Budgeting for Assisted Living

[SantaClaus]

We are still in the "planning for retirement" stage and I've been able to find lots of great info about budgeting for the "active" stage of our retirement at TV, but I'm finding little to no info about the costs associated with assisted living, again, preferably at the villages. There is an 11 year age difference between my wife and I and I don't want one of us to have to give up an active lifestyle because the other needs a bit more care. As near as I can tell there are two facilities for TV residents, but I've been unable to find any kind of ball-park pricing. I just need a very rough idea so that I plug it into my planning, so any help would be appreciated.

[Nlnicholson]

Check out Sumter Place Sumter Place | Sumter Place (http://www.sumterplace.com). We have a family member there and are very pleased with the quality of care.

[TraceyMooreRN]

Freedom Pointe is a CCRC--you can "purchase" into the Independent Living and then progress to each facility (one person or both) as you progress with age--they have nursing facility (the rehab)--you can live there fulltime if you buy their lifetime? package. There is also a memory care building and assisted living. Bring your wallet--the cost of this care is big--but pays 100% if care is needed.

[kittygilchrist]

Santa, surely you have an Earth Benefactor Retirement Plan?

[buggyone]

This is a good time to think about long term care insurance. Look for a reputable company, look for inflation guard of at least 5 percent per year, and look for no lifetime cap on benefits.

[red tail]

no one has answered his question. santa is looking for a ball park figure for planning purposes, not a catalog of places.

[SantaClaus]

Santa, surely you have an Earth Benefactor Retirement Plan?


My benefits package took a big hit when the elves unionized ;-)

[Nlnicholson]

Since long term care prices vary with regard to care needed it's very difficult to give a ballpark figure. The assisted living place places you in a category and you are charged accordingly.as your needs increase so does your cost. Best to contact the places and get an estimate from them

[ahayward65]

I looked at the site mentioned but there are no prices mentioned. What is the monthly cost?

[tippyclubb]

Why don't you contact the assisted living places and ask them? There was a link to Sumter Place above and here's another one.

Freedom Pointe at The Villages | Florida Independent Senior Living | Retirement Community (http://www.brookdaleliving.com/freedom-pointe-at-the-villages.aspx)

My father-in-law was in assisted living and the cost was $2500 a month, but that was five years ago.

[SantaClaus]

I understand that rate scales with service, but I guess the question is more "how do you budget for something you can't schedule"? I doubt I'll live much into my 70s, but what if I end up needing assistance for 10 years, or nursing for 3? How do you budget for such? I know we'd all like to spend the morning on the back nine and then slip painlessly away recuperating on the Lanai, beer in hand. But is that all we "plan" for and then just hope it works out? Or do we worry that the pile is never big enough to cover every contingency and therefore never retire? What are you planning for and are you prepared for it?

[SantaClaus]

I'm sure that I will contact the ALFs directly at some point, I'm just not ready to sit through the hard-sell, so I thought I'd ask here first. I assume this has to be on a lot of folks radars at TV.

[jane032657]

Assisted Living is going to cost you to start at least $3300 for a studio apartment and probably more by the time you need it. Add on someone to help you with a shower, about $200 a month; $250 medication management; add on for help with dressing, escort to meals, mobility assistance. If you need memory care, triple your costs.

Long term care is one solution, best idea is to have your kids pay for it to protect their inheritance if you have kids. Costs of LTC go up, last year we had a 50% increase which had nothing to do with us as nothing has changed for us, it is that the companies are fewer and fewer who are providing it because of the payouts.

If you are a Veteran, you and your spouse may be eligible for up to a few thousand dollars a month as a couple, less as an individual, and that application takes about 6-12 months and cannot be applied for until you need it.

There is Medicaid support for people who do not have enough but that covers the assistance and not the rent.

There is no easy answer to this. Also the proceeds of your home can go toward monthly rent payments but if you want your spouse to stay in the home you may not have enough for Assisted Living.

The Villages has no shortage of Assisted Living. There are many here now and many in progress of being built. They are all expensive.

As I have said many times before on this forum, don't just look at how beautiful the building is. Talk to residents, talk to families, and also find out about staff turn over. If staff leave in droves, there is a problem. Who is the Administrator and what is their personality ( I am a licensed Assisted Living Administrator but not running a property at this time) Make sure the Administrator has personality and is approachable and cares as much about mission as margin.

Look at past surveys of the property, ask for them, they are public documents. See where the facility is strong and weak.

If you need help, call me, I am a sponsor on this site.

The Other Daughter: Assisted Living and Elder Care Services (http://www.theotherdaughter.org)

Jane Bloom
The Other Daughter

[JourneyOfLife]

It is a good idea to plan. Some of the planning is not financial, but that is usually one of the biggest concerns for most people.

