“I wish I made the move sooner. I just didn’t think I could afford it.”
“We didn’t even consider looking into a senior care facility for mom and dad because we thought it was a lot more expensive than staying in their home.”
Those sentiments may resonate with you if you’re a senior or a family caregiver. The cost of senior living is a legitimate concern, shared by a soaring population. Just look at these numbers:
- Every day 10 thousand baby boomers (born between 1946 and 1964) are turning 65 years old. By 2030, for the first time in our country’s history, seniors will become the largest population.
- By 2036, the population of adults older than 85 will double and by 2049, it will triple, with 7 out of 10 people needing assisted living support.
- The U.S. Department of Health and Human Services reports that someone turning 65 today has almost a 70 percent chance of needing long term care services and support.
- According to Consumer Affairs, nearly one million Americans already reside in assisted living facilities.
- The US is way behind in preparing for the one million new senior living units needed by 2040.
Future News Headlines
Those numbers are quietly building what could become two of the biggest news stories (and challenges) in our country:
- The US does not have nearly enough senior living facilities to care for what will be the country’s largest ever population of seniors.
- Americans are waiting too long before researching living options and that delay will diminish their choices –– and quality of care.
So, Why the Delay in Considering Senior Care?
Part of the delay is simple denial.
A national survey by Genworth Financial and Age Wave/Harris Interactive found that only 37% of the people surveyed believe they’ll ever need these services.
The reality?
Nearly 70% of us living in the US will require long term care as we age.
And there are two other factors at play: Fear of the unknown and fear of the costs are common reasons we wait until it’s too late to investigate senior living.
Until living at home is no longer safe or affordable.
Until an accident occurs, medications are missed or a caregiver is no longer available.
Until there’s an immediate need for help but no openings.
Life gets a lot more complicated very fast.
Last month, we addressed the fear of the unknown, in our blog, When Is it Time To Look Into A Senior Living Community? The Answer May Surprise You. We shared many of the benefits of independent living, assisted living and memory care.
The active lifestyle of the baby boomer generation is shaking up senior living, from tailored health care services; to creative living options like penthouses, cottages and apartments with beautiful yards, decks and open kitchens; to the expansive options of resident-directed activities like pickleball, tennis, bocce ball, swimming, off-site adventures and classes and socials at the club-like community centers with coffee and wine cafes.
Today, let’s address concerns about costs. By the end of this blog, you’ll know:
- The general cost of living in a senior community can be less than living at home. And certainly safer.
- Those costs can be adjusted up or down depending on changing needs.
- Price is determined by many factors including size of the facility, types of services and amount of care.
- There are two main pricing models for senior living. (Keep reading. We’ll tell you why we believe there’s a huge advantage to one of those models)
- There are subsidized and non-subsidized ways of helping finance the senior living community lifestyle.
Our guide in this blog is one of those fortunate people who knew earlier than most of us, what he wanted to do when he grew up. Jordan Costanzo is Marquis’ director of operations. He’s a graduate of Oregon State University with a degree in Health Care Administration and – lucky for us –a focus on long-term care of seniors.
“My mom was a registered nurse, so good health has framed much of my thinking,” says Jordan. “Seventeen years ago, when I was in college, I saw the growth trajectory of the baby boomers and I knew long-term care and helping seniors live their best lives was going to be a hugely important endeavor–– and a big challenge.”
Jordan is a walking dictionary on all things having to do with quality senior care: Medicare, Medicaid, Medigap, Assisted Living, Skilled Nursing –– you name it, he understands it.
And as you can imagine, Jordan is the trusted advisor for his friends and family entering their senior years.
“Here at Marquis, we’re devoted to becoming your trusted advisor, even if you’re just dipping your toe in with a few questions. It’s not how we can help you today, it’s how we can help you in six months, three years, six years, even ten years from now.”
So, let’s get going with Jordan’s 4 tips for understanding senior living care costs and financing options.
Tip #1 Understand what you pay now
“This part takes a little time but it’s critical to identify and write down your current out of pocket costs,” says Jordan. “Don’t forget to think into the future. Many people make the mistake of not including home improvement costs associated with aging, such as adding safety design elements like handrails, walk-in showers and stairlifts.”
Write down what you currently pay for:
- Rent or mortgage
- Utilities
- Home renovations for upkeep and to live safely (grab bars, rails, walk-in shower/tubs, wider doorways, Life Alert)
- Social – meals, coffee, and outings with friends
- Car costs
- Home and care insurance
- Housekeeping, yardwork, outside maintenance
- Classes: gym, art, golf, etc.
- Equipment like wheelchairs or walkers
- Medical costs associated with falls and other mishaps that often happen as we age.
If you’re the caregiver, you have expenses as well.
“That includes hard costs like fuel or time off work. And it includes emotional costs like time away from other family members, loss of free time, worry and burnout.”
