My Mom just moved into an old folks home just 2 days ago. We visited several before she picked one. Seems they all do it a different way.....so the answer is it depends on the place, (you'll have to call and ask) . In her situation it is one big monthly payment for food, electricity, AC/Heat, basic cable, and security, are included, but no internet or phone is provided. The dining is included in the rent (they have a chef prepare 3 meals a day for them, and then free snacks) It's a very nice and pretty large place with 200 or so people living and dining there.