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.

How to Pay for Assisted Living in Wisconsin

Determining how to finance assisted living often starts with the question, “What’s the cost?” In today’s economy, where inflation plays a significant role, having current data is crucial for senior living financial planning. AssistedLiving.org has gathered cost information from its expansive network of over 75,000 senior living providers. This data offers a glimpse into the average expenses for assisted living in Wisconsin and 61 additional cities within Wisconsin.

How Inflation Has Impacted the Cost of Assisted Living in Wisconsin

Wisconsin’s assisted living costs increased from $4,269 in 2022 to $4,992 in 2023. Inflation has played a major part in this 17% increase, and prices are expected to reach $5,606 by 2024. The national average has also increased, reaching $4,459 in 2023, and is likely to hit $4,802 in 2024.

Inflation has impacted neighboring states to differing degrees. Costs in Illinois actually decreased by 4%. The increase in Minnesota was less than 1%, and Iowa’s increase was just 2%. In Michigan, assisted living costs rose to $4,111 per month.

Assisted Living Costs in Wisconsin's Top Cities

Assisted living costs can vary widely within the same state. In Manitowoc, the average price is $3,982 per month. Green Bay’s prices are also more affordable than the state average of $4,530. At $5,275, Milwaukee’s costs are slightly higher than the Wisconsin average. The state capital of Madison has some of the highest costs, with seniors there paying $7,154 each month for assisted living care.

The Cost of Other Types of Senior Living

There are a range of senior living options available to older adults in Wisconsin. The cost of these communities varies depending on the amenities available, the level of care provided and any specialized services offered. Independent living is the most affordable choice at $2,760. Assisted living is in the middle of the range with a cost of $4,992. Memory care, which provides a high level of aid to people with dementia, costs $6,082 per month.

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 and Low-Cost Resources for Seniors in Wisconsin

There are many resources in Wisconsin that assist seniors in their retirement. Assistedliving.org has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.

Area Agency on Aging

Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.

Cash Assistance Programs

Cash assistance programs in Wisconsin provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.

Food Assistance Programs

Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Wisconsin seniors afford the nutritious food they need.

Health Insurance & Prescription Drug Coverage for Seniors

Wisconsin seniors who meet certain income criteria can apply to local resources to help them pay for prescription drugs. Eligible residents can also receive assistance through health insurance and other programs to access free or discounted medical services.

Legal Resources

Many organizations offer free or low-cost legal services to Wisconsin seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.

Senior Engagement

Senior engagement resources and programs in Wisconsin help older adults remain active and ensure they contribute to the community. Resources include wellness programs, volunteer opportunities, support groups and organizations that help residents connect with the community to live fulfilling lives.

Medicaid Resources

Navigating the Medicaid system is often difficult and confusing. Several Wisconsin resources help older adults by providing advice on Medicaid options, waiver programs and eligibility criteria to help seniors receive the right health care benefits.

Social Security Offices

Social Security offices in Wisconsin help seniors and disabled people access the benefits they’re entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.

Tax Assistance

Seniors can apply for tax assistance from several Wisconsin resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.

Utility & Energy Bill Assistance

Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Wisconsin retirees could also qualify for emergency funding programs if they’re in danger of losing utility services due to unpaid invoices.

Veteran’s Services

Wisconsin retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they’re eligible for and provide advice and information on a variety of issues.

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.

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.