Assisted Living in Wisconsin

Wisconsin is home to world-class aging research institutions and elder advocacy groups. The state also holds a yearly healthy aging summit and provides many grants for aging-based community services. With a large retiring population and many opportunities for elders in a state clearly dedicated to supporting their aging population, Wisconsin is a great place to retire.

Directory of Assisted Living Facilities in Wisconsin

It is very important to research any facility you may be considering for yourself or your loved ones. You’ll want to know the size of the facility and the rooms it offers, amenities they provide like recreational activities and social gatherings, rates, and more. Use the tool below to compare and research multiple facilities near you.

Paying For Assisted Living in Wisconsin

The Cost of Assisted Living in Wisconsin

The monthly median cost of assisted living in Wisconsin is $4,300, which is slightly more costly than the national average of $4,000. According to Genworth’s 2018 Cost of Care Survey, assisted living in Wisconsin is among the most expensive of all the states in the area, with Iowa and Michigan being the least costly.

 

The average cost of assisted living varies widely across the state. The La Crosse area is most affordable by far, at only $2,638 a month on average, followed by Fond du Lac at $3,744. The rest of the state stays around the national average, though the Wausau, Sheboygan, and Racine are much higher and the Oshkosh area averages the highest at $5,000 a month.

 

The cost of assisted living in Wisconsin is about half the price of nursing home care, which averages at $8,334 a month. It is most affordable to live completely independently, but for those that need in-home care or memory care, costs are very close to the price of assisted living, which is the least expensive option.

Financial Assistance for Assisted Living in Wisconsin

Assisted Living Medicaid Waivers

Wisconsin has Medicaid waivers available for home and community based care such as services received while in assisted living facilities. These waivers are now available in all 72 counties, without waiting lists for eligible participants.

IRIS Self-Directed Support Waiver

IRIS stands for Include, Respect, I Self-Direct and it provides a means for every resident that needs nursing home level care is able to decide their care providers, living environment and personal care services within an individual budget. Participants create personal care plans with the help of their caseworker, care team and a nurse that will re-evaluate the plan at least once a year. This waiver is for people who would like to self-direct their care as much as possible, and are not residents of assisted living facilities.

Family Care Waiver

The Family Care Medicaid waiver is for the frail elderly (meaning age 65 and older and in need of help with activities of daily living) who need financial assistance paying for long-term care services. This waiver may pay for room and board in a Medicaid certified community-based residential facility (CBRF) or residential care apartment complex (RCAC). Participating facilities are bound to strict resident rights regulations, such as required space and transportation services.

Who is Eligible?

Waivers for long-term care funding are created for participants who would otherwise need nursing home care. Applicants must qualify for Medicaid to be eligible the waiver. To qualify for long-term care coverage through Medicaid, Wisconsin citizens must meet the following eligibility criteria:

• Applicants must be legal US citizens or resident aliens, and residents of the state.
• Monthly income limits are set at 300% of the federal SSI standard, which is a total of $2,313 for an individual and $3,471 for a married couple in 2019.
• Total assets cannot exceed $2,000, or $3,000 for a couple. Community spouse laws may apply that allow for protection of some assets, like houses with equities valued between $585,000 and $878,000. An eligible spouse may have other income guidelines and some asset protection.
• The applicants need to be age 65 and older, or disabled.

How to Apply

To find out if the Medicaid waivers are right for you and your loved ones, and what you are eligible for, contact the Wisconsin Aging & Disability Resource Center (ADRC) or your Medicaid worker.

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 Wisconsin

Elder Tax Counseling and Preparation Assistance

The state partners with the IRS and the AARP to provide free tax counseling and filing assistance for elders. Interested elders can also volunteer their time to help others with tax questions and preparation. Visit the Wisconsin elder tax assistance website or call (608) 266-2486 to find a participating tax preparation site.

Long-Term Care Ombudsman Program

The Long-Term Care Ombudsman (LTCO) program provides free advocacy and counseling to residents over age 60, caretakers, and loved ones of consumers of long-term care facilities in Wisconsin. You can see the name of your area Ombudsman here, e-mail, or call 1-800-815-0015 to speak with an Ombudsman for services like:

• Investigation of complaints against long-term care services (complaint form).
• Resolution and mediation of issues regarding long-term care, and bringing in enforcement agencies where necessary.
• Information and education on long-term care facilities, resident rights, and abuse reporting and prevention.

Wisconsin Area Agencies on Aging

Area Agencies on Aging (AAA) is a network of hundreds of nonprofit organizations across the country that provide federally and locally funded services to adults over 60 in their areas. Wisconsin has many Area Agencies on Aging that provide free resources to seniors and serve as entry points to long-term care assistance like Medicaid waiver guidance and long-term care advocacy.

In many areas of Wisconsin, the Aging and Disability Resource Centers serve as the AAA for the region. See the table below to find the nearest AAA point of contact.

