Know the REAL cost.
Before you sign.

The right place, named, with the reason. Real monthly cost on each. A written recommendation, plus two 20–minute calls.

Three business days from your intake call. Fits inside a discharge clock.

Some only quote on a tour. We'll call you and offer one comparable backup nearby, so you still end up with three verified prices.

No. Assisted living, memory care, nursing homes, home health. If you have a list, you can use this.

Naomi. She started Palmelle after going through it herself — the calls, the conflicting prices, the wrong placement before the right one.

The national average is about $5,830 a month, and the usual range runs $4,000 to $8,000 depending on the state, the apartment and the level of care. The District of Columbia is highest at roughly $7,956; Louisiana is lowest at about $4,429. That average is the all–in figure, not the room–and–board number a community quotes you on the phone.

A one–time charge due before your parent moves in, similar in spirit to a deposit but usually non–refundable. The national median is $3,000, and it typically runs $1,000 to $5,000. It is separate from the monthly rent and it is the single largest one–time cost in the move. Ask about it before you tour, not after.

It is the charge for personal care, on top of rent. A nurse assesses your parent's activities of daily living — bathing, dressing, toileting, eating, grooming, transferring, mobility — and assigns points based on how often help is needed and how much. Points map to a tier; most communities run three to five tiers, and the monthly surcharge commonly falls between $300 and $2,500.

The number nobody publishes is what a single point costs. Documented rates run roughly $12 to $25 per point, so two communities can score your parent identically and bill very differently. Charging by need is fair — a resident who needs less should not subsidise one who needs more — but you cannot compare two quotes without knowing each community's rate.

Usually because the quote was priced off what the family described, and the community runs its own assessment after the agreement is signed. Families routinely underestimate: they say a parent manages their own medication, or that mobility is fine, and the assessment finds otherwise. The care tier lands higher and the monthly figure moves with it. This is not a bait and switch — it is the gap between stated ability and actual ability, and almost nobody researches it before moving in.

Yes. Most communities reassess every few months, or after any significant change in condition — a fall, a hospital stay, a new prescription. A higher score means a higher tier and a higher monthly bill. It can move the other way too: some communities do not reassess for a year, which means a resident whose needs have decreased may be overpaying. Ask how often they reassess and whether you can request one.

Typically $300 to $800 a month, scaled to complexity — a single daily pill costs far less than three–times–daily administration. In many communities it is also scored inside the care points rather than billed as its own line, so ask which it is before you add it to your own math twice.

Sometimes. Some communities fold scheduled medical transport into the monthly fee; others bill per trip or per mile at roughly $25 to $75 each way, with wheelchair and stretcher transport costing more. Ask about the schedule and the service radius as well as the price — a community that only runs Tuesdays is a different proposition to one that will take your parent when the appointment actually is.

Yes, and by more than general inflation. Increases in 2026 have run about 4% to 6% across the industry, with some datasets covering thousands of properties reporting 6.8% to 8.5%. The pre–pandemic norm was closer to 3–3.5%. When you budget, model the increase — a $6,000 monthly cost at 5% is roughly $6,300 in year two and $6,615 in year three.

Usually. A second–person fee has a national median of about $1,200 a month on top of the apartment rate, and each person may be assessed for their own level of care separately.

No. Original Medicare (Parts A and B) does not pay for room and board or personal care in an assisted living community, and neither Medicare Advantage nor Medigap covers the room–and–board portion in any state.

Medicaid is different but limited: 47 states and Washington, D.C. cover some assisted living care services through Home and Community–Based Services waivers — personal care, medication management, health monitoring. Federal law bars Medicaid from paying room and board anywhere, so families remain responsible for that portion. Most families pay out of pocket, through long–term care insurance, or via a state HCBS waiver.

Six that get you most of the way there: What is the community or move–in fee, and is any of it refundable? How do you score level of care, and what does a point cost? Which tier would my parent land in, and what would move them up one? How often do you reassess? What is billed separately — medication, transport, laundry, incontinence supplies? And what was your rate increase last year?

Most placement services are free to families. Palmelle charges $199 and does a different job: we call your three communities and pull out the full cost structure, and we read the public record on each one — every federal health inspection, deficiency and fine, registered nurse hours and staff turnover. We also run checks a listing site does not, such as flagging a community whose star rating is higher than its own inspection results support, or federal fines sitting underneath a good overall score.

Your advisor checks this is the right service for where you are. If it isn't, you'll know what to do instead.