How Louisiana regulates memory care

Does Louisiana license memory care separately?

No. Louisiana has no stand-alone memory care license; an ARCP may run a specialized dementia care program, defined in R.S. 40:1101.2 as a program or unit that separates residents with probable Alzheimer's disease or a related disorder to limit their access to areas outside it and that is marketed as specialized dementia care.

The definition has two parts, and both matter. A program that locks or separates residents with dementia, and that advertises itself as dementia care, is covered by the rule. A building that simply admits some residents with memory loss, without a separate program, is not. Nursing homes care for many residents with dementia under their own license and federal rules.

Only 2 licensed ARCPs in the six parishes carry memory care in the licensed name itself (Laketown Village, Residential Care & Memory Care, Anderson Memory Care LLC), but many more market dementia programs, which is why the written program policies matter.

What must a Louisiana dementia care program have?

An ARCP that offers a specialized dementia care program must disclose it to LDH when it starts and when it ends, keep written policies for it that staff, residents and the public can see, set written criteria for who is included, give those criteria to the resident and family, and lock doors 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).

For families, each requirement becomes a question. May we take home a copy of the program's policies? What are the written criteria for moving into, and out of, the program? Who approved the locked doors, and when?

How much dementia training do Louisiana memory care workers need?

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

Staff with regular resident contact who do not give hands-on care need four hours within 90 days and two hours a year. Outside a dementia program, every ARCP's direct care staff still need at least two hours of dementia training within 90 days and annually, because residents with early memory loss live in ordinary ARCPs too. Ask who teaches the training, whether night and weekend staff attend, and to see the attendance records the rule requires providers to keep.

How many staff must be on a memory care unit at night in Louisiana?

Louisiana sets no numeric staffing ratio for dementia programs: the rule requires enough trained direct care staff on site to meet residents' 24-hour scheduled and unscheduled needs, at least one awake employee at all times, and a CPR- and first aid-trained staff member on duty.

That makes the overnight number the most important question on a tour. A 20-resident program and an eight-resident program can both meet the letter of the rule with very different staffing. Ask how many people are on the unit at 2 a.m., whether any are agency staff, and who covers the unit when one worker is helping a resident in the bathroom. The current work schedule the rule requires shows the answer.

When does a resident with dementia have to leave an ARCP in Louisiana?

A resident must move when his or her needs cross into conditions no ARCP may serve, such as a need for chemical or physical restraints, or when the ARCP's written criteria for its dementia program are no longer met; the residency agreement must spell out those criteria and the discharge process (LAC 48:I.6833, 6837).

Louisiana prohibits restraints in ARCPs entirely, so behavior that a provider cannot manage without them usually means a move to a nursing home or a geriatric psychiatric unit. A resident can appeal an involuntary termination of the residency agreement to the Division of Administrative Law within 30 calendar days of the written notice. Families should read the termination criteria before signing, not after the first incident.