Once you’ve made the decision that assisted living would be a good move, the next question is usually: How much will it cost? The national median cost for assisted living is $4,500 per month, but prices vary widely from state to state and facility to facility, according to Genworth.
The way assisted living facilities break down their costs also differs from community to community. Many residences charge a basic fee, which includes rent, meals, housekeeping, access to activities and exercise. Then they will group additional services, like therapies and medication disbursement, into different payment tiers. Other facilities consider themselves all-inclusive, but may have add-on fees, which can increase your monthly bill by several hundred or even thousands of dollars.
Some facilities, after a periodic assessment, may either try to bump your payment plan up a tier, or start charging more for added services. You are entitled to contest the additional services and fees as long as you can prove they are not needed, which may require the assistance of an aging life care manager, social worker or other professional who can attest to that.
It’s important to read your contract carefully and make sure the costs of all services are clearly indicated. Services that may incur additional fees can include:
- Dressing. Fees can be split for dressing in the morning and undressing in the evening.
- Bathing. Fees may be different for full help with showering or having someone in the room while the individual showers.
- Bathroom/incontinence care. Some individuals may need help getting to and from the bathroom, sitting and standing, wiping and changing adult diapers.
- Laundry.
Medical costs
Other hidden costs of assisted living may be medical. If an older adult needs any of the following, it may come at an additional fee.
- Health screening before moving in. Some facilities include this in their overall pricing upon move-in, but others many indicate it on the bill as a separate one-time charge.
- Medication management. Depending on the needs of the resident, staff may simply remind a resident to take their daily dosage, while other facilities will store and administer medications and record medication disbursement.
- On-site pharmacy or doctor access. Does the facility have a doctor or pharmacy on-site? You may be charged an additional fee for the convenience, disguised as a monthly “facility fee.” However, the services the doctor renders or the price of the prescription may be covered by Medicare or Medicaid.
- Treatment for temporary wounds or illness. Some facilities will tack on an additional fee for cleaning out and monitoring wounds from a fall or helping a resident get over a long-lasting flu.
- Blood pressure monitoring.
- Blood glucose monitoring and insulin injections.
Mobility and other care costs
In addition to medical costs, the following may incur service fees or monthly payments.
- Escort to and from the dining room or activity center.
- Checking in on resident at regular intervals.
- Reminders to go to the bathroom every few hours or before bed, to take medication or to get to weekly activities and therapies on time.
- Use of gym or spa, if available on premises.
- Transportation to area shops, doctor’s office.
- Extra fee to deep-clean the bathroom.
- Telephone usage.
Also keep in mind, for some facilities, there may be an admission and/or discharge fee. One-time admissions fees may show up on bills under names like “service initiation fee” or “community service fee.” Also, look at the fine print in the contract for discharge policies to make sure you are entitled to a refund for prepaid services that were not used.
Other hidden costs of assisted living
These are costs that aren’t charged by the assisted living community itself, but ones that you might incur as part of the transition to assisted living.
- Moving costs, which may include hiring a junk removal service, paying for movers and/or the costs involved in selling a house.
- Travel expenses.
- Lawyer or elder care manager fees.
