Entering assisted living- how to pay

[Anonymous]

Anonymous wrote:I have a question. OP mentioned in one of her posts that these ILs both have long term care insurance. Doesn’t that change the calculus?

Not OP, but this should make a difference. Though LTC probably doesn't pay entrance fees for CCRC. Given the suspected ages of OP's elderly they probably have one of the few remaining really good plans. But even then it doesn't necessarily cover the full daily amount and generally only covers for X # of years.

LTC pays if the insured meets the criteria laid out when the policy was purchased. I think there are 5 things and the person has to meet 4 of them?? It doesn't sound as if OP's people are close to that point yet.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Plenty of places without entrance fees. Those places are a rip off.

If you have the money, they are not a rip off. If you enter a CCRC while healthy in IL, yes you pay more. But with the entrance fee and the extra, you are guaranteed "any advanced care" with no additional costs (except for the extra 2 meals per day typically). And in most of them, if one parent goes to "advanced care" (memory, assisted living, nursing, etc) the other gets to keep the same Ind Living apartment for no increase cost. For my parents, it would only take ~1 -1.5 years for each of them to be in "advanced care" to pay for itself.

In the meantime, my parents are enjoying life to the fullest, never have to worry about cooking or cleaning or fixing anything. And the key part---should you need "advanced care" there are always spots kept open for the CCRC residents, so it's not a search and pray process for finding the care when they need it. Also, I live 3K miles from them, so it's nice to know I can manage an emergency from a distance and they will be well taken care of. Also, the IL spouse can visit the other one daily as it's right there---they will never be in separate facilities where someone has to drive one to the other.

But in reality, if you have the money, this is what you have saved for. Why not spend it for a nice last 5-20+ years?

+1

A good CCRC will be expensive up front, but is a great option for those who qualify. My parents were in a similar place, my father was in assisted living, mom in independent living, but in the same unit. He eventually went to memory care and then passed away. As awful as that was, it was so much simpler than if they had been in a one-size-fits-all/month-by-month place or at their home. And likely would
have aged my mom even more.

Now, I have a sibling who is still upset about it, because they think it will cut into our inheritance, but they can die mad, since they also didn’t want to take care of our aging parents.

I also have a sibling who will be upset, does nothing to help (both are a distance, I'm much farther). I'm the POA and have all control, they are allowed to "get information about my parents/be informed" and that is it (parent's choice). Asked my parent's to inform the sibling that should there be anything left in the estate, after basic bills, I get paid back next with interest for the entrance fee I paid . Basically sibling likely won't get much if anything. The $400K+ I provided with interest is now over $450K. Realistically, I'm not even getting paid back fully.
But sibling was upset when told and will likely have "forgotten" and be upset when estate is settled.
We were happy to pay the fee and have them spend their hard earned money. I don't expect or need an inheritance. I'd rather they live their final years in comfort and happiness (and at a much nicer level than the rest of their lives were). Finally spending the money they worked so hard to save

We did a version of this and FIL put it in writing and reminded the siblings and their wives at a family dinner of the arrangement. Super awkward, but thankfully there was no way to misconstrue when FIL passed.

This should be in the will or there will be no way to enforce this.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Plenty of places without entrance fees. Those places are a rip off.

If you have the money, they are not a rip off. If you enter a CCRC while healthy in IL, yes you pay more. But with the entrance fee and the extra, you are guaranteed "any advanced care" with no additional costs (except for the extra 2 meals per day typically). And in most of them, if one parent goes to "advanced care" (memory, assisted living, nursing, etc) the other gets to keep the same Ind Living apartment for no increase cost. For my parents, it would only take ~1 -1.5 years for each of them to be in "advanced care" to pay for itself.

In the meantime, my parents are enjoying life to the fullest, never have to worry about cooking or cleaning or fixing anything. And the key part---should you need "advanced care" there are always spots kept open for the CCRC residents, so it's not a search and pray process for finding the care when they need it. Also, I live 3K miles from them, so it's nice to know I can manage an emergency from a distance and they will be well taken care of. Also, the IL spouse can visit the other one daily as it's right there---they will never be in separate facilities where someone has to drive one to the other.

But in reality, if you have the money, this is what you have saved for. Why not spend it for a nice last 5-20+ years?

+1

A good CCRC will be expensive up front, but is a great option for those who qualify. My parents were in a similar place, my father was in assisted living, mom in independent living, but in the same unit. He eventually went to memory care and then passed away. As awful as that was, it was so much simpler than if they had been in a one-size-fits-all/month-by-month place or at their home. And likely would
have aged my mom even more.

