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What Drives the High Prices of Assisted Living Facilities?

What Drives the High Prices of Assisted Living Facilities
Are you worried that your parents or grandparents will have to exhaust their assets to the point of poverty so that Medicare will kick in and begin covering necessary care? Or maybe you thought an assisted living facility would be a more affordable option, only to discover plenty of hidden fees lurking right below the surface.

Let’s explore what drives the high prices of assisted living facilities and the possible negative ramifications of continued price gouging of our elderly.

Assisted Living Facilities—What Are They and Who Lives There?

Assisted living facilities advertise themselves as communities that offer older adults personalized and ongoing care in residential settings. These types of residences offer an intermediary option for people who are no longer able to live on their own but who do not yet require the intensive care provided by nursing homes.

Some older adults may also actively choose to live in an assisted living facility despite still being able to live and function on their own. That’s because these facilities can offer a sense of community, which is important for decreasing health risks associated with social isolation and loneliness, including premature death. According to the U.S. Centers for Disease Control and Prevention (CDC), nearly 25% of all adults over the age of 65 are socially isolated.

An assisted living facility might be an ideal alternative to a traditional nursing home for adults who can no longer live alone but are otherwise still generally active. Support for activities of daily living (ADLs) such as getting dressed, managing medications, and bathing are provided on an increasingly as-needed basis in these types of facilities.

And for every additional service, there is almost always an additional cost.

The Hidden Costs of Assisted Living Facilities

The base cost of assisted living facilities can appear much more affordable—at first. But in the United States, four out of every five assisted living facilities are run by for-profit companies. Many are controlled by international real estate investment trusts, which expect large returns on their expenditures.

The real costs of living in an assisted living facility are often much greater than most residents and their families realize.

The typical assisted living facility provides care à la carte. Residents may be charged an additional cost or fee for services like:

  • Help showering or using the restroom
  • Having meals delivered to their rooms
  • Reminders to take medication or eat
  • Administering medications
  • Medication management
  • Access to community activities
  • Laundry
  • On-site pharmacy services
  • Delivery of medication (if from off-site pharmacy)
  • Pre-move-in health screenings
  • Health monitoring (including monitoring blood pressure and glucose)
  • Access to on-site amenities
  • Grooming reminders
  • Phone access
  • Bed rails
  • Assistance with clothes selection

Many of these facilities don’t employ healthcare professionals directly on-site and instead hire third-party doctors and nurses who aren’t covered by Medicaid. This increases the cost of care for residents and boosts profits for owners and operators.

The added costs for these types of additional services can cost the same or more than the base cost of rent. A study from KFF found that around 45% of participants reported that either they or a loved one were faced with unexpected costs for services they thought were included at their long-term care facility.

Very quickly, what may seem like an affordable option can double or even triple in price.

And the problem is only getting worse. As reported by the New York Times, “the median annual price of assisted living has increased 31% faster than inflation, nearly doubling from 2004 to 2021, to $54,000.” Facilities that offer specialized care, including dementia care, cost even more.

Does Insurance Cover the Cost of Long-Term Care?

To complicate matters further, Medicare typically does not cover the cost of assisted living. It will only pay for certain covered services, such as doctor’s appointments and some medications. This means that, unlike nursing home residents who may have a financial lifeline through Medicare coverage, the vast majority of the costs associated with assisted living facilities are out of pocket for residents.

And as the American population has aged, the once sizeable market for long-term care insurance has all but disappeared. Only a small percentage of people who require long-term assisted care are covered by any type of insurance that helps pay for the costs.

Does Higher Cost Mean Higher Quality Care?

If the cost of living in an assisted living facility can outpace the cost of a nursing home, can residents at least expect to receive higher-quality care?

Unfortunately, this is not a situation in which a bigger price tag equals better services. Long-term residential facilities are not immune to any of the familiar issues that we often see in nursing homes. As detailed by the American Health Care Association (AHCA), assisted living facilities are dealing with some of the following challenges:

  • 63% are facing staffing shortages
  • 98% of facilities with shortages ask staff to take on extra shifts or work overtime
  • 50% rely on temporary workers

These aren’t just numbers and percentages. These figures represent the real-life impact that residents suffer despite paying more for care.

For example, take the case of Jane Burton-Whitaker. In 2016, she was paying $5,795 each and every month to live in her assisted living facility. This included a $270 monthly charge for urinary catheter care. Her catheter bag needed to be emptied multiple times a day, yet staff would frequently empty it only once per day. She was also charged $153 per month for daily skin checks due to a medical condition. Despite paying for three checks per day, staff members rarely performed any checks at all.

Elder Abuse and Neglect in Assisted Living Facilities

We know that Pennsylvania families want the very best care for their loved ones as they age, and rightfully so. Every person deserves the opportunity to age with grace and dignity while receiving necessary care during their later years.

Unfortunately, as for-profit organizations have expanded and grown into the field of long-term care, it is our parents, grandparents, aunts, uncles, and other family members who are facing worse care for higher costs.

According to the National Coalition on Aging (NCOA):

  • 10% of Americans over the age of 60 have suffered at least one form of elder abuse.
  • Fewer than 5% of all instances of elder abuse are ever reported.
  • Elder abuse increases the risk of death by 300%.
  • Financial exploitation accounts for up to $36.5 billion in losses annually.

Shrager, Sachs, & Blanco—Standing up for Our Nation’s Most Vulnerable Population

Your loved one deserved better. If you or someone you love was hurt, abused, neglected, or financially exploited by those entrusted with their care, Shrager, Sachs, & Blanco is here to help. We are a law firm made up of experienced and compassionate Philadelphia nursing home abuse attorneys.

We want to guide your case to the most successful outcome possible. For a completely free, no-obligation opportunity to speak with a real lawyer, get in touch today. We’ll schedule you for a no-cost case evaluation at your earliest convenience.

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