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Report on Selected
Non-Subsidized
Assisted Living
Facilities for Seniors
in Edmonton, Alberta
-costs and
considerations
Prepared by:
Society for the Retired and Semi-Retired
Advocacy Committee
June 2004
1
Contents
Page
Executive Summary
3
Background/Project Development
4
Findings/Discussion
5
Summary
6
Appendices
Appendix 1 - Questionnaire
Appendix 2 - Sample Cases
2
Executive Summary
The purpose of the project was to examine basic and additional costs and
services offered relating to nonsubsidized assisted living facilities in Edmonton,
Alberta. The Advocacy Committee of the Society for the Retired and Semi-
Retired, in collaboration with the Society's Housing staff, initiated the project to
determine information gaps related to housing services along with costs to the
consumer. The project targeted a small, but rapidly growing, segment of housing
options available to the middle income group.
The Advocacy Committee with input from the Society's Housing Program staff
planned the project and visited six facilities operated by three different
companies and which represented a middle price range.
Highlights of findings:
1 Basic costs differ in types of services offered.
2 Actual costs are difficult to interpret as considerable variance is evident
depending on individual needs and the offerings of a specific facility.
3 Costs appear to exceed the incomes of lower middle and low income
groups.
It is suggested that individuals who choose non-subsidized assisted living must
be aware of appropriate questions to ask when considering assisted living
facilities. To assist our clients, the questionnaire used for the survey has been
modified for use by the Housing Program at the Society and is available to other
individuals and groups.
Non-subsidized assisted living is a vibrant growth industry and a thriving
business. It is a growing industry in keeping with the increasing population of
seniors across Canada and USA. The Society for the Retired and Semi-Retired
plays a role in assisting seniors to identify their individual needs along with
expected costs. Seniors are encouraged to be cognizant of actual and potential
costs involved when selecting the non-subsidized assisted living option.
The main purpose of the project was twofold: to add to available information for
the Society's Housing program, and to offer a wider distribution of our findings to
individuals and agencies to help them be more aware of seniors' needs for
affordable housing.
Recommendations of the report address: tools and information from the project
for on-going use by housing program, on-going monitoring of issues related to
non-subsidized housing, and dissemination of the information in the report to
decision makers involved with seniors' housing.
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Background
In March, 2003, Consumers' Association of Canada Consultant Wendy
Armstrong, presented the paper, "Eldercare on the Auction Block" to the
Advocacy Committee and Housing Staff of the Society. The report described the
Alberta environment for various levels of housing facilities while noting how the
reduction in public care facilities for the elderly in the past decade has
encouraged the growth of a private unregulated "assisted living" industry. In
many cases these facilities provide a less institutional type care, but with
significantly increased cost. This increase has been integrated and is confounded
by hidden costs and by "unbundling" of services, that is, the previous
arrangements of all-inclusive costs have gradually been eliminated. For example,
meals, laundry, recreation, administration of medicine, escort to meals, etc., may
be priced and charged separately from the advertised monthly costs. Further,
our Housing Program staff reported that costs, although listed in the facilities'
printed materials, were increasingly unclear and difficult to identify and interpret
for clients and their families.
Project Development
The Board of the Society endorsed the Advocacy Committee's plan to investigate
the situation in Edmonton. For this review a questionnaire was compiled and
drafted with the assistance of the Society's Housing Program staff. It was
modified from a questionnaire developed by the University of Alberta Association
of Professors Emeriti, Seniors Issues Interest Group, M. Engelmann.
For gathering information it was decided that Advocacy Committee members
would visit up to eight selected non- subsidized assisted living residences in
Edmonton representative of mid-price range facilities. The costs of the different
facilities are reported with basic costs along with prices of extra services
available. The purpose is to increase awareness and knowledge of actual costs
when seniors are considering assisted living as a housing option.
The questionnaire used for the survey is intended for use by housing staff to
assist clients who are seeking housing in the assisted living area of care. It is
also available to other interested individuals and groups (See Appendix 1). A
distinction must be made between the private care available and the relatively
few suites in these facilities which provide additional supportive and nursing care
funded in part or in full through the public health system. The sample cases
provided in this report refer only to the costs associated with private care, not to
services covered by the public health system. Also they represent short-term
episodic health problems, such as a sprained ankle, and not long term chronic
conditions.
Findings
Sample cases are developed to illustrate differing needs of individuals and the
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variation in cost between facilities. (See Appendix 2).
Detailed costs of each facility visited in the region varied from $1190 to $2500
per month for basic living expenses. Costs for various additional services are
considerable (See SRSR Housing Guide, 2004/05).
