How Louisiana regulates memory care

Is memory care licensed separately in Louisiana?

No: Louisiana has no memory care license, and an ARCP that wants to serve residents with dementia in a separate program runs a specialized dementia care program, which R.S. 40:1101.2 defines as a program or unit that segregates residents with probable Alzheimer's disease or a related disorder to limit their access outside it and that is advertised as specialized dementia care.

Both halves of the definition matter. A building that separates residents with dementia and markets that service is covered. A building that simply has some residents with memory loss mixed in with everyone else is not running a program, even if staff are kind and experienced. Nursing homes care for residents with dementia under their own license and federal rules.

Across the region, 1 licensed ARCP uses memory care in the licensed name (Holly Court Assisted Living and Memory Care); more buildings market dementia programs without saying so on the license, so the written program policies are the document that matters.

What does Louisiana require of a dementia care program?

The ARCP must report the program to LDH when it begins and ends, keep written policies for it that staff, residents and the public may read, set written criteria for who belongs in it and give those criteria to the resident and family, and lock exits only where residents' clinical needs require it and the Office of State Fire Marshal approves (LAC 48:I.6851).

• An ARCP may run a separate and distinct program for residents with Alzheimer's disease or a related disorder, with individualized care based on an assessment of each resident's cognitive and functional abilities (§6851.A).
• The ARCP must disclose the program to LDH when it starts it and when it ends it (§6851.B).
• An ARCP that markets a specialized dementia care program must keep written policies for it that are available to staff, residents and members of the public (§6851.C).
• It must have written criteria for who is included, and give those guidelines to the resident, family and legal representative (§6851.C).
• Door locking to create a secured area is allowed only where residents' clinical needs require it and the arrangement is approved by the Office of State Fire Marshal (§6851.C).
• Staff who give direct face-to-face care in the program need at least eight hours of dementia-specific training within 90 days of hire and eight hours every year after (§6867).

Each line in that list becomes a request on a tour: a copy of the program policies to take home, the written criteria for moving into and out of the program, and the date of the Fire Marshal approval for the locked doors.

How much dementia training must Baton Rouge memory care staff have?

Staff who give hands-on care in a specialized dementia program need at least eight hours of dementia-specific training within 90 days of hire and eight more hours every year, covering the nature of Alzheimer's disease and related dementias, communication, behavior management and supporting residents' independence in daily activities (LAC 48:I.6867).

Employees with regular resident contact who do not give hands-on care need four hours within 90 days and two hours a year. Direct care staff in ordinary ARCP settings still need two hours of dementia training within 90 days and two hours yearly. Ask who teaches the course, whether night and weekend aides attend, and to see the attendance records the provider must keep.

How many staff must work a Louisiana memory care unit at night?

Louisiana sets no number: the rule requires enough trained direct care staff on site to meet residents' needs around the clock, at least one employee awake at all times and someone trained in CPR and first aid on every shift.

That makes the overnight head count the single most useful number to ask for. A 24-resident program with one aide after midnight and a 12-resident program with two aides both meet the letter of the rule. Ask who covers the unit when an aide is helping a resident in the bathroom, and whether agency staff fill night shifts.

When must a resident with dementia leave a Louisiana ARCP?

When needs cross into conditions no ARCP may serve, such as a need for chemical or physical restraints, or when the resident no longer meets the program's written criteria; the residency agreement must spell out those criteria and the process for ending the agreement (LAC 48:I.6833, 6837).

Restraints are banned in every Louisiana ARCP, so behavior that cannot be managed without them usually leads to a nursing home or a geriatric psychiatric unit. Residents may appeal an involuntary discharge to the Division of Administrative Law within 30 calendar days of the written notice. Read the termination criteria before move-in, not after the first difficult night.