Hidden Costs in Assisted Living Facilities

The cost of living in a skilled nursing home, assisted living facility or memory care unit varies greatly across the United States.  Charges can vary from around $3,000 to $7,000 a month for basic expenses, but hidden fees can drive the cost much higher.  It is these unexpected charges that sometimes cause the greatest stress for families trying to keep a relative in a comfortable facility.

Basic Costs for Senior Living

While the exact prices will vary at different facilities and in various parts of the country, below is a list of sample basic charges from a facility which offers different levels of care in Orange County, California. Their basic charges are for independent living.  The costs increase as the resident begins to need more types of care.

The least expensive level is independent living.  This includes meals, weekly housekeeping, and access to activities, exercise classes, a fitness center and swimming pool.

Below were the basic monthly charges for one person living in the sample facility in 2016, and the prices have continued to rise since then.  It is important for families to discuss the current costs and expected future increases in prices when they commit to having a loved one move into a CCRC.

Junior Studio          $3177
Small Studio           $3167
Large Studio           $3539 - $3609
One Bedroom         $4162 - $4343
Two Bedroom         $5324 - $5429

If two people are living in the same apartment, there is an additional monthly fee of $1000.  Upon moving into this particular facility, there is also a non-refundable processing fee of $1500.

Residents can also expect these monthly rents to increase periodically.

Additional Hidden Costs of Assisted Living

What many retirees and their families do not expect is that there could be a number of necessary extras which can dramatically increase the cost of living in the typical assisted living facility.  Below are examples of some of the possible fees.  While these are just a sample of possible charges, based on one facility, everyone should ask about the cost of these services before they select a residence, because these charges can potentially amount to thousands of dollars above the cost of basic housing.


Medication Management:        $410 - $525 a month

Dressing / morning hygiene:     $400 a month

Undressing / evening hygiene:  $400 a month

Escorting residents to meals/activities:  $300 a month

Checking on resident every two hours:  $500 a month

Incontinence Care:                  $600 a month

Cueing (reminders):                 $120 a month

Stand-by during showers:         $480 a month for 7 showers a week

Full Assistance in showers:       $700 a month

Treatments for wounds, etc:     $10 per treatment

Blood pressure or sugar monitoring:    $40 per check

Laundry:                                 $100 a month

Other types of assistance:         $4 to $15 per service 

As you can see, someone could easily be charged as much as $3,500 to $4000 over the basic apartment rental, if the resident needed a great deal of personal assistance and attention.  Of course, few people will need all of those types of assistance.

Memory Care Facilities are All-Inclusive

If you or your loved one needs to move into a Memory Care Residence, the expectation is that they will need 24 hour a day personalized care, so many types of assistance are already included in the $6844 a month fee for the sample residence.  However, there could be additional charges for any special medical or personal services they need.

Ask About Hidden Expenses Before Choosing a Facility

While this article used examples of charges from only one facility, it is intended to educate aging seniors and their families on the types of hidden expenses they might expect. It is important for people to have a firm understanding of the potential cost of living in a facility before they commit to it. It is also important to ask lots of questions before you move yourself or a loved one into a facility. While the basic charges may seem reasonable, the true expense could be thousands of dollars more each month, depending on what services the resident eventually needs.

Long-term Care Insurance

One way to reduce or eliminate the high cost of a skilled nursing facility is to purchase a long-term care insurance policy while you are still healthy ... which usually means buying it in your 50s or 60s.  If you wait too long, you could easily become uninsurable.  In addition you should know that, over time, the cost of your premiums will rise.  However, if you need care in your later years, you will be glad you purchased the policy.

Continuing Care Retirement Communities

Another option to help you contain your expenses is to move into a Continuing Care Retirement Community or CCRC.  With most of them, you have to be ambulatory and in reasonably good condition in order to become a resident.  They can also be very expensive.  However, once you buy-in to the facility, you are guaranteed skilled nursing care or memory care, as needed, for the remainder of your life.  With most CCRC's, you will have to pay a high buy-in fee, as well as a monthly charge which can be as much as the typical assisted living facility mentioned above.  However, if your costs become too high for you to afford because of the services you need, the extra charges will be taken out of your original buy-in.  According to many of the CCRC agreements, a percentage of whatever remains from your original buy-in can be returned to your heirs after your death or to you, in the event you move to a different facility.

As with any legal contracts, it is extremely important that you do careful research before moving yourself or a loved one into an assisted living facility or a CCRC.  You want to know exactly how high your costs will be before you sign a contract.

You can find additional information about them at FindContinuingCare.com.

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