# Kelsey Manor

Our Home Is Your Home Away From Home

## Level of Care & Pricing

If you're shopping for assisted living, you'll need to familiarize yourself with the levels of care, as the monthly rate for assisted living will depend on the level of care that the resident requires.

Cost is a factor for most consumers. Be sure to ask whether the cost of care is included in the monthly rate. If it isn't, it's likely the costs of care are stratified into levels of care or the individual services are charged separately. Most assisted living facilities that stratify costs have three or four levels of care. A higher level of care will result in higher monthly payments. Sometimes services will be charged on an individual basis even when a pricing structure is in place for basic levels of care. These individually priced services are usually specialized; examples include incontinence care and medication management. Pricing structures that incorporate levels of care as well as à la carte services can be very complicated, so ask specific questions before signing an agreement.

Why are there levels of care? What's the point?

Levels of care help facilities to simplify their pricing structures; once a resident requires a certain amount or kind of care, then the costs rise. This avoids a constant reassessment of costs every time a resident's needs change. Levels of care are also convenient for the consumer: you know the pricing up front, and can avoid feeling "nickeled-and-dimed" every time a change occurs in care needs.

How are care levels assessed?

Although the components of each level of care vary from facility to facility, there are some basic guidelines. Many facilities use a point system to determine a resident's required level of care. No cost-of-care fee applies if the resident is considered independent and doesn't require any help. This can also apply to residents who only need verbal instructions to complete the activities of daily living (ADLs). Residents who do require care are assessed prior to moving into the facility. The components that typically determine the level of care a resident requires are listed below.

Bathing

There are two factors to consider regarding a resident's bathing needs: (1) whether the person requires help showering or bathing and (2) how often they require it. For example, a resident who needs help washing and setting her hair on a weekly basis would require a lower level of care than a resident who requires help with all bathing activities.

Clothing

An assisted living facility will want to know if a resident can dress without assistance. Dressing oneself requires a certain amount of dexterity (e.g., zipping things up, buttoning, and moving one's body). It also requires making good choices such as picking appropriate clothing for the weather or occasion.

Grooming

Grooming includes activities such as brushing one's hair and teeth, and shaving for men. This means not only being physically able to do it, but also remembering to do so daily or on an as-needed basis.

Mobility

Assisted living facilities need to determine how much help a new resident needs in getting around-this includes walking as well as moving from a seated to a standing position. At the highest level of care, a resident might need a Hoyer lift to be transferred. Lower levels of care could mean that a resident only requires minimal assistance with walking or help moving to his or her wheelchair. At move-in, most assisted living facilities require residents to be able to walk into the facility without assistance from another person (using a mobility aid such as a walker is okay).

Continence

Residents who are able to manage their incontinence without assistance (e.g., a resident who is able to change his or her own liner or diaper) shouldn't have incontinence factored into the costs of care. Residents who require help with their supplies will be charged. Higher levels of care include residents who exhibit behavioral issues around their incontinence; for example, a resident who refuses to let aides change his or her diapers.

It is relatively common for facilities to price incontinence care according to an individual resident's needs, rather than incorporating the cost into the levels of care.

Written by Allen Jesson for eZineArticles.com