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I was checking into some AL and MC facilities for a friend and man was I shocked. The prices do vary and quite a bit. There are thousands of dollars difference in the same things. What really caught my attention was the $2500.00 move in fee. This is just to let you in the door and move in. It's not them paying for packing, unpacking, transport, etc. I spoke with two places who had them. One place was only $1500.00. I'm just curious as to whether this has become common. When, I was researching ALs in 2014, no one mentioned a move in fee.

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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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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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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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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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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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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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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 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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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 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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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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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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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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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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The cost to build a new Assisted Living or even a Nursing Home comes to multi-millions of dollars depending on size.   Before the building is even built, land has to be bought or rented, zoning has to be approved and those meetings can takes months on end.   Architects designing and re-designing is costly.   Then one has deal with planning/transportation to see what would be the traffic impact.   Those are extra costs that the general public does see.

My office is in the middle of helping investors who want to partner with a company that will build a nursing home, and the birth of the idea was over a year ago.   We are still dealing with the County who have been extremely helpful.   Everything has to tie together, and that in itself is very complex.

Cost of building, the sub-contractors from every aspect, plus cranes to come in to lift the beams, the list goes on and on.   Winter weather can stall a project.   Heavy rains can stall a project.   Worker strikes can stall a project.   It could take a year just to complete a structure before the first paying client comes through the doors.

Once the building is up and running, there is the cost of 3 shifts of nurses... aides.... Med techs.... cleaning crews.... maintenance crew... linen service.... kitchen staff & waitstaff for the dining rooms.... landscape maintenance that not only takes care of the grounds and parking lots but do snow plowing.   Cost of huge electric generators in case the power goes out.

The cost of Admin staff.... front desk service.... "cruise director".... medical insurance for the employees.... cost of phone service... cable service.   Imagine what the real estate property tax would be on that building.   Imagine what the liability insurance would cost.   Heavens, imagine what the electric bill and water bill would be !!

Now one can get an idea why Independent and Assisted Living is expensive.   I found it a lot cheaper than having my Dad remain in his home and have 3 shifts of caregivers from a private licensed Agency.  

The money I saved for a fun-filled retirement is now being earmarked for future continuing care for myself.   The was all an eye opener.
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A 'move-in fee' or sometimes called a 'community fee', is very common and can range from $500 to over $10,000. 'Move-in fee' is a terrible name because it can be misconstrued to mean that it has something to do with your actual move. It's more closely related to the community's cost for the move...getting the apartment ready, establishing all of the paperwork and record-keeping for a new resident (prescriptions, care plan, emergency plan...).

Here's a tip...not all, but many communities are 'softest' in this area if you are looking to deal. They will reduce or even waive the fee on a case-by-case basis or across the board as a promotion when they have more than a couple apartments available.
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I can appreciate the need for such fees to a point, but I believe a certain portion of it should be refundable if the resident hasn't damaged the property. Painting the walls and replacing the carpet shouldn't be that big a deal if the resident hasn't had "accidents" or brought in pests as described by surprise's comment. This would also give the resident (and his/her family, if there is one) some incentive to keep the room clean.
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A security deposit is nothing like a move in fee, security deposits must be held in trust for the tenant and returned when they move out, with interest. And the security deposit can only be applied toward damages beyond normal wear and tear, not routine maintenance. IMO the move in fee is simply gouging. And as Helennn states, it would certainly give tenants pause if they feel a need to move to a different place.
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Most AL are private pay. In only some states are they licensed. Regardless, whether or not they are licensed, the costs are governed by the contract one signs with the facility. In our state, the licensed facilities usually cost more than the unlicensed. Unlicensed AL cannot administer medications but can do medication reminders. They cannot do any type of "nursing" care either. The bottom line is they can charge whatever is in the contract. The other caveat is that the contracts usually have a mandatory arbitration clause. This prohibits filing suit against the facility and requiring any cause of action to be arbitrated---sometimes even by an arbitrator chosen by the facility.
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Looking at it from a landlord's perspective: If I have a college kid move in, I charge an extra month's rent as a security deposit, and chances are, I will have to use that money to clean up and repair something from beer and ignorance of how to take care of things. I make sure to get damage$ before move in. because the kid may not move out until moving out of state. I have no way of tracking him down to get him to pay damages, and I would no longer be making my minimum rate of return on the apt investment - why would I stay in real estate if I can't make my 5% return on investment?

