Assisted Living in Maine

This state is celebrated for its low crime rates and peaceful way of life, and Maine’s healthcare system is among the best and most accessible in America. Though it is generally more expensive to live in the northeast, Maine is one of the most elder-friendly states in the country and has the lowest cost of living in the New England region. Even with its high average costs, Maine takes an unconventional approach to making assisted living possible for people at any income level.

Directory of Assisted Living Facilities in Maine

To simplify your research process in finding the care that you need, we have captured data on a comprehensive list of facilities in the state of Maine. Here, you will find facilities listed with information on their amenities, Medicaid acceptance status, and costs.

Paying for Assisted Living in Maine

The Cost of Assisted Living

According to the Genworth 2018 Cost of Care survey, Maine’s assisted living expenses can be relatively high among surrounding states in or near the New England area. However, as prices are generally higher in this region, some New England states can have average costs that far exceed those of Maine, such as Massachusetts, where the median price is nearly $5,500.

 

One of Maine’s most affordable areas for assisted living is its third most populous city of Bangor. As is often the case in other states, Maine’s most populous city of Portland has the highest costs, and the second most populous city (Lewiston) isn’t too far behind.

 

The type of care that a Maine resident may need can dramatically affect their expenses. Nursing homes in this state are some of the most expensive in the country, with the average cost of a semi-private nursing home room costing nearly $9,500 per month. Adult day healthcare and independent living are, by far, Maine’s cheapest options for assistive services for the elderly.

Financial Assistance for Assisted Living in Maine

MaineCare Private Duty Nursing and Personal Care Services Coverage

The Medicaid program for the state of Maine is called MaineCare, and it offers coverage to assisted housing residents up to a yearly, per-person funding cap. Private duty nursing and personal care services are commonly covered for residents of assisted housing programs, and they provide reimbursement for help with medication administration and activities of daily living.

Who is Eligible?

Coverage of these services is available to anyone in need of assistance with at least two basic activities of daily living, such as eating, walking around, or bathing. Alternatively, reimbursement is also available to those who need assistance with only one activity of daily living (ADL) plus at least two instrumental activities of daily living (IADL), which are things like doing laundry or seeing to personal finances. A list of ADLs and IADLs can be found on Legislature.Maine.gov.

Basic eligibility for MaineCare is also a requirement, and this includes the following::

• Must be 65 or older, or otherwise blind or disabled
• Must be a citizen of Maine
• Must have an income of less than $2,250 per month, with some financial eligibility caveats
• Asset limits apply based on whether the state counts an asset as Available or Exempt

How to Apply

To begin an application, the DHHS advises that interested parties contact a service worker for help at the Maine offices for the Area Agencies on Aging. You can find a list of AAA offices in your area by consulting our table. View a list of application materials for MaineCare at Maine.gov, or download an application at Maine.gov/DHHS.

MaineCare Adult Family Care Coverage

There are less expensive assisted living options available for people who agree to live in private or semi-private bedrooms within shared facilities. These establishments are called Residential Care Facilities (RCFs), and while they do not require the same type of licensure as ALFs, they can provide many of the same support programs. Room and board costs for Medicaid-eligible RCF residents are also legally limited. Prices for these individuals are based on the current Supplemental Security Income payment plus an optional state supplement.

Through Adult Family Care Coverage, RCFs can receive Medicaid reimbursement for assistive services. For residents with greater medical needs, RCFs are required to provide a high level of largely indirect support to help residents get the care they need, such as by providing resource counseling and transportation to medical appointments.

Who is Eligible?

• Residents of Level III or Level IV Residential Care Facilities
• Residents of Adult Family Care Homes
• Those who need assistance or cueing with at least two activities of daily living
• Those who qualify financially for MaineCare

How to Apply

Applicants must take an assessment that will determine their Resource-Adjusted Price for services covered by MaineCare. To find more information on Adult Family Care coverage and to set up an assessment, find your local ombudsman or Area Agency on Aging in the directories below, or contact the Office of MaineCare Services at (800) 977-6740.

An application can be found online at Maine.gov/DHHS. This state website includes information on how to receive application assistance and how to submit applications to your local long-term care office.

The Home and Community Benefits for the Elderly Waiver

This HCB waiver makes it possible for nursing home-eligible MaineCare recipients to avoid institutionalization by getting their benefits at home or in an assisted housing program. The waiver comes with individual cost limitations that effectively place a cap on how many recipients can be accommodated. Accepted applicants can expect to have their names added to a waitlist.

The Home and Community Benefits waiver provides the following forms of assistance:

• Assistive technology devices and service
• Care Coordination
• Environmental modifications to recipients’ living space
• Financial management services
• Home delivered meals
• Home health services
• Attendant services
• Physical/occupational therapy
• Assistance with activities of daily living, like eating, bathing, and standing up/walking
• Coping strategy coaching for self-management of conditions

Who is Eligible?

