Two assisted living quotes, two different numbers — how do you compare them?

The short answer

Five steps, in this order. Ask both communities to price the same care tier. Turn each quote into a twelve-month total that includes base rent, the tier fee, the recurring extras and the one-time fees. Ask each one to put in writing what is not covered, because an item missing from a quote is not free. Compare the notice period each contract requires before a rate change, not just the rate. Then ask both what happens on the day private funds run out.

Do the arithmetic before you visit a second time. Families usually compare the two rent figures, decide the difference is a few hundred dollars a month, and choose on feel. At the survey's national median of $6,200 a month for assisted living — $74,400 a year — a decision made on the wrong line is a four-figure annual error, and it repeats every year the person stays.

Step 1: put both quotes on the same care level

Assisted living prices are tiered. The rent in the brochure is normally the base rate for someone who needs almost no help, and the monthly price climbs as the care tier climbs. A community quoting $5,900 at tier one and another quoting $6,300 at tier two may be quoting the same money for the same person; the reverse is also true, and it is the more common surprise.

So the first question to both is not “what is the rent” but “which tier would you put my mother on, and what does that tier cost.” Then ask for the tier definitions in writing and read them against what the person actually needs now: bathing, dressing, medication reminders, toileting, transfers, and supervision for memory loss. If one community's tier two includes medication management and the other charges for it separately, the two tier prices are not the same product.

Ask a follow-up that most families skip: what would move this resident up a tier, and how is that decided? A community that answers with a written assessment schedule is easier to budget for than one that answers with “it depends.”

Step 2: build a twelve-month total, not a monthly one

A monthly number hides the fees that are charged once. Build a table with one column per community and one row per charge, then multiply the monthly rows by twelve. The worked example below uses a hypothetical pair of quotes at the survey's national median, $6,200 a month, so the arithmetic is easy to follow; the figures in your own table will come from the two fee schedules.

The community with the lower rent ends the year $6,640 higher. Its care tier is one step up, which adds $1,300 a month against the $500 it saves on rent, and its non-refundable move-in fee is larger. Every month, the rent line pointed the wrong way. That is the whole method: the cheaper quote is the one with the smaller twelve-month total at the tier the person will actually be on, with the fees charged once included.

Two rows are worth adding even when the answer is zero. Pet rent and parking are common small monthly charges, and a “care coordination” or “wellness” fee is sometimes a fixed monthly line that appears in the agreement but not in the brochure. The list of what assisted living fees usually exclude covers the recurring items in more detail, and the care cost calculator annualises a monthly figure so the two columns can be compared against savings and income.

Step 3: ask what is not on the sheet

A charge that is missing from a quote is not automatically free, so the question to put to both communities is the same: which services that a resident commonly needs are not included in this monthly price? Then ask for the answer by email, because a written fee schedule is what a state regulator will look at if a dispute starts.

California writes that rule down plainly. Under Health & Safety Code section 1569.884 and Title 22 of the California Code of Regulations section 87507, no fee may be charged that is not clearly stated in the admission agreement, and an item or service that was not available when the agreement was signed has to be presented to the resident as a list with charges, for acceptance or refusal, under section 1569.269. Washington approaches it from the other side: WAC 388-78A-2710 requires an assisted living facility to disclose the scope of care and services it offers, on the department's approved disclosure form, to interested consumers on request. Either way, the comparison document is the fee schedule and the agreement — not the folder the sales office hands over.

Step 4: compare what each contract allows later

Two identical quotes today become two different bills in eighteen months, and the difference is written in the notice clause. California requires at least 90 days' prior written notice of an increase in any rate for services under Health & Safety Code section 1569.655(a), and the notice has to state the amount, the reason and a description of the added costs. An increase that comes from a change in the resident's level of care is treated separately: section 1569.657(a) allows written notice within two business days after the new level of service begins, with an itemisation of the charges.

Washington's rule runs the other direction and is worth asking about in any state: WAC 388-78A-2710 requires at least 30 days' written notice before a decrease in the scope of care or services, and at least 90 days' notice when that decrease would result in the discharge of a resident. A community that can reduce what it provides on 30 days' notice is a different risk from one that cannot, and the family is the party who absorbs that risk.

Three questions turn this from a legal abstraction into a comparison. What notice does this contract require before a rate increase? What were the increases for each of the last three years, in writing? And does the agreement cap increases, or promise not to raise the rate in the first year? Some admission agreements are stricter than the statute requires, and that clause is worth more than a few hundred dollars of rent difference. The reasons assisted living costs rise explains what tends to drive those increases.

Step 5: what happens when the money runs out

Assisted living is paid privately in the ordinary case. Medicare does not pay the monthly rent, and Medicaid has no assisted living benefit by that name: what can pay is a home and community based services waiver, and whether a community accepts waiver payment is a question for that community. A community that takes private pay and does not take waiver payment will ask a resident to leave when the money is gone, and that is a cost of choosing it, even though no line on the quote shows it.

Ask both communities, in the same conversation, whether they accept Medicaid waiver payment, whether they keep a Medicaid bed, and what the notice and discharge terms are if a resident spends down. Then compare the two monthly figures against what care actually costs elsewhere: a semi-private nursing home room runs $9,581 a month at the national median, so a family planning for the years after assisted living should compare against the nursing home cost page as well. Whether Medicaid pays for assisted living covers the waiver route, and paying for care when savings run out lays out the order of spending.

Red flags in a quote

• A monthly price with no care tier attached to it.
• A community fee described verbally as “refundable” with no refund conditions in the agreement.
• “Care is included” with no definition of what care means.
• A tier definition that would move the resident up after the first assessment.
• No written answer to the question about the last three years of increases.
• A quote that will not be put in writing before a deposit is requested.

None of these are proof of bad faith. They are the questions the contract has not answered yet, and they cost nothing to ask before signing. The national median of $6,200 a month is a reference point for whether a quote is in the normal range; local assisted living cost figures are the ones to compare the two quotes against.

Where these rules come from

The $6,200 monthly and $74,400 annual figures are the 2025 national median for an assisted living community published in the CareScout Cost of Care Survey (fieldwork July–November 2025), which is the source this site uses for every national median; the semi-private nursing home median of $9,581 comes from the same survey. The California rules were read from the statutory citations reproduced in CANHR fact sheet 41, “Rate Increases and New Charges: What's Permitted?”: Health & Safety Code sections 1569.655(a), 1569.657(a), 1569.884 and 1569.269. The Washington disclosure and notice requirements were read from WAC 388-78A-2710 on the Washington State Legislature site. The statement that Medicare does not pay assisted living rent is from Medicare.gov. The hypothetical quote table is illustrative arithmetic, not a survey of real facilities; the community fee, tier pricing and transport charges shown there are line items to check, not published averages. Nothing on this page is legal advice, and no figure here replaces the fee schedule of the community you are considering.