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How Much Does Assisted Living Cost in the US

By Koob Moua October 26, 2021 Aging

Navigating the ins and outs of an Assisted Living Facility is an arduous task. Understanding the associated costs and affordability of Assisted Living Facilities is an additional battle. Alongside our Guide to Assisted Living Facilities, we take you through a more specific vessel – costs associated with Assisted Living Facilities. 

We take you through how:

  • Specific services utilized within Assisted Living Facilities can contribute to the monthly fees incurred by residents
  • Costs within Assisted Living Facilities vary by geographic locations
  • Financial assistance can be made available for qualified residents transitioning to Assisted Living Facilities 
  • Pricing structures can influence the monthly fees associated with a resident’s stay within an Assisted Living Facility 

Cost of Assisted Living Facilities 

Many variables are factored into the costs of Assisted Living Facilities and can vary quite significantly. For starters, the type of apartment layout, amenities offered, and the amount of services required by the resident can sum up the general cost reflected on the monthly fees. The most recent analysis provided from Genworth Financial established the average cost of Assisted Living Facilities in the United States to be $141 daily – amounting to a monthly expense of $4,300. 

Being a resident of an Assisted Living Facility isn’t exactly a cheap option but it may be the best environment for your current health and well-being. If being at home has been continually difficult to carry out your self-care routines and/or you’ve had a history of falls within your home, it may just be that time to consider an Assisted Living Facility is a viable option. Although accounting for the cost of Assisted Living Facilities within your budget is a stressor in itself, we help you understand the costs of Assisted Living Facilities through a simple guide. As you determine which facility will be the best for your health and well-being, we guide you through ways to cut back on costs and get the best bang for your buck. 

Rising Costs of Assisted Living Facilities 

Leading experts studying transitional care for seniors found that the average cost of Assisted Living Facilities increased annually. Specifically:

  • The monthly cost of Assisted Living Facilities rose from $2,524 in 2004 to $3,500 in 2014. 
  • In 2006, the average monthly cost was $2,968 compared to $2,969 in 2007. 
  • In 2010, the cost of Assisted Living Facility was $3,293 per month for a resident compared to $3,477 in 2011, with a calculated difference of $184 per month – a 5.3% increase. 

Cost of Assisted Living Facilities by Region

Aside from the amenities and the number of services a resident requires to maintain their health, costs from Assisted Living Facilities also depend on geographical regions. The same group of experts found in their review that: 

  • In 2006, Connecticut had the highest monthly costs associated with Assisted Living Facilities, amounting to an average of $4,327 per month, whereas the monthly costs of Assisted Living Facilities were $1,340 in Miami, Florida. 
  • In 2014, the average costs of Assisted Living Facilities totaled $6,890 per month while the average in Georgia and Missouri were $2,500 per month. 
  • In 2004, the range of costs associated with Assisted Living Facilities were $1,340 to $4,327, rising continuously up until 2014 which resulted in prices ranging from $2,500 to $6,890. 

For the most updated costs of Assisted Living Facilities, please see the chart below with data provided from Genworth Financial. The chart details the daily, monthly, annual, and anticipated annual cost in 2030 of Assisted Living Facilities. As you make your decision to transition to an Assisted Living Facility for the next phase of your life, consider if you have any family members or friends in other states. Moving to a different state can save you a large chunk of money at the end of the day if making the leap is a realistic option. Based on the data provided from Genworth Financial, the difference can range from several thousands to several tens of thousands annually. 

Cost of assisted living facilities
Genworth Financial 2020

Long Term Costs vs Short Term Costs

Seeing the horrifying prices of Assisted Living Facilities can easily discourage you from making the transition to an Assisted Living Facility. The staggering prices and affordability of the associated costs for Assisted Living Facilities may have you pondering over questions such as, “How does anyone afford this type of thing?” or “I’m better off just staying at home rather than paying such a high price.” These are both valid thoughts and concerns. Before making up your mind, consider this alternate question, “Will the long term costs outweigh the short term costs in the end?”

Although daunting, you have to be honest with yourself. If you are currently in a situation in which your current health and home setup is no longer conducive for you to live and thrive, you may be better off transitioning to an Assisted Living Facility. The reason being is that a hospital admission, a fracture from experiencing a fall, not keeping up with your self-care or hygiene routine, and your overall health debilitating eats a bigger cost at the end of the day. 