Applicants must be eligible for MaineCare and should also be nursing home-eligible. Part of the application process includes a face-to-face assessment with the Department of Health and Human Services that will determine applicants’ resource-adjusted price for services

How to Apply

Applications for waiver services can be initiated by contacting your local Area Agency on Aging or long-term care Ombudsman’s Office. Find more information online in the MaineCare policy manual available at Maine.gov, or contact the Office of MaineCare Services at (800) 977-6740.

More Ways to Finance Assisted Living

Some additional ways to finance assisted living costs include:

• Veterans Benefits: Veterans can take advantage of several different pension programs to help cover the cost of assisted living. For more information, see the article on benefits.va.gov.

• Life Insurance Policies: Even if a spouse or loved one hasn’t died, certain types of life insurance policies can be used to pay for assisted living. More information is available at longtermcare.acl.gov.

• Long-Term Care Insurance: Long-term care insurance is a type of insurance policy that pays for long-term care when it becomes necessary, including the cost of assisted living. For more information on the benefits and drawbacks of this financing method, visit longtermcare.acl.gov.

• Reverse Mortgages: Reverse mortgages allow seniors to access the equity from a home that they own, and these funds can be used to pay for assisted living. The U.S. Department of Housing and Urban Development offers a federally insured reverse mortgage program.

Free Assisted Living Resources in Maine

Maine Rx

Maine Rx is a pharmacy discount program that is available to all legal residents and requires no enrollment application. Cardholders automatically receive the lowest possible prices for their medications based on available promotions and discounted wholesale prices. While it is possible to save up to 75% through the program, most cardholders save an average of 30% on their prescriptions. There are no restrictions to participate in Maine Rx, and Maine citizens only need a Maine Rx card to use the program’s services at their local pharmacy.

Become a cardholder by visiting MaineRxCard.com/create where users may print off an automatically generated card or order custom cards. To look up the cost of a prescription at any Maine pharmacy, Maine Rx offers a look-up tool online at MaineRxCard.com.

Low Cost Drugs for the Elderly

This is a program that covers medications prescribed for a list of common illnesses affecting the elderly. Costs that enrollees of this program may pay for medications cannot exceed $2 plus 20% of the program’s established acceptable price for any drug. The list of illnesses for which drugs may be covered includes conditions like arthritis, glaucoma, COPD, and diabetes. The full list can be found on Legislature.Maine.gov.

Who is eligible to receive Low-Cost Drugs for the Elderly?

• Legal residents of Maine
• People who are at least 62 years of age
• Anyone who is eligible for both MaineCare and Medicare Part D
• Households with an income less than 175% of the federal poverty line
• Households with not more than a 25% greater income than the federal poverty line where over 40% of income goes to unreimbursed prescription costs
• Individuals with less than $50,000 of liquid assets or couples with less than $75,000

Maine 211

The United Way of Maine has 211 information centers across the state where citizens can find information and referrals for any kind of social service. 211 puts callers in contact with the support that they need and walks them through the process of finding and receiving needed services.

To reach Maine 211 simply dial 2-1-1, or for rotary phones, dial (866) 811-5695. Text your zip code to 898-211 to get in touch with a 211 specialist, or view their directory of social service providers at prd.icarol.com.

The Long-Term Care Ombudsman

Each state maintains an Office of the Ombudsman for the protection and support of people who use long-term care services. Ombudsmen are usually volunteers coordinated by office specialists, and their job is to visit with assisted living residents to field complaints, offer information on available resources, and ensure that the long-term care environment is up to code. Volunteers are also tasked with helping residents remain informed of their rights, and they can easily be reached to provide advocacy.

The Ombudsman’s Office is in Augusta, ME and can be reached toll free by dialing (800) 499-0229. The Office can also be emailed directly at MLTCOP@MaineOmbudsman.org, and more information is available online at MaineOmbudsman.org.

Area Agencies on Aging

Maine’s Department of Health and Human Services has Aging and Disability Resource Centers in multiple locations throughout the state. These centers are Maine’s point of contact with the national Area Agencies on Aging program. The AAA works to facilitate access to care and to reduce confusion for elders and caregivers who are searching for long-term care support. Maine’s AAA offices can be located using the table below.

Veterans Affairs

Veterans Affairs services can be an important part of the retirement years for Maine citizens. The VA keeps multiple locations throughout the state, including a regional benefit office, a medical center, and multiple clinics. The state of Maine hosts one of the best VA Medical Centers in the country, as well as three medical clinics to serve different regions.

Social Security Offices

The federal government maintains a central website for the Social Security Administration at SSA.gov. Many Social Security-related tasks can be completed online, including:

• Applying for Social Security Benefits
• Requesting replacement Social Security cards
• Making sure you qualify for benefits
• Estimating your benefits
• Receiving Social Security statements electronically or by mail

For further assistance, contact or visit the SSA office in your local area. Refer to the alphabetically sorted table below to find your nearest location.