Tip #2 Understand what you will likely not pay at a senior living community
“A lot of people don’t realize that when you compare the costs of senior living to the expense of living in your own home, the two are competitive –– often even less at a senior community where you’re also receiving the specific assistance you need to keep leading a full life.”
Now let’s look at the senior care industry’s general range of costs for each type of senior living:
Independent Living: Across the country, the general industry costs for independent living, range between $4,000 to $5,500 a month, depending on square footage, style (cottage, apartment, penthouse, single or shared room) and number of bedrooms and bathrooms. Many expenses you’d normally pay at home are included, for instance at Marquis, the flat rate includes:
- All utilities, cable, internet, water electricity, sewer
- General maintenance services (light bulbs, garbage disposal, garage door and more)
- Every other week housekeeping services
- Landscaping maintenance
- Safety design features
- Membership at community centers for activities, socials, gym, pool and fitness classes
- Residents also do not pay property taxes or home insurance
Assisted Living: The general industry range for assisted living is $5,000 to $7,000 and reflects the increased level of care needed. Services include:
- Grocery and meal prep expenses
- Care providers
- Assistance with daily living activities: bathing, dressing, grooming, dining, etc.
- Some transportation costs
- All utilities, cable, internet, water electricity and sewer
- General maintenance services (light bulbs, garbage disposal, garage door, etc.)
- Every other week housekeeping services
- Landscaping maintenance
- Safety design features
- Membership for community centers for activities, pool and fitness classes
Memory Care: The general industry range of $6,800 to $8,000 depends on the choice of private or shared occupancy and includes:
- 24/7 care with team of memory care specialists
- Assistance with daily living activities: bathing, dressing, grooming, dining, etc.
- Home environment designed with specific and pleasing paint schemes, floor plans and lighting
- Security and monitoring
- Meals
- All utilities including cable, internet, water electricity, sewer
- Maintenance
- Housekeeping
- Safety design features
Post-Acute Rehab (PAR) or Skilled Nursing. “Think of post-acute rehab or skilled nursing as 24/7 care needed in the short term,” says Jordan. “Typically, a patient has just been discharged from the hospital and needs skilled nursing care before transferring home or back to a senior living community. Medicare or HMO benefits will cover the costs, depending on co-pay and deductibles but if a patient is staying longer and has very high care needs, those costs can average about $465 a day.”
“We work in advance with our patients and their family members to help them understand exactly what their coverage includes and when it will kick in. We want to remove any chance of surprises, so patients can just focus on getting well and their loved ones know the best care is being provided.”
Services include:
- 24/7 assistance for all meals and activities including: getting dressed, incontinent management, bathing, medication management. dressing changes, behavioral management, diabetic management, transfer assistance, transportation and mechanical lifts, specialty diets, etc.
- 24/7 licensed nursing care supported by CNAs
Tip #3 Understand the two ways facilities determine costs for independent living, assisted living and memory care: the “point system” or the “bundled care” system
“Here’s an insider tip we want everyone to know because nobody likes feeling nickel and dimed for every service. When that happens, you may be reluctant to get the help you really need,” says Jordan.
Independent, assisted and memory care facilities normally use one of two methods for determining costs:
A point system establishes a fee to every service added. Extra for laundry, for medication management, for mealtime reminders, for transportation assists, etc. If a resident’s needs are changing every month, that means the monthly bill is changing too and less predictable.
A bundled system identifies levels of many services that naturally go together. At Marquis, this is the long proven system that gives our residents and their families peace of mind. We believe it’s more stable, more predictable and takes away all the nagging worries of additional monthly costs.
To give you an example of how this works at Marquis assisted living facilities, we studied the typical services people need at various stages of life. Then we bundled them together into four levels.
- Assisted Living Base Level: This person is quite independent. Services include laundry, housekeeping, meals, transportation and licensed nurse oversight of care needs.
- Assisted Living Level 1: Services include laundry, housekeeping, meals, transportation, licensed nurse oversight of care needs, medication mgt., showering assistance and mealtime reminders.
- Assisted Living Level 2: Services include laundry, housekeeping, meals, transportation, licensed nurse oversight of care needs, showering assistance, help to and from meals, medication management, administering routine vitals (pulse, weight, temperature, respiration) and supervision of anticoagulant treatments.
- Assisted Living Level 3: Services include laundry, housekeeping, meals, transportation, licensed nurse oversight of care needs, dressing and showering assistance, help to and from meals, medication management, administering routine vitals (pulse, weight, temperature, respiration), supervision of anticoagulant treatments, incontinence mgt., catheter and ostomy care (colostomy and urostomy), behavioral supervision, diabetic supervision, diet management and assistance in
“Don’t be afraid to ask facilities you’re interviewing whether they conduct periodic reviews on services needed,” says Jordan.
“At Marquis, we schedule service plan reviews upon move-in day, after 30 days and then every 90 days. We want to make sure we’re pinpoint accurate on the care our residents are receiving. This also gives us time to get to know each patient and make sure we’re staying on the right track.”
