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What Does Assisted Living Really Cost? ©

By: Clare Absher RN, BSN

The cost of Assisted Living across the country ranges from $1500 to $5000/monthly with the average probably somewhere around $2500-$3500 per month. These statistics and following information are based on my personal experiences as a RN Care Manager researching numerous facilities for families in need of housing/care for their aging loved ones. The cost of living in a particular area, facilities' onsite amenities, and extent of services provided help dictate costs as you would expect. In addition, the base monthly rent also depends on whether the accommodations are semi-private or private rooms, suites sharing bathrooms, studios with or without kitchens and one, two, or three bedroom apartments. The monthly rent is actually considered as room and board with daily meals provided, in addition to housekeeping, laundry and transportation services. Be sure to know whether 1, 2 or 3 meals are served, whether every day or just certain days of week and if snacks are offered. Actual square footage, room location i.e. distance from dining room, and desirable views may be cause for further price variation within each facility.

Admitting, entry, community, endowment or buy-in fees all refer to the possible up-front money that may be required prior to moving in. Although many of the Continuing Care Retirement Communities (CCRCs) or Life Care Communities still commonly require these fees, it seems to be less popular in recent years. Monthly rents in CCRCs are comparable to those in Assisted Living Facilities when the entry fee does not apply. The Assisted Living element of these communities offering the continuum of care is very attractive to many, but frequently less available then 55+ community accommodations. I have found it to be difficult to enter at the Assisted Living level of care as priority is given to in-house 55+ community residents who are waiting. If this type of community appeals to you, be sure to plan ahead and have a professional financial or legal advisor review long-term care contracts.

Once the base rent has been determined, don't be fooled in to believing this is your total monthly expenditure. Most Assisted Living Facilities have some structure for levels of care established with a corresponding fee schedule. They might include a certain amount of care in this base rent limited to about 30 minutes/daily. The levels of care might be described as minimal, moderate, and maximal or as care assist and care enhanced. A facility might use a numeric system from 1 to 3 or 1 to 5 based on a the number of Activities of Daily Living (ADLs) a person needs assistance with such as bathing, grooming, dressing, and medication monitoring. I know of others who ascribe to a point system where the nurse assessing the resident subtracts points for his or her care deficiencies. Regardless of the facility's practice, it's important to understand this ala-carte method of assigning levels of care with fee increments of $300-$400 for each level can add up to $2000 additional monthly costs. I have found most facilities to be very forthcoming in explaining their fee structures thoroughly so there will be no surprises later. It is in their best interest as well as the potential resident to understand what is included in the monthly rent and what is considered additional. Most facilities have additional charges for medications, personal hygiene and medical supplies.

Keep in mind that the monthly rent for most facilities includes utilities except for phone and perhaps cable TV. Remember you will no longer have the financial burden of homeowner's insurance, property taxes, home maintenance and repairs. I will share some tips I've discovered on cutting costs to help make Assisted Living more affordable in my next article.

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