Assisted Living Laws and Regulations in Maine

The state of Maine licenses nine types of what it calls “assisted housing programs” which can offer assisted living services. The designation of assisted housing program can refer to nine facility types:

• Assisted Living Programs (ALPs)
• Four levels of Residential Care Facilities (RCFs)
• Four levels of Private Non-Medical Institutions (PNMIs – a type of Residential Care Facility).

The four levels of RCFs and PNMIs are delineated based on the number of residents that they accommodate, with Level I facilities housing one to two residents and Level IV facilities housing at least six people. The main difference between ALPs and the other two assisted housing program types is that assisted living programs offer apartment living while the latter facilities offer private or semi-private bedrooms within shared spaces.

Assisted Living Service Plans

Most assisted living facilities will meet with prospective residents to interview them and find out how best to meet their needs. This helps to establish and manage the expectations of the resident and includes disclosure of how the facility can accommodate them. The service plan, and also a residency agreement are required to be completed within the first 30 days of residency. These documents are a means of confirming that new tenants have been informed of all expenses and services available as well as their rights at the facility. Residents are reassessed by facilities every six months to one year in order to maintain proper service planning.

Assisted Living Admission Requirements

Admission to an assisted housing program can only be offered to individuals whose medical and physical needs can be met at the facility they have chosen to apply with. If the facility is a good match, refusal of admission is otherwise contingent upon whether the potential resident may be a danger to themselves or others, requires restraint, or does not have sufficient financial resources to pay for any part of the facility’s costs not covered by MaineCare or other provision.

If residents become a threat to the health or safety of others during their residency, or if their intentional behavior results in significant property damage, they may be evicted. Residents who develop greater needs during residency than their facility is equipped to accommodate may be approached for the arrangement of a transfer to a more suitable environment.

Assisted Living Scope of Care

The scope of care that is provided in any facility depends upon what level of resident impairment it is equipped to accommodate. In private non-medical institutions and other residential care facilities, residents can receive assistance with personal care services. However, on-site nursing to meet a greater medical need is not offered unless additional, need-specific licensure is obtained.

Assisted living programs, unlike private non-medical or residential care facilities, are licensed to offer direct medical and nursing services. Assisted living programs offer two levels of care, with Level II facilities offering nursing services in addition to all offerings of Level I facilities. The nursing services offered at a Level II ALP involve licensed nurses overseeing and coordinating all unlicensed personnel in their dealings with residents.

Level I Assisted Living Programs provide:

• Personal care services (assistance with activities of daily living)
• Medication administration
• Personal supervision
• Protection from environmental hazards
• Physical/social activities
• Dietary services
• Care management
• Housekeeping

Level II Assisted Living Programs provide:

• Personal care services
• Medication administration
• Nursing services
• Personal supervision
• Protection from environmental hazards
• Physical/social activities
• Dietary services
• Care management
• Housekeeping

Assisted Living Medicaid Policy

MaineCare, Maine’s Medicaid program, reimburses residents for personal care services at any type of facility that offers assisted housing. The program also reimburses for nursing services in facilities that accommodate nursing care. For a limited number of MaineCare recipients who wish to remain in assisted living as an alternative to a nursing home, Medicaid 1915(c) waivers are available.

In facilities designated as residential care or private non-medical, room and board costs are limited for the Medicaid-eligible. Recipients will be charged only the payment amount that would be given in Supplemental Security Income plus an additional amount described as an optional state supplement. In 2018, the SSI payment amount is $750 per month, and the optional state supplement is between $8 and $234, to be determined based on personal need.

Assisted Living Facility Requirements

Every type of assisted housing in the state of Maine comes with certain logistical requirements which specify what kind of living space should be available to each resident. For example, all assisted living programs must provide apartments with fully functional kitchens and bathrooms. Residential care facilities, being shared spaces, have more specific amenity requirements. RCFs will have at least one full bathroom per six residents, and for Level IV RCFs (facilities with more than six residents), there must be a bathing facility for every 15 residents.

While there are no basic square footage requirements for residents of assisted living programs, in residential care facilities and other establishments where rooms are provided rather than private apartments, there must be at least 100 square feet of usable space per room. Residential care facilities also specify that a maximum of two residents may live in a single unit, and shared bedrooms must provide at least 80 square feet per resident.

Medication Management Regulations

Medication records are maintained for every resident of a Maine facility offering assisted housing services. Unlicensed personnel tasked with administering medications must take a state-approved course to become certified, and then repeat training and recertify every two years. Facility staff is limited as to what types of injections they may administer for residents, and apart from bee sting kits and insulin, unlicensed personnel cannot administer injections.

