What is the Cost of Assisted Living Facilities?

by Adam Wilson

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As you consider assisted living options for yourself or a family member, there are countless factors to consider. Do you want to move to a large residential complex or a small boarding home? Do you need companionship, personal assistance, medical services, or all of the above? Do you require specialized assisted living services, such as physical or speech therapy? Making these decisions will help you narrow in on the right assisted living arrangement, but there's one factor that will inevitably affect your choice: the cost of assisted living.

How to Break Down the Cost of an Assisted Living Facility

The national average cost of assisted living for one year is $50,000. But that figure varies greatly by location. For example, the monthly average cost of assisted living services in Boston is $6,500, but it is only $2,500 in Jackson, MI. The cost of assisted living also depends on level of care, facility and amenities, how much medical assistance is involved, and other factors.

Smaller boarding homes or adult family homes that assist two to ten residents with a small, non-medical staff are typically the least expensive assisted living option. In the middle, you have residential assisted living facilities, like apartment or condo complexes designed for seniors. And at the high end of the cost of assisted living are full-service, 24x7, medically staffed nursing homes. For all models of care, the cost of assisted living can be broken down into similar categories. Knowing what the typical fees are for each element of assisted living care can help you tally the potential cost of the services you require.

Entry Cost For a Facility:

Admittance, entry, community, endowment or buy-in fees are the names given to any up-front payment required to join the assisted living community. Many assisted living facilities do not require an entry fee, while others such as Continuing Care Retirement Communities (CCRCs) or Life Care Communities typically do—and the fee can range from $25,000 to $100,000 or more. Before paying an admittance fee and signing a contract, seek legal advice and find out from the facility if any of the fee is returnable if you decide not to stay. Many will refund you up to 90%.

Room and Board Fees:

Typical room and board fees range from $1,500 to $5,000 a month, with the average around $3,000. The space and facility you select will impact costs significantly. For example, a private, fully equipped one-bedroom apartment in a modern residential facility will cost much more than a room and shared bath at a boarding home. But with any facility, you can typically expect to pay a monthly fee that includes meals, housekeeping, laundry, and potentially transportation. Be sure to ask exactly what is included in your room and board fee, such as how many meals and snacks, room square footage and amenities, use of shared recreational equipment and games, etc.

Additional Costs:

Your monthly room and board fee is only your base cost of assisted living. Find out what services the facility includes in that fee and which personal and care services will incur additional charges. For example, some assisted living facilities include 30 minutes of care per day in the fee, with anything above that costing extra. Many facilities categorize the costs by care level, with fees of $300-400 for going up a level. Most facilities also charge for medications, hygiene care needs, and medical supplies.

Medical Care:

Complex medical care, specialist doctors, medications, and supplies can significantly add to your overall cost of assisted living. Ask facilities to explain their fees for emergency and routine medical care (some may even have a menu of services).

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How to Pay for the Cost of Assisted Living Facilities

While employee health insurance does not pay for nursing home care, some people purchase long-term care insurance that may cover the cost of assisted living services. Medicare, the federal health insurance program that covers people 65 and older, pays for some of the cost of assisted living. Eligibility for Medicaid varies by state, and Medicaid will only pay for care that is provided at a facility certified by the government. In some states, there are financial aid programs for people who live in assisted living homes, such as the Assisted Living Subsidy or the Medicaid Waiver for Older Adults in Maryland. Experts estimate that approximately one-third of assisted living residents pay all of their costs from their personal funds.

It can be overwhelming to figure out how to pay for the cost of assisted living, but organizations like the AARP and the Council on Aging are available to help you understand your options and restrictions. Assisted living facilities should also have people on hand who can help you figure out your options for covering the cost of assisted living. Because the cost of assisted living services can be so high and you never know what the future holds, find out what a facility would do if you ran out of money. Some retirement communities help residents who can no longer pay for their care, but others show them the door. Most states require assisted living facilities to give 30 days' notice before evicting senior residents. And be sure to ask the provider about expected rate increases over years. Before you sign a resident agreement with an assisted living facility, have someone you trust review the materials with you.