The United States is getting older. With more than 58 million Americans who are 65 years or older and more than 800,000 who live in assisted living facilities, the aging baby boomer generation is significantly impacting the need and demand for more of these specialized long-term care options.
Finding an assisted living facility for those who need care can be a daunting task. There are many factors to consider, including level of care, quality of care and cost of care, and demand for assisted living facilities may exceed supply of rooms for nursing or assisted living care, especially at the most desirable and best-rated facilities. Many of them have waiting lists with facilities requiring deposits to hold a spot.
Here’s what you need to know about assisted living waiting lists.
[READ: Assisted Living Costs and How to Pay]
Assisted Living Facilities Have Limited Availability
Assisted living facilities are a type of specialized residence designed for older adults who need assistance with activities of daily living (ADLs), such as feeding, toileting, grooming and managing medications. Unlike nursing homes, which provide round-the-clock care outside of a hospital setting, assisted living facilities offer a space for older adults to receive support, while maintaining some level of independence.
Across the country, there are about 30,600 assisted living communities with nearly 1.2 million licensed beds in the country today, according to the American Health Care Association and the National Center for Assisted Living (AHCA-NCAL). The average assisted living community offers 39 licensed beds, but those beds are not always available for new residents.
“Turnover can be unpredictable. You can have no turnover 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.
[READ: Who Qualifies for Assisted Living: Requirements for Residents]
How Facilities Manage Demand: Waiting Lists
A Centers for Disease Control and Prevention national survey of residential care facilities from 2016 found that 29% of senior housing communities currently have admissions waiting lists. More recent research from the AHCA-NCAL showed that assisted living facilities are limiting admissions due to labor shortages of nurses and health aides, which has not rebounded since the COVID-19 pandemic.
Whether or not a facility in your area has a waiting list depends on where you live.
“Some assisted living communities may have a waitlist because they have a great reputation and are, therefore, at capacity,” says LaShuan Bethea, executive director of NCAL in Washington, D.C. “Waitlists can also be driven by the Medicaid program if low-income seniors are on the waitlist to enroll in the state’s home and community-based waiver program that covers assisted living care.”
It’s smart to look into availability at assisted living facilities 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 Amie Clark, co-founder and senior editor of The Senior List.
[READ: Independent Living vs. Assisted Living: What’s the Difference?]
How Assisted Living Waiting Lists Work
Waiting lists at assisted living facilities prioritize applicants based on the date of their application, with some facilities also considering the urgency of the individual’s needs. Potential residents are typically notified where they are on the list and the estimated wait time, which can vary depending on availability and demand.
Each facility has different rules
Since many assisted living facilities are run independently, there are various rules at each site.
It’s very important to know what is required for the 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, moves in with family or chooses another facility.
Prepare to put down a deposit
Some assisted living facilities charge an application fee or may require a deposit that is usually one month of charges, but may be more for assisted living facilities in metro areas or those in high demand. For most people, putting down a deposit means the time to become a resident is getting close, usually within six months. In many facilities, there is no time limit.
“We will hold the deposit for six months or six years,” Ferri says.
Some assisted living facilities also have a buy-in program, which is a financial arrangement in which future residents make an upfront payment or investment to secure a place in the facility. This upfront payment can be substantial — upwards of $100,000 or more. Residents will receive a large percentage of the upfront payment back once they move to another facility or transition to long-term care, such as a nursing home or memory care unit.
“Buy-ins were a strong marketing tool for us a while ago, but not as much now and fewer facilities offer that as an option,” says Dana Payton, regional director of operations for Meadows of Franklin Grove and Prairie Crossing Supportive Living in northern Illinois.
You can accept or reject an open room
When a space opens up, 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 and they will continue to hold the original deposit.
Keep in mind, there are several types of rooms in assisted living communities, including studios, one-bedrooms and two bedrooms.
“There may be an opening for a studio, but the resident is on the waiting list for a one bedroom, so they may have to wait a bit longer for an opening,” Payton explains.
How to Master the Waiting Period for Assisted Living
There is no one-size fits all approach to getting on the waiting list since that process varies from facility to facility. Connect with friends, family and neighbors about who may have direct experience with the local assisted living facilities in your area.
You can also receive independent information from the Long-Term Care Ombudsman program in your state that provides information about how to find a facility and answer questions about how waiting lists work.
Find information about the ombudsman program in your state at this online resource available through the National Consumer Voice for Quality Long-Term Care.
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.
“It doesn’t hurt to get on a waiting list early. If you identify a place you like, get on the list,” Clark says. “Even if you 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.”
It’s also important to review the admissions agreement to determine what the core services to support ADLs are and what they consider add-ons — similar to an a la carte menu.
Examples of core services related to ADLs include:
— Help with their medication
— Assistance showering or toileting
— Management of changing health needs
“This all needs to be spelled out in the admissions agreement so there are no surprises and the families and staff are on the same page,” says Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care (The Consumer Voice) in Washington, DC.
Consider the exceptions to the waiting list rules
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, the process can often speed up because it is crisis-driven.
“If something is really crisis-driven and it is imminent to place a loved one, we would accommodate them,” Ferri says.
Of course, accommodations are only possible as long as there is room available.
On the other hand, seniors with medically complex health concerns may find it harder to access assisted living. 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 lower.
“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,” Clark says. “It’s not always an exact science.”
Build relationships at the facility
It’s important to visit the facilities and meet the staff you may be considering in advance.
“The goal is to plan ahead of time and to build a relationship with the facility so, when it’s time, everything is seamless,” Ferri says.
Ferri suggests seeing what life is like there by asking other residents how they like living there and build clear lines of communication with the management team to help you and your family develop rapport and feel comfortable with the choice.
Prepare for the transition
Once you’ve made it to the top of the waiting list and are ready to make the move, be prepared to help your loved one transition to their new home.
“Change is hard and it takes time for people to make the transition to a new place,” Bethea says. “Assisted living communities are focused on supporting residents when moving in and helping create a smooth transition.”
Bottom Line
Finding the right assisted living facility for a loved one can be a challenging task, especially when there are few options to choose from in your community. There are many considerations for choosing an assisted living facility, with how soon they can move in being at the top of families’ list of concerns.
Waiting lists are a major concern because they show a high demand for limited spaces, causing delays for new residents to receive the proper care they need. While waiting lists vary from each community, they can create stress for prospective residents and their families, making future care planning difficult.
Explore Top-Rated Assisted Living Facilities with U.S. News
Let U.S. News help you find the best-rated assisted facilities near you through its 2024 comprehensive guide. Search by state, city or ZIP code to find the right assisted living community.
U.S. News analyzed data from nearly 400,000 resident and family survey responses at more than 3,500 senior living communities nationwide. The survey asked residents and family members about their satisfaction with aspects of the community such as safety, caregiving, management, staff, food/dining and activities. The ratings recognize communities that excelled at providing highly satisfactory services and making residents feel safe and well cared for.
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