Now, I have a sibling who is still upset about it, because they think it will cut into our inheritance, but they can die mad, since they also didn’t want to take care of our aging parents.

I also have a sibling who will be upset, does nothing to help (both are a distance, I'm much farther). I'm the POA and have all control, they are allowed to "get information about my parents/be informed" and that is it (parent's choice). Asked my parent's to inform the sibling that should there be anything left in the estate, after basic bills, I get paid back next with interest for the entrance fee I paid . Basically sibling likely won't get much if anything. The $400K+ I provided with interest is now over $450K. Realistically, I'm not even getting paid back fully.
But sibling was upset when told and will likely have "forgotten" and be upset when estate is settled.
We were happy to pay the fee and have them spend their hard earned money. I don't expect or need an inheritance. I'd rather they live their final years in comfort and happiness (and at a much nicer level than the rest of their lives were). Finally spending the money they worked so hard to save

This makes no sense.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Plenty of places without entrance fees. Those places are a rip off.

If you have the money, they are not a rip off. If you enter a CCRC while healthy in IL, yes you pay more. But with the entrance fee and the extra, you are guaranteed "any advanced care" with no additional costs (except for the extra 2 meals per day typically). And in most of them, if one parent goes to "advanced care" (memory, assisted living, nursing, etc) the other gets to keep the same Ind Living apartment for no increase cost. For my parents, it would only take ~1 -1.5 years for each of them to be in "advanced care" to pay for itself.

In the meantime, my parents are enjoying life to the fullest, never have to worry about cooking or cleaning or fixing anything. And the key part---should you need "advanced care" there are always spots kept open for the CCRC residents, so it's not a search and pray process for finding the care when they need it. Also, I live 3K miles from them, so it's nice to know I can manage an emergency from a distance and they will be well taken care of. Also, the IL spouse can visit the other one daily as it's right there---they will never be in separate facilities where someone has to drive one to the other.

But in reality, if you have the money, this is what you have saved for. Why not spend it for a nice last 5-20+ years?

Can you give an example or name of a place like this? After a sobering holiday visit, I think my parents should go somewhere like this and it’s all overwhelming to me right now.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Plenty of places without entrance fees. Those places are a rip off.

If you have the money, they are not a rip off. If you enter a CCRC while healthy in IL, yes you pay more. But with the entrance fee and the extra, you are guaranteed "any advanced care" with no additional costs (except for the extra 2 meals per day typically). And in most of them, if one parent goes to "advanced care" (memory, assisted living, nursing, etc) the other gets to keep the same Ind Living apartment for no increase cost. For my parents, it would only take ~1 -1.5 years for each of them to be in "advanced care" to pay for itself.

In the meantime, my parents are enjoying life to the fullest, never have to worry about cooking or cleaning or fixing anything. And the key part---should you need "advanced care" there are always spots kept open for the CCRC residents, so it's not a search and pray process for finding the care when they need it. Also, I live 3K miles from them, so it's nice to know I can manage an emergency from a distance and they will be well taken care of. Also, the IL spouse can visit the other one daily as it's right there---they will never be in separate facilities where someone has to drive one to the other.

But in reality, if you have the money, this is what you have saved for. Why not spend it for a nice last 5-20+ years?

Can you give an example or name of a place like this? After a sobering holiday visit, I think my parents should go somewhere like this and it’s all overwhelming to me right now.

This is OP look up continuing care retirement community. The company we are looking at is Erickson senior living

[Anonymous]

Anonymous wrote:

Anonymous wrote:I have a question. OP mentioned in one of her posts that these ILs both have long term care insurance. Doesn’t that change the calculus?

Not OP, but this should make a difference. Though LTC probably doesn't pay entrance fees for CCRC. Given the suspected ages of OP's elderly they probably have one of the few remaining really good plans. But even then it doesn't necessarily cover the full daily amount and generally only covers for X # of years.

LTC pays if the insured meets the criteria laid out when the policy was purchased. I think there are 5 things and the person has to meet 4 of them?? It doesn't sound as if OP's people are close to that point yet.

