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The last 3 years rent has gone up about 5%; now they are charging a "daily rate" and the total is MUCH more. I've called & written letters, researched and visited other facilities. What it ends up with is that I really believe that moving her from the place she is (??) familiar with (although she always thinks she just moved in) will upset her so much it may lead to a fatal condition. Paying the rate increase means she won't have money left for her favorite thing -- gifts for her sisters, kids grand & great grands. I don't want to threaten but what else is there?

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We worked briefly a man from a care placement agency. He isn't at all impressed with the large commercial facilities, feeling they offer nothing but window dressing. He took us to facilities in converted homes. Same services, smaller population, less cost. After having my dad in two nursing homes, I completely agree with him, smaller is not only more cost effective but better.
There should be an assisted living facility search site on or linked from your state's health care quality office. Of course they require the same scrutiny as far as care, culture, and cost. We've found that many assisted living facilities are willing to increase the level of care and negotiate prices because the market is so competitive. While they are also allowed to raise their fees annually, because they start lower, the pricing may not hurt as much. And some do take vouchers from the state or Veterans Affairs.
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If mom is capable, I would include her in the decision after offering her whatever options are available. If she's involved, it might make the adjustment easier. Also, is it possible for the children to help w/the increase? As far as I know, the state doesn't pay for assisted living - only Nursing Homes.
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The thing is, for the last 3 years the increase has been a (more reasonable) 5% per year; now suddenly they are charging a "daily rate comparable to a hotel room", which is a 25% increase. No increase in staffing or services. The facility itself is not to blame, head office is.
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As others have said go and meet with administration to see what the options are.
And what is their plans for the future. Do they anticipate the rate to increase even more for 2012, 13. etc? There may be something afoot that is totally different.

My mom's IL went from a great deal of $1,600 mo to $ 2,600 mo in about 4 yrs.
There was a real cut back in driving services like 1 day a week shopping/activity from 2 and no more you can stay @ the mall and meet friends who bring you back later everybody had to go & come back together. The drive you to the doctor visits for free were changed to 3 days a week and 10 days in advance scheduling from whenever just call. My mom liked the place (well as much as she is ever going to like something), food was great and it seemed to fit her needs when she moved in

My mom was in IL in a tiered facility - from IL,AL, NH. It is not a CCRC. However it is a part of a larger group that has two other tiered facility - these 3 are old in that they have been around since the 1960's. As such all the IL's are kinda large, hers was 750 sq ft, some of them are 1,000 sq ft and all have balconies or private patio's. The parent company has expanded into doing CCRC with a minimum buy-in of 100K. That is their focus now and they are taking the empty IL and renovating them to create a buy-in apt. My point is they may be increasing the rate to shake off those that don't have the private pay resources as there are other plans for the space.

As far as her giving gifts to family. Please be careful with this. If you get to the point that she needs to go on Medicaid (and unless she is truly wealthy, if they live long enough they will run out of $$) all those funds given to family can be considered gifting in the 5 yr look back and you could face a penalty period in having her Medicaid application approved. This will mean that you will be responsible to private pay the facility for whatever the penalty amount is. Each state is different in how they figure out the % on this.

The Medicaid application actually get's scrutinzed and they can have access to all bank accounts for 5 years. You don't know when it happens. You sign off on that ability for them to do that when you do the application.

With my mom’s application we had a glitch with $ 1400 ck for to Jim Smith written in 2006. It actually was for auto repair but the check was to Jim Smith instead of Jim Smith Auto Repair. TxHHS asked was this gifting. Found the receipt and faxed it along with a copy of the guy's business card. When I was looking for this, I found there was only like 10 checks that she wrote in 06 that had a comma in them.All of those were for a company, like Visa or Richards's Electical. It was only 1 that wasn't, the one to Jim Smith. They probably have a program that filters's all this and presto! that check comes up. My point is you may face a penalty for any $$ she gives away if she goes on Medicaid.
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Costs for everything are outrageous, I work for an assisted living facility for the Developmentallly Disabled. Costs have increased, county and state funding has decreased, additional staff cannot be added but so many staff are required for the care for each individual. Private facilities, have had to raise costs to make up for lost funding. I know its hard but dont blame the facility, they either raise the costs or they end up closing. In my state, anyone living in a facility and receiving help after medicare, are only allowed 89-129 a month for personal needs, everything else is paid for with the exception of small prescription copayments.
For long term care, if she has been covering all her own expenses, and has money banked to pay for her assisted living then that has to be used before state assistance kicks in, once it kicks in funds will be limited regardless of where she is living. At home care will cost to have health aids 24/7. Try not to blame the facility for their increases as long as the economy gets worse they have no choice, to add to the problem, most of the care givers are underpaid, and not making near enough to live on. To know that your parents are being care for in the way they should be, I dont think there is a price too high, with my dad I have said I will quit working to take care of him and mom if it comes to that.
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I was able to make a better deal with my mother's assisted living facility because she moved in when they had several empty rooms and were more willing to negotiate and I never mention it to any of the other residents families that we were able to get a discounted rate. Because your Mom has been in her place for a while, it might be worth it for you to approach the manager and say that your mother may not be able to stay because of the huge increase. It is sometimes worth it for them to keep a steady customer than to loose good residents and possibly have a vacancy for a while. If they have a waiting list of people wanting to get in, you probably won't have much luck but if they have empty rooms, you might give it a try. Nothing ventured - nothing gained!

Don't forget to get it in writing and ask them to commit to at least 12 months!!
Good luck!!
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That's what's got me so angry -- there is no increase for additional services, they are not hiring more staffers, there is no increase in level of care!! In MO, there's licensing for Assisted Living, AL I, ALII and Skilled Nursing. They have been AL I for several years and 5% rate increase for 3 years is reasonable; but 25% is NOT.
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What is the amount of increase in cost as residents advance in their needs & level lof care?
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I agree that moving her would be traumatic. Could you fudge a little and let her know that "the kid's gifts are taken care of" and just let the potential receivers know that your mom can no longer afford this but that she really wants to feel she is giving? Maybe with everyone working together, and her limited memory, you can play along and then not move her.
The other option is moving her, but she sounds fragile. You are really the only one who can decide what is best. It's always hard - these decisions.
Take care,
Carol
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