Assisted Living in New Mexico
Over the years, New Mexico has grown into a popular retirement destination thanks to its mild, sunny climate, scenic surroundings and reasonable cost of living. Although the Land of Enhancement lags behind other contenders in our 2022 Senior Living Report, it ranks in the top 20 for health care and transportation, and it was our 28th pick for quality of life.
Today, New Mexico is home to more than 380,000 senior citizens who represent about 18% of the state’s 2.1 million residents. Experts estimate that more than 30% of the population will be aged 60 or older by 2030. Older residents have access to excellent medical facilities, including the Senior Health Center at the University of New Mexico School of Medicine. On top of that, the cost of living is 18% lower than the national average, and assisted living prices are on par with the rest of the country. You can expect to pay about $4,500 per month for this type of residential care.
This guide takes a look at the cost of assisted living across New Mexico and the Southwest. It also highlights financial assistance programs, government agencies and nonprofits that can help you get the support you need.
The Cost of Assisted Living in New Mexico
Assisted living costs in New Mexico are almost on par with the national average at $4,498 per month. According to research from Genworth Financial’s 2021 Cost of Care Survey, this is about midrange compared with other states in the region. Seniors in Arizona ($4,000) and Texas ($3,998) pay about $500 less per month, which represents savings of around 11%. On the other hand, average assisted living prices in Colorado are about $250 higher at $4,750.
The cost of assisted living in New Mexico varies depending on your location, the facility you select and your personal care needs. Prices in Las Cruces are within $5 of the state median at $4,495. Care in Farmington costs approximately $3,999 per month, which is about $500 less than the New Mexico average. On the other end of the spectrum, seniors in Albuquerque pay about $250 more at $4,750, while the median rate in Santa Fe is the highest in the state at $5,814, a 30% increase compared to the state and national averages.
At a cost of $4,498 per month, assisted living can provide a good value to seniors who require a minimal to moderate amount of care. Seniors who prefer to remain at home pay $4,605 for homemaker assistance or $4,652 for home health aide services. Individuals who require 24-hour supervision and skilled care provided in nursing homes pay the highest rates of $7,604 per month for a semiprivate room and $8,365 for private accommodations. Adult day health care provided on weekdays is a low-cost community-based alternative at an average cost of $1,993 per month.
Does Medicaid Cover Assisted Living in New Mexico?
New Mexico’s Centennial Care Medicaid program provides robust coverage for services provided in the state’s assisted living facilities. This Medicaid system follows a managed care model where benefits are administered by private insurance companies. Centennial Care helps residents pay for medical care, behavioral care and long-term services and supports when these services are necessary.
Individuals who require a nursing home level of care and meet financial requirements for full Medicaid coverage are eligible for Personal Care Option services. To meet the level of care requirements, applicants must need help with at least two activities of daily living due to a disability or functional limitation. Benefits may also be available to individuals who require assistance with instrumental ADLs as determined by a personal needs assessment.
What Assisted Living Services Are Covered by Medicaid in New Mexico?
The goal of PCO services is to prevent nursing home placement and help seniors maintain their health and independence. It covers a variety of residential supports, including the following.
- Assisted living
- In-home care
- Emergency response systems
- Private-duty nursing
- Adult day health care
- Home modifications
- Skilled therapy
- Housekeeping
- Meals and nutritional services
You can learn more about this program and other available benefits by contacting the state’s Aging and Disability Resource Center at (800) 432-2080.
Other Assisted Living Programs
Program of All-Inclusive Care for the Elderly
The Program of All-Inclusive Care for the Elderly, better known as PACE, is an integrated health coverage option available to older adults who require a nursing home level of care and qualify for Medicaid or Medicare. Multidisciplinary services are designed to prevent institutionalization and help seniors remain in the community.
If you’re eligible for Medicaid, you won’t have to pay a monthly premium. If you only have Medicare, you must keep paying your Part B and prescription drug coverage premiums, but there are no co-pays or deductibles. With PACE, you receive medical care and long-term care through a single provider. Assisted living is part of the benefits package when these services are deemed necessary.
Although the PACE model is used across the country, availability is limited to specific cities and zip codes. Currently, PACE is available to qualifying Medicaid and Medicare beneficiaries in the Albuquerque area, including parts of Bernalillo, Sandoval and Valencia counties. You can learn more by calling the InnovAge PACE center in Albuquerque at (505) 916-1932.
How to Know if You’re Eligible for Medicaid in New Mexico
If you require a nursing home level of care and meet age and disability requirements, you may be eligible for Medicaid long-term care benefits, which have different financial eligibility criteria than other government-sponsored health insurance programs. You must also have limited income and assets. New Mexico sets the monthly income limit at 300% of the federal benefit rate. For 2022, this is $2,523 per month, or $30,276 per year.
Assets are limited to $2,000 per individual or $4,000 if you and your spouse require long-term care. If your spouse isn’t applying for long-term care coverage and will remain at home, he or she can keep up to $137,400 in assets. You’re also entitled to a vehicle and personal belongings. The value of your home may be excluded, and your spouse may be available to claim a portion of your income as a monthly needs allowance to help you qualify.
