Assisted Living Facilities: What Do They Cost?

Finding out how much assisted living costs—especially at a particular facility—can be frustrating. Assisted living homes rarely advertise their costs on their websites. When they do, you might only get a broad range or a starting price. Getting specifics often requires a conversation with the sales department, which you might find intimidating, annoying, or even shady.

Why isn’t assisted living pricing more transparent? These facilities may be afraid of scaring off prospective residents and their families with sticker shock. The price is not comparable to a mortgage or monthly rental payment because it includes far more than just housing.

The monthly cost of assisted living may include utilities, common area maintenance and repairs, landscaping, unit maintenance and repairs, nurses, nurse aides, and other staff. The size and location of your room—and whether you have a roommate—also affect cost. Then, the specific services each resident needs are factored into their custom cost. What’s more, that cost is likely to fluctuate throughout each resident’s stay as their needs change.

Some assisted living websites will give you base prices if you complete a form that asks for your name, email, and phone number. Ultimately, you’ll have to talk to the specific facilities you’re interested in to learn about their current pricing, but you can at least go into the conversation prepared and rule out places that are definitely not in your budget without wasting anyone’s time. 

Understanding Assisted Living Costs

The monthly national median cost of assisted living in 2021 was $4,500 for a private, one-bedroom unit, according to the annual Genworth Cost of Care Survey. Genworth is a long-term care insurance company that has produced this survey, covering 435 cities and towns in all 50 states, since 2004. Monthly costs range from a low of $3,000 in Missouri to a high of $6,978 in the District of Columbia. Both small-group homes and large facilities fall under the umbrella of assisted living.

Costs can fall within a wide range even at assisted living facilities owned by the same company. For example, Brookdale, a major senior living provider with 695 communities in 42 states, says starting rental costs range from $800 to $7,725 per month depending on location, apartment type, and level of service. If you want to live a block from the beach in Santa Monica, you’re going to pay toward the higher end of that range. Brookdale is an outlier in price transparency, even if it could do more by providing detailed breakdowns for the cost of care services and other items not included in the base rent.

Assisted living costs increased by 6.15% from 2019 to 2020—the largest jump of any type of care the survey covers—because COVID-19 imposed more costs on assisted living homes. These facilities had to pay for personal protective equipment and dealt with labor shortages and trouble attracting and retaining workers. Assisted living costs have increased on average by 3.8% per year from 2004 through 2020.

Which Services Does Assisted Living Provide?

Assisted living, which may be called “residential care” in California, is permanent housing where residents receive personal care and healthcare. The level of care is typically less than a nursing home would provide, but more than a home health aide can offer. Someone who needs help with activities of daily living can receive these services in an assisted living home.

These are the activities of daily living:

• Dressing
• Bathing/showering
• Toileting
• Transferring/mobility
• Eating
• Continence

Assisted living can also help people with cognitive impairments such as dementia, which can endanger their health and safety. Memory care—a higher, more expensive level of care—can provide specialized assistance to these individuals to make sure they eat regularly, maintain proper hygiene, take medications on schedule, and don’t get lost. 

In addition to basic daily services that keep residents alive and healthy, assisted living homes usually provide meals, transportation, laundry, cleaning, easy access to medical care, fitness activities, and social activities. In many ways, life in a nice assisted living facility is not unlike life in a high-end college dorm.

Assisted Living Costs Compared With Other Types of Care

Assisted living is almost 2.7 times as expensive as adult day healthcare. It’s a little more than half of what a semiprivate nursing home room costs. It’s comparable to the cost of 44 hours per week of home health services or a home health aide. The national average monthly costs for 2021 are:

• Adult day healthcare: $1,690
• Assisted living: $4,500
• Homemaker services: $4,957
• Home health aide: $5,148
• Semiprivate nursing home room: $7,908
• Private nursing home room: $9,034

It’s difficult to generalize about assisted living costs, not only because people need different levels of care but also because there are so many facilities, and they set their own prices. The United States had about 28,900 residential care communities as of 2016 (the most recent year available), according to the Centers for Disease Control and Prevention. The financial impacts of COVID-19 could put many of these operations out of business.

Hidden Costs of Assisted Living

Genworth’s 2020 Cost of Care survey found that 61% of the 6,183 facilities that completed its survey charged a nonrefundable community or entrance fee. According to the American Seniors Housing Association, an industry advocacy group, this fee is usually between $1,000 and $5,000.

Help with specific activities of daily living is another expense that is added to the base price. Depending on the home, you may pay an additional rate based on a certain threshold of care. The pricing can also be more a la carte. You may pay extra for help with dressing and undressing, showering, medication administration, getting to and from the dining room, and transportation to doctor’s appointments.

Affordable Housing for Seniors

Some assisted living communities offer affordable housing for seniors who meet location-specific income requirements. Your local government may be able to provide information about these communities and their requirements.

Another way to save is by having a roommate. Sunrise Senior Living, one of the country’s biggest senior living providers, offers “Companion Living” for people who need a more affordable option and/or prefer not to live alone. They say they try to match residents according to common characteristics that can serve as a basis for friendship.

The Bottom Line

The cost of assisted living, at a median of $4,300 a month, may not sound like a bargain, but it can be comparable to the cost of hiring someone to help with activities of daily living at home. It wraps many ongoing living expenses, such as rent, utilities, maintenance, and transportation, into a single monthly fee, then it adds fees for help with things such as eating, bathing, and taking medication.

Assisted living can also provide balance and peace of mind for a loved one’s caregivers. For those who can afford it, it can be worth every penny. For those who can’t, a combination of family caregiving and a home health aide may be a reasonable solution.