Veterans Benefits

The Department of Veterans Affairs in Wisconsin provides many services for eligible veterans, including:

• Veterans benefit counseling and assistance
• Three 24-hour skilled nursing care homes for veterans (with waitlists)
• A one-time occupational licensing fee waiver
• Free and reduced prices on hunting and fishing licenses, and trail passes
• A Wisconsin resident GI bill for eligible veterans and surviving dependents, separate from the federal bill, for use at over 200 educational institutions and 350 apprenticeship or training programs statewide
• Property tax credits for veterans and eligible spouses
• Three state cemeteries for veterans and burial assistance may be available
• Designer license plates customized for over service 50 medals

See the listings below to find your nearest VA office to apply for benefits.

Social Security Offices

Call or visit your local Social Security Administration office to find out about potential retirement benefits, disability, medical coverage or for questions about federal programs for elders. Go online or call (800) 772-1213 to speak to a representative.

Wisconsin Senior Centers

There are many senior centers in Wisconsin which offer a variety of services, such as:

• Communal and home-delivered meals
• Art and jewelry making classes, as well as outdoor activities like senior hikes.
• Exercise, yoga and balance-improvement programs
• Foot care, massage, blood pressure monitoring, and other healthcare clinics
• Scheduled games like bingo, poker and pinochle, and free use game rooms, libraries, and computer labs
• Community events like holiday parties, bake sales, and craft fairs, and cultural activities like trips to museums, parks, and historical sites
• Durable medical equipment (DME) like wheelchairs and hearing aids to borrow
• Senior service specialists to counsel and enroll eligible seniors in local programs like Meals on Wheels, senior food boxes, food pantries, and clothing closets

See this list of senior centers in Wisconsin that have websites. Click and find the activities calendars to see more about the programs they offer and what their fees might be, as well as the minimum age for services (usually 60 in Wisconsin). Call your local Area Agency on Aging to find senior centers that aren’t on this list as well as to find more aging resources.

Assisted Living Laws and Regulations in Wisconsin

In Wisconsin, assisted living is delivered in a community-based residential facility (CBRF). These facilities offer the lowest level of assistance with activities of daily living (ADLs), providing no more than three hours of care a week. There are many facilities in Wisconsin designed for elders who want to remain in their chosen community as they age but will need more access to services as they become increasingly frail. A CBRF may contain wings called residential care apartment complexes (RCAC), designed for residents with higher care needs, which can provide up to 28 hours of care a week. RCACs can operate independently as well as within a CBRF.

Assisted Living Admission Requirements

To be a resident of a CBRF, a person may need personal care services but for no more than three hours a week. The CBRF may admit a wider range of residents, such as the developmentally disabled or mentally ill as well as the elderly and those with dementia. No assisted living facility is able to extend residency to someone who is unable to evacuate on their own in the case of an emergency.

Requirements differ for admission to an RCAC. These facilities are designed for those that need higher levels of care but are not:

• Diagnosed with Alzheimer’s disease or related dementia
• Incapacitated from making their own decisions
• In need of in-depth health monitoring

People who fall into this category may move in with their spouses, as long as their spouses hold legal responsibility.

Assisted Living Scope of Care

Assisted living facilities must provide their residents with:

• Three regularly scheduled meals daily served restaurant or family style, and full access to snacks at all times, and accommodate any residents special diet wishes or physician prescribed diet. There are strict requirements for kitchen safety and food preparation hygiene in facilities as well.
• A clean, odor-free and home-like apartment that is decorated and fully furnished, unless the resident wishes to provide their own furniture.
• Clean and well-maintained laundry facilities.

The CBRF is for residents who currently need a low level of personal care but want to enjoy the other benefits of communal living like family dining and chore assistance. As more services are required, many facilities offer a residential care apartment complex (RCAC) within the community to provide residents the opportunity to increase their care services without moving from their chosen homes. An RCAC is for residents who may initially only need four hours of care per week, but will eventually need up to 28. Personal care services include:

• Supportive services like housekeeping, transportation, and recreational activities
• Personal assistance with activities of daily living (ADL)
• Nursing services such as medication management and administration
• Emergency assistance available 24 hours a day

There is no limit to the hours of personal care a resident can receive from friends and family, or for those under hospice care. A resident who experiences an injury or sudden illness may utilize more than 28 hours of care a week and stay in the facility as long as the condition lasts no longer than 90 days.

Assisted Living Medicaid Policy

While Wisconsin Medicaid doesn’t directly cover the costs of assisted living, it does provide assisted living waivers for the elderly and disabled residents who qualify under age, income, and other restrictions. The Family Care program provides funding for eligible seniors to live in a community-based residential facility (CBRF) or certified residential care apartment complex (RCAC). This program has recently expanded to all 72 counties as of 2018, without waitlists.

Assisted Living Community Requirements

All residents of assisted living in Wisconsin are entitled to their own private apartments, complete with individual living and sleeping areas, restrooms, and kitchen areas. A CBRF may contain between 5 and 257 apartments, while a higher care-level providing RCAC can have between 5 and 109 individual apartments.