IMO, LTC insurance with inflation protection is a good idea... assuming you and/or your wife are insurable and can afford it. Even though premium costs have been increasing, insurance is often a good way to lay off much of the risk. It might seem expensive, but so is the cost of LTC.

You can find all kinds of planning information/resources on the internet.

It would be a good idea to acquaint yourself with your State's Medicaid rules about LTC, just so you understand them... if for no other reason, just in case. Understanding the rules are helpful in planning for worst case scenarios if you or your spouse wound up on Medicaid.... since you mentioned a concern about the pile being big enough.

It looks like Florida has a Long-Term Care Partnership Program. If you are considering LTC insurance, definitely worth a look. Many states have these programs now days to encourage people to buy LTC insurance.

AHCA: Florida Long-Term Care Insurance Partnership Program (http://ahca.myflorida.com/Medicaid/ltc_partnership_program/index.shtml)

Average or Median nursing home costs in areas can be found on the internet by state, but costs vary by town and facility. You can call specific facilities in your area, they will tell you... probably email you a fee schedule if you ask. Same goes for Assisted living.

2012 median cost of care data as provided by Genworth for certain areas of Florida

Florida Long Term Care Insurance Costs, Information, Partnership Policies and Quotes for Miami, West Palm Beach, Tampa, Jacksonville & More (http://www.completelongtermcare.com/states/florida/)


Some basic planning info

Home - Long-Term Care Information (http://longtermcare.gov/)

[Bizdoc]

Keep in mind that Freedom Pointe (CCRC) and SumterPlace are the only places where Villages amenities are available. I assume that you're looking at assisted living here because you want those amenities. Note that SumterPlace will be building another assisted living at Buffalo Ridge.

AL is not cheap. You are paying for rent, 3 meals a day, activities, transportation, and some level of health care. As nice as SumterPlace is (and my parents lived there before moving to skilled nursing), you may find it restrictive. Call SumterPlace and talk to Cathy Jackshaw - she can give you a good estimate based on what level of care you need.

The step after assisted living is the tough one - skilled nursing is going to run $250-350/day each. And that is today's prices. Expect that to double (or more) in 10 years.

[jane032657]

Freedom Pointe's new Assisted Living is not a buy in. Also just as a side note, you are absolutely correct that if the ALF is not is The Villages, the residents do not have access to the amenities. It may be interesting to note that the majority of ALF residents do not use the amenities because of all the ALF offers, plus their own mobility and health issues. So if that is the case for yourself or your loved one, looking at the new Emeritus in Oxford, or the new HarborChase in Lady Lake, or some of the others a throw from the actual perimeter of The Villages, is a good idea. There is also a new one approved for Spanish Springs and I believe two being built in The Brownwood area. There is no lack of choice, only lack of price competition!

[SantaClaus]

There have been some very helpful replies and I'm most grateful. I am curious about Freedom Pointe. My parents, who live independently up the road at Spruce Creek have been considering them, but said after their tour that "membership" was a "couple hundred thousand"!? Anybody know what this is about? It sounds like they are pre-paying for a housing and care package?

[JourneyOfLife]

There have been some very helpful replies and I'm most grateful. I am curious about Freedom Pointe. My parents, who live independently up the road at Spruce Creek have been considering them, but said after their tour that "membership" was a "couple hundred thousand"!? Anybody know what this is about? It sounds like they are pre-paying for a housing and care package?

Sounds like they may be a CCRC or have a CCRC option. This articles gives some general information about CCRCs. The terms vary depending on the facility, type of contract, etc.

https://en.wikipedia.org/wiki/Continuing_Care

[Villages Kahuna]

We are still in the "planning for retirement" stage and I've been able to find lots of great info about budgeting for the "active" stage of our retirement at TV, but I'm finding little to no info about the costs associated with assisted living, again, preferably at the villages. There is an 11 year age difference between my wife and I and I don't want one of us to have to give up an active lifestyle because the other needs a bit more care. As near as I can tell there are two facilities for TV residents, but I've been unable to find any kind of ball-park pricing. I just need a very rough idea so that I plug it into my planning, so any help would be appreciated.It's a daunting problem, particularly given the age difference you've noted.

I can tell you that I managed the finances of two elderly people during the final years of their lives. Both had assets that I thought they could never outlive. In both cases, I'm talking liquid assets well into six figures...very well into six figures.

Both ladies were placed in nationally known assisted living facilities. Neither had medical conditions that required anything like hourly care and attention or frequent hospitalization. The cost--several years ago--ran between $10-11,000 per month. Well in excess of $100,000 per year. I'm certain those costs would be more expensive in 2014.

