Assisted Living Residence Cost Calculator Page 2
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1
2-Tray service to room
-Incontinence assistance
-Checking on resident am/pm throughout the
day
-Escort to meals/activities
-Emergency Accident Care
-Toileting assistance
-Meal Assistance (delivery/setup/clean up)
-Ted Hose assistance
-Treatments (e.g. eye drops, lotions)
-Oxygen Support
-Other Assists
________________________
________________________
________________________
Medical Supplies (e.g., incontinence or
ostomy — write in needs and costs)
Beauty/Barber Shop
Amenities
Extra
__Carport
ER response system
__Fully furnished
unit
__ Full Bath(s)
__Carpeting
__Local phone
service
__ Internet service
__Cable-TV hookup
__Basic cable-TV
__Mini refrigerator
__Lockable door
__Gas/electric/water
__Window
treatments
__Stovetop burner
__Other_________
__Other_________
Total Additional Charges
Step 3: Add the following:
Rent
_______
One-time charges
_______
Additional fees (e.g. meals)
_______
Second-person fees
_______
Renter’s insurance
_______
Cost of personal services
_______
TOTAL MONTHLY CHARGES
________
TOTAL LIVING EXPENSES
________
GRAND TOTAL
* It is recommended that you figure another 20% to 25% for other expenses to
determine total living expenses.
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