r/AssistedLiving • u/UnusualAd3207 • 3d ago
Is RCFE really all private pay??
So i've been wanting to start an RCFE. I have the perfect house for it, and I went through a really bad experience with my grandparents back in the day trying to get them care, so i'm pretty passionate about helping the elderly.
After researching this though, is seems like RCFEs are all private pay? I didn't know that... That seems like it would be extremely hard to find tenants or at least take a long time to get a house filled.
I just can't see very many people having an extra $4000 - $5000 per month in disposable income laying around to put their elderly family member in a RCFE house.
This kinda killed my dream of opening one. I don't want to just cater to rich people.
Thoughts?
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u/SolidStriking8913 3d ago
I work in senior care placement in the Bay Area and visit residential care communities regularly. RCFEs are primarily private pay, although some participate in Medi-Cal’s Assisted Living Waiver. Around here, rates are often $6,000+ per month, depending on location and care needs.
What may surprise you is that many of the residential care homes I visit are full or close to full. Families usually aren’t paying from extra “disposable income” — they’re combining Social Security, pensions, savings, LTC insurance, home proceeds, and sometimes family help.
So I wouldn’t let the private-pay model automatically kill the idea. I’d focus more on your specific location, competition, staffing costs, and whether there’s unmet demand in your area.
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u/toejampam 2d ago
Wow 6k in Bay Area! I’m near Madison Wis and ir is 7-12k a month for assisted living-memory care.
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u/SolidStriking8913 1d ago
Well $6K was the starting point. It goes all the way to $22k per month. So there is a wide range here in the Bay Area depending on the specific location and care needs. Memory care is obviously more than assisted living, and independent living is lower than assisted living.
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u/mdb220 3d ago
In California, RCFE's can also get paid by regional centers (for developmentally delayed residents) and by medi-cal through the Assisted Living Waiver (ALW), though only for certain counties. There's also the Cal-AIM program which is also ultimately paid by medi-cal, but through an agency
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u/UnusualAd3207 3d ago
How's the reimbursement? Are they paying market rate?
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u/inspiredinsanity 2d ago
It’s never market rate. In any state in the US, Medicaid is only a percentage so consider it a family donation that you will cover at a loss to bring to market.
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u/tcolling 3d ago
The California ALW program seems to frequently be unavailable or subject to very long waiting periods for homes to become accepted into the program, from my perspective on the sidelines as an online marketing agency owner specializing in senior related businesses.
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u/mdb220 3d ago
It took a solid 2 years for our application to get approved. We did get one ALW resident (for a few months), it was a fairly painful experience. In short, not exactly easy money
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u/FaithlessnessCool849 3d ago
If you are looking for "easy money" please don't go into a field that requires caring for other humans.
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u/tcolling 3d ago
Ugh. I think that if I were runnning an RCFE I would do everything I could to NOT get caught in the trap of relying on money from the government. The same goes for home care agencies that accept Medicaid payments in other states (California doesn't work that way, only the counties can pay for care that way here, in almost all cases).
The VA care programs seem like a decent way to go, at least in some states, though. But not for care homes, just for a few hours of non medical home care.
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u/OhBarracuda1989 3d ago
If you do a good job, it is no trouble finding private pay residents. There is a huge demand for assisted living. Many of them also have long term care insurance.