2022 Medicaid Income Limits for Seniors in New Mexico
Annual Income Limits
Asset Limits
Single Applicant
$30,276
$2,000
Two-Person Household
(Only One Person Applying)
$30,276
$2,000 for applicant
$137,400 for non-applicant
Two-Person Household
(Both People Applying)
$60,522
$4,000
As part of your application, you must provide proof that you:
- Live in New Mexico
- Are a U.S. citizen or legal resident
- Require a nursing home level of care
- Are aged 65 or older or are disabled
How to Apply for Medicaid in New Mexico
The Human Services Department provides several application options. You can apply online, over the phone or by visiting a local office.
- For faster service, complete an online application at Yes.State.NM.us
- To apply over the phone, call the Consolidated Customer Service Center at (800) 283-4465
- If you’d like to use a paper application, mail your documents to the Central ASPEN Scanning Area (CASA), P.O. Box 830, Bernalillo, NM 87004.
- You can also fax a copy of your paper application to (855) 804-8960.
- To apply in person, visit the nearest Income Support Division field office.
- If you don’t have a printer, the customer service center can mail you an application.
Information You Will Need
Make sure that you have the following documents on hand when you complete your application.
- Address and proof of residency
- Valid identification
- Social Security number
- Proof of citizenship or immigration status
- Medical records related to disabilities
- Health insurance information
- Proof of income
- A list of assets
- Details about any government benefits you receive
How to Get Help Applying for Medicaid
If you need help completing your application or if you have questions about the process, you can contact the following agencies for assistance. Free advice may also be available through senior centers and legal aid offices in your area.
Resource
Contact
Description
(800) 283-4465
For help with Medicaid and other benefits available through the Department of Human Services, contact the Consolidated Customer Service Center. Agents can help with applications and answer eligibility questions.
(800) 432-6217 option 6
If your application for Medicaid was denied, or you've been notified that your benefits have been reduced or terminated, you're entitled to appeal. Contact the Office of Fair Hearings for more information.
(505) 827-7263
The Income Support Division operates a network of county-level field offices that handle applications for a variety of financial assistance programs, including Medicaid, food stamps and help with housing or utility bills.
(505) 827-3100
The Medical Assistance Division of the HSD is responsible for administering the state’s Centennial Care Medicaid program. It provides resources for consumers and providers.
Does Medicare Cover Assisted Living in New Mexico?
The short answer is that no, Medicare does not cover the cost of assisted living in New Mexico. 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 New Mexico.
Other Financial Assistance Options for Assisted Living in New Mexico
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.
How to Apply
How It Works
Aid and Attendance
Learn more and apply online at va.gov.
Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.
Reverse Mortgages
Learn more about your options and how to apply at ftc.gov
If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
Long-Term Care (LTC) Insurance
Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.
Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.
Free and Low-Cost Resources for Seniors in New Mexico
If you need long-term care, a number of other government and nonprofit agencies in New Mexico provide free resources to help you pay for services and maintain your health and independence. You can learn more about some of the resources available in your community below.
Resource
Contact
Description
(800) 432-2080
The New Mexico Aging & Long-Term Services Department operates four Area Agencies on Aging that serve seniors in Albuquerque, Bernalillo County, non metro areas and tribal territories. These agencies can help with chore assistance, respite care, legal advice and long-term care planning. They administer federal benefits available to seniors aged 60 and older, and members of some tribal groups may qualify for assistance starting at age 55.
(800) 432-2080
New Mexico’s ADRC provides a wide range of helpful resources for seniors who want more information about long-term care, options counseling and government benefits, including Medicare and Medicaid. The center operates the Senior Medicare Patrol program that helps beneficiaries identify billing errors, and the ADRC provides information about financial assistance programs for those who need help paying premiums and co-pays.
(800) 698-2411
The VA offers a variety of benefits ranging from pensions to health care and transportation to medical appointments. Veterans in New Mexico are served by the VA Health Care System in Albuquerque as well as a number of community-based outpatient clinics and vet centers that offer counseling and social services. Seniors who want to apply for the VA's Aid and Attendance benefit to help pay for assisted living can contact a local veterans services organization for assistance.
(800) 772-1213
The Social Security Administration provides benefits to individuals who are retired or unable to work due to a disability, including an optional state supplement payment for individuals who receive SSI and live in an adult residential care home. Surviving spouses and dependents may also be entitled to compensation. You can manage your benefits and apply for assistance online or by contacting your local SSA office.
(866) 451-2901
New Mexico’s Long-Term Care Ombudsman Program advocates for seniors who live in assisted living facilities and nursing homes. Ombudsmen visit long-term care communities, educate residents about their rights and take steps to investigate and resolve any issues that arise. The ombudsman is an impartial advocate for anyone who has questions or concerns about the state’s assisted living facilities.