Yes, it is a really good plan at least the one the older spouse has. It was used a decade ago after a serious illness. We are trying to get them in a CCRC before his health declines again. I suspect he will need more care within 18 months

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It looks like my in-laws are finally willing to enter assisted living. I will try to get them in with their estate planner but would like to hear from BTDT people about how they got the money for the entrance fee. Does it make the most sense to sell the house first or pull from investments/reserves? I think net worth is between 1.5-2 .5 million including a vacation condo unfortunately purchased this year. I think it will be mentally difficult for them to sell one or both homes so we could potentially look at renting them out if it makes sense.

No one can really answer this. There are just too many unknowns. Rushing into a sale is often a mistake, as the capital gains hit can be substantial. Talking to a professional is the right thing to do and no big financial decisions should be made until you do. Renting isn’t necessarily the answer, but don’t be too freaked about “being a landlord,” if the property is right you can generate significant income and easily pay a property manager. If the vacation condo can be AirBnB’d that can be very lucrative. In any case, just wait until you talk with the estate planner. If the can’t talk to you knowledgeably about income generation now, you need to speak to a fee based CFA as well.

Thank you. I’m not opposed to becoming a landlord for them. I think holding on to the property would probably make them feel better. Luckily they downsized 5 years ago so their primary residence is a paid off condo, new appliances without a ton of crap. After taxes/HOA it could generate about $1000/month.

Famous last words, lol.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Plenty of places without entrance fees. Those places are a rip off.

If you have the money, they are not a rip off. If you enter a CCRC while healthy in IL, yes you pay more. But with the entrance fee and the extra, you are guaranteed "any advanced care" with no additional costs (except for the extra 2 meals per day typically). And in most of them, if one parent goes to "advanced care" (memory, assisted living, nursing, etc) the other gets to keep the same Ind Living apartment for no increase cost. For my parents, it would only take ~1 -1.5 years for each of them to be in "advanced care" to pay for itself.

In the meantime, my parents are enjoying life to the fullest, never have to worry about cooking or cleaning or fixing anything. And the key part---should you need "advanced care" there are always spots kept open for the CCRC residents, so it's not a search and pray process for finding the care when they need it. Also, I live 3K miles from them, so it's nice to know I can manage an emergency from a distance and they will be well taken care of. Also, the IL spouse can visit the other one daily as it's right there---they will never be in separate facilities where someone has to drive one to the other.

But in reality, if you have the money, this is what you have saved for. Why not spend it for a nice last 5-20+ years?

Can you give an example or name of a place like this? After a sobering holiday visit, I think my parents should go somewhere like this and it’s all overwhelming to me right now.

My parents are in a CCRC but should they need assisted living or skilled nursing the costs go up significantly. Just mentioning because they all have different funding structures. Many people seem to stay in IL as long as they can with private care givers.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It looks like my in-laws are finally willing to enter assisted living. I will try to get them in with their estate planner but would like to hear from BTDT people about how they got the money for the entrance fee. Does it make the most sense to sell the house first or pull from investments/reserves? I think net worth is between 1.5-2 .5 million including a vacation condo unfortunately purchased this year. I think it will be mentally difficult for them to sell one or both homes so we could potentially look at renting them out if it makes sense.

No one can really answer this. There are just too many unknowns. Rushing into a sale is often a mistake, as the capital gains hit can be substantial. Talking to a professional is the right thing to do and no big financial decisions should be made until you do. Renting isn’t necessarily the answer, but don’t be too freaked about “being a landlord,” if the property is right you can generate significant income and easily pay a property manager. If the vacation condo can be AirBnB’d that can be very lucrative. In any case, just wait until you talk with the estate planner. If the can’t talk to you knowledgeably about income generation now, you need to speak to a fee based CFA as well.

Thank you. I’m not opposed to becoming a landlord for them. I think holding on to the property would probably make them feel better. Luckily they downsized 5 years ago so their primary residence is a paid off condo, new appliances without a ton of crap. After taxes/HOA it could generate about $1000/month.

Famous last words, lol.

Haha. By that I meant “hiring a property manager”

[Anonymous]

Be very, very careful. We had two abysmal experiences with places in MoCo (The Seneca in Rockville and the Brightview in Bethesda.) The Seneca was worse. The care is awful; the "Doctor" attending is basically never there; do not use the in-house PCP; bring your own. The nurses and med techs are mostly terrible though there are a few good ones. The way they get you is with nice looking common areas, fancy looking menus, etc. but this is a trick. They are all owned by private equity companies who are trying to screw you. If you must, find one that is non-profit. This sounds weird, but the worse looking places are probably better. Do anything you can to keep them in their home and bring in care.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Plenty of places without entrance fees. Those places are a rip off.

