at the owner’s expense, to ensure residents’ health and safety aren’t at risk. To operate a secure dementia unit, assisted living facilities must be licensed as a Level 2 facility and meet additional requirements.

Facility Scope of Care

Level 1 assisted living facilities must provide core services, including:

• Partial assistance with personal care
• Limited assistance with dressing
• Cueing
• Infrequent assistance with mobility
• Limited assistance with incontinence and catheters
• Minor non-sterile dressing changes
• State 1 skin care
• Assistance with getting medical, optometry and dental care
• Assistance with transportation
• 24-hour monitoring

Level 2 facilities must meet health care occupancy requirements and provide services in addition to Level 1 core services, including:

• Increased assisted with activities of daily living
• Increased assistance in maintaining continence and skin integrity
• Assistance in maintaining nutrition and hydration
• An activity program developed by a professional trained in dementia-specific activities

Admission Requirements

Assisted living facilities in Wyoming can admit a wide range of residents as long as they’re able to fulfill all the needs of each resident, but certain restrictions apply to individuals admitted into a secure dementia unit. New residents must have a medical history and physical performed in the 90 days prior to admittance. The following table provides an overview of the Alzheimer’s sufferers who may and may not be admitted to a Level 2 assisted living facility.

Care Plan Requirements

A registered nurse must complete a preadmission assessment to determine each new resident’s needs, and Level 2 facilities also must complete a Mini-Mental State Exam for individuals being considered for a secure unit. Additional assessments and MMSEs must be completed at least annually, and anytime there’s a significant change in a resident’s physical or mental condition. Assessments are used to develop, review and revise individualized care plan requirements. Plans must include what, when and how care will be provided, who will provide care and the expected outcome. Facilities must include residents in the development of their own care plans. A relative or another interested party may also participate, especially if the resident has limited participation abilities.

Medication Management Requirements

A registered nurse must always be responsible for the supervision and management of all residents’ medication administration, including a review of medications every two months and when medications are prescribed or changed. The nurse must also document whether a resident is capable of self-administering medications. Only registered nurses or licensed practical nurses can administer medications to residents who can’t self-administer. However, non-licensed staff may assist with oral medication, but only by helping to remove container caps or medication from a container for residents with functional disabilities, or by providing reminders and watching while residents take their medications.

Facility Requirements

Apartment-style units aren’t required in Wyoming. Half of the beds in a facility must be in private rooms, and private residency rooms must be at least 120 square feet in size. A maximum of two residents may share one unit by choice, and shared units must provide at least 80 square feet of space per resident. Two residents are permitted to share a room with one bed by mutual consent, if the bed is a double or larger. A facility must provide at least one sink and flush toilet for every two residents, and at least one tub or shower for every 10 residents.

Staffing Requirements

In Level 2 facilities, a licensed nurse must always be on duty to perform ongoing resident evaluations and administer medications, as needed. If this nurse is an LPN, an RN must be available on the premises or by phone. Also, the facility must always have at least one on-duty staff member with specialized training in providing care and supervision of residents with severe cognitive impairment. All assisted living facility staff must pass a Department of Family Services central registry screening and Wyoming Division of Criminal Investigation fingerprint background check before having direct contact with residents. Level 2 facility staff must complete at least 12 hours of dementia care-related continuing education on a yearly basis.

Medicaid Policy

Medicaid doesn’t pay for room and board in assisted living facilities; However, Wyoming’s Assisted Living Facility Waiver, which is now part of the Community Choices Waiver program, may help qualified residents cover certain costs. This waiver may provide financial assistance for services received while in a licensed assisted living facility, including daily care services, memory care services, case management and others benefiting residents with Alzheimer’s or other forms of dementia.

Reporting Abuse

Wyoming is a mandatory reporting state, so anyone suspecting abuse of a memory care, assisted living or nursing facility resident must legally report it. This includes any type of abuse, including injuries of unknown source, plus mistreatment, neglect or misappropriation of resident property. Suspicions of abuse may be reported to one of these three agencies:

• The Wyoming Long Term Care Ombudsman, located on the 4th floor of the Wyoming Department of Health at 2300 Capitol Avenue in Cheyenne, which can be reached by calling 307-777-2885.

• Adult Protective Services, administered by the Wyoming Department of Family Services, which can be reached toll free at 1-800-457-3659 or by contacting a local DFS office directly.

The Office of Healthcare Licensing and Surveys, located in Suite 510 of the Wyoming Department of Health offices at 2300 Capitol Avenue in Cheyenne, which can be reached by calling 307-777-7123 and asking to speak with a health surveyor.