The Costs
Assisted living facilities vary widely in cost depending on room size, services offered, and several other factors. Unlike nursing homes, Medicare does not pay for assisted living services under any conditions. Most facilities accept only private pay, although some states offer assistance with payment, such as Medicaid or Supplemental Security Income. Inquire at your local Medicaid or health office for information on whether or not your state has a comparable plan. Assisted living is covered by some long-term insurance plans. Some facilities also offer subsidies and financial aid, although a waiting list typically exists for these purposes.
Fees can start at $1,000 a month and increase with amenities, level of care offered, and additional services provided to about $3,000 a month. Many facilities also require a deposit that may or may not be refundable. The average cost for an assisted living facility falls between $60 and $70 per day, compared to $75 to $235 per day for a nursing home. Make sure you know what you are paying for. The cost almost always covers room and board and meals. Ask about which services, utilities, and care are also provided in the monthly cost and the additional fees for services not provided.
Selection Tips:
Choosing the right assisted living facility should be an involved and carefully thought-out process. Picking the right assisted living facility is as important as choosing a house or apartment.
Visit the facilities you are considering, talk to the staff and residents, and read through any brochures and information offered. Make several visits at varying times of the day and week in order to get a complete impression of the facility. When you tour the facilities, pay special attention to the attitudes and overall friendliness of the staff and residents because they are potential housemates.
The following are things to consider when choosing a facility:
Atmosphere/Comfort Level
- Are pets allowed?
- What types of meals are offered by the facility? Consider nutrition, choice, appearance, variety, and taste. Are special meals available for dietary restrictions? Does a dietician approve resident meal plans?
- How big is the facility? Larger facilities may have more organized activities, socialization opportunities, and transportation.
- Can residents bring their own cars?
- What are the facility’s visiting hours? What types of accommodations are available for visitors? Are there any restrictions on having guests?
- How clean is the facility in reference to appearance and odor?
- What is the general attitude and appearance of the residents?
- What is the general attitude of the staff? Is the staff friendly and courteous to residents and each other?
- What is the participation level of residents in activities and outings?
- How often and in what manner does the staff interact with the residents? Does the staff recognize all of the residents? Are members of the staff friendly toward the residents?
- What is the resident’s and family’s involvement in the development of the service plan?
- How often are each resident’s needs reassessed?
- What are the admission requirements?
Services and Activities 
- Is socialization encouraged and promoted? Is it easy to socialize with other residents? Do lounge areas and a common dining room exist?
- What is the extent, range, and frequency of planned activities?
- Are there a lot of opportunities for transportation? How flexible is the transportation?
- Do opportunities for involvement with the surrounding community exist?
- How flexible is a resident’s daily schedule? How much independence is allowed?
- Is the facility licensed by the state?
- Is the facility’s administrator licensed by the state?
Equipment/Amenities
- Are exercise facilities available to the residents? What kind of opportunities do residents have to exercise?
- What types of amenities are available to residents?
- Is the facility equipped to support any special needs of the patient?
- Is extra storage space available?
- Is the facility located close to shopping centers and/or entertainment?
- Do the units have a telephone and television? How is billing handled?
- Is there a kitchen with a sink and refrigerator in the unit?
- Are religious facilities available?
Financial Considerations
- What is the monthly cost of the facility?
- What are the trends in rate increases over the past years?
- Is a deposit required? Is it refundable?
- What services are included in the monthly cost? What services have to be paid for separately? What other services are available?
- Are utilities included in the cost?
- What circumstances might force a resident to leave the facility?
- What kinds of opportunities are available for a resident to receive further care as a condition or problem requires?
- Is the facility connected with a nursing home or other kind of facility?
- What types of housing are available? (private/shared, apartment, suite)
- Is the housing furnished? If so, what is included?
- What types and what amounts of personal belongings is a resident allowed to bring?
- What happens if you are unable to pay for services?
- When can care services be terminated, and what is the refund policy?
- What are the payment, billing, and credit policies?
Safety Considerations
- Are intercoms installed in each room?
- Is there a 24-hour emergency response system accessible from each unit?
- What is the level of safety in the facility? Is there proper lighting? Are there handrails, emergency pull-cords, and door alarms? How extensive is the fire system?
- Are exits clearly marked and easily accessed?
- Does the facility have air conditioning?
- Is the ventilation and heating adequate?
- Is the facility’s security adequate? Are there lockable doors for each unit?
- Does the facility have handicapped access and accommodations?
- How close is the nearest hospital?
- Is there a doctor or pharmacy on-site?
- How many staff members are on duty for each shift at the facility?
- How long does it take for the staff to respond to a resident’s call for assistance?
Find out which state and federal regulations apply, and make sure that the facility properly complies with them. Most importantly, involve loved ones in making your decision.