What Care Costs in Long Beach, and Why We Will Not Quote an Average

Long Beach is two markets wearing one name

The state licenses 38 homes in this city for six residents or fewer and 11 for twenty five or more. Those are not two price points on one scale. They are two different products with two different pricing models, and the cheaper one is not always the small one.

A house of six sells you a person. A community of two hundred sells you a building plus a person. Which is better value depends entirely on how much of the building your mother will actually use. If she will be at every exercise class and every trip to the market, the big place is good value. If she is going to stay in her room, you are paying rent on a dining room she will not eat in.

How a small home builds its number

Usually one monthly rate, all in. A shared room is cheaper than a private one, often by a lot, and in a house of six a shared room is a real option rather than an embarrassment. Some homes then add a care charge once they have assessed your father, and that is the part to pin down.

Ask what the rate includes. Specifically: incontinence supplies, laundry, medication assistance, a hospital bed if he needs one, transport to dialysis or infusion, and whether a family member has to come to every doctor's appointment. Ask what happens to the rate if he declines. Ask what happens to it in January, because a rate that goes up every year is normal and a rate that goes up without notice is not.

Many small homes take private pay only. Ask that on the first call, not the fourth. It saves everybody a week.

How a larger community builds its number

Three separate things, and they are quoted to you as one. There is rent, which depends on the apartment and whether it is shared. There is a care charge, set by an assessment that scores how much help your mother needs. And there is usually a one-time fee before she moves in, which people hear as a formality and which is often a substantial sum.

The care charge is the one that moves. Ask who decides she has changed levels, how often she is reassessed, what each level costs, and what specifically triggers a move up. Ask what a second caregiver for transfers costs. Ask whether medication management is inside the level or billed separately. Ask whether incontinence care is billed by supply or by visit.

Then ask two things nobody asks. What has the rate increased by in each of the last two years, and is the move-in fee refundable if this does not work out in the first month. Get both in writing. A family that budgets to the quoted figure exactly is a family that gets an unwelcome phone call in month seven.

The bills that are not on the quote

These are the ones that turn a workable budget into a difficult one, and none of them come up on a tour.

• A private caregiver hired on top, when a home will take your parent but only with extra hands for part of the day
• Pharmacy delivery and over the counter supplies, billed monthly
• Incontinence supplies, if they are not in the rate
• Transport to appointments once it is more than the community bus can cover
• Salon, cable, phone, and the small recurring extras
• The deposit on the next place, if the first one turns out to be wrong

Veterans, which comes up constantly in this city

Long Beach was a Navy town for most of the twentieth century. The shipyard and the naval station both closed in the nineteen nineties, but the people who worked and served here did not leave, and a lot of them are now in their eighties and nineties. The VA Long Beach campus is still out on Seventh Street. A veteran turns up in a lot of these conversations here.

There is a federal benefit for wartime veterans and surviving spouses that can go toward the cost of care. We are not going to print eligibility rules or amounts on this page, because those change and a website is the wrong place to learn them. What we will tell you is where to go and how long it takes.

Talk to a VA accredited representative, or to the county veterans service office, both of which help at no charge. Be careful with anyone who wants a fee to file the claim for you. And start it the week you start looking rather than after the move, because the process is slow and the bills are not.

Medicare and Medi-Cal, and two things families get wrong

The first is assuming Medicare pays for this. Medicare is health insurance. It is not a way to pay the monthly cost of living in a care home, and families who plan around a misunderstanding of that lose months.

The second is assuming that what applies in a nursing home applies in a licensed care home. They are different licences with different rules and different funding, and the answer for one tells you nothing about the other. Do not take either answer from a website, this one included. Ask the county, ask before anyone signs anything, and if someone tells you the rules with total confidence and no source, treat that as a reason to check.

How families here actually pay

Most commonly a pension and social security covering part of it, with the rest coming from savings or from the house. If your parent owns a home in Long Beach and has for thirty years, that house is usually the plan, and the choice between selling and renting it out is worth a real conversation with an accountant before anyone lists it.

If there is a long term care insurance policy, find the actual policy rather than relying on what your father remembers about it. Read the daily benefit, read the waiting period before it starts paying, and check whether it pays for a licensed care home at all or only for skilled nursing. Policies from the eighties and nineties often do not cover what families assume they cover.

If siblings are splitting the cost, put it in writing at the start, while everybody is still being generous. Reverse mortgages come up a lot and occasionally make sense, but not as a first move and not without independent advice from someone who is not selling one.

What we do about money

We ask you for a budget early, which feels intrusive and is the kindest thing we can do. Knowing it means we only send you to homes that will actually accept it, and it means we can tell you honestly when a budget does not meet this market and what the options are then, including asking each home a city or two over for its own rate rather than assuming the answer. Size drives price more than anything else, and the state register for this catchment tells you the size of every licensed home before you make a single call.

We are paid by the community when a placement works out, never by your family. That is worth knowing when you weigh our advice, so weigh it: we will tell you when the cheaper home is the better home, and we will tell you when you are being quoted a level of care your father does not need.