Both women lived long enough that their assets were completely exhausted and I had to apply to have them placed on Medicaid, where the state pays for their care. One of the requirements of Medicaid in almost every state--Medicaid is a state program--is that the patient can have no assets remaining and any income above a very modest amount has to be assigned to the state. In Illinois, all assets of any kind and any income above $30 per month had to be assigned to the state as an offset of their payment of the nursing home, doctor's and hospital bills. The procedure was similar in Michigan, where the other woman was institutionalized.

Fortunately both assisted living facilities reacted to the new financial situation of both women the same way. They arranged to place them in "Medicaid beds" they had available and simply placed both in that category. From their point-of-view there was no real change in their level of care. In fact, both were permitted to stay in the same rooms where they had been living. But nursing homes are not required to act as they did. They could simply say that they had no room for Medicaid patients--they are only paid about 30% of their normal fees by Medicaid--and send them to a facility that cares for indigent Medicaid patients. Believe me, those types of low cost facilities aren't places where you or a loved one would want to spend the end of your life.

As a starting point for your planning, while this anecdotal information might be disturbing, I hope it helps. Be aware that the situation regarding Medicaid is far worse now than even a few years ago. The federal government has dramatically reduced it's funding to the states to help pay for Medicaid. In some states--Florida is one I believe--the state simply does not have the money to pay for the care of all the elderly that need it and cannot pay for such care themselves. It's a critically serious problem we seldom read about. Do some 'Googling' to research that problem yourself.

[ncarvalho]

We are still in the "planning for retirement" stage and I've been able to find lots of great info about budgeting for the "active" stage of our retirement at TV, but I'm finding little to no info about the costs associated with assisted living, again, preferably at the villages. There is an 11 year age difference between my wife and I and I don't want one of us to have to give up an active lifestyle because the other needs a bit more care. As near as I can tell there are two facilities for TV residents, but I've been unable to find any kind of ball-park pricing. I just need a very rough idea so that I plug it into my planning, so any help would be appreciated.

HI,
We checked about , and this was over a year ago, an assisted living for my mother-in-law - Because she was on the low-income, SS retirement. About 20 miles from TV, we found a place for her and at that time it was around $2700-3000, as basic costs, no meds included, just for the monthly costs at the facility. I was surprised, because I thought it would have been much more. I am not retired yet, but I am budgeting at current prices (2014) close to $3000/month, all other things taken care. Best of luck.

[JourneyOfLife]

It's a daunting problem, particularly given the age difference you've noted.

I can tell you that I managed the finances of two elderly people during the final years of their lives. Both had assets that I thought they could never outlive. In both cases, I'm talking liquid assets well into six figures...very well into six figures.

Both ladies were placed in nationally known assisted living facilities. Neither had medical conditions that required anything like hourly care and attention or frequent hospitalization. The cost--several years ago--ran between $10-11,000 per month. Well in excess of $100,000 per year. I'm certain those costs would be more expensive in 2014.

Both women lived long enough that their assets were completely exhausted and I had to apply to have them placed on Medicaid, where the state pays for their care. One of the requirements of Medicaid in almost every state--Medicaid is a state program--is that the patient can have no assets remaining and any income above a very modest amount has to be assigned to the state. In Illinois, all assets of any kind and any income above $30 per month had to be assigned to the state as an offset of their payment of the nursing home, doctor's and hospital bills. The procedure was similar in Michigan, where the other woman was institutionalized.

Fortunately both assisted living facilities reacted to the new financial situation of both women the same way. They arranged to place them in "Medicaid beds" they had available and simply placed both in that category. From their point-of-view there was no real change in their level of care. In fact, both were permitted to stay in the same rooms where they had been living. But nursing homes are not required to act as they did. They could simply say that they had no room for Medicaid patients--they are only paid about 30% of their normal fees by Medicaid--and send them to a facility that cares for indigent Medicaid patients. Believe me, those types of low cost facilities aren't places where you or a loved one would want to spend the end of your life.

As a starting point for your planning, while this anecdotal information might be disturbing, I hope it helps. Be aware that the situation regarding Medicaid is far worse now than even a few years ago. The federal government has dramatically reduced it's funding to the states to help pay for Medicaid. In some states--Florida is one I believe--the state simply does not have the money to pay for the care of all the elderly that need it and cannot pay for such care themselves. It's a critically serious problem we seldom read about. Do some 'Googling' to research that problem yourself.

I must be missing something. $10k a month seems awful high for an assisted living facilty.

[OBXNana]

My mother was $8,000.00 per month in 2009 for her private facility. There was no buy in and the fee was on a monthly basis. All meals were included, help with personal needs, and she was given her meds as prescribed. In her case the facility did not participate in Medicaid and we saw many people moved to other facility's when their funds ran out. This facility had a great reputation, was clean, and far less expensive than many I visited when the need came for her to move from her home. In our area, $10,000.00 for assisted care is not that unusual.