A team of researchers looked at the relationship between hospital admission, hospital readmissions, and traits of Assisted Living Facilities. Based on the researcher’s review on the topic, they found that: 

  • Overnight hospital stays and readmissions can result in trauma or medical complications on the necessary treatments received. 
  • The traumas and medical complications experienced from the hospital stay often resulted in a decreased quality of life. 
  • Hospital stays increase the chance of seniors’ health to decline, have decreased ability to care for themselves, experience falls, and be admitted to a nursing home. 

As your body and health go through changes, don’t let a price or your pride get the better of your life. Financial assistance is available for those that aren’t able to pay for Assisted Living Facilities. Rid your pride from blurring your decision to transition to an Assisted Living Facility if you’ve been unable to keep up with your general day to day routines or have experienced falls in your home. 

Financial Assistance for Residents 

Medicaid is the primary source of payer associated with Assisted Living Facilities in the United States. As muddy as the topic of paying for Assisted Living Facilities already is, qualifying for Medicaid adds on another layer of mud. The majority of residents enter into Assisted Living Facilities paying out of their own pockets. 

Each state has their own regulations for a resident’s eligibility to qualify for Medicaid to pay for their stay in an Assisted Living Facility. The fundamental root of this dilemma is that a resident only qualifies for Medicaid to pay for their residence at an Assisted Living Facility if their assets are below a certain number. As a result, if a resident’s assets are too high, he or she ends up paying out of pocket until he or she exhausts their total assets to qualify for Medicaid. Once qualified for Medicaid, he or she no longer has to pay out of pocket for their residence. 

It’s recommended to speak to a financial adviser or your family members before making a decision. Case managers or social workers are experts in advising residents the best route to take in order to save yourself the most money at the end of the day. Many case managers or social workers work at Assisted Living Facilities and can provide you and your family with the suggested route to take at the intake of signing up for a new Assisted Living Facility. 

Pricing Structure 

Circling back to the way Assisted Living Facilities are priced, four general pricing structures help better understand the associated costs of Assisted Living Facilities: 

  • All Inclusive Care Pricing
  • Personalized Care Package
  • Minute by Minute Tiered Pricing 
  • A la carte Pricing 

Before diving into the details of the four pricing structures, it’s helpful to understand frequently asked questions related to fees through a rapid fire style approach. Let’s give it a shot!

  • What is included in the monthly fee? 
    • Monthly fees cover what is defined as what is necessary to live comfortably, including an apartment, utilities (heat, air conditioning, and electricity), dining services (two to three meals per day), and basic housekeeping (laundry or bed linens, vacuuming, and sweeping). 
    • Assistance with personal care such as bathing, dressing, and grooming along with medication administration will likely be an additional cost as a package or hourly basis cost. 
    • Transportation, personal laundry services, and salon services typically come at an additional cost and are not considered to be part of the basic fee. 
  • Which services will incur an additional cost? 
    • Residents pay for cable, internet, and phone services for their own apartment. Free Wi-Fi has become much more readily available for most Assisted Living Facilities. 
    • Residents are expected to provide their own toiletries, health and beauty products, hairdressing, clothing, incontinence care supplies, and dry cleaning/personal laundry. 
  • Is the monthly fee a set rate? 
    • Similar to a renting lease when signing an apartment, the majority of Assisted Living Facilities have a year-long lease that residents sign. 
    • Outlined within the lease, you can find the base monthly fee as a set amount. The total monthly cost will depend on the fee system that a resident adds on for personal care assistance. 
  • Are there any upfront fees?
    • Some facilities charge a fee for an assessment of the resident prior to moving into an Assisted Living Facility. The assessment will determine the general health of the resident and generate a rough idea of how much assistance the resident will need in order to maintain their health. 
    • The initial assessment will also cover a wellness assessment, development of a tailored service plan, assistance with moving in and settling in, and preparation of the apartment. 

Now that you have a better understanding of how general associated costs of Assisted Living Facilities can stack up, let’s circle back to the four main pricing structures that are offered. 

