Finding an affordable memory care or assisted living community can be a daunting task. Even this senior housing guru had to plan strategic questions before touring four memory care communities for my mother-in-law. See the questions HERE.
My husband and I flew 1000 miles to Seattle. We only had two days to tour memory care communities in the Seattle area. This required researching the Internet, calling former senior housing colleagues for recommendations and scheduling tours before we left. The timing was tricky because our limited time included visiting with my husband’s mom.
My husband created a spreadsheet to compare costs between these four memory care communities. The pricing is so complex that even someone working in the senior living field (like me) had trouble figuring out the monthly cost for my mother-in-law.
Care points, care levels or all inclusive costs?
Most assisted living and memory care communities seem to have a charge for room and board, then additional costs for care. Pricing can be very gray and feels like an illusion of smoke and mirrors. Care costs can be priced on a point system or a level system.
My mother-in-law, Amy, was assessed at 223 points at her current memory care community. Care costs varied dramaticly. Some of our tour guides were actually guessing what level of care or point total she might be, before a nurse could assess her. This is what makes pricing difficult to compare. The community recommends that you to move her in and then they will figure out the monthly price. Sigh…
Here were the room and board costs of four memory care communities in the Seattle area (these prices do not reflect care costs):
Community A Private Room: $2,330
Community B Private Room: $5,095
Community C Private Room: $4,050
Community D Private Room: $4,137
Room and board costs for a shared room in memory care are less:
Community A Shared Room: $1,050
Community B Shared Room: $4,895
Community C Shared Room: $2,850
Community D Shared Room: $3,837
So let’s try to figure out care costs:
Community A has four care levels: Amy’s current care level two (estimate) – $3,860
Community B has five care levels: Amy’s current care level three (estimate) – $2,595
Community C uses care points: Daily charge .54 a point x 223 = $3,613
Community D uses care points: Daily charge .73 a point x 223 = $4,884
So the price is so high, we decide to consider a shared room. So let’s add the shared room with the care costs to see what Amy would be charged each month:
Community A – Amy’s monthly total: $4,910
Community B – Amy’s monthly total: $7,490
Community C – Amy’s monthly total: $6,463
Community D – Amy’s monthly total: $8,721
Each place said it would reassess Amy in two weeks. They implied the price would bump down, but it might bump up in price. Right?!!? So that led us to ask what could be the maximum cost for Amy’s care in a shared room?
Community A – Amy’s maximum cost: $6,820
Community B – Amy’s maximum cost: $9,045
Community C – Amy’s maximum cost: $9,006
Community D – Amy’s maximum cost: $12,159
Community D was priced the highest, but it also had the highest staff ratio and was a drop-dead gorgeous new building. We had to eliminate it due to Amy’s finances. Community A was priced the lowest and had a wait list. It was cheaper, but gross and we saw a low staff ratio. So that left us Community B or C. Community B had a care level pricing and was brand new. Community C was based on care points and was a dated older community. This is where our spreadsheet came in handy.
The bottom line for the family: Amy’s care was more important than a new community that looked great walking in the lobby. We felt Community C had outstanding personnel! Every single person greeted us on our tour. They painted the picture of Amy’s reality, but explained how they would provide the best care in a homey environment. We felt they were experienced enough to correct Amy’s medications that had been over prescribed at the hospital (You can read about drugging and diapering seniors HERE.).
So Community C will initially cost the family around $6,000 a month, plus the one time community fee. They assessed Amy the same day we toured (another example of excellent service) and determined that 223 points was too high. Her new assessment is less than 200 points.
One-Time Community Fee
Assisted living and memory care communities typically have a community fee (one time) when someone moves in. Here were the memory care community fees for the four places we toured:
Community A: $2,500
Community B: $4,895
Community C: $6,500
Community D: $10,433
It’s complicated to compare senor-housing options; I hope this information can help you. Some other assisted living and memory care communities are all inclusive and only charge extra for incontinence care. Do your own research. Cheaper does not always mean better. Look beyond the superficial newness to the quality of the nursing and caregiver staff. Don’t forget to ask about turnover of staff. Community C has two key staff that have worked over 10 years for the company.
What have you encountered?
I haven’t even discussed who can afford these expensive prices? What about poverty level seniors? What happens when a senior runs out of money? Why is Medicaid almost impossible to find at licensed assisted living communities? These questions are addressed in my new book, “Your Senior Housing Options.” It is available on Amazon.com with a 5-star rating.
I work in an Independent Living facility. We have “memory issue” residents that we have to give more attention to (making sure they come to meals, getting them to activities), but as we are a small community, it does not really put an extra burden on us.
I really enjoyed reading your article. We are an all inclusive pricing that starts at $1240.00 and goes up to around $1900.00. Our prices are based on the size of the apartment chosen (studio and two room only). The only extra charges we have are: Med reminders, second person (meal cost only) and if we furnish furniture.
We are also the “cheapest” option, but our atmosphere is family style. Our staff all feel like the residents are part of our “family” and so they are treated as such and they feel the same love for us. We also try to let all residents to stay with us, even as they need more care (if they can afford Private Home Care, they stay until the end of their life).
Our biggest problem in trying to fill our community is that long term insurance does not recognize an Independent living facility because we do not have to be licensed and do not have nurses on staff. I think this needs to be changed, but losing the battle.
Monthly rates for facilities in israel are lower but vary too in service architecture and location.
Any way the search is tideous and hard.
