Before You Sign: The Assisted Living True-Cost Worksheet
The advertised rate is the starting bid. This worksheet finds the real number.
Assisted living in North Carolina now runs a median of about $6,200 per month. But national investigations have documented what families learn the hard way: the base rate is only the beginning. Facilities commonly use point-based "level of care" pricing where help with medications, bathing, or even blood pressure checks adds hundreds or thousands per month, and nearly half of families report being hit with fees they did not expect.
If you are touring communities, bring this worksheet and get every line IN WRITING before signing anything.
Part 1: The Real Monthly Number
| Item | Ask exactly this | Their answer |
|---|---|---|
| Base rate | "What does the base rate include, listed out?" | $______ |
| Care level today | "Based on your assessment, what care level is my parent NOW, and what does that level cost?" | $______ |
| Medication management | "Is medication help included or extra?" (Commonly $200-$500/mo extra) | $______ |
| Incontinence care | "Is this a separate charge?" | $______ |
| Second-person assist | "If she ever needs two staff to transfer, what changes?" | $______ |
| Meals, cable, wifi, laundry, transport | "Which of these are extra?" | $______ |
| Real monthly total | $______ |
Part 2: The One-Time and Future Charges
- Community fee / move-in fee:** typically $1,000 to $5,000+, often non-refundable. Amount: $______
- Annual increase history:** "What were your base-rate increases each of the last three years?" (3 to 5 percent per year is common; some markets have seen far more.) ______%, ______%, ______%
- Reassessment policy:** "Who decides when my parent moves up a care level, how am I notified, and can I get an outside opinion?" Care-level jumps of $500 to $2,000+/month are where budgets break.
- Rate at the next TWO care levels:** $______ and $______ (You are not buying today's price; you are buying the price curve.)
Part 3: The Exit Questions (ask them even though it feels dark)
- nder what conditions can you discharge my parent?" (Assisted living residents have far fewer legal protections against eviction than nursing home residents. Common triggers: care needs exceed license, behaviors, or running out of money.)
- hat happens if her money runs out? Do you accept State/County Special Assistance or Medicaid at any point?"
- hat is your refund policy on the community fee and prepaid rent?"
Part 4: The Quality Checks (free, five minutes)
- ok up the community's NC Star Rating (adult care homes are rated 0 to 4 stars from state inspections): info.ncdhhs.gov/dhsr/acls/star
- k for overnight and weekend staffing numbers, not ratios "during activities."
- k about caregiver turnover and how long the current executive director has been there.
- dementia is involved: confirm the community holds NC's Special Care Unit designation, and ask about elopement history.
- sit unannounced at dinner time. Eat the food. Watch how staff speak to residents.
- ntact the regional Long-Term Care Ombudsman (free, confidential) and ask about complaint history.
The Comparison Worth Running First
Before signing a $74,000+ per year contract, price the alternative honestly: targeted home care hours in the Charlotte area run about $26 to $36 per hour. Daily half-day support at home often costs less than assisted living, in the house your parent already loves, without move-in fees, care-level surprises, or eviction clauses.
Sometimes assisted living genuinely is the right call, and this worksheet helps you buy it with eyes open. But if you want to price the stay-at-home option first, that is exactly what we do, for free: tell us your budget once, and we introduce you to one licensed, vetted home care provider that fits it.
HelpAtHomeNC | (704) 380-0344 | helpathomenc.com
Serving Concord, Kannapolis, Harrisburg, Albemarle, Salisbury, Mint Hill and the surrounding Cabarrus, Rowan and Stanly county communities.
Doing this for your own family? We are HelpAtHome NC, an independent, free matching service. Tell us your situation and hourly budget once and we introduce you to one licensed, vetted provider that fits, never a list. If you want the numbers worked out first, the Cabarrus Home Care Plan puts your schedule, your real monthly cost, and the right providers on one page.
Get matched free or call or text (704) 380-0344
Serving Concord, Kannapolis, Harrisburg, Albemarle, Salisbury, Mint Hill and the surrounding Cabarrus, Rowan and Stanly county communities. This guide is general information, not medical, legal, or financial advice.