Models of Pricing for Assisted Living

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The day has come: you and the senior in your care have made a huge decision, likely after several years of using alternate methods of caregiving. You have decided that the best hope for a longer, healthier life for your loved one is for him or her to reside in an assisted living facility.

This is not everyone’s first choice; aging in place is preferred overwhelmingly by aging adults; they want to remain independent in their own homes. Yet, for various reasons such as healthcare needs, transportation issues, or safety concerns, the time may come to choose a facility that will be right for your loved one. In your initial search for these kinds of facilities in your area, you may come up with a few good options. However, you may also see some very confusing pricing options.

Navigating these pricing models can be confusing if you are not already familiar with this type of healthcare. Different facilities will also often include specifics that can be hard to distinguish from each other. In order to make the best decision for you and your loved one, you need to understand the usual pricing models used at such facilities.

Fees per Service

Depending on needs, a fees per service model might work best. This means that your loved one only pays for services he or she uses, on top of a flat fee for rent or for a room and board meal plan. For seniors who can cook and care for themselves, or even provide for their own transportation and healthcare outside of the facility, costs will be lower, since services inside the facility are likely to be more expensive. If the senior has excellent health insurance or receives benefits from the Veterans’ Administration, such as visiting nurses or cheap pharmaceuticals at little to no cost to them, assisted living costs will be lower. You should still inquire ahead about services that are most likely to be needed and cannot be predicted with certainty—care after a fall, for example, or a trip to the emergency room. These kinds of services should be priced out and accounted for in case they crop up during your loved one’s residency in the facility. An emergency fund can be kept to be drawn on if such sudden changes do occur.

Levels of Care

In some facilities, seniors and their loved ones choose a level of care based on basic healthcare and day-to-day needs. This model includes basic care all the way to fairly or highly intensive care. Such a continuum of services and attendant costs is fairly common in facilities which directly address memory care, since dementia and other memory-loss conditions worsen over time. Choosing care from a continuum allows for services only to be paid for when they become a necessary part of routine life. Seniors who choose this model will find that changing levels is typically easy and low-stress, though it may require moving to another part of the facility. Those with progressive disorders may find this a comfort, since they know what they will be spending as they age and require more services, and they know where they will be.

All-Inclusive

An all-inclusive facility bills for everything: room and board, laundry, healthcare, transportation, hygiene and activities of daily living, and even security. Costs month-to-month are essentially the same, meaning that predictability and billing are simpler to manage. If you are hoping for insurance and/or Medicare to cover some or all of this cost, this makes reimbursement or payment simpler to process for many people. It also means that changes in need can be addressed without changing levels or pricing out individual services, making them less time and energy consuming. However, these are typically the most expensive options, and some facilities will still charge extra for certain services which are considered above and beyond.

Entrance Fees and Other Costs

On top of a flat fee, payment in levels, or specific service fees, many facilities will also charge a moving-in fee, designed to pay for renovating or cleaning a room for a new resident as well as labor for help moving someone in. Such fees may be charged in the first month or even before someone lives there.

Always make sure you have a breakdown of fees, including flat month-to-month fees, taxes, and any other financial concerns before you move a loved one into a facility. The worst possible outcome is that your loved one gives up a personal home, finds a great place and moves in, only to be asked to leave due to a failure to pay unlooked for fees. Keeping on top of the financial picture before and during a residency in an assisted living facility is the key to avoiding that kind of logistical and emotional disaster.

 

Sources

Argentum. Cost of Assisted Living. ALFA.org. Available at http://www.alfa.org/alfa/Assessing_Cost.asp. Retrieved May 20, 2016.

National Center for Assisted Living. Assisted Living Community Profile. Available at https://www.ahcancal.org/ncal/resources/pages/alfacilityprofile.aspx. Retrieved May 20, 2016.

Paying for Senior Care. Fee Structures and Pricing Models in Assisted Living and Alzheimer’s Care. Available at https://www.payingforseniorcare.com/assisted-living/pricing-models.html. Retrieved May 20, 2016.

SeniorLivingLink.org. Assisted Living. Available at http://www.seniorlivinglink.org/resources/senior-living-communities-and-housing/assisted-living. Retrieved May 20, 2016.

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