Discussion
Standard Costs Exceed Financial Capacity of Many Seniors
The current maximum old age security pension is $463 (the average amount paid
is about $20 less) while the Guaranteed Income Supplement is $550 for a total of
$1,013 per month, according to the tables provided on the Human Resources
Development Canada (Government of Canada) website. Consequently,
without benefits from the Canada Pension Plan (CPP) or some other pension, a
single person would fall short of having the minimum income necessary for all of
the eight facilities visited. The lowest basic cost with no additional services was
$1190 per month. Even with full CPP, a single person would have less than
$1,800 month. This would leave a small amount for any additional costs such as
health care charges. Moreover, Statistics Canada data indicates that 60% of
Alberta seniors had total incomes of less than $20,000 ($1,666 a month).
Approximately 60% of these are female (Source: Statistics Canada, Small Area
and Administrative Data Division). In Edmonton, 18% of seniors (aged 65+), or
16,435 in 2000, had after-tax annual incomes below the low income cut-off of
$15,907 for an individual or $19,410 for a couple (Edmonton Social Plan:
Edition 4, 2003, Edmonton Community Services, 2000 data.
www.edmonton.ca/socialplan).
Advantages of private non- subsidized assisted living facilities are that they offer
pleasant surroundings and opportunities for a variety of activities and
socialization. Assistance is available for health and mobility problems. Some
individuals may benefit from facility living which promotes a safe and healthy
environment including regular meals. Prevention of injury may be enhanced
with supervision in such facilities. The facilities afford increased opportunity for
social connections and availability of help for episodic illnesses. While the cost
may be beyond the reach of the majority of older persons in low and middle
income segments, many seniors may have equity in their own homes. Seniors
who sell their homes at current retail prices may have added income. If used
wisely it may afford them an income higher than basic pension amounts.
Disadvantages are the basic costs and added services not included in basic
costs which can be substantial, even for a short period. This includes regular
annual rent increases up to 5% a year in some cases. These factors must be
clearly understood by seniors wishing to investigate the private facilities.
Several recent reports in Alberta have addressed the lack of affordable housing
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for low and lower middle income seniors. The Government of Alberta Report,
Alberta for all Ages: Directions for the Future, Impact of Aging Population
Study 2000 www.gov.ab.ca/mcd/seniors/impactaging/media.htm
includes the following recommendations for seniors' housing;
"Ensuring safe, affordable and appropriate housing choices. Housing
and the availability of safe, affordable and appropriate housing choices, is a
major issue of concern to seniors today. As Alberta's population ages and
expectations change, it will be important to address a range of housing needs on
an ongoing basis." http://www.gov.ab.ca/acn/200006/9268.html
Summary
The non-subsidized assisted living facilities vary in the services offered in the
basic cost. Added service costs are difficult to determine within each facility and
can be significant as presented in the sample cases cited in Appendix 2. The
facilities visited by members of the Advocacy Committee appear to target the
higher middle income group. On-going monitoring of the progression of the
private non-subsidized seniors' housing industry is recommended for the Society
for the Retired and Semi-Retired and others concerned with affordable housing
for seniors.
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`
Appendix 1
SENIORS' NON-SUBSIDIZED ASSISTED LIVING RESIDENCES
INFORMATION CHECK LIST
Name of Facility
Manager's Name
Address
Phone:
Fax:
E-Mail Address:
Web Address:
Pre-admission requirements:
Application Form
Deposit
Amount:
Medical Form
BUILDING
Who owns the building?
Year built:
Name of Organization that manages the building?
Location of Facility Office:
Office hours:
Minimum age for residents:
Average age of residents:
Elevators: Number
Capacity
Location
Number of Floors:
Stairs(location & width:
Number of units:
Number occupied:
Smoking:
Permitted
If permitted, where?
Not Permitted
Rental increases:
Dates of last increases
Amounts and %
Date of next increase
Amount and %
Amount of notice usually given
7
Length of contract: Month to Month
Annual
Other (specify)
Amount of notice required when vacating unit
Penalty for ending contract early
Rental arrangement and charge if resident changes to another unit
Parking:
Yes
No
surface uncovered
Extra cost? $
surface covered
Extra cost? $
plug in
Extra cost? $
underground,
Extra cost? $
APARTMENTS/UNITS
Loft
Studio
1 Bedroom
2 bedroom
and
Others
Number of
suites
Number
Barrier Free
Square Feet
Or
Square
Metres
Damage
Deposit
Rent or
Condo Fees
Ask for a Brochure showing floor plans
8
Utilities:
Included in rent
Not Included in rent
$
Cable:
Included in rent
Not Included in rent
$
High Speed Internet available?
Yes No
If Yes
DSL(phone) or
Cable
Laundry:
Included in rent
Not Included in rent
$
Location of laundry area:
Other Occupancy Costs: item
$
Item
$
Appliances included in base cost:
Refrigerator Stove/Oven
Dishwasher Microwave
Washer
Dryer
Appliances available at extra cost:
Refrigerator $
Stove/Oven $
Dishwasher $
Microwave $
Washer
$
Dryer
$
Other
$
Kitchen (open design, type of counter tops, etc.)
