A Planning Worksheet for a Move to Assisted Living

In this article

1. Number one, what comes in every month
2. Number two, what the community charges every month
3. Number three, the gap
4. Number four, how long the gap is covered
5. What this worksheet will get wrong, including ours
6. The calls to make, in this order
7. When the runway is short
8. Keep it on paper

A workable assisted living budget is four numbers, not a spreadsheet: what comes in every month, what the community charges every month, the gap between them, and how many months of savings will cover that gap. Divide the savings by the gap and you have the answer families actually want, which is how long this lasts.

Most planning advice skips straight to programs and benefits. Do the arithmetic first. The number it produces decides which programs matter, and it takes about twenty minutes at a kitchen table with a bank statement and a pen.

Number one, what comes in every month

Write down every payment that arrives whether or not your parent moves. Social Security. A pension. An annuity. Required withdrawals from a retirement account. Rent from a property. Interest and dividends, but only the part actually paid out.

Add the ones that start only after a move. A veteran or a surviving spouse who needs help with daily activities may qualify for an added VA pension called Aid and Attendance. A long term care policy pays a daily or monthly benefit once its conditions are met. Neither is instant, so put them on the sheet with a start month rather than counting them from day one.

Leave out the house until it sells. A home you intend to sell is not income, it is the savings line further down, and only for what it clears after the mortgage, the agent, and the repairs.

Number two, what the community charges every month

Ask for the rate in writing for the room you would actually choose, not the lowest advertised one. Then ask what is not in it. Our own starting rates are published, so you can begin the worksheet before you call anybody.

Add anything the community charges separately: a one time community fee, a medication management charge, incontinence supplies, salon visits, transport to appointments outside the standard schedule. Add the costs that follow your parent regardless: Medicare premiums, supplement and drug plan premiums, copays, dental, and a small monthly allowance for clothing and haircuts.

Then subtract what stops. A family running this worksheet for the first time usually forgets this half and frightens itself. The mortgage or rent, property tax and insurance, utilities, groceries, home maintenance, a yard service, and often a car and its insurance all fall away or shrink. In many households that side alone covers a third of the new number.

Number three, the gap

Income minus cost. If it is positive, the monthly math works and the worksheet is mostly a record. If it is negative, that figure is the gap, and it is the only number the rest of the plan turns on.

Number four, how long the gap is covered

Total the savings that can be spent on care: bank accounts, brokerage accounts, retirement accounts after tax, cash value in a life insurance policy, and the net proceeds if the house sells. Divide that total by the monthly gap.

That quotient is your runway in months. Take one year off it before you trust it. Rates rise, care needs grow, and a surgery or a hospital stay arrives without warning.

What this worksheet will get wrong, including ours

A published starting price is a floor, not a quote. Assisted living rates move with how much daily help a resident needs, and that is settled by a nurse assessment, not by the page you read it on. A family who builds a worksheet on a starting rate and finds their parent needs two people for every transfer will be over budget in month one, and the community that published the number is the one that looks wrong. So run the worksheet twice, once on the starting rate and once on a figure a third higher, and plan against the second.

The other thing it gets wrong is the ending. Savings rarely run to zero. Florida Medicaid can pick up the care services in assisted living for those who qualify, though it does not cover room and board, and the application takes time. The runway you calculated is really the runway to an application deadline.

The calls to make, in this order

Work down this table. Each call settles one line of the worksheet, and doing them out of order wastes weeks.

Step six is not a formality. A community decides for itself whether to accept Medicaid, so a family can be approved and still find nothing open nearby. Both of our communities accept it, and even then the room that is available on the day you need it may not be the one you toured. Ask every community on your list the same question, and ask whether there is a wait.

When the runway is short

Under about two years, apply for everything now. Eligibility rules look back at money that moved, applications take months, and a family that waits until the account is nearly empty spends that wait paying privately. Our guide on what to do when the money will not stretch walks through the options in order, and the page on assisted living that accepts Medicaid in Citrus County covers how that works locally.

Over five years, the worksheet is a yearly check rather than a plan. Redo it every January with the new rate and the new Social Security amount, and keep the old sheets. Three years of them show a trend, which is worth more than any single calculation.

Keep it on paper

Copy the four headings onto one sheet: what comes in, what goes out, the gap, the months covered. Bring it to every tour and fill the second column in while you are standing there. A family with that sheet asks better questions than a family with a folder of brochures, and the administrator can give you a straight answer in ten minutes instead of a call back.

If you want the cost questions to ask on a tour, our Citrus County assisted living cost guide is a printable one pager. Or send us the four numbers and we will tell you honestly whether we are in your range before you drive out.

Frequently asked questions

How do I work out if we can afford assisted living?

Write down four numbers: what comes in every month, what the community charges every month, the gap between them, and the savings available to cover that gap. Savings divided by the monthly gap is how many months the plan lasts. Subtract a year from that figure before you rely on it.

What should I include in an assisted living budget?

On the income side, Social Security, a pension, annuity payments, retirement withdrawals, and any VA or insurance benefit that starts after a move. On the cost side, the room rate plus anything charged separately, Medicare and drug plan premiums, copays, and a small personal allowance. Then subtract the household costs that stop, which is the half most families forget.

How long will my parent's savings last in assisted living?

Divide the savings that can be spent on care by the monthly gap between income and cost. That is the runway in months. Take a year off it, because rates rise and care needs grow, and treat the result as a deadline for applying for help rather than the day the money ends.

Can a community raise the rate after we move in?

Yes, and Florida Statute 429.24 requires at least 30 days written notice before it takes effect. The same law requires the unused portion of what was paid to be refunded within 45 days if a resident moves out or dies. Ask to see both provisions in the residency agreement before signing.

Is the starting price the price we will pay?

For assisted living it is a floor. The real rate depends on how much daily help a resident needs, which a nurse assesses before move in. Build the worksheet on a figure about a third above the starting rate so a higher assessment does not break the plan. Memory care is a set rate at both of our communities.

Sources

• Florida Statute 429.24: assisted living residency agreements, rate increase notice and refunds
• VA: Aid and Attendance benefits and Housebound allowance
• Florida Agency for Health Care Administration: Medicaid long term care program
• Florida Department of Elder Affairs: Elder Helpline and long term care programs
• Florida Department of Financial Services: long term care insurance questions

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Written by

Cameron Hernando Clark

Community Relations Director

Cameron Hernando Clark is the Community Relations Director for The Manors of Citrus. He writes this family guide to help Citrus County families make sense of assisted living and memory care, drawing on the day to day of running two family owned communities on Florida's Nature Coast.