Can the ALF Mom resides at force us to hire an outside aid to stay with her 24/7?

Yes, if your mother needs help all day long ALFs can request you to provide it. They are not able to provide that level of care. The only options would be a hired caregiver or moving to a NH if she needs all-day care.

Assisted Living is not designed for someone who needs 24/7 supervision. It is pretty much a temporary situation for someone who can't stay home, but does not need a Skilled Nursing Facility. They cannot force you to hire an aide, but if you read the admittance forms you signed, they don't have to keep her as a resident if she is wandering away or going in other folks' rooms or refusing to bathe or is getting aggressive.