Hiring Your Own Aide in Assisted Living in Massachusetts
Need help in Massachusetts? Care Remedy provides home health aides at $45 an hour, stair assistance at $200 a visit and wheelchair transportation from $115 each way. Call 781-957-8076 .
Yes. Massachusetts assisted living regulations give a resident the right to contract directly with outside care providers for services in the unit, subject to the residence's reasonable requirements. Families do it when the monthly fee buys short scheduled help and the person needs someone for a solid block of hours. Ours is $45 an hour, one to eight hours a day, with no minimum contract and no assessment fee.
Does the residence have to let my own aide in?
The resident rights section of the state regulations, 651 CMR 12.08, says a resident may directly engage or contract with licensed or certified health care providers, and with other necessary care and service providers, to obtain care in the unit to the same extent available to someone living in their own home. The qualifier in that same sentence is "subject to reasonable requirements of the Residence." So the right is real, and the residence can still ask you to work within its rules.
Tell the residence in writing before the first shift. The service plan rules in 651 CMR 12.04 require the plan to describe services arranged by a person or entity not affiliated with the residence, naming private duty aides specifically, once the resident or their representative gives notice that they have arranged them. That notice is how your aide becomes part of the record instead of a disagreement at the front desk.
Ask the practical questions early, because the regulation does not answer them. Does the aide sign in at the desk. Are there hours when outside staff may not be in the building. May the aide use the dining room, the elevator, the laundry. Get the answers from the residence rather than assuming either way.
An aide working one to one in a resident's own unit, which is the part a monthly fee does not buy.
Why pay for an aide on top of the monthly fee?
Because the fee buys a share of staff, not a person. Assisted living staff cover a building, so help arrives as short scheduled visits. What families usually need is a continuous block: the ninety minutes around getting up and washed, the hour at dinner, the evening stretch when someone gets anxious and calls the family six times.
Read the residency agreement before you buy anything. The regulations require it to explain what the fees include, to itemize bundled services, to explain what is available at extra charge, and to state the limits on what the residence will provide. The answer to whether you need an outside aide is often already in those paragraphs.
What does a private aide in assisted living cost?
$45 an hour, one to eight hours a day. No minimum contract, no assessment fee and no four hour minimum per visit, which matters here, because many agencies will not send anyone for the two hours that actually solve the problem.
On a 30 day month: three hours twice weekly is about $1,170. Two hours a day is about $2,730. Three hours a day is about $4,095. Four hours a day is about $5,460. Six hours a day is about $8,200 and eight hours a day about $10,900. Overnight is $540 for a twelve hour night, about $16,200 a month if it is every night, and around the clock care is $1,080 a day, about $32,800 a month.
Most families in assisted living buy two or three hours a day, not a shift. Start with the hour that is going wrong.
What can the aide do, and what stays with the residence?
Our aides are trained, background checked and insured, and they are not nurses. They do not administer medication, including insulin, do not change dressings and do not make clinical judgments. An aide can be present while a resident takes their own medication, can help if something goes wrong and can call for help.
That boundary matters more in assisted living than at home, because medication help is often already part of what the residence provides under its own rules. Skilled nursing has a separate rule: the regulations permit it in a residence only through a certified provider of ancillary health services or a licensed hospice. If the need has moved to nursing, you are buying a different service, and we price nursing separately.
- Bathing, dressing, grooming and toileting
- Transfers, and walking beside someone who is unsteady
- Meals in the unit, laundry, tidying and groceries
- Company and supervision for someone who should not be alone in the evening
- Escort to appointments outside the building
Meals, laundry and tidying in the unit are ordinary aide work, and they are often what the family is quietly doing on weekends.
Is it cheaper to bring the person home instead?
Sometimes, and you should run your own numbers rather than take a guess. A monthly residence fee plus 30 hours a week of private aide time is a large bill, and past a certain number of hours the same money buys more care at home. The crossover depends entirely on the hours, so compare the two figures you actually face.
What should I try before hiring anyone?
- Ask the residence what its next service tier costs. For a short task a few times a day, their own package is sometimes cheaper than an outside hourly aide.
- Ask what actually triggered the worry. If it is one event at one hour of the day, buy that hour, not a shift.
- If the resident has MassHealth, ask whether a program they qualify for already covers personal care. Do not pay privately for what a benefit covers.
- Ask the residence to document the incident. A fall or a wandering episode in the record is what gets a care conference scheduled, and sometimes the plan changes without you paying anyone.
Related reading
Getting started
We staff assisted living units the same way we staff houses, from offices in Woburn, Springfield and Brockton. Call 781 957 8076 or email info@careremedyinc.com with the building, the hours you want and the day you want to start. Visits are logged in MyCase, our coordination platform, so you can see that the aide arrived without having to ask.
This page summarizes state regulations in plain language and is not legal advice. Your residency agreement and the current text of 651 CMR 12.00 govern. Confirm the specifics with the residence, and anything contractual with your own attorney.
Share