If you have the money, they are not a rip off. If you enter a CCRC while healthy in IL, yes you pay more. But with the entrance fee and the extra, you are guaranteed "any advanced care" with no additional costs (except for the extra 2 meals per day typically). And in most of them, if one parent goes to "advanced care" (memory, assisted living, nursing, etc) the other gets to keep the same Ind Living apartment for no increase cost. For my parents, it would only take ~1 -1.5 years for each of them to be in "advanced care" to pay for itself.

In the meantime, my parents are enjoying life to the fullest, never have to worry about cooking or cleaning or fixing anything. And the key part---should you need "advanced care" there are always spots kept open for the CCRC residents, so it's not a search and pray process for finding the care when they need it. Also, I live 3K miles from them, so it's nice to know I can manage an emergency from a distance and they will be well taken care of. Also, the IL spouse can visit the other one daily as it's right there---they will never be in separate facilities where someone has to drive one to the other.

But in reality, if you have the money, this is what you have saved for. Why not spend it for a nice last 5-20+ years?

+1

A good CCRC will be expensive up front, but is a great option for those who qualify. My parents were in a similar place, my father was in assisted living, mom in independent living, but in the same unit. He eventually went to memory care and then passed away. As awful as that was, it was so much simpler than if they had been in a one-size-fits-all/month-by-month place or at their home. And likely would
have aged my mom even more.

Now, I have a sibling who is still upset about it, because they think it will cut into our inheritance, but they can die mad, since they also didn’t want to take care of our aging parents.

I also have a sibling who will be upset, does nothing to help (both are a distance, I'm much farther). I'm the POA and have all control, they are allowed to "get information about my parents/be informed" and that is it (parent's choice). Asked my parent's to inform the sibling that should there be anything left in the estate, after basic bills, I get paid back next with interest for the entrance fee I paid . Basically sibling likely won't get much if anything. The $400K+ I provided with interest is now over $450K. Realistically, I'm not even getting paid back fully.
But sibling was upset when told and will likely have "forgotten" and be upset when estate is settled.
We were happy to pay the fee and have them spend their hard earned money. I don't expect or need an inheritance. I'd rather they live their final years in comfort and happiness (and at a much nicer level than the rest of their lives were). Finally spending the money they worked so hard to save

We did a version of this and FIL put it in writing and reminded the siblings and their wives at a family dinner of the arrangement. Super awkward, but thankfully there was no way to misconstrue when FIL passed.

Sibling was informed and the estate lawyer put it all in the documents. But my sibling will still forget and be pissed when the time comes and they get little to nothing. Thankfully i am in charge and they will just be informed. Sibling has always thought they are entitled to a lot and expect others to pay for things for them.

Now I don't need to money back, sibling could really use it. But at this point, they do nothing have not seen parents is 10 years. So I will take what I am owed and use it for my family.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Plenty of places without entrance fees. Those places are a rip off.

If you have the money, they are not a rip off. If you enter a CCRC while healthy in IL, yes you pay more. But with the entrance fee and the extra, you are guaranteed "any advanced care" with no additional costs (except for the extra 2 meals per day typically). And in most of them, if one parent goes to "advanced care" (memory, assisted living, nursing, etc) the other gets to keep the same Ind Living apartment for no increase cost. For my parents, it would only take ~1 -1.5 years for each of them to be in "advanced care" to pay for itself.

In the meantime, my parents are enjoying life to the fullest, never have to worry about cooking or cleaning or fixing anything. And the key part---should you need "advanced care" there are always spots kept open for the CCRC residents, so it's not a search and pray process for finding the care when they need it. Also, I live 3K miles from them, so it's nice to know I can manage an emergency from a distance and they will be well taken care of. Also, the IL spouse can visit the other one daily as it's right there---they will never be in separate facilities where someone has to drive one to the other.

But in reality, if you have the money, this is what you have saved for. Why not spend it for a nice last 5-20+ years?

Can you give an example or name of a place like this? After a sobering holiday visit, I think my parents should go somewhere like this and it’s all overwhelming to me right now.

My parents are in a CCRC but should they need assisted living or skilled nursing the costs go up significantly. Just mentioning because they all have different funding structures. Many people seem to stay in IL as long as they can with private care givers.