  1. All Inclusive Pricing: This option offers one total monthly fee for housing, meals, activities, housekeeping, laundry, transportation and personal care assistance with dressing, bathing, grooming, and toileting. Going this route, you can rest assured that additional charges will not be added to your monthly fees. Although most services are covered under this structure, some facilities tend to exclude services such as medication administration and assistance with incontinence. Within this system, a resident that is very independent and does not need much self-care assistance would be paying the same monthly fee as a resident that requires daily help with bathing, dressing, and grooming.
  2. Personalized Care Package: This option is based on the specific personal care needs and other amenities required for each individual resident. Within this system, a basic fixed fee is the starting point, in which housing, meals, laundry, and housekeeping is included. Personal care services are added onto a resident’s monthly fee based on the wellness assessment performed prior to moving in. Considerations of the resident’s physical abilities, abilities to manage their own medications, or changes in memory influence the typic of personalized services that will be included in a resident’s monthly fee. Families and residents receive the biggest reassurance with this option, know that the appropriate amount of assistance is provided for the resident to prevent further decline in health. If a resident experiences a change in health status or comes back from a hospital admission, a wellness assessment is performed again to ensure appropriate care is being provided. 
  3. Minute by Minute Tiered Pricing: This option is dependent on the time and number of caregivers needed for the resident. Similar to the Personal Care Package, the model for Minute by Minute Tiered Pricing increases its fees by the needs and services required by the resident but differs by the amount of time, encounters, or number of caregivers are needed to assist the resident. If a resident tends to have better health from month to month, this option can save a bit of money as the monthly fees will differ from month to month. Things to consider when going with this option is to find out exactly what services are covered within each tier, find out if this will be the most economical option based on the wellness assessment, and understand what happens if the resident reaches their maximum time allotted within their tier. 
  4. A La Carte Pricing: This option allows families and residents to select specific services that are necessary for the resident then pay the monthly fees associated with the chosen services. Under this system, charges are made and tracked by specific services, the amount of assistance provided, or by time. Time is measured in quarter hours (25 minutes). In other words, if a resident needs assistance with a task that only requires two minutes, the charge will still amount to a total charge of 25 minutes. Many disputes from residents and families occur under A La Carte due to some residents having memory impairments. Each month can come with a much larger bill that is a surprise but if the resident isn’t able to recall an event, disagreements can easily occur. It’s heavily encouraged to check in daily when the services are provided, have the staff members document or contact family members when services are provided to make sure everyone is on the same page. 

How Most Residents Pay for Assisted Living Facilities 

It’s difficult to compare apples to apples as every person’s financial, social, and physical situation differs. Costs associated with Assisted Living Facilities range from city to city. On top of this, the acceptance of Assisted Living Facilities with financial programs such as Medicaid is not universally accepted. 

Most residents end up paying for Assisted Living Facilities from their current social security income and pensions coupled with personal savings. If once a homeowner, may residents use their proceeds from selling a home to afford their stay at an Assisted Living Facility. 

For residents with limited resources and assets, Medicaid is a large payer for costs associated with Assisted Living Facilities but only among communities that participate. Most facilities that are privatized are less likely to accept Medicaid as a source of payment, whereas non-profit facilities are more likely to accept Medicaid from qualified residents. 

Questions to Ask 

Don’t show up empty handed when touring an Assisted Living Facility. Bringing a handful of questions let the staff members know that you’re serious and not someone to be taken advantage of. Especially with paying such a high price, it’s important to understand all of the details. See below for a helpful guide of questions to start off with!

  • Costs and Fees
    • What is included in the basic monthly cost? Make sure to ask for a printed copy or have it emailed. 
    • Does the residence have a written schedule of fees for extra services? Request a copy if available. 
    • Under what circumstances might the fees change? Will we be notified if the fees change?
    • Is a security deposit required and if so, what is the fee associated with it? 
    • Is there a refund policy for the deposit?
    • Does the Assisted Living Facility participate in the Medicaid program? 
    • Is there a list of services and amenities that cost extra? Ask for a copy if available. 
  • Pricing Structure
    • Do you have a list or handout of the different pricing structures offered? What are the exact monthly fees associated with each system? 
  • Upfront Fees
    • Are there any upfront fees with the initial wellness assessment prior to moving in? 
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The Author

Koob Moua, OTR/L, has a doctoral degree in occupational therapy. He works in a hospital setting to help people return to their lives after experiencing severe physical trauma, disability, or a new medical diagnosis through rehabilitation. On his free time, he advocates for his profession by publishing academic journals focusing on self-management of chronic diseases.

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