Occupancy levels are at a record low, according to Mark Parkinson, the chief executive of the American Health Care Association and National Center for Assisted Living, the largest industry trade group, representing about 4,000 centers. “Revenue is at record lows, and expenses are at record highs,” Mr. Parkinson said, adding that the industry, unlike other heath care sectors, received federal assistance only in September.
Most residents at assisted living facilities pay out of pocket, since federal programs like Medicare typically don’t cover the stays. Unburdened by federal oversight or existing insurance contracts, assisted living facilities have wide latitude to charge residents a variety of fees. Some have raised rents, while others have charged residents to cover rising cleaning costs and masks.
“There is a real desire to not have to pass on any of these costs,” Mr. Parkinson said.
Still, in more than a dozen states, ombudsmen, who advocate on behalf of residents in long-term care facilities, said in interviews they worried such fees were only a fraction of what’s being tacked into bills and slipped into monthly rent statements. With nursing homes and assisted living facilities restricting visitors, there is less scrutiny of their practices. And some residents may assume that the cost is theirs to bear.
Mr. Hambley, whose mother faced the $900 charge at her assisted living facility in Portage, Mich., had a particular reason to be skeptical: He works in the industry, running a continuous care facility in another state.
Some of the extra charges, including an $11 daily lunch fee, stood out, especially because his mother had been complaining about the quality of lunches since the start of the pandemic. “It seemed like this was an opportunity to take advantage of a population that is already vulnerable,” Mr. Hambley said. “They have no visits, no engagement. And on top of that they are scared.”
After Mr. Hambley complained to state regulators, the facility rescinded the fee. He asked that the place not be named because his mother still resides there, and he did not want to affect the quality of her care.
The charges may soon be coming to more doctor’s offices. Last month, the American Medical Association lobbied Medicare to begin paying for a new billing code that covers increased protective costs.