The U.S. is getting older. About 1.5 million Americans now live in assisted living facilities and nursing homes, a number that has risen by more than 200 times since the 1960s and doubled in the past two decades, according to The Senior List. And experts predict that the number of seniors in the U.S. is only going to increase.
Finding a place to care for the elderly is not an easy task. There is a lot to consider, and cost is at or near the top of most families’ list of concerns. Because demand is greater than supply of rooms for nursing or assisted living care — especially at the most desirable and best rated facilities — many have waiting lists. Often, those lists require a deposit to hold a place in line.
Here’s what you need to know about assisted living waiting lists.
[READ: Assisted Living Checklist.]
Assisted Living Facilities Have Limited Availability
According to the American Health Care Association and the National Center for Assisted Living, there are about 28,900 assisted living communities with just under 1 million licensed beds in the U.S. today. The average assisted living community offers 33 licensed beds. Those beds are not always available for new residents.
On average, residents live at assisted living facilities from two to three years, according to AARP. “Turnover can be unpredictable. You can have none for two or three months, then one a month,” says Grace Ferri, chief marketing officer at United Hebrew of New Rochelle, a campus of comprehensive senior care in Westchester County, New York.
Many Facilities Keep Waiting Lists
A Centers for Disease Control and Prevention National Survey of Residential Care Facilities survey from 2016 found that 29% of senior housing communities currently have admissions waiting lists. Whether or not a facility in your area has such a list depends on where you live and what other housing options are available, says Amie Clark, co-founder and senior editor of The Senior List.
It’s smart to look into this well ahead of time. “That’s not something you want to wait for. You need to figure out where you want to be before you need to be there,” says Clark, a former long-term care ombudsman who has worked in skilled nursing facilities and specializes in geriatric care management and senior housing advisory.
Waiting Lists Typically Require a Deposit
That deposit is usually one month’s rent, not unlike a security deposit on an apartment, Ferri says. For most people, putting down a deposit “means the time to come in is close, usually within six months,” she says. But, in many facilities, there is no time limit. “We will hold it six months or six years,” she says.
You Can Accept or Reject an Open Room
When a space opens, the person at the top of the waiting list gets notified. He or she can take the room if ready or decline if not. If the room is declined, the person goes back to the bottom of the list. There is no penalty for declining a room at most facilities.
Each Facility Has Different Rules
These rules are not universal, however. It’s very important to ask for and understand what is required for your facility. You should ask about the deposit amount, length of the wait and the policy for declining a room, including whether the deposit is refundable if the senior decides to age at home or moves to be with family.
Consider the Exceptions
In some circumstances, people may be able to jump the line. If an elderly patient needs a place for short-term rehab from, say, a hip replacement, “we can speed up the process because it is crisis-driven,” Ferri says. “If something is really crisis-driven and it is imminent to place a loved one, we would accommodate them,” she says. Of course, accommodations are only possible as long as there is a room available.
On the other hand, seniors with medically complex health concerns may find it harder to access assisted living. And the person’s financial situation may also be a factor. A facility may take only a small amount of people on Medicaid because the reimbursement rates are too low, Clark says. “Sometimes it’s just about timing. (There are) scenarios where you thought it would take a long time, and a room opens and you get in right away,” she adds. “It’s not always an exact science.”
You Want to Build a Relationship
“The goal is to plan ahead of time, to build a relationship with the organization, so when it’s time, everything is seamless,” Ferri says. That means shopping around and visiting the facilities you may be considering well before it’s needed. Ferri suggests to see what life is like there. Ask other residents how they like living there, and build clear lines of communication with the management team so that you and your family develop rapport and feel comfortable with the choice.
Start Early and Be Prepared
Some assisted living communities attract more interest because of their amenities or reputation, and highly desirable facilities are naturally harder to get into, Clark says. “It doesn’t hurt to get on a waiting list early. If you identify a place you like, get on the list,” she says. “Even if don’t think it’s on the horizon, educate yourself on all this. It’s better to be prepared than be caught off guard and in crisis.”
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