Assisted Living in Colorado

Assisted living prices in Colorado are continuously influenced by inflation. The state experienced a 5.4% increase from 2022 to 2023, with prices rising from $4,392 to $4,630. Meanwhile, the United States saw a higher increase of 9.5%, bringing monthly costs to $4,459. Inflation has also raised prices in neighboring states. In Wyoming, prices increased by 26.7%, while Nebraska experienced a 12.5% increase. Utah's costs rose by 11.8%, and New Mexico saw a 20.5% jump in assisted living rates

Elderly, Blind, and Disabled Waiver (EBD)

In order to qualify for the EBD Waiver, seniors must receive Colorado Health First Benefits. Age, income, disability and citizenship status factor into eligibility. Income caps are as follows:

• Income must be less than 300% of Supplemental Security Income (SSI) limits
• Single seniors cannot have more than $2,000 in resources
• Couples cannot have more than $3,000 in resources

Through the Medicaid Buy-In Program for Working Adults with Disabilities, seniors may still qualify for the EBD Waiver.

Services covered under this waiver include but aren’t limited to:

• Transportation
• Personal care
• Medication assistance
• Housekeeping

In addition, EBD recipients receive all Health First Colorado services other than long-term nursing facility or hospital care. Some of these services include:

• Primary physician visits
• Specialist visits
• Emergency room visits
• Ambulance visits
• Dental care

To sign up for the EBD Waiver, seniors must be enrolled in Colorado Health First and contact their respective Single Entry Point (SEP) or Member Contact Center. Applications for Colorado Health First can be completed online, by mail, in person or by phone at (800) 221-3943.

Community Mental Health Supports Waiver (CMHS)

Seniors must meet eligibility and level-of-care requirements to qualify for the CMHS Waiver. Applicants must have a mental health condition that interferes with their ability to perform activities of daily living. Developmental and intellectual disorders are not applicable, nor is substance abuse disorder without an additional mental disorder present.

Applicants must require long-term care that’s comparable to nursing facility services and meet the same financial requirements as for the EBD Waiver, which are as follows:

• Income must not exceed 300% of Supplemental Security Income (SSI) limits
• Single seniors must not have resources exceeding $2,000
• Couples must not have resources exceeding $3,000

Seniors with income in excess of these amounts may still qualify for the CMHS Waiver through the Colorado Medicaid Buy-In Program.

The CMHS Waiver adds to Colorado Health First Services such as doctor visits, specialist visits, emergency room visits and dental care. In addition, the following are added:

• Adult day services
• Nutritional services
• Homemaking services
• Life skills training
• Mentorship services
• Personal care

To enroll in the CMHS Waiver, seniors must already be enrolled in Health First. If not enrolled in Health First, individuals can complete applications online, by mail, in person or by phone.

Seniors enrolled in Health First who want to also enroll in the CMHS Waiver can contact their applicable Member Contact Center or Single Entry Point (SEP) to apply.

Health First Colorado is the state’s Medicaid program operated under the Colorado Department of Health Care Policy and Financing. Colorado Medicaid has eligibility requirements including age, disability status, citizenship, income and resources. General requirements state the seniors must:

• Be aged 65 or older
• Be disabled and/or blind
• Not exceed income and resource limits
• Be a citizen of the United States or a legal alien
• Have a gross yearly income that does not exceed $32,904 for singles and $65,808 for couples.
• Have no more than $2,000 in resources, and $3,000 for couples.

2022 Medicaid Income Limits for Seniors in Colorado

There is help available for Colorado residents who need assistance applying for Medicaid. Seniors can contact local government offices as shown in the table below to get help with their application. In addition, local Area Agencies on Aging (AAAs) can provide assistance with benefit applications for Medicaid and waiver programs.

The short answer is that no, Medicare does not cover the cost of assisted living in Colorado. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Colorado.

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

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

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 in Colorado 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.

Whether living in their own home or in a senior living community, Colorado seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.

