There were many variations in pricing structure among the ALFs nationwide. Some ALFs had a single monthly price for what they defined as basic services and accommodations. Other ALFs had multiple rates, varying with either the type of accommodation or the service package provided to the resident.
The most common monthly price was between $1000 and $1999 for both facilities with a single rate (i.e., 45 percent were in this range) and for facilities with multiple rates (i.e., the range covered the most common rate for 52 percent of the ALFs). Thus, the most common basic price was between $12,000 and $24,000 per year. However, it is important to note that the average price was depressed by the presence of a very large number of ALFs (59 percent) that offered minimal or low privacy and services. The most common base price for facilities that offered multiple rates was just over $22,000 per year for the high service/low privacy ALFs and $23,000 for the high service/high privacy ALFs. For the high privacy/low service ALFs, the most common basic annual rate was slightly more than $22,000 when one combines single rate and multiple rate facilities.
These rates are striking for two reasons. First, in many ALFs, they do not cover all services. Residents often pay extra for such services as medication administration, transportation, and any assistance with ADLs or nursing care above the minimum covered by the basic rate of a facility.
Second, the rates are largely out of reach for most low-income older persons and unaffordable for many moderate-income elderly unless they are supplementing their income with additional funds generated by disposal of their assets. According to data from the U.S. Bureau of the Census,11 40 percent of persons aged 75 and older had incomes in 1997 of less than $10,000 per year. Eighty-four percent of persons aged 75 and older had incomes of less than $25,000 per year in 1997. This would make the average high service ALF or the average high privacy ALF unaffordable for the vast majority of older persons, particularly since they must also pay for other basic needs (e.g., supplemental insurance, out-of-pocket spending on health care and medications, clothing).12