Yes it differs at all ccrcs. My parents found one that the entry fee and slightly higher monthly costs means no increase for advanced care (sans the extra 2 meals). So one can be in advanced care and the other can keep the 2bedroom IL all for the $7-8k per month they currently pay. Only extra cost is 2 meals per day for the AC person. And if they both end up in advanced care they give up the ail place and pay for two extra meals for each of them and that's that. So right now AC for both would only cost $9k per month total. Hence why we did it. It will take only 18 months of One in AC for the entry fee to be worth it. Even less if both go to ac

[Anonymous]

Anonymous wrote:Be very, very careful. We had two abysmal experiences with places in MoCo (The Seneca in Rockville and the Brightview in Bethesda.) The Seneca was worse. The care is awful; the "Doctor" attending is basically never there; do not use the in-house PCP; bring your own. The nurses and med techs are mostly terrible though there are a few good ones. The way they get you is with nice looking common areas, fancy looking menus, etc. but this is a trick. They are all owned by private equity companies who are trying to screw you. If you must, find one that is non-profit. This sounds weird, but the worse looking places are probably better. Do anything you can to keep them in their home and bring in care.

Definately find a non profit. And one with a history. My parents are in one with over 100 years experience. And at least 30+ as a full CcRC

[Anonymous]

Anonymous wrote:

Anonymous wrote:Be very, very careful. We had two abysmal experiences with places in MoCo (The Seneca in Rockville and the Brightview in Bethesda.) The Seneca was worse. The care is awful; the "Doctor" attending is basically never there; do not use the in-house PCP; bring your own. The nurses and med techs are mostly terrible though there are a few good ones. The way they get you is with nice looking common areas, fancy looking menus, etc. but this is a trick. They are all owned by private equity companies who are trying to screw you. If you must, find one that is non-profit. This sounds weird, but the worse looking places are probably better. Do anything you can to keep them in their home and bring in care.

Definately find a non profit. And one with a history. My parents are in one with over 100 years experience. And at least 30+ as a full CcRC

What’s the name of the place?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Plenty of places without entrance fees. Those places are a rip off.

If you have the money, they are not a rip off. If you enter a CCRC while healthy in IL, yes you pay more. But with the entrance fee and the extra, you are guaranteed "any advanced care" with no additional costs (except for the extra 2 meals per day typically). And in most of them, if one parent goes to "advanced care" (memory, assisted living, nursing, etc) the other gets to keep the same Ind Living apartment for no increase cost. For my parents, it would only take ~1 -1.5 years for each of them to be in "advanced care" to pay for itself.

In the meantime, my parents are enjoying life to the fullest, never have to worry about cooking or cleaning or fixing anything. And the key part---should you need "advanced care" there are always spots kept open for the CCRC residents, so it's not a search and pray process for finding the care when they need it. Also, I live 3K miles from them, so it's nice to know I can manage an emergency from a distance and they will be well taken care of. Also, the IL spouse can visit the other one daily as it's right there---they will never be in separate facilities where someone has to drive one to the other.

But in reality, if you have the money, this is what you have saved for. Why not spend it for a nice last 5-20+ years?

+1

A good CCRC will be expensive up front, but is a great option for those who qualify. My parents were in a similar place, my father was in assisted living, mom in independent living, but in the same unit. He eventually went to memory care and then passed away. As awful as that was, it was so much simpler than if they had been in a one-size-fits-all/month-by-month place or at their home. And likely would
have aged my mom even more.

Now, I have a sibling who is still upset about it, because they think it will cut into our inheritance, but they can die mad, since they also didn’t want to take care of our aging parents.

I also have a sibling who will be upset, does nothing to help (both are a distance, I'm much farther). I'm the POA and have all control, they are allowed to "get information about my parents/be informed" and that is it (parent's choice). Asked my parent's to inform the sibling that should there be anything left in the estate, after basic bills, I get paid back next with interest for the entrance fee I paid . Basically sibling likely won't get much if anything. The $400K+ I provided with interest is now over $450K. Realistically, I'm not even getting paid back fully.
But sibling was upset when told and will likely have "forgotten" and be upset when estate is settled.
We were happy to pay the fee and have them spend their hard earned money. I don't expect or need an inheritance. I'd rather they live their final years in comfort and happiness (and at a much nicer level than the rest of their lives were). Finally spending the money they worked so hard to save

We did a version of this and FIL put it in writing and reminded the siblings and their wives at a family dinner of the arrangement. Super awkward, but thankfully there was no way to misconstrue when FIL passed.

This should be in the will or there will be no way to enforce this.

I'm the PP. It was written into the trust documents.