Two pricing models, and they do not compare
A six-bed house almost always quotes one monthly number covering the room, the meals and the care, occasionally with a care level added on top. A large community quotes a base rent for the apartment plus a care tier, assessed at move-in and reassessed afterwards. The second number is the one that moves.
So when you line up quotes on a kitchen table you are comparing an all-in figure against a starting figure. Which one ends up cheaper depends entirely on how much help she needs further down the line, and you cannot tell that from either brochure.
The fix is boring and it works: ask every home for the total first month, in writing, with every line item on it. Not the headline rate. The total.
What actually moves the price here
No home can quote properly until somebody has assessed her. If you are given a firm monthly figure over the phone by someone who has not asked about transfers, continence and what she does at night, that is a number they fully intend to revise after move-in.
- Shared room or private, which in a six-bed house is a large part of the whole difference
- Two-person transfers, because they need two staff on the floor and the home prices for it
- Incontinence care, which is billed separately far more often than families expect
- Medication management, and specifically how many medications at how many times of day
- Night-time needs, which is where otherwise similar quotes pull apart
- Whether she is a fall risk, because that changes the supervision the home has to staff
The one-time costs nobody mentions on the first call
There is usually a community fee or move-in fee, charged once. It is worth asking whether it is negotiable, because sometimes it is, particularly on a room that has been empty. There may be a separate assessment fee.
Then the things that are simply yours: furniture, a hospital bed if she needs one, incontinence supplies, a phone line, and often the cost of her own doctor's visits arranged in and out. None of that appears in a quoted monthly rate and together it is not a small number.
Who pays, and the questions to settle in writing
This is where we will not pretend to be your benefits adviser. These programmes change, the eligibility tests change, and any page that states them as fixed facts is telling you what was true on the day somebody wrote it. We would rather hand you the right questions than a confident answer that has gone stale.
Establish each of these from the programme itself, dated and in writing, before you build a budget on it:
- Whether Medicare covers any part of what you are actually looking at, or only a short skilled nursing stay after a qualifying hospital admission. Ask Medicare, not a community's sales office.
- Whether California's Medi-Cal assisted living waiver is open to new enrolment, what it covers, and what the wait looks like in Los Angeles County right now
- Whether her long-term care policy pays for board and care as well as assisted living, and exactly what triggers the benefit
- For a veteran or a surviving spouse, what the VA's Aid and Attendance benefit currently pays and what this year's eligibility test is
Get the policy out of the drawer early
If there is a long-term care policy, find it this week. Read what it calls a qualifying facility, because some policies pay for a licensed assisted living community and not for a six-bed house, and that single definition can decide which half of the Santa Monica field you are shopping in.
Also check the elimination period, which is the number of days of care you pay for before the policy starts. Families budget from the monthly benefit and forget the gap at the front, and the gap at the front is the part that hurts.
Why there is no range on this page
We could put one here. It would get quoted back to us, it would look authoritative, and it would not match a single actual quote you receive.
Santa Monica is a 15-home field. 11 more sit across the rest of the Westside. 26 homes is small enough that we can telephone them and tell you what they are asking this month, for a resident with your mother's real needs, rather than publishing an average and calling it local knowledge.
That is the entire argument for using somebody local in a market this size. A number you can act on beats a range you cannot.
Where the money goes further, and where it does not
The 6 large Santa Monica communities hold 646 of the city's 696 licensed beds, and their rent reflects the ground they stand on. The 9 houses hold 50 between them, which is a very small amount of the cheaper end of this market.
A few blocks the other side of Centinela is a different property market with the same state licence over it. Culver City alone has 7 licensed homes and 533 beds. Across the catchment there are 26 homes and 1,401 beds.
That is not us steering you out of town for the sake of it. It is what the supply looks like, and pretending otherwise would cost your family money.
What to do this week
Get her assessed, by her own doctor or by a home, so that quotes mean something. Find the insurance policy. Work out the ceiling your family can hold for the long run rather than for the first few months, because a placement you cannot sustain is the genuinely expensive outcome.
Then call and we will do the ringing round. There is no charge to your family; a home pays us if a placement holds. If the honest answer is that the budget does not reach a licensed home and you need to be talking about home care instead, we will tell you that on the first call rather than the fifth.
Written and reviewed by Senior Placement Santa Monica, , against the California Department of Social Services licence register.