sooner or later, I believe, you will begin to see assisted living facilities (ALFs) lower their prices to attract more of the mid-income folks...they have to. People are getting stingy with their money/nest eggs, and state Medicaid programs are not going to pay for the care - ANYWHERE, given reduced budgets & no other source of funding. The beds have to come from somewhere, and occupancy levels in ALFs are falling. They cannot, imo, stay in business if they continue to charge what they do; the solution? Charge less, since you're really not providing much in the way of healthcare, let insurance companies pick up the tab when care is provided, and pay your note with higher occupancy vs. higher rates - don't try to have BOTH in a POOR ECONOMY! They are trying to be nursing homes AND independent/assisted living residences, but cannot continue to care for sick patients, imo...they are going to get in more & more trouble from the regulatory side if they keep sick people just to collect rents. Home health & hospice provide a supplemental 'care delivery vehicle' that relieves them of some of the liability, but cannot relieve it when they're NOT there (i.e., at night, after treatment, etc.). SOOOOOO...why not reduce rents, devise a revenue split w/ home health for patients they DO treat (if it's not a conflict), and fill up the place? Then, nursing home patients could go to nursing homes (even if they ARE private paying customers), where there are beds (& staff) to accommodate - and care for - them. OR, since increased occupancy doesn't necessarily mean more staff, just fill the place up with people who don't need "care" but who are willing to reside in a nice place where they CAN get assistance if they NEED it. The goal for ALFs should be to run a high-end residential community at good rent (based upon offering assistance when needed) without the headache of providing a whole lot of care, imo.