(800) 876-6257
Legal Resources for the Elderly is a free, phone-based hotline available to state residents aged 55 and older. Attorneys at the State Bar of New Mexico can answer questions about housing, long-term care, family law, consumer rights, estate planning and government benefits, such as Medicare and Social Security. Assistance is available in English and Spanish.
COVID-19 Rules for Assisted Living in New Mexico
The following information is based on research done on several government websites, including cv.nmhealth.org and cdc.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 3/22/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.
Visitation Policies
Are loved ones allowed to visit to provide emotional support?
Are relatives allowed to visit for end-of-life care?
Are residents required to quarantine after visiting with a loved one?
Are visitors required to wear PPE (including masks) in order to visit residents?
Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?
Are visitors checked for elevated temperatures?
Are visitors required to answer questions about health, travel, and potential virus contact?
Outings & Social Activities
Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?
Are residents who leave required to quarantine when they return?
Are senior living communities required to cancel all group outings?
Are residents allowed to eat meals together in a common area?
Are residents allowed to gather in common areas for group activites?
COVID-19 Safety Measures for Staff and Residents
Are loved ones allowed to visit to provide emotional support?
Are relatives allowed to visit for end-of-life care?
Are residents required to quarantine after visiting with a loved one?
Are visitors required to wear PPE (including masks) in order to visit residents?
Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?
Are visitors checked for elevated temperatures?
Are visitors required to answer questions about health, travel, and potential virus contact?
Assisted Living Laws and Regulations in New Mexico
Assisted living facilities in New Mexico are licensed by the Department of Health through its Health Facility Licensing & Certification division. Facilities must meet strict licensing standards for design, staffing and individual care plans.
Assisted Living Admission Requirements
Long-term care facilities that are licensed to provide assisted living may not admit residents who require 24-hour nursing care. Seniors who use a ventilator, need continuous IV medications or pose a threat to others may be prohibited from admission. These restrictions may be waived for individuals who elect to receive hospice care through a qualified agency.
Assisted Living Scope of Care
Assisted living facilities are licensed to care for two or more adults who need assistance with at least one activity of daily living. Facilities must provide three daily meals, laundry and housekeeping services as well as recreational and social activities that are consistent with residents’ needs and abilities.
Assisted Living Medicaid Policy
New Mexico’s Centennial Care program provides Medicaid long-term care benefits, including many services provided in assisted living facilities. Individuals must meet eligibility requirements, and the facility must be authorized by Medicaid.
Assisted Living Facility Requirements
Assisted living facilities must follow strict guidelines for resident accommodations, bathing areas and recreational spaces. Private rooms must provide at least 100 square feet of living space. Semiprivate rooms must have at least 80 square feet of living space per person and can be shared by a maximum of two people. Facilities must provide at least one safety-equipped bathroom for every eight residents. The building must also include at least 40 square feet of communal living areas per resident, including dining rooms, activity centers and space for socializing.
Medication Management Regulations
Assisted living facilities may assist residents with medications if written consent is provided to the administrator. All medications must be administered in accordance with state and federal laws by staff members who've completed an approved medication management course. Some medications may only be administered by a registered nurse or licensed nurse practitioner. Facilities must maintain appropriate medication assistance records and have a staff or consultant pharmacist review these records quarterly.
Staffing Requirements
New Mexico has minimum staffing ratios based on the size of the assisted living facility. At least one direct care staff member must be on duty and awake at all times for every 15 residents. Additional staff is required for facilities with more than 16 residents, although some requirements may be reduced at night. Facilities must provide staffing records for the last 30 days at the agency’s request.
Staff Training Requirements
Certified nursing assistants in New Mexico must complete a 75-hour state-approved training course. Facilities must provide at least 16 hours of training before new employees may provide unsupervised care. The state requires at least 12 hours of continued training annually.
Background Checks for Assisted Living
New Mexico requires criminal background checks for all direct-care workers and staff members with access to resident information. Facilities must conduct a comprehensive criminal background check on all new hires within 20 days of employment. A search of the Employee Abuse Registry is required prior to hiring.
Requirements for Reporting Abuse
Allegations of abuse, neglect or exploitation occurring in an assisted living facility should be reported to the Division of Health Improvement. Consumers are encouraged to call the Health Facility Complaints Hotline at (800) 752-8649. Health providers and other required reporters should use the state’s online reporting system. You can submit a paper report if needed.
Frequently Asked Questions
How Many Assisted Living Facilities Are in New Mexico?
New Mexico has 150 assisted living facilities. These communities provide a senior care option for older adults that need a little extra help to remain active and independent. They do not provide round-the-clock nursing care. Read More
Who Qualifies for Assisted Living Financial Assistance in New Mexico?
Seniors who qualify for assisted living financial assistance in New Mexico satisfy eligibility criteria regarding their age, residence status, income and asset holdings. The state Medicaid program, which is called Centennial Care, operates managed care programs under which eligible seniors can receive diverse care services while residing in New Mexico’s assisted living facilities. Read More