Looking for assisted-living facilities for yourself or a loved one? If so, you should probably start by examining a map and your portfolio: Due to a variety of factors, the spot you choose on the former will have a huge impact on the latter.
“People often say that healthcare is local,” said Robert Bua, president of CareScout, who, in conjunction with Genworth, produces an annual Cost of Care report that compares the cost of long-term care in 440 regions around the country. “But the cost of long-term care is local, as well.”
According to the company’s latest report, for example, the national median monthly cost for accommodation in an assisted-living facility (ALF) is $3,500, or $42,000 per year. However, a look at the 50 largest metropolitan areas in the country reveals monthly costs ranging from $2,250 ($27,000 per year) to nearly $6,200 ($73,950 per year). Among the most and least expensive cities in annual cost:
5 least expensive*
- El Paso: $27,000
- Miami: $30,000
- Las Vegas: $33,000
- Atlanta: $33,300
- Jacksonville: $33,540
5 most expensive*
- Boston: $73,950
- Honolulu: $59,700
- Chicago: $59,520
- Philadelphia: 57,960
- Columbus: $57,630
(*All figures refer to private, one-bedroom accommodations in facilities that provide assistance with daily living, e.g., health services and personal care, to people who do not need the level of care provided by a nursing home.)
The range is primarily a function of supply, demand and the relative cost of care. As with other healthcare services, local costs associated with labor, real estate and regulatory requirements vary across the country, while the building and subsequent filling of facilities is, says Bua, “a constant search for equilibrium.”
Currently, there are approximately 31,100 ALFs in the U.S., supporting around 750,000 residents. According to the National Center for Assisted Living, more than half of residents are 85 or older and, on average, need help with three activities of daily living.
“This is a needs-driven service,” said David Kyllo, the center’s executive director. “It’s not like moving into 55-plus senior housing. It’s not a ‘lifestyle.’”
Yet it’s a style of living that’s likely to see increasing demand as the nation ages and Baby Boomers begin investigating their long-term care options. Local differences aside, Bua believes, there may be a slight oversupply in available ALF accommodations, one reason the median monthly rate increased only 1.45 percent over last year, vs. an average annual growth of 4.29 percent over the last five years.
It’s almost certain that future demand will increase, negating any oversupply and pulling costs up along with it. For one thing, Kyllo says, 40 percent of ALF residents have Alzheimer’s or other dementias that require more staff and higher-cost “memory care.” For another, history suggests that Baby Boomers will approach retirement the same way they have every other life stage they’ve experienced.
“The Boomers won’t be looking for the same types of services and amenities that their parents and grandparents did,” said David Schless, president of the American Seniors Housing Association. “Ten years from now, the available facilities will look very different than those built in 1985.”