I am a developer of new senior housing buildings, and part of my job in researching a market is calling existing facilities. This research includes understanding rents and care costs which I understand marketers may want to shield from folks like me. What baffles me is that why cost information is also so hard for families to get too. Getting surprised by costs AFTER your loved one is moved in, leads to hurt feelings, buyer’s remorse, negative reviews, move outs, etc.
My strategy if I were Director of Marketing for the day? If our strategy was to compete on price, I would print our lowest price in BIG BOLD letters. If we competed on service, we would print our price and extol our service in BIG BOLD letters. If our pricing strategy was mid-tier, print our pricing and make sure our bang-for-the-buck message was evident in every marketing channel. Mine is an oversimplification, and therefore I apologize to marketers and directors who face this daily challenge.
Diane Masson’s mother-in-law had the advantage of an industry insider as her advocate. My heart goes out to the families of those who must suffer the gauntlet of extracting comprehensive costs of care options for their family. Hopefully, I face harsh scrutiny because when I call I am understood to be the enemy. Unfortunately, I suspect the norm to be that less information is purposely given than is needed, and therefore families are forced into a leap of faith decision in vacuum of incomplete understanding.
Thanks for your comment Adam! It is so hard for families to figure out pricing, I think it is impossible. I loved giving the tip on finding out the maximum cost for care. Every time I asked, they said that no one was at that level. They tried not to give it to me.
Thanks Diane for taking the time to share your research and frustrations. I know my Mom will be moving to our city sooner than later and it was good to see the research and different costs by facility… Appreciate your efforts and I also know your mother -in-law is lucky to have you both working to get her the best care within your budget. Many seniors do not have that support. Thanks
I appreciate your comment Bill!
As the primary finance contact at my Assisted Living/Memory Care community, I am the focus of confusion, and in some cases frustration, regarding the wide array of charges in a facility of this type. Our community offers private style apartments, priced competitively via routine market analysis; in addition to base rent, personalized care costs are incurred on the basis of individual need. Since our residents vary in acuity on both sides of the community, a tiered care level system (catered to each neighborhood) works for us – also available are products like our tiered personal care program, involving incontinence supplies offered to residents at a reduced cost compared to external purchase. Though we are not the newest or most aesthetically pleasing community in the market, it is our care, sense of community, and resident interaction that set us apart – obviously paramount to families, this is often the deciding factor for choosing our service over one that may be considerably less expensive. Above all, it is the acceptance of purpose over self, and passion for the industry, which is the dominant precursor to sustained occupancy and customer satisfaction.
I am a RN,BSN and I worked the last 9 years in a State Veterans Nursing Home. I worked as a staff nurse and Supervisor for the 3-11 and 11-7 shift. I never looked at the costs, but worked very hard to take care of the residents. We did have a higher staff to resident ratio than the private homes. We had a secure unit and an open unit. There were dementia residents on both sides, but the secure was for the escape risk or those requiring a more regimented or focused community. On the secure side where I worked the most it could seem to be chaotic at times as there was so much going on and the residents could be louder at times. The physical layout was 2 beds to a room and most had a shared bathroom/shower between 2 rooms. The stage level of dementia was 3-4/ 7 stages of dementia generally as a rule to be in the unit and it graduated from there. Each stage was subdivided by tenths. Social Services did a pre-evaluation Mini Mental sometimes before they were officially admitted and on admission and every 3 months thereafter unless there was an event requiring another. The Supervisor of the unit, DON, Pharmacy, Social Service, and the NHA( final review) before a resident was admitted and which unit was more appropriate for the resident’s needs. I’m sure there was a small group who went over the residents records again to make the decision which unit was appropriate. As the night Supervisor I did some resident evaluations of records for admission, but this was usually handled by the Day Supervisor.
Anyway the point is I will soon face this daunting task when my wife gets to be too much for me to handle at home. She will stay at home until she is probably a late 4 or early 5. Longer if I can get some help from other Agencies to keep her in the home. I greatly appreciated the article and looking at the numbers for cost. Also we gave visits at times to prospective families on 3–11 shift as well as weekends. I think I had a couple of looking families come around 11 or so over the span of years. We had an open policy for family members to visit 24 hours a day to check on their loved ones. Whenever we had a loss of a resident you always knew a new one would be coming soon, especially on the secured unit. The Secured unit had a waiting list longer than the open side, but we had a waiting list for any resident.
The biggest thing I instilled in the staff on taking care of the resident was this can be your mother, father, brother, or sister. Love them and care for them as they were your own family member.
What a wonderful story of love and dedication to your residents and wife. I know you will find a great quality place for her. You will be able to feel it after meeting several staff and residents for yourself. I am glad my information helped.
Hi Diane-
Really great to see this discussion. We have facilities here in CA that charge $12k per month. Imagine how pricey this assistance will be in 20 years? Are the children of the parents that are needing care today purchasing long-term care insurance for themselves for the future? If not then after you secure a comfortable situation for mom or dad then secure coverage for yourself to make it easier for the next generation. http://www.solomonSmoore.com
As an attorney who counsels adult family home providers in WA state, I have observed a wide range of quality in this industry. I have clients, Adult Family Homes providers, who provide the highest quality of care in beautiful environments that are similar to spas: towel warmers, baby grand piano, chandelier, soft music, lush gardens, well-adorned windows, delicious meals…and only 6 residents with full staff day/night. Safe. Personal. Professional.