Watch Out for These Hidden Costs of Assisted Living

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Once you’ve made the decision that assisted living would be a good move, the next question is usually: How much will it cost? The national median cost for assisted living is $3,750 per month, but prices vary widely from state to state and facility to facility. 

The way assisted living facilities break down their costs also differs from facility to facility. Many residences charge a basic fee, which includes rent, meals, housekeeping, access to activities, and exercise. Then they will group additional services, like therapies and medication disbursement, into different payment tiers. Other facilities consider themselves all-inclusive, but may have add-on fees, which can increase your monthly bill by several hundred or even thousands of dollars. (Read more about how assisted living costs work and how to pay for assisted living here.)

Some facilities, after a periodic assessment, may either try to bump your payment plan up a tier, or start charging more for added services. You are entitled to contest the additional services and fees as long as you can prove they are not needed, which may require the assistance of a geriatric care manager, social worker, or other professionals who can attest to that.

It’s important to read your contract carefully and make sure the costs of all services are clearly indicated. Services that may incur additional fees can include:

Hygiene Costs

  • Dressing. Fees can be split for dressing in the morning and undressing in the evening.
  • Bathing. Fees may be different for full help with showering or having someone in the room while the individual showers.
  • Bathroom/incontinence care. Some individuals may need help getting to and from the bathroom, sitting and standing, wiping, and changing adult diapers.
  • Laundry

Medical Costs

  • Health screening before moving in. Some facilities include this in their overall pricing upon move-in, but others many indicate it on the bill as a separate one-time charge.
  • Medication management. Depending on the needs of the resident, staff may simply remind a resident to take their daily dosage, while other facilities will store and administer medications and record medication disbursement.
  • On-site pharmacy or doctor access. Does the facility have a doctor or pharmacy on-site? You may be charged an additional fee for the convenience, disguised as a monthly “facility fee.” However, the services the doctor renders or the price of the prescription may be covered by Medicare or Medicaid.
  • Treatment for temporary wounds or illness. Some facilities will tack on an additional fee for cleaning out and monitoring wounds from a fall, or helping a resident get over a long-lasting flu.
  • Blood pressure monitoring
  • Blood glucose monitoring and insulin injections

Mobility and other care costs

  • Escort to and from the dining room or activity center
  • Checking in on resident at regular intervals
  • Reminders. This may include reminders to go to the bathroom every few hours or before bed, to take medication, or to get to weekly activities and therapies on time.
  • Use of gym or spa, if available on premises
  • Transportation to area shops, doctor’s office
  • Admission/Discharge. A one-time admissions fee may show up on bills under names like Service Initiation Fee or Community Service Fee. Also, look at the fine print in the contract for discharge policies to make sure you are entitled to a refund for prepaid services that were not used.
  • Extra fee to deep-clean the bathroom. Hard to believe, but although most cleaning services are part of a standard monthly charge, some facilities may add on a deep-cleaning charge from time to time.
  • Telephone

Other hidden costs

These are costs that aren’t charged by the assisted living facility itself, but ones that you might incur as part of the transition to assisted living.

  • Moving costs. Includes hiring a junk removal service, paying for movers, and/or the costs involved in selling a house
  • Travel expenses
  • Lawyer or elder care manager fees
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