[gomoho]

I can only talk at this point about memory care, but, am currently looking at moving my mom from a memory care center in Florida to one in North Georgia and was astounded at the difference in cost.

She started in assisted living in Florida in 2005 at $2000k a month. 9 years later she is in memory care in Florida paying over $5000k a month. The two facilities I am looking at north of Atlanta are under $4000k for the same level of care. I am not talking quality cause I don't have that information - I am talking level of care. I

It is ridiculous what Florida is charging because they can - had no idea how bad it was. Actually the rates I am hearing in north Georgia and southern
Tennessee are $3900 a month all inclusive. That is a big, big difference.

As far as planning for it. I can only thank my brother, who is a financial planner, for investing our mother's money wisely when our father passed away so she has more than enough to cover her expenses. Between her ss, pension, and my dad's pension she actually withdrew less than she made in her invesments made last year. So I guess to make this long story short you should probably talk to a certified financial planner to figure out what your best course would be.

[jane032657]

I have operated two five star assisted livings. One was a national company, international actually.

If you have little need for assistance and you have a one bedroom apartment, in our area of in Seattle where I came from, the costs are very similar. About $4300 for a one bedroom, about $3500 for a studio, and then up from there. If you need care in assisted living, not memory care, you can get up to about $6000. If you need memory care, you can get up to $9,000 plus if intensive care. Nursing Home care is about $9500 and up.

If you are paying $6000 for basic assisted living, you are in a luxury assisted living. If you cannot afford that, and most cannot, you can find one for less.

If you have questions, contact me. I do not charge for a conversation.

Also companies that take you to look at assisted living and do not charge you get a commission from the assisted living equal to about one month rent and care. Not totally objective in helping you choose....

I do not get commissions, I charge an hourly rate for taking someone around but their needs is all I am thinking about and I help them choose based on their situation both in regard to care, finances and lifestyle.


The Other Daughter: Assisted Living and Elder Care Services (http://www.theotherdaughter.org)

Jane Bloom
janeinthevillages@gmail.com

[SusanOfWoodbury]

My benefits package took a big hit when the elves unionized ;-)


Need to throw in my 2 cents. Unless you have long term insurance, once your money runs out where are u going to go!!!

I believe people need to stay in there homes as long as they can!

[Bonnevie]

I'm trying to put off taking social security for as long as possible for just this reason. I know when my mother went into assisted living, having social security and my father's pension helped a lot to defray the monthly cost.

[Bizdoc]

There have been some very helpful replies and I'm most grateful. I am curious about Freedom Pointe. My parents, who live independently up the road at Spruce Creek have been considering them, but said after their tour that "membership" was a "couple hundred thousand"!? Anybody know what this is about? It sounds like they are pre-paying for a housing and care package?

Freedom Pointe is (except for direct entry into ALF or skilled nursing), a continuing care retirement community. CCRCs generally (altho it varies by state) are a life interest in your apartment with guaranteed availability of ALF and skilled nursing when you need it. Your buy in is, in part, prepaying for that guarantee and part (but not all) of the costs of ALF and skilled. Your heirs may (or may not - depends on the state and the facility) get part of the buy in returned when you are gone.

We looked at CCRCs in several cities (including FP). While it is true that they have activities at the CCRC, what they offer may or may not be what you want. One thing we found useful was to pay attention to the folks we passed in the halls and common areas during tours. How many are smiling and happy?

After considering roughly 20 CCRCs (and looking at info at another couple dozen), we decided to buy a house here rather than go the CCRC route.

[JourneyOfLife]

Freedom Pointe is (except for direct entry into ALF or skilled nursing), a continuing care retirement community. CCRCs generally (altho it varies by state) are a life interest in your apartment with guaranteed availability of ALF and skilled nursing when you need it. Your buy in is, in part, prepaying for that guarantee and part (but not all) of the costs of ALF and skilled. Your heirs may (or may not - depends on the state and the facility) get part of the buy in returned when you are gone.

We looked at CCRCs in several cities (including FP). While it is true that they have activities at the CCRC, what they offer may or may not be what you want. One thing we found useful was to pay attention to the folks we passed in the halls and common areas during tours. How many are smiling and happy?

After considering roughly 20 CCRCs (and looking at info at another couple dozen), we decided to buy a house here rather than go the CCRC route.


I would also add that there are differences in CCRCs and even the Contracts for CCRCs.

I would like to see legislation that would standardized and improve financial safeguards and protections for customers.

The model still seems to be evolving.

[FloridaShrimp]

This also does not answer your question about costs for assisted living, but an option is in-home care, keeping you both in your home. I would guess that those costs would be less, if it is a workable option, since you won't be paying for overhead.