Cost of Assisted living: How to not be taken advantage of

Assisted Living, Alzheimer/Dementia Cost breakdown:

Most Assisted Living and Alzheimer/Dementia care facilities cost breakdown can be broken down into 3 categories:

Monthly costs: Cost for the room and care

Admission Fee: One time non-refundable fee (AKA move in fee)

Deposit: Refundable at end of stay depending on the state subject to certain laws.

Note: There are other moving costs and internet costs, but these are all the costs that are paid to the facility directly.

Referral Agency/Marketers:

Referral agencies often exist as middle men. Any time someone hands you a card to call for help or a random person comes in and tells you about help finding a facility, tell them no thank you unless they are the owner of the facility. It doesn’t matter if it is a nurse or any other person who works for the person giving care; money is paid to these people which is usually paid out indirectly by the client.

The reason facilities have high admission fees and deposits are to pay for marketing. This is true for smaller facilities in particular.  If you contact the facility and tell them you did not use a referral agency, you can negotiate a lower monthly rental fee and a low if not no admission fee.

Also these middle men are not bias. Usually they have very little contact with the facility or they work directly for the facility.  

If you want to find a good senior care facility, go to yelp. If you want an approximate price google the facility. These pricess are reliable for small 6 bed facilities but not for larger facilities.  Do not use the phone numbers on these websites to contact the facility, as many facilities that have information will charge the facilities a fee for helping them get in contact with you. Contact facilities directly through the phone number listed on yelp.

Tour all facilities and make sure they are appropriate for whoever is looking for care.  In the future I plan on making a post on touring and what to look for, but always visit a facility before making a decision and once more without an appointment before making a final decision.

Admission Fees

Many larger facilities will charge high non-refundable admission fees in addition to a deposit and move in fees. By high I mean this fee not including a deposit can be 2X, 3X or 5X the monthly rent/fee.

First if you have not used a referral agency and contacted the facility directly, make sure to say-so. Many facilities spend entirely on admission fees to defray costs associated with referral agencies.  Always mention if you have not used a referral agency and ask to lower admission fees and/or deposit costs. Also always try to negotiate a lower rate.

Now here is the problem though. The minute there is a change in care, the facility will say, that they can no longer care for the client. Even if there is an injury that the client is completely expected to recover from within a short period of time, the facility may still say they cannot stay while convalescing unless thy hire a very expensive non-medical home care aid for 1-on-1 care.

And the truth is this fact is also likely that their staffing may not be able to or willing to change for a single client change in health.  They will even claim that the state demands that they must leave which is usually true as you cannot have someone in your facility you lack the ability to take care of.

So you may find yourself after 3 months, having to move the client out after paying 15,000 out in a non-refundable admission fee. So avoid any facilities that charge large one time fees.

Point system

Often you will tour a facility which seems to quote a very reasonable monthly cost.

However they will have a fairly long perhaps 10 or more list of care requirements they use to bill for monthly care. You will look at the list and you will say, oh we only need a few of the care requirements so the additional cost will be low.

However when you get the bill instead of an additional $500/month cost, you may find yourself seeing  an increase of more than $2000 extra monthly cost.

Now increases to monthly costs are consistent with pretty much every facility.  If someone ends up requiring a wheel chair when before they didn’t or someone decides to go on hospice; costs will often increase.

However many facilities lure you in with a low rate only to jack up the price by claiming care requirements after the fact. It’s not odd for a caregiver at facilities such as this, to record everything they do so that they can squeeze every additional care cost out of a client.

Now not all facilities that bill by this method are to be avoided. The highest cost for a facility is not the billing but the care they provide so a facility should have a simple and open way to increase costs if the care a client needs radically changes.

However it is immoral to me, that people will go in thinking they will pay 3,500/ month; then a month later without any change in health of the client find themselves being billed 6,500/month.

People assume when they go to an Assisted Living and Alzheimer/Dementia care facility that the costs will be upfront and not change. This is not the truth. So be cautious of any facility with a large list of care services they bill for.  

If a client needs help to the bathroom once a month, you may find yourself paying an additional cost. IF a client needs a reminder or escort to the dining room, you may find that this equates to “Assistance with Eating.” So not only do the care requirements not have to be required consistently, the descriptions used may be vague or difficult to understand.

Often times this type of pricing happens in large facilities with a low census (Less than 70%).

Hopefully this article will help you avoid unnecessary costs with facilities. Feel free to ask any questions below if you have them.

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