What To Ask About Assisted Living

Base Rates, Level Changes, and Points

It is important for you to know how a facility charges for care-giving services; base rates are just the beginning. Level charges group a number of services (bathing, medication, incontinency, (etc.) and charges a monthly fee for these services.

Level charges can range from $300 to $500 per month, and while most facilities have three to four levels, some will have up to seven different level charges.

Point systems allow for flexibility by assigning specific fees, or points for the services than an individual may need. In a level charge you may have to pay for an entire level when you need only one service in that grouping.


Level charges are calculated by assessments. You want to find out when the assessments are done, how often, and who does the assessments.

Many facilities will not do an assessment until the resident has lived there for 14-30 days. Therefore, you may be quoted a monthly price before move-in and find out on 30 days that there will be additional charges because the resident needs more care than expected.

While the point system, reassessment may only mean $45 more per month, a level charge system could mean an additional $300 per month. Is staffing based on the assessments?

Find out if the facility has a method or formula for calculating staffing based on the assessments of the residents. Many facilities will continue to assess people at higher levels and yet not provide additional staffing when the residents' needs have changed.

Beware, because of low occupancy rates in many assisted living facilities, administrators have been given authority to negotiate rates and levels. Administrators may bring in someone who would be a level two and classify them as level one. You can bet that once the resident is settled in, a reassessment will occur and rates will increase.

Rate Changes

Find out when and how often the facility's rates change and if the administrator in the facility has input as to those changes. Ask about the percentage changes in the rates over the past three years.

Many facilities are owned by large publicly held companies where rates are based on corporate profits. Rates in these companies will be determined by boards or officers who have no real understanding of the market conditions in your town. Rent changes in the chain-facilities continue to increase at rates exceeding inflation in broad consumer price.