Tip #4 Understand what financing may be available to you
“First, the good news,” says Jordan. “We can help you identify sources of funding. We find that more than 90 percent of people coming to us don’t understand what Medicare will pay for the duration of coverage and the level of care.”
“It’s a myth that Medicare will cover every level of care. The federal government has very specific rules and requirements of what triggers a Medicare covered stay in a skilled nursing setting.”
There are two basic categories of funding, subsidized payment options, which generally come from federal or governmental programs; and non-subsidized payment options, which are private assets or loans.
Let’s see which benefits can be used for assisted living and/or post-acute rehab (PAR)/skilled nursing situations.
Assisted Living
Subsidized benefits for assisted living:
- Medicaid Benefits: These are dependent on whether there’s room in the facility or whether the facility holds a Medicaid contract. The benefits help if you don’t have the resources to pay privately. They vary from state to state and there are limits in coverage. To learn more, visit the government’s Medicaid website.
- Veterans’ Benefits: If you’re a veteran or a family member, you may be eligible for assistance from the Department of Veterans Affairs. These benefits can range from covering physical therapy, care provider support, senior living communities and more. According to the VA, nearly all veterans who served in combat their spouses, and children of deceased veterans, may qualify for health care. You don’t have to be disabled or injured to receive medical treatment. You must show proof of honorable discharge from service. To learn more, visit the US Department of Veterans Affairs website.
Non-subsidized benefits for assisted living:
- Private Savings and Assets
- Life Insurance Policy Conversion: Some policies offer ways to access built-up cash. Make sure to ask your policy insurer about payouts and tax considerations.
- Long Term Care Insurance: These policies, unless purchased long before you need them, are generally very expensive but are designed to cover the costs associated with chronic care.
- Loans: Home care and assisted living loans should only be considered in a short term care case.
Post-Acute Rehab (PAR) or Skilled Nursing
Subsidized benefits for post acute rehab/skilled nursing:
- Medicare in the long-term care area is primarily used after a hospitalization or acute health episode to cover rehabilitation from the event that landed you in the hospital. It covers room and board, various therapy service and skilled nursing. The duration of services is less than 100 days before benefits stop. To learn more about eligibility, visit the Medicare website.
- Medigap or Medicare Supplement policies are private insurance company policies that fill the “gaps” between what Medicare covers and what you These can include health care costs when traveling internationally, deductibles, copays and prescription drug coverage. For more on these choices visit the AARP website.
- Medicare Advantage Plans are a step beyond Medigap coverage and offer more comprehensive benefits, all managed by an HMO provider like Blue Cross/Blue Shield, Kaiser, Providence or AgeRight Advantage. This may be a good choice for you if you have long term health issues. Because there are several approved providers, there are more options to find lower premiums.
- Medicaid Benefits: These are dependent on whether there’s room in the facility or whether the facility holds a Medicaid contract. The benefits help if you don’t have the resources to pay privately. They vary from state to state and there are limits in coverage. To learn more, visit the government’s Medicaid website.
- Veterans’ Benefits: Again, if you’re a veteran or a family member, you may be eligible for assistance from the Department of Veterans Affairs. These benefits can range from covering physical therapy, care provider support, senior living communities and more. According to the VA, nearly all veterans who served in combat, their spouses, and children of deceased veterans may qualify for health care. You don’t have to be disabled or injured to receive medical treatment. You must show proof of honorable discharge from service. To learn more, visit the US Department of Veterans Affairs website.
Non-subsidized benefits for post-acute rehab/skilled nursing:
- Private Savings and Assets
- Life Insurance Policy Conversion: Some policies offer ways to access built-up cash. Make sure to ask your policy insurer about payouts and tax considerations.
- Long-Term Care Insurance: These policies, unless purchased long before you need them, are generally very expensive but are designed to cover the costs associated with chronic care.
- Loans: Home care and assisted living loans should only be considered in a short term care case.
A Lesson From Grandma
“We know all these options can seem overwhelming,” says Jordan. “But here at Marquis, we can do a lot of the footwork for you –– verifying your benefits and helping you understand true out of pocket expenses and payment options.”
“My grandma would urge you not to delay. She put off signing up for the government programs she was entitled to receive, then it became a huge, stressful scramble when suddenly she needed to move into an assisted living facility. It takes a while to gather documents you need and eligibility can take months to determine. So, start early and have fun exploring your choices. As always, we’re here to help you!”
Read Senior Healthcare Costs & Options for more on costs and options.
Read 5 Questions to Ask About Assisted Living Costs for the most important questions to ask when visiting senior living communities.
To arrange a casual, no-pressure tour and ask us questions, please contact your nearest Marquis facility.
We hope you join us next month when we’ll help you prepare to check out a senior living community –– what should you ask, what should you watch out for (good things and red flags) and how to find the community that’s just right for you or your loved one.