How do I budget for Mom to live in assisted living? Are there any surprise costs?

In our major metro area, a 1 bedroom Asst Living is about 3,900-4,200 per month, with 4% raise on rent per year. The medication help is 2-parts, one for Medication Management (or Set-Up), and a separate and additional fee for Administration, depending on how many times per day, how many rx's, and what type (injections of insulin cost more). Some places only include 20 meals per.month, others 2 meals per day, all sorts of variations on tbis. But as others have said there is another charge to have the meal delivered to their room.
For my mom, her rent plus medications, Depends, and extra services added up to approx $60,000 per year. Her renter's insurance, Medicare Supplement Insurance, Deductible, Co-pays, presciption costs, vitamins, Eyeglasses, orthopedic shoes, clothing, PT/OT, would all be another $8-10,000 per year in addition. The doctor visits would still have to be handled by me--From picking up the phone to make the appointment, driving over to pick her up, getting her into my car plus her purse & walker, drive/park, usher her in to the medical building....I don't know of any ALF that is going to do that level of service for medical.appointments. her laundry would also be an issue--they only provide ONE load of laundry per week. And all items thrown in the same load, while they clean her apartment, but she would have to go down the hall to put them in dryer, take out & fold, get them back to her apartment and re-take the bed. I thought that was pretty low level of service, but they do offer 30 mins/day of extra help at $615/month (can't buy just one day per week). Other facilities might operate differently. But in my estimation, I would still be required to do about 10-12 hrs per week of Real Work, which the facility simply would not do, or only at a steep price.
So, be sure to remember, the facility does NOT do everything.

Transportation availability and fees vary. At my mom's first AL, up to 3 trips per month for medical visits were included. However, they were subject to the availability of the mini-bus. At her current facility, they have a car and a limo, and medical visits are about $15 round trip. I usually transport my mom, but if time is tight, I use the transportation service and meet her at the doctor's office. If the resident needs as escort, they are charged by the hour.

What about doctor visits? Do AL's provide transportation to them or help with them at all (and at what price?) or does the caregiver still do all of that part?

Hi there!! I happen to have a list of a local place right here. (I'm in central Florida and use this facility for monthly respite care). Their monthly fees start at 2,300 and go up to 4,175 depending on the level of assistance. They have a 1,500 one time, non-refundable admission fee due upon "move-in". I didn't have to pay that since mom is only there 1 week per month. Medication management is 275.00 per month, a security pendant is a 125.00 one time fee. Room service is 3.00 per meal. Motorized Cart Fee one time fee of 500.00. Internet Fee is 10.00 per month. Pet fee is one time of 250.00, and the beauty shop is 15.00 for a wash and set. There is one here that says furniture option of 125.00 per month..I'm not really sure what that one is..maybe renting what they have. Mom uses a respite room for 100.00 per day. It is a private room at the end of a hall so she can blast her TV without disturbing anyone. (Free cable) She has a bed, dresser, armoire , nightstand, recliner (but insists on bringing a straight back chair from home (luckily it fits in the trunk). There is a little kitchenette area too, and her private bathroom. We started using them in October and it was the best decision and money ever spent!!! She is actually there now, we pick her up this Sunday, and she will return in mid-January. I'm sure each state, and even city will have different rates. This one is a very nice facility in Lakeland, Florida. Good Luck on your search. When you view a place, they should give you a Fee Schedule, you may be a little surprised at some of the fees, but at least you will know what they are before moving her in.

Great tips here and things to be aware of ... I am starting to feel more confident about this decision. Thank you all.

My MIL is paying for her call button around her neck. Also, anything that she would normally be buying at home - toilet paper, hand creme, home phone.

cmcwrinkl1, Yes my mom's rate was raised at her first AL. It was around 2% if I recall correctly. It was on her anniversary date. The second year there was no increase.

akdaughter raises a very good point. At my mom's first AL, there was no Medicaid waiver. Once she was out of money she would've been out on the street. At the place she is now, they will accept Medicaid after two years of private pay. That certainly adds to her and my peace of mind.

