Four years ago, I moved my then-78 year old aunt from FL to an assisted living in NJ (I am her POA - she has no children) to be closer to family (I have 5 siblings). My sister was very familiar with this AL and for the first few years everything was good - care, activities, consistent staff. We even moved our parents to the same facility so we could easily have family get-togethers. Then the Administrator retired and then the DON resigned and things started to slide.

We started to notice that our aunt was unkempt and stayed in her room more of the time. It seemed to us that she required the next level of care for her dementia. But the facility didn't seem to notice - they didn't really have time to notice because they were busy trying to find new administrators and a competent DON and to keep "the ship afloat." So we initiated her move to the Memory Care unit within the facility. She thrived in this unit because it only has a max of 20 residents and the staff was very attentive. That was a year and a half ago. Mind you, she has been private pay this entire time and NJ is one of the costliest states for care.

When she was within 2 months of going on Medicaid they stated that she needed even more care and she would owe an additional $2,100 per month onto her already $6,700 bill. DON stated that the CNA's told her my aunt needs max care. When I talk with her usual caregivers privately, they tell me "she's the highest functioning resident on the unit". She walks with a walker, eats indep., converses, follows directions- her main issues are incontinence and short term memory. I guess moving her is the only option. Any ideas?

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You need her evaluated by the DON not on the assumption of a CNA. And be there when its done. I live in SJ and we have two ALs one being cheaper and no MC unit. Mom needed help getting showered, dressed, put to bed, toileted and gotten to the dining room. Her cost for care was about 2500 depending on how many days in the month. MC is more expensive than an AL. But it should already be a given that if in MC more care is needed. I would think an evaluation was done when she entered MC. Ask to see what you were paying for then and what they feel she needs now that cost 2k more.
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Reply to JoAnn29

Fuzzman, based on your description, it sounds like the new Director of Nursing may be inexperienced and/or has been instructed by the new Administrator to look for ways to increase revenues, probably due to pressure by the owner(s). But the price increase may also be due to your aunt's increased ADL needs. And if New Jersey's Medicaid reimbursement rate is higher than the $6,700 rate she is paying, that would further incentivize the facility to increase her private pay rate before she qualifies for Medicaid, thus possibly reducing Medicaid's future scrutiny of her care needs. In short, several factors could be in play, but it sounds like the rate increase is not something that should cause you or your aunt a lot of worry, since she will very soon be Medicaid dependent. At this