4 new alz facilities under construction within 15min of our home. This is in addition to all the pre existing places. I am hoping the competition will lower the price. Does anyone have loved ones in facility w guaranteed locked in rate vs paying for level of care increases? The sales lady w the fixed price felt price increases as loss of skills was stressful and and made financial planning difficult. The cost range from 7k price fixed to 6200 a month. I was aware to negotiate the move in cost. Since all are new construction I asked if competition forces them to lower prices they extend to our contract and was hoping to have a cap on price of living increase. Wound care is additional as is incontinent products, haircuts. I want to have a realistic idea of expenses before I commit.
Onewife, expenses are very important, I agree. But I don't know of any facility that will just charge you one fee, the changes in our loved ones demand more care & with that comes additional costs.
To me the most important factors when choosing a memory care facility are the staff's expertise in dementia care and the resident/staff ratio. In my husband's unit (a Men's Behavior Unit) the ratio is 3.5/1, meaning that for the 10 residents, there are 2 care aides & one nurse on every shift. I'm leery about a nurse that is "in the building" and drops by to give meds, because they don't have the intimate knowledge of our loved ones and their needs. Our facility has an LPN on each shift except for the overnight shift, which has one LPN for the whole building. During that time there are no meds being given, no wound care, no baths, and most residents are in bed. I am much more comfortable leaving my husband in the hands of not only caring aides, but an expert in the behaviors and needs of these stages of the disease. In this facility, I pay $9,000 per month (I'm in Minneapolis, MN) and luckily, with LTC insurance, we are able to afford it - at least for now. The cost does go up for the level of care he needs, but I believe it's justified.
I did have him in another facility that had Independent living, Assisted living and a Memory Care Unit. Their interpretation of Memory Care was to have a locked ward and some activities. Their residents had all sorts of issues including; different types of dementia, very fragile and aged people, difficult behaviors, all stages and levels of incapacity - all living together. It was chaotic and NOT conducive to the calm stress-free atmosphere that dementia people need. There was very little behavior training that staff received and the residents didn't have any individual attention. I realize that with the upcoming deluge of dementia care projections, investors are jumping into the residential care business. But very few are experts in dementia care. I hope you find a facility that give your spouse great care at a price you can afford.
While I hope competition will help keep prices down, there is a danger of lowering standards and cutting corners to lower prices. A single fee for all residents means that the facility is taking a risk that it will have the proper mix of residents to stay profitable (even a nonprofit needs to raise enough money to cover costs). And the facility might feel a need to push out residents requiring more care if the mix of residents includes fewer high cognitive residents than expected. Or they may decide that the single price for all residents isn't working out for them.
But you have a good point about how the unpredictability of future expenses is stressful. My wife's facility has 4 levels of care: 1, 2, 3a and 3b, with each level having its own daily rate. It is a locked down memory care only facility so the daily price includes many extras that other facilities would charge extra. In contrast, a Sunrise would charge a medication management fee based on a complex formula of how many times a day the resident needs medications and the number of medications. I do have to pay for adult disposable underwear, some facilities even include that cost. The only major fee I might see is if I need to hire an outside aide to be with my wife 24/7 (and that was partly for the protection of the other residents). I suspect that no one at my wife's facility is at level 1 care and that most are at level 2, which covers a wide variation of abilities. I suspect my wife wouldn't be considered level 3a unless she needed assistance with eating.
Location seems to be a major factor in prices. Facilities in areas with higher cost of living, especially higher land costs, tend to cost more. Though I was surprised by the cost of my wife's facility given its location. Paying only $6,200 to $7,000 a month for her care would be great.
I wouId not be surprised if the older facilities end up being where the medicaid patients go to meaning the care will be just OK (for the most part). The newer Memory Care will be for those that self pay which should by logic mean better care. But, as the dementia patient numbers increase and more rely on Medicaid, that will not be possible.
In general ALFs are self-pay (though Medicaid might pay for medical services and other social services might pay for room & board).
I keep wondering why Medicaid won't pay for ALFs since they are less expensive than NH. At my wife's ALF residents move from ALF to NH simply because they need Medicaid, the ALF part can provide a high level of care. But thinking about it today I thought that we have no national standards for ALF and Medicaid will not pay for something as poorly defined as ALFs are today. And we cannot expect any move towards a national standard because this will be seen as federal interference and additional regulations.
I have started to receive a lot of unsolicited brochures for all kinds of retirement communities, including over-55 condos, independent living, and ALFs. Many of them have been recently built. I think this is investors' cashing in on the baby boomers' arrival at senior citizenship status. There's a lot of money to be made off our generation.
Around 10-20 years ago there was a splurge in building ALFs to cash in on aging baby boomers. Many didn't do well because they overestimated the number of baby boomers who would need ALFs and be able to afford them.
I'm not surprised these developers could not find customers. Ten years ago, the oldest baby boomers would have been 58. (Twenty years ago they would have been 48!) Kind of young for assisted living.