Number of Bathrooms:
Bathroom 1: Shower Tub Neither
Bathroom 2: Shower Tub Neither
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Fireplace
Yes
No
Balcony
Yes
No
Type of flooring in suite:
Entrance
(Carpet, tile, hardwood, linoleum)
Hallway
Livingroom
Bedroom(s)
Bathroom(s)
Wheelchair/Walker Accessible Suites:
Bathroom
Yes
No
Kitchen
Yes
No
Other (e.g. Ramps) Specify
Safety features: Grab bars
Yes
No
Cost $
Grab Bar Installation
Yes
No
Cost $
Emergency call system
Yes
No
Cost $
Other:
Cost $
AMENITIES WITHIN BUILDING
Amenities on site:
Beauty parlour/barber shop
Chapel
Computer, internet and e-mail facilities in complex
Convenience store
Exercise room
Games room
Gardening
Guest Suite with bathroom
Cost of Guest Suite:
$
10
Maximum length of stay:
Limitations? (young children, pets)
Library
Mail drop
Amenities on site:
Parking for guests
(continued)
Where:
Costs: $
Piano in complex
Allowed in suite?
Pool
Sauna
TV room
Whirlpool
Workshop
Other
PETS
Are Pets permitted?
Yes
No
Dogs?
Yes No
Number permitted:
Cats?
Yes No
Number permitted:
Birds?
Yes No
Number permitted:
Others?
Yes No
Specify:
Is there an additional charge for pets?
Yes No
$
Any limitations?
FOOD
Dietician available on site?
Yes
No
Dining room:
One
More than one
Private dining room for special occasions
Cafeteria:
Yes
No
Sample meal before moving in?
Yes
No
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Meals: Included in Rent?
Yes Number of meals per day included
No
Minimum required to purchase per month:
Breakfasts:
at $
Lunches:
at $
Dinners:
at $
Number of sittings at main meal:
Number of entrees offered at main meal:
Meal service to room when necessary? Yes
No
Cost $
What is the policy for paying for meals during prolonged absences (adjustment,
refund)?
Will special diets be accommodated (diabetic, kosher, vegetarian, ethnic)
Yes No
If Yes, what diets?
What is the usual charge for guests?
Lunch
$
Dinner
$
Will guests' special diets be accommodated?
Yes No
SERVICES
Cleaning of Apartment:
Frequency
per
Cost
$
Recycling Facilities?
Yes
No
If Yes, where?
Garbage Disposal on each floor? Yes
No
Laundry Service:
Change Linen
Frequency
per
Cost $
12
On-Site Banking Services
Yes No
How often?
Dry cleaning pick up and delivery
Yes No
How often?
Additional services:
Portering to meals
Yes No
Cost $
Other (specify)
Cost $
HEALTH CARE
Is there a health office?
Yes No
If Yes, where?
Is there 24 hour on-site emergency response service?
Yes No
Is there an RN on call 24 hours? Yes No
Who arranges Home Care?
On-site health professional
Resident
Number of Professional Staff :
RNs
LPNs
PCAs
Recreation Therapists
Other (specify)
Doctor available on site?
Yes No
Frequency of Visits:
Dentist available on site?
Yes No
Frequency of Visits:
Podiatrist (foot care)?
Yes No
Frequency of Visits:
What health services are offered?
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Service
Cost
(per hour/day/week/month/event?)
Provision of medications
$
per
Bathing
$
per
Feeding
$
per
Dressing
$
per
Other
$
per
$
per
$
per
$
per
Is there a charge for calling an ambulance?
Yes No Cost $
If health deteriorates, how is the decision made for re-location?
Connection with Health Authority (Home Care)?
TRANSPORTATION
How close is the nearest bus stop?
How close is the LRT?
Transportation to:
Doctor:
Yes No Cost $
Dentist:
Yes No Cost $
Other medical appointments
Yes No Cost $
Shopping
Yes No Cost $
Private van service to other destinations within Edmonton?
Frequency
14
Destinations
Restrictions
Cost
RESIDENT PARTICIPATION
Is there a Resident Council?
Yes No
If Yes, what is it responsible for?
Are there organized social activities that take place in the building? Yes No
If Yes, how frequently?
Is there a charge for participation?
Yes No
Cost $
Are there organized outings (theatre, restaurants, etc)?
Yes No
If Yes, is transportation provided?
Yes No
Cost?
Is there a Program Coordinator/Recreation Therapist?
Yes No
Qualifications:
Hours per week:
SECURITY
Daily checks on clients?
Yes No
By whom?__________________
Type of door locks in units? (Key, number pad, electronic card)
Is there video surveillance in the lobby?
