What Is Assisted Living?

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Assisted living is a long-term residential option for older people that combines housing with medical, nursing, personal, and other supportive services under one roof. It is for older adults who are independent, but need help doing daily activities in a safe environment. Residents have their own room or suite, with a bathroom, but take meals communally in a dining room.

Staff who work at assisted living facilities include doctors, nurses, social workers, and therapists. Although the staff will help residents take medication, assisted living is not for people who have serious medical conditions that need a skilled nurse on a regular basis; for this type of care, you would need to choose a nursing home or skilled nursing facility.

Unlike nursing homes, assisted living facilities do not operate under a federal regulatory standard. Each state has its own licensing guidelines so the standards and costs vary from state to state and facility to facility.

Services provided

Some of the basic services provided by an assisted living facility may include:

  • Assistance with daily life activities, including bathing, dressing, taking medication
  • Daily meals
  • Housekeeping, laundry
  • Exercise programs
  • Recreational activities
  • Social services
  • Medical, health, therapeutic services (physical, speech and occupational)
  • Transportation arrangements
  • Security

Cost and how to pay for it

The 2017 estimated national median cost for an assisted living facility was $3,750 per month, or about $45,000 per year, for a private one-bedroom, according to the Genworth Cost of Care Survey. But the actual cost can vary widely from state to state; for example, the monthly cost in Yuma, Arizona is about $2,500 while in northern New Jersey you could pay $6,700 per month.

Many facilities break down costs into various tiers:

  • The all-inclusive model will bundle monthly rent, meals, housekeeping, laundry, activities, services, transportation, and security. But exactly what services are bundled, again, differs at each facility.
  • Next, the level-of-care model will group costs into different tiers: An individual who doesn’t need help getting dressed, bathing, or taking medication will be in a lower-cost tier than someone who needs all of those services.
  • Finally, there’s the fee-for-services plan, where room and board will be a monthly set price, but each service rendered will be billed à la carte.
  • Some facilities will also charge a one-time entrance fee.

Most assisted living facilities are paid for through private funds. Low-income adults may be able to use Medicaid to help pay for some costs, but the coverage depends from state to state. Some Medicaid plans can help pay for home and community-based services (HCBS), but not room and board. (Services that may be covered under Medicaid for HCBS include dietary management, skilled nursing care, personal care, and various therapies, like speech, occupational, or physical.) While Medicaid doesn’t pay directly for room and board, some states’ Medicaid programs may help with those costs through supplemental assistance or other ways of defraying those costs. Always check to see if the facility is Medicaid-certified.

Medicare does not help pay for long-term care, including assisted living. Medicare is a health insurance program, so it covers various medical and nursing services, if you quality for them. Assisted living is considered custodial care, which is not covered by Medicare. That said, individuals can use Medicare to help pay for certain prescriptions and therapies while living in an assisted living facility.

What to look for in an assisted living facility

It can be daunting to try to figure out which assisted living facility you or your loved one will enjoy and find the necessary services all under one roof. Ask for recommendations from trusted family members and friends, as well as consulting (if you have them) geriatric care managers, social workers, elder law attorneys, and financial planners. You can browse assisted living facilities in your area using our service finder:

It’s always best to visit several residences, both during the day and, if possible, at night, so you can get a sense of the vibe at different times. Generally speaking, you should consider these questions:

  • What kind of services do you want and/or require and how may they change over time? You might not need a reminder to take your medication or help getting dressed now, but you may in a few years.
  • How much will each facility cost, and which services does that cost cover? Get the specifics in writing.
  • How will you pay for it? Can Medicaid help cover certain costs?
  • When you visit the residence, consider: Is it bright? Is it clean? How are the staff? How do the residents look? How are the meals? In essence: can you see yourself living there?
  • Is the location convenient for friends and family to visit?
  • Are the offered services things you need or care to participate in?
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