Facilities can dispense medications by doing the following:

• Reading labels for residents
• Observing residents taking their medications
• Checking dosage
• Opening packaging
• Removing prescribed dosage from packaging

Staffing Requirements

Assisted living programs are required to have at least one administrator on staff who is always available. However, there are no staffing requirements regarding ratios of staff to residents. As long as a facility keeps enough employees on hand to provide timely and sufficient care to residents, the number of hired staff can vary.

Residential care facilities must have more specifications in place due to their more communal and varied nature. Level IV RCFs, like an assisted living program, require an administrator to be available at all times, and this person is required to obtain special licensure. However, Level I, II, and III RCFs will have a designated provider instead. The provider will, like an administrator, be constantly available or on the grounds, or plan for someone to fill their post while they are away.

In any RCF, if food service, medical accommodation, or medication administration is found deficient by the Department of Health and Human Services, the Department may require that additional support staff is retained by the facility. This may mean hiring a qualified consulting dietician, a registered nurse, or a pharmacist. Level IV RCFs do, unlike assisted living programs, have staff to resident ratio regulations, and they require at least one to two caregivers to be awake and on the premises for every 12, 18, or 30 residents, depending on the time of day.

Staff Training Requirements

Maine’s Department of Health and Human Services takes an individualized approach to the staffing of assisted housing programs in the state. In doing so, the DHHS does not have one general set of training requirements for assisted housing. If, upon regular inspection, the department determines that a facility could benefit from further training of its staff in any specific area of long-term care management, then all staff, including administrators, are required to complete the training.

Administrators of most types of assisted housing programs are required to be at least 21 years old, and must possess a combination of education and experience sufficient to the specifications of the DHHS. For Level IV residential care facilities, special licensure must be obtained by administrators in the management of multi-level or residential facilities, and training must be repeated yearly. All assisted housing facility administrators must supplement their training with an added focus in financial management and staff supervision.

A baseline of education and training for assisted living program staff is specified by the department, but staff of Level IV residential care facilities may need to meet further requirements. Direct care staff in a Level IV RCF must complete a 50-hour certification course called Personal Support Specialist training, and any employees who administer medications need 40 hours of medication training which they will repeat on a yearly basis.

Background Checks for Assisted Living

Certified nursing assistants, direct care workers, and all unlicensed assistive staff in Maine’s assisted housing programs are subject to state and federal background checks before employment can be established. An administrator of a facility who hires someone who is later found to have an ineligible background will be penalized by state regulatory agencies. Background checks include criminal history and identification verification in accordance with state and federal laws, as well as registry checks for nursing and direct care personnel. Any applicant for employment at an assisted housing program will be denied if they have ever been convicted of, or have incurred substantiated reports of abuse, neglect, or the exploitation of others.

Reporting Abuse

Assisted living residents in Maine have resources at their disposal to report misconduct on the part of caregivers or facility administration. There are separate departments to handle reports of facility breaches of contract and elder abuse. A complete list of relevant contact numbers can be found on Maine.gov.

To report a breach of contract in any type of assisted housing program, Maine citizens can call the Division of Licensing and Certification hotline at (800) 383-2441.

To report elder abuse, including physical or emotional abuse, neglect, exploitation, theft, or abandonment, the Office of Elder Services can be reached anonymously at (800) 624-8404, or by dialing 7-1-1 to use the Maine Relay service. To report a registered nurse, the Maine CNA registry hotline can be reached by dialing (800) 383-2441, or to report a home health aide, call (800) 621-8222.

Maine COVID-19 Rules for Assisted Living Facilities

Note: The following information was compiled and most recently updated on 2/8/22. Since COVID-19 is a rapidly evolving crisis, be sure to contact your assisted living facility or local Area Agency on Aging for the most up-to-date information.

COVID-19 Rules in Maine
Are loved ones allowed to visit residents in their assisted living community?	Yes (Conditions Apply)
Are residents required to quarantine after their loved ones visit?	No
Are loved ones required to wear masks when visiting residents?	Yes
Are Hairdressers and other non-medical contractors allowed in assisted living communities?	Yes
Are visitors screened for elevated temperatures before entering the assisted living community?	Yes
Are residents allowed to leave the assisted living community for non-medical reasons?	Yes
Are residents who leave required to quarantine when they get back to the assisted living community?	No (Conditions Apply)
Are assisted living communities required to cancel all group outings?	No
Are assisted living communities allowed to host group activities within the community?	Yes (Conditions Apply)
Are staff members regularly checked for elevated temperatures?	Yes
Are staff members regularly tested for COVID-19?	Yes (Conditions Apply)
Are residents regularly screened for COVID-19 symptoms?	Yes
Are residents regularly checked for elevated temperatures?	Yes
Are residents regularly tested for COVID-19?	Yes (Conditions Apply

 

Sources: www.maine.gov www.cdc.gov