Yes No
Can the resident view who is at the front door on their TV?
Yes No
Is there security staff / concierge on site?
Yes No
Number of hours per day:
How often are Fire Drills held?
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GENERAL IMPRESSIONS
Type of neighbourhood (residential, business etc.)
Overall outside appearance and environment (attractiveness, quietness, etc):
Appearance and upkeep of lobby, halls, etc
Social Atmosphere (friendliness of staff, other residents, etc):
Adapted from: Checklist for Seniors' Residences, M. Engelmann. Seniors' Issues Interest
Group, Association of Professors Emeriti, University of Alberta, April/01. Revised,
October, 2004 and January, 2005
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Appendix 2 - Sample cases
Facility A.
Costs Incurred
(Based on facility's Published Rental & Other Charges, January 2004)
Sample Case A1: Independent resident in a one-bedroom unit who receives
breakfast and an evening meal in the dining room. (The two-meal a day plan,
with one snack, is the basic option offered by Facility A).
Facility A-1
Total Monthly Cost
1 Bedroom for Independent Resident, 2 meals per day
Monthly rental
$ 1,545.00
Telephone
$ 23.45
Additional charges
Basic laundry
$ 10.00
Security System
$ 19.95
Mid range cable/internet Shaw
$ 81.27
Total additional costs
$ 111.22 $ 111.22
Total Cost
$ 1,679.67
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Case A2: One-bedroom unit for a resident, who requires 3 meals per day, twice-
weekly transport to meals and one-meal per week within the suite. Other services
include a personal care attendant for 1-hour per day; housekeeping service of
two hours per week, and laundry service, covering two loads per week. Provision
is made for two trips by taxi each week to medical appointments (round trip $25).
Note, the cost of assisted transport to meals assumes one-round trip takes 20
minutes at an hourly rate of $17.50.
Facility A-2
Total Monthly Cost
1 Bedroom, 3 meals per day, assistance
Monthly rental
$ 1,545.00
Telephone
$ 23.45
Additional charges
Laundry Service
$ 60.00
Housekeeping
$ 120.00
Personnel care/ 1hrs per day
$ 525.00
Security System
$ 19.95
Mid range cable/internet Shaw
$ 81.27
Lunch service for 1
$ 120.00
Portering to meals 2X/ wk
$ 46.67
1 meal per week delivery chg
$ 8.00
Return taxi to medical/2X per wk $ 200.00
Total additional
$ 1,180.89 $ 1,180.89
Total Cost
$ 2,749.34
Note-Case Comparison A comparison of Cases 1 & 2, indicate that an
individual tenant suffering episodic illness/injury, could face monthly cost
increases of approximately 64% to cover such additional items as additional
meals, occasional portering to meals, occasional meal delivery, one-hour of
personal care per day, laundry and cleaning service and twice-weekly trips to
medical appointments.
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Facility B
Sample Case B1
Costs for 1 bedroom suite for resident who requires evening meal only, access to
personal laundry, housekeeping and enjoys trips to shopping centre or other
activities.
All services included in base rent = $1190/mo
Sample Case B2
Resident in one bedroom suite, requires three meals, occasional assistance to
meals and delivery of trays to suite, personal care attendant, housekeeping,
assistance with laundry.*
Facility B-2
$ per Month
Rental one bedroom - smallest size
1,190.00
Additional charges
Requires breakfast
175.00
Meal service to room
(8 times per month)
8.00
Transport to meals
(twice weekly @ $5.00)
40.00
Other costs - assistance with
housekeeping, laundry, bathing
approximate monthly cost
350.00
Total additional charges
573.00 573.00
Total living costs
1,763.00
Note - Case Comparison- * Increase of approximately $600.00 $700.00/mo
(50-60% increase) with additional costs which do not include home care or
transport to appointments.
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Facility C
Sample Case C1
Suite and basic services only.
1 Bedroom Suite (590 sq. ft.)
$1400.00
Evening meal provided with rent
n/c
Washing machines on each floor
n/c
Scheduled housekeeping service
n/c
Scheduled transportation to grocery
n/c
stores
Total living costs
$1400.00
Sample Case C2
Extra services required*
1 Bedroom Suite (590 sq. ft.)
$1400.00
Requires three meals per day
Breakfast
$100.00
Lunch
$135.00
Evening meal
n/c
Assistance: escort to meals
$3.00 each way, 2X per
$48.00
week
Personal care services
Personal care aide:
$18.00/hr.
$270.00
1/2hr.X30 days
$60.00
Bathing per month
Light housekeeping
$125.00
Weekly personal laundry
1 load per week
$100.00
Taxi service for appointments
3X per week $10.00 per
$240.00
way
Total living costs
$2490.00
Note- Case Comparison- *The total monthly living costs represent a 56%
increase over the base rent of $1400.
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