Assisted Living Service Agreements

Residents of residential care apartment complex (RCAC) communities in Wisconsin need to complete a service agreement and a risk agreement by the move-in date. The service agreement outlines services that a resident would be provided in the facility and their associated costs, as well as additional services that could be provided to the tenant. Facilities must also specify how they notify their resident’s of changes in fees in this contract. The service agreementdetails the activities and social connections that the facility will assist the resident in maintaining.

The risk agreement is a document that outlines any situation in which a resident would desire a course of action that is contrary to facility policy. In an effort to maximize resident free will, any possible adverse scenario needs to be outlined in advance in a risk agreement to ensure that the facility is respecting the resident’s wishes at all times, regardless of policy. One example that could be negotiated in a risk contract is mobility devices, such as the preference of a cane over a walker; even though a facility might find a walker safer, a resident could choose a cane.

A community based residential facility (CBRF) has an admissions agreement the includes the information found in a service agreement as well as tenant information. Information needed includes security deposits required, policies regarding holding rooms while residents are away, refunds, and move-out notification policies.

Medication Management Regulations

Residents in assisted living in Wisconsin must have a prescriber’s orders for any medication and list that medication in their service plans. A registered nurse may assist in taking or give medication to a resident, and it also must be documented in their plans if they are receiving assistance with medication. If there are residents that take psychotropic medications living in an assisted living facility, the residential care staff must be trained in the side effects of that medication and that resident needs their medication assessed quarterly.

Wisconsin Assisted Living Staffing Requirements

The facility manager must be present from at least 7 am to 7 pm if residents are present, and 24 hours a day for larger facilities. The facility manager must have at least two years of experience or a degree in healthcare. In an RCAC, there must always be a staff manager awake and available to help residents with whatever needs may arise. This person determines the staffing requirements for the facility.

Licensed caregivers must be at least 21 years old and pass all background check requirements, but resident care staff need only be 18 years old. All staff are screened annually for transmittable diseases including tuberculosis. All residential care community employees have an individual file with all employment, training, background check, and screening information.

Assisted Living Staff Training Requirements

Generally, the facilities that manage direct care staff are responsible for providing training programs for all employees in the facility. Personal care services are provided by licensed providers like the resident’s nurse. All employees of a community-based residential facility (CBRF) must be trained within 90 days of employment in:

• First aid, CPR, and other safety training
• Fire prevention, control, and evacuation policies
• Any service that they are employed to provide

Care staff in residential care apartment complexes (RCACs) are required to be trained in the any area before providing care, or be supervised while working. Personal care services that require training include:

• Medication management if the employee will help with medication.
• Bathing, grooming, dressing, and skin care
• Transferring and walking
• Exercising
• Meal preparation and eating

Nurses and administrators are held to higher standards, requiring a nursing license and a nursing home administrator license, respectively.

Background Checks

The state requires that all administrators, operators, healthcare staff and any applicant over the age of 18 to a direct care position submit to a thorough background check, even in the case of temporary employment. This check must be done at the time of application as well as every four years, with inquiries to:

• The Department of Justice criminal history database
• The caregiver and nurse aide misconduct registry
• The state child welfare database containing all reports of neglect and abuse against children in Wisconsin

If the prospective caregiver is a new (within the past three years) resident of Wisconsin, they are also required to submit to an FBI fingerprint database check. Licensed healthcare workers and administrators are also searched for in the Department of Safety and Professional Services for adverse findings.

No one convicted of a serious crime may be licensed to operate an assisted living facility. A fine of up to $1,000 can be imposed if a person intentionally neglects to inform a facility of their convictions. All caregivers found to have violent, neglectful or otherwise abusive activity in their background checks are placed on the lifetime caregiver misconduct registry and are required to provide information about the convictions and their rehabilitation efforts to their resident clients and/or client’s families.

Requirements for Reporting Abuse

Community-based residential facilities (CBRF) and residential care apartment complexes (RCAC) are required to meet the care needs of the people that live there, as well as all unscheduled needs and 24-hour security. While a CBRF is licensed by the state, An RCAC may be either registered or certified. Certified RCACs are eligible for Medicaid payments, are inspected and complaints are investigated. A registered RCAC must only investigate complaints, they aren’t inspected and, as such, can’t accept Medicaid.

In the event that a facility doesn’t abide by their responsibilities, you can contact the Long-Term Care Consumers board, or the Long-Term Care Ombudsman to help find a resolution. To report an issue with a caregiver or nurse aide, call 608-243-2019 or visit the caregiver complaint submission website.

To report abuse or yourself or a loved one, please call the Wisconsin’s Victim Resource Center at 1-800-446-6564.

Wisconsin COVID-19 Rules for Assisted Living Facilities

Note: The following information was compiled and most recently updated on 2/15/22. 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 Wisconsin
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?	Not Available*
Are residents who leave required to quarantine when they get back to the assisted living community?	Not Available*
Are assisted living communities required to cancel all group outings?	Yes
Are assisted living communities allowed to host group activities within the community?	No
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.dhs.wisconsin.gov www.cms.gov

*Note: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.