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My husband was in respite care for 2 weeks while I was out of town. He already was in a room (huge bed, refrigerator, the works, totally not what we are used to since we stay in youth hostels, etc.) So we decided now was the time to have him stay in assisted living. I went to sign the papers. Nothing was ever said about a move-in fee. Nothing! At the very end of the paper signing, the "sweet" lady who had been advising us to move him in permanently, said "Oh, by the way, there is a $12,000 move-in fee." No explanation. He hated it there. We moved him to a non-commercial assisted living and paid a $3,500 move-in fee without complaint.
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Bettysdance, that $12k move-in fee is way out of sight. Makes me wonder if it was ready the first month rent plus non-refundable security deposit or last month's rent.
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The places in my area quoted $3000-5000 and called it a community fee. All the different fees they have now dreamed up, even since we toured places 8 years ago for my step father, show that it's all business and income to them. To us it's family. There are a few places still that do treat residents like family. Fortunately the board and care places did not have these community fees.
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Move-in fee of $5,000 will be temporarily waived if client enters under the 30 day respite available, but after the 30 days, the move-in is due if the client stays. Ask the facility if they do that and you need AL right away.
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I still think these places are charging too much. My mom pays from her own money and does not qualify for medicaid. Her income is becoming less and less and we (children) are sometimes paying with own money. She pays a monthly fee (rent) and that should cover any damages done to property. They have few employees and many residents, so I am sure they are making money. I need their help. So we pay up and shut up. I see my mom every other day, so I make sure she is okay. I feel sorry for those residents whose children only visit once in a while.
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Look at the cost this way... if your love one was still living on their own in their own house and needed around the clock care..... you would need to hire 3 shifts per day from a professional licensed bonded and insured caregiver agency, it would cost between $10k and $20k per month, yes per month, depending on location.

My Dad still lived in his house, paying property taxes, utilities, doing the fixing up and maintenance and here he was in his 90's and a fall risk.   He worried so much about the snow and wanted to shovel the driveway.   With caregivers he was able to stay in his house, but the $20k per month was always on the top of his mind.

He decided one day to move to Independent Living where he could have his own 2 bedroom apartment, with living room, and a full size kitchen.   He said that would work.   And the cost of the apartment was $4k per month.   At that price, Dad was able to bring his favorite private caregivers to work mornings to get him ready and make him breakfast and lunch.   It was a good routine for him.   Dad saved for this "rainy day".

Dad loved the housekeeping service that would come in once a week... linen service once a week... if something broke, he could call maintenance... and Dad got supper in the main dining room, the food there was excellent.   Dad said he felt like a King in that place, so I was so pleased he was happy :)

Now I do realize that isn't the case everywhere, especially if there is only one IL/AL facility in an area.   Where I live, there is a lot of competition.   Dozens upon dozens of such facilities.

Another way of looking at price, what is the cost of a regular apartment that anyone could rent?   In my area, apartment rentals can go up to $1,500 per month.  So subtract that amount from the IL monthly cost.  Then you will have the total cost of all that is included. 
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I too was surprised at the cost of assisted care and dementia care facilities. Two that I have worked with had a "move-in" deposit although they were different prices. The latest was $2,000. I guess this is not uncommon. Home care is about $10,000. a month and dementia care in a facility is about $5,000 a month, depending on the level of care needed. So even with the deposit it is still less than bringing care into the home. So pros and cons to every move.
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The posters who have explained the costs and expenses of senior facilities are correct. In my search for a Continuing Care Retirement Community, I've examined financial statements and haven't found them to be overpriced. They have to cover expenses or go bankrupt.
The buy-in is a means for the facility to cover the costs incurred in getting a new resident, whether paperwork, physical and mental assessment, or remodeling.
You can complain all you want about the price and how seniors are being gouged, but the fact is that the marketplace will provide competition for a place that is overpriced. I don't think facilities are colluding to set high prices. They are probably looking at how their competitors set their fees and trying to assign the income they get to the costs they incur as much as possible. That's just business.
As freqflyer points out, we will all be better off in our senior years if we save for that rainy day. It's a choice we ought to make early in life. If you haven't chosen to save and prepare for retirement, you have made a choice to live in poverty; and you get to live with your own choices.
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I'm a business owner and I've looked at this from all kinds of angles. Any which way I look at it, this nonrefundable move-in fee is overreaching, imo. I'm pretty sure they cannot charge that for non-private pay residents. In my state, the state provides payment for AL and MC for certain disabled persons and seniors who qualify. (Similar to Medicaid.) Maybe, the ones who accept private pay only are the ones who charge the Move-in fee or maybe, they only charge it for private pay residents.
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I just moved my mother to an ALF, and the initial fee was 2500.00, I was told it is used to maintain the facilities in general. Since mom's apartment was brand new (new wing on the building), they could not pass it off as some fee to clean up the apartment from the prior tenant. I think it is fairly common.

But we got lucky, they were offering the first month's rent free if we moved in before the 1st of the year. Which was twice what the move in fee was.
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One time move in fees are typical in Texas - expecially with larger projects like Brookdale. It usually goes to pay a commission to the person you spoke with a A PLACE FOR MOM or some other "free" placement agency. The best way to avoid a fee is to google facilities within your area of interest and tell them you are not represented by a placement agency and do not wish to pay a fee. If that fails, then call them directly and introduce yourself as being the decision maker of where your friend or relative will locate and ask what they will pay you for choosing their facility. Most pay a referral fee - they just try to collect it from the resident as opposed to a % of the first month's rental as regular rental commissions are paid.
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As some else had mentioned, "move-in" fees can also be for putting together the paperwork for the elder or POA to sign upon accepting an apartment/suite in a facility.

Then there is the assessment of the elder to make sure the elder is able to live successful in Independent Living or would be better off in Assisted Living.   The assessment is quite a booklet, and the Staff needs to review to make recommendations.

Plus list of doctors/dentist/specialist that my Dad is using.   And keeping on file his Living Will and DNR.

Diet assessments are also done.   My Dad is lactose-intolerant so the kitchen needs to take note of that.   I was able to bring in special ice cream for Dad that the dining room kept in the refrigerator for desert.

Then the Nurse needs to transfer all the meds that the elder is taking so that the elder is using the pharmacy that had bid to be the pharmacy for the facility.   And to set up a schedule for once or twice a day a qualified Aide to give the meds to the elder.
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I think either a move-in fee or a minimum stay is in order. Imagine how much time it takes to understand an older persons needs and schedules, fit that into the caregivers' routines, thinking of medicines, bedding, food, etc. I would think a month's equivalent would work, and reimburse it if something goes wrong.
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My mom's AL charged a $3,000 community fee. While I think that's a lot of money, it's not a buy in place.
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