From all inclusive rates to individual charges for rent and services, find the best match for you or a loved one
Many older people who need help with daily activities opt to move to an apartment in an assisted living building. But shopping for the right place can be confusing, especially when it comes to the pricing.
Some buildings charge rent and also for each individual service. Other assisted living properties charge what's called a "bundled" or "all inclusive" rate that includes most of the everyday services. Still other buildings offer pricing based on levels of care.
The variety of pricing options makes it difficult for families and seniors to compare the cost of different buildings. It's also hard to know what the exact monthly cost will be, which makes it tough to budget.
"Buying assisted living is like any other purchase," says Signe Gleeson, president at ElderCare Solutions, a Naperville-based firm that helps families and seniors with care decisions. "Consumers have to be aware of the variations in pricing."
The average assisted living building costs about $3,100 a month, according to a recent survey by insurance giant MetLife. The rise in the cost of long-term care has slowed somewhat during the recession. Fewer people are able to sell their homes and move into assisted living, so buildings are holding the line on rents. But it's still a hefty price for many seniors and their families.
Pricing is generally broken down into two basic components: rent and services. The rent pays for the apartment. The cost of the unit will depend on its location and size.
An assisted living apartment in an upscale suburb will cost more than one in a less desirable location. A large apartment will cost more than a shared room. The units in a building with lots of amenities and fancy finishes will generally cost more than a building without those features.
What services are included?
Many assisted living buildings roll basic services into the rent. These services typically include three meals a day, once-a-week housekeeping, utility charges (except for the phone), transportation, and some personal assistance. Base rents at assisted living buildings in the Chicago area range from about $2,000-$4,000 a month.
"Make sure you know exactly what you're getting," says Gleeson. "Some places only include two meals a day."
The cost of care services can catch consumers by surprise. These can be as much as $1,000 a month on top of the base rent. Care services include help with dressing and bathing, escorting the resident to meals, medication management, and other personal services. A senior with memory problems will require additional care services, which can add even more to the bill.
To get a handle on how much service will be required and what it will cost, a nurse at the facility will conduct an assessment of the senior before he or she moves into the building. Activities are assigned points that translate into the amount of time needed to provide a package of services appropriate for that senior. For example, a senior may need 15 minutes of help dressing every morning, and 30 minutes of help at mealtime. Care costs will depend on the amount of time spent helping the senior.
Many buildings package services into three or four levels of care. Those who need more help purchase a higher level of care. The higher the level of care, the higher the price. Residents are routinely re-evaluated to gauge whether more services are needed.
Tiered pricing does get confusing, notes Jamison Gosselin, senior vice president at the Assisted Living Federation of America (ALFA), Alexandria, Va. "But consumers know exactly what they are paying for."
Brookdale Senior Living offers assisted living and just changed from a pricing system with levels of care to a fee-for-service system with caps. Residents only pay for the services they use. The average assisted living resident pays a total of about $3,500 -$4,000 a month for rent and care services.
"Ask very specific questions," advises Gleeson of ElderCare Solutions. For example, find out how much help the senior will get. Is it 15 minutes in the morning and evening, or 30 minutes two times a day. Also ask at what point the senior would exceed the building's ability to provide care. "That's really important," she says.
Perhaps the building has a sister facility that offers nursing care. Some places may allow you to bring in your own nursing help. Others will not permit a helper or nurse to live in. Be cautious of a place that claims they can take care of people through the end of life. "Ask what kind of staffing they have to provide that care," says Gleeson.
Since families often want an idea of the total monthly cost, many buildings offer an all-inclusive type pricing. Belmont Village has four assisted living buildings in the Chicago area. Its all-inclusive pricing covers rent, meals, housekeeping, activities and transportation as well as personal care, such as help with dressing and grooming. A licensed nurse is available 24 hours a day.
Some services are charged separately. Medication management at Belmont Village costs $525 a month. If the senior needs injections, the charge for medication management is $950 a month. The cost for incontinence management is $625 a month.
Extras add up
Watch out for ancillary charges that can quickly increase costs. An incontinence program, for example, does not usually include the cost of the products needed. Other extras include items such as haircuts and outings. "All those things can be a surprise if you're on a tight budget," says Gosselin at the Assisted Living Federation.
Assisted living buildings do not charge a large entrance fee, but they typically ask for a community fee of about one month's rent. Leases are typically month to month, though many buildings will guarantee a set rental rate for a year.
Another option is the state's Supportive Living Program. It was designed to offer low-income seniors in Illinois an affordable assisted living option. There are about 120 supportive living buildings throughout the state. The buildings are open to those of all incomes. The monthly all-inclusive rent is about $2,500. But unlike private pay assisted living buildings, supportive living buildings take Medicaid payments. For those who qualify, the state pays for the services and the senior's Social Security covers the rent. "Most people think they can't afford assisted living," saysBeth Quarles at BMA Management, which operates 33 supportive living buildings. "But it's a great option for many people."Copyright © 2015, Los Angeles Times