Adult Living Facility Options
Definitions and Descriptions
The following is a summary of different
types of adult living facilities, the Activities of Daily Living (ADL)
issues that may be required for
admission, and the approximate costs involved.
Note: The prices listed
here are for California, and will vary depending upon location and
Often referred to as Retirement Communities,
these may consist of apartments, single family homes, condominiums,
or mobile homes. It is common
for meals, laundry facilities, local transportation and social
activities to be offered. No physical assistance is offered. Some facilities
residents to hire outside help just as they would in their own
$2000 TO $2600 PER MONTH PLUS $500 FOR THE SECOND PERSON*
- Able to do own grooming and self care
- Capable of remembering meals
- Socially appropriate behavior
ASSISTED LIVING or RESIDENTIAL CARE
Licensed and regulated by the State,
these facilities vary from the small 4-6 bed Board and Care homes to
large Residential Care Facilities.
Some states are licensing Intermediate Care Facilities. $2000 -
4000 PER MONTH *May have a one time processing fee of $1000.
may require assistance:
- Assistance with meals, laundry and housekeeping
- Grooming, bathing
and dressing assistance
- Medication and safety supervision
- Toilet assistance
- Ambulation assistance
- Reminding and prompting
- Emergency care during the night
Licensed and regulated by the State, these facilities offer
room and board, personal care, medical and protection services. There
levels of care:
Basic Care: Personal care, ambulation, and supervision
needs at a more intense level than offered at a residential care
Skilled Care: Basic care above and medical situations
that require the
services of a registered nurse, on a regular basis, for treatment and
- Feeding tube, N/g tube or colostomy
- Administration of oxygen
- Injections or wound care
Sub-Acute: Inpatient care for those who have an acute illness, injury
or exacerbation of a disease process.
$4599 Semiprivate room to $9000 private room PER MONTH*. Additional
charges may be made for medical equipment, dressings, tissue, liquid
AFTER a qualifying 3-day hospital day stay. As of
2003, Medicare pays all of the first 20 days of skilled care at a
SNF (Skilled Nursing Facility). You will
to $101.50 per day for days 21–100 and you will pay everything
after that. Under the MEDICAID Program (MEDI-CAL in California), some
states offer residential care coverage. CHECK WITH YOUR LOCAL
FOR REFERRAL FOR INFORMATION.
CONTINUING CARE RETIREMENT COMMUNITIES
These CCRCs offer the continuum of care from independent
living, to assisted living to nursing home care all in one facility.
are two types
of these facilities.
Continuing Care Facility (CCF): There is a charge for entry to this community,
and the monthly charge is increased as the client moves from one level
of care to another. All levels of living are usually contained within
the physical community.
Some offer a DIMINISHING RETURN ENTRY FEE: $30,000 to $120,000.* (If
client leaves or dies within the first 5 years, there is a prorated
amount returned to client or the estate. After 5 years there is no refund).
Independent Living: $1600 to $3050*
Assisted Living: $3046 to $5170* (If more than 2 hours/day of assistance
is required, there may be an added charge of $3350 to $5775)
Skilled Nursing: $5070 to $5880*
Alzheimer's Unit: $4600 to $4800*
Lifecare Facility: The charge to enter this community is larger than
the CCF, however there is no increase in monthly fees as the client needs
to move from one level of care to another. May include financial coverage
for all medical needs. All levels of living are usually contained within
the physical community.
Example 1: DIMINISHING RETURN ENTRY FEE: $86,000 to $365,000.* Same
rules apply for any return of funds as with CCF. Monthly fee $1900 to
$4000. *Require age 65, Medicare Part A and B.
Example 2: 90% REFUND OF INITIAL ENTRY FEE: $550,000 to 1.6 Million.*
$25,000* for second person in unit. Monthly: $3100 to $5700* with second
person charge of $1500. *May include an Alzheimer's special unit. No
age restriction. Client is responsible for own health care costs outside
of care offered in facility.
Some offer a Buy-In plan where you purchase the real estate instead
of having an entry fee, and it becomes an asset.
ALZHEIMER'S / DEMENTIA
These are special units or services offered within
the SNF or Residential Care facility. They offer assisted living
and skilled nursing care
as needed. $4800* semiprivate room to $6200* private room. There
may be a one time entry fee of $1000.*
Programs such as Project Match will match those seniors
who want to stay in their homes, but need someone living there with
purposes or companionship. In exchange for options of room and
board, small salary, etc. individuals needing housing offer housekeeping,
meals preparation, and transportation services.
ADULT DAY SERVICES
Usually community or non-profit based programs
tailored to support seniors requiring supervision, assistance with
personal care and
activities. These are particularly important when an elder lives
with their adult children, and daytime supervision is needed,
or for respite.
Prices vary and may be on a sliding scale.
Use of agency assistance or private hire of caregivers.
Agency example: RN Case Manager fee of $160* per month required.
$20 to $24/hour.* RN coverage $48/hour. *
Private hire: $150 to
$200* per 24-hour day plus room and board, and you are responsible
all employee federal and state law and tax issues. Unless covered
homeowner's insurance, expect to be responsible for workman's compensation
insurance for your employee. Medicare or Medicaid may have some
assistance under certain circumstances.
Comprehensive services offered to those who have a terminal
illness, have a life expectancy of 6 months or less and are only
pursuing palliative care. Usually offered only in the home where there
a primary care
giver or at a SNF (Skilled Nursing Facility), few hospices have
their own inpatient facilities. If the agency is a Medicare Approved
and the client is eligible for Medicare, Part A of the Medicare
Benefit covers most services and medical expenses. Custodial care is
included. Hospice benefits change occasionally, check with your
If there is no Medicare coverage, expect expenses to be similar
to the Home Care above - although the hospice may have a non-profit
foundation to help defray patient expenses.