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 Colorado seniors afford the nutritious food they need.

Due to the high cost of purchasing new medical equipment, several organizations in Colorado collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.

Colorado 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.

Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Colorado have different eligibility criteria and often assist retirees by providing grants or loans.

Many organizations offer free or low-cost legal services to Colorado 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 centers in Colorado bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.

Senior engagement resources and programs in Colorado 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.

Social Security offices in Colorado 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.

Seniors can apply for tax assistance from several Colorado 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.

Colorado 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.

Topic

Rule

Assisted Living Service Plan Requirements

The facility must conduct a deep appraisal of the prospective resident’s mental condition, social factors (interests and hobbies), and level of functioning. Applicants must submit a medical evaluation from their physician detailing health status, prescriptions, medical conditions and special dietary needs.Based on these factors, facilities create personalized care plans. This care plan should be updated whenever the resident has a significant change in their health or status.

Assisted Living Admission Requirements

To be admitted, residents must be able to administer their own medication. If they need services beyond the facility’s scope of care, they must be able to obtain services off-site. The facility can’t admit anyone who requires around-the-clock skilled nursing services. It can’t retain residents who become bedridden, require help with all daily living activities or develop mental conditions with behaviors that may be disruptive to other residents.

Assisted Living Scope of Care

Assisted living facilities provide ongoing assistance with daily living activities including personal care, money management and assistance with self-administered medication. Additionally, they provide three meals plus snacks daily, regular observation of residents’ health and condition and planned activities programming.

Assisted Living Medicaid Policy

Medi-Cal, California’s Medicaid program, covers long-term residential care under the Assisted Living Waiver Program. Communities in several counties in California accept payment from the state's Medicaid 1915(c) Assisted Living Waiver program. This program covers the services the individual obtains through assisted living, but it doesn’t cover room and board. 

Assisted Living Facility Requirements

In California, ALFs can provide single or double-occupancy rooms; apartment-style units are not mandatory. For every six residents, there must be at least one toilet and sink, and one bathtub or shower per ten persons. Each unit must have a kitchen with a cooking appliance and a refrigerator. Assisted living facilities must be sanitary and in good repair at all times. Facilities need common rooms, recreation and activity rooms, and dining rooms.

Medication Management Regulations

Certified medical professionals are the only employees permitted to administer medication to residents. Assisted living facilities can provide medication reminders and assist with self-administration of medications in limited circumstances. Assisted living facilities can only admit and retain diabetic residents if they can perform their own glucose testing and medication administration. 

Staffing Requirements

Every assisted living community in California is required to have a certified administrator managing the property. Staffing requirements for awake staff are determined by the size of the community. Communities with 16-100 residents must have at least one awake staff member, while those with 101-200 residents require one on-call and one awake, plus one additional awake staff member for every 100 residents.

Staff Training Requirements

Caregivers must have first-aid training, complete 40 hours of initial training, and 20 hours of continuing education every year. Training topics include emergency response, resident rights, personal care services, cultural sensitivity, seniors’ psychosocial needs, and identifying dementia. All staff must receive on-site training about community resources, sanitation, resident medication administration, and how to determine if a resident may be in need of professional help.

Background Checks for Assisted Living

All employees and licensees are subject to a criminal background check and must not have been convicted of any crime other than a minor traffic violation. Fingerprints must be submitted to the Department of Justice and the Federal Bureau of Investigations. Anyone living within the community who is not a client in need of assisted living care is also subject to a background check. Under limited circumstances, volunteers may be exempt from this rule.

Requirements for Reporting Abuse

All assisted living employees are mandated reporters and must report instances of physical, sexual, emotional or financial abuse, neglect or exploitation. Anyone can file complaints regarding suspected abuse to local law enforcement, as well as the Department of Social Services, Community Care Licensing Division by calling 1-844-LET-US-NO (1-844-538-8766), or email letusno@dss.ca.gov.