Charges at AL facilities can vary significantly. Windytown gave a very good summary of charges that you can expect in addition to the monthly rate. Make sure that you ask each facility that you visit about the deposit (which is usually non-refundable), what services are included in the monthly fee, and what the charges are for extra services. My mom is in her second AL facility (the first one was not a good fit as her dementia worsened), and this one allows 30 minutes of personal care daily as part of the fee. This allows mom to have a few minutes of help dressing and undressing each day without an extra fee. She pays extra for cable TV, beauty shop services and medication management. If your mom is on a lot of expensive meds, ask if they must be purchased from a specific pharmacy and research costs. If you can manage her meds, this won't be an issue.

As far as annual increases - the first AL upped the price on the anniversary of the move-in date. The second one raises rates for everyone on July 1 of each year. Ask what the rate increase history has been when you visit the facilities.

My mom's current facility is a non-profit owed by a church, and is actually a little cheaper than the first facility which was corporate owned and had stockholders to satisfy. I don't know if a non-profit is available in your area, but you might want to check. You might also ask if the facility you are considering is Medicaid waiver. This means that if mom's money runs out, she could possibly stay on Medicaid. Facilities differ in their Medicaid rules, often requiring a certain number of months as private pay before they will accept Medicaid. Some do not accept Medicaid at all.

If your mother wears glasses, a hearing aid or has dentures, you may want to factor in replacements if they are broken or lost.

Angel

Windytown, thank you for the detail! All very good info. Nansacola, thank you, too. Does anyone know if rates go up on an annual basis, too, just as a matter of policy? Like 4% or something? I think I read that somewhere but can't remember.

Cable TV, a small refrigerator, and food for snacks are things that help them when they do like what is served for dinner. I also keep my mother's refrigerator stored with water, cheese, and yogurt.

If your mother is incontinent, you will have to provide depends and other sundries.

First of all, be prepared for a non-refundable deposit of around $2,000 on the day you make an agreement with an AL. That kind of shocked me with mom's first place as I didn't have a checkbook with me. Normally, I just use a debit card, so that was a surprise!

There is a separate charge, in my experience, for each ADL (activity of daily living).

ADL's include help with toileting, dressing themselves, medication assistance and so forth. If your mom needs meds and can handle them herself, that is a blessing. In my experience, it's around $30.00 a DAY for med assistance. Yes, crazy, I know.

Your mom will be assessed before intake at how many ADL's she requires.

Be prepared, as her needs change, for the charges to creep up. For example, my mom is suddenly incontinent. Be prepared to do some things on your own, such as supply your own Depends. I think it's around $10.00 per day if you rely on a facility to provide them. Also, for them to provide Ensure drinks, it's $2.00 per can. Stuff can add up quick!

Most AL's also won't deliver meals to the resident's room if they are ill. Where my mom is currently living, it's an extra $8.00 per meal. I get around that by providing her nightly meals. Thankfully she has a small fridge and microwave, so her CNA's heat up her meals at no extra charge.

If your mom likes her TV, as mine does, there could be a charge for cable. Her last AL provided it for free, but at her current place it is $25.00 per month. Also consider salon costs. My mom gets her hair done weekly at $23.00 a time.

Make sure the place you chose has a good food program and be sure to supplement with snacks they like.

Be prepared to pay around $200 (one time)for their alert pendant that they wear on a lanyard to summon help. My mom's place charges $25.00 per month for this service. It was the same at her last AL, so I assume this is standard.

Be prepared to wash your mom's clothing if you want anything to last. They use high heat washers and dryers for their germ killing capabilities. Can't blame them.

I personally bring all of mom's clothing items home to wash. I let them take care of the sheets and towels, though her towels need replacing. :(

You are wise to ask about hidden costs ahead of time. If I think of anything else, I will let you know. I wish you the best on this long road.