For old people, the reasoning would be pretty close to the same, except the damages are going to be worse. Urine has a much stronger holding power than beer, and usually is applied over a larger area - not just the living room. If urine soaks through the carpet padding (usually not the case with beer since that is just one cup full), it gets into the plywood subfloor and reeks! That is a much more expensive clean up.

And how about the extermination that is required? Kids get roaches, which are pretty straightforward to get to an acceptable level; old folks don't mean to, but they bring in book lice, scabies, and other creepy crawlies from their special items from home that have not been moved in years.

Finally, our elderly resident that caused the damages is not just out of state, but gone! I could submit that bill to probate, but if the estate has no money left - common in the world of trying to get Medicaid to pay for everything - then I'm left paying for damages out of my pocket. Again, why would I invest in an elderly residence if I'm not making a minium rate of return?

If you want to have more homes available/ shorter waiting lists, people have to be willing to reward the investors who build them by paying for the service. They don't spring out of the ground fully formed - someone has to pay to build and maintain the building.
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We paid a $1700 move in fee. It helps them keep the place looking nice. We didn't think much about it.
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Yes, we paid $1700. Guess it kept the place looking good. I accepted it.
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We paid 1600.00. I was told it was to keeping people from switching around to different nursing homes. They want to keep you there.
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I agree. The AL, which also has a MC wing, in the facility that my cousin resides does not have a Move-in fee. They are also the most reasonably priced place that I have come across. AND their points/stars as graded by the state are much higher than some of the fancy places. I regularly go online and check these things. Some of the most upscale places in appearance, have NO stars or just a couple. Looks can be deceiving.

I wonder how those places with a move-in fee would respond, if the client said, "We are interested. We are private pay and would like to move daddy in, but, we are not paying a move-in fee. If that can't be waived, we'll go to the next one on our list." And then do it.

There may be a big demand for AL, but, from my inquiries, ALL of them had availability. Even MC.
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sg, thanks for this topic, I'm looking at the same thing with my mother and want to be able to discuss it with her. I personally come away from this thread with a feeling somewhere between stacyb's response and the rest. :) This isn't just a condo, and there are many processes they do to ramp up. It also never hurts to discuss the terms with your #1 choice and see if you can negotiate the fee down. I believe $2500 is the precise figure at the place in mid-state Virginia we're looking at.
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They worked so hard all their lives to leave something for their kids and it's all gone when they have to enter one of these places. It's ridiculous. I don't care about my inheritance but it's just sad. Thank God that before they leave this world, they don't even realize that all their hard work went to these places, who just keep charging more and more.
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My mother paid $3,000. I have to presume this is what pays for the cleaning, painting, carpet shampooing, etc. that is done when an apartment turns over. Management informs prospective tenants that all these things are done prior to move-in. The reality is that residents are paying for it.
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I agree with Jessiebell.
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Whatever the facility can get away with, they will charge. They want to turn as big a profit as possible.
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Assisted Living is a 'racket'.. and a very lucrative business. Yes, move-in fees are standard most places today. We paid the non-refundable $2500 as well. Because 'the system' does not take care of our elders today and many did not pay (understandably) or plan for LTC, AL facilities can basically charge whatever they want. Then you have those residents that MUST live in AL because they have Dementia or the like where kids or family members can no longer give the care they need - for whatever reason. Just for the room alone - not including the a la carte items such as medicine mgmt. and Reminiscence care - $4,000 a month. Highway robbery I say... shop around - sometimes places have 'specials' where they will waive fees here and there or give one month free - depending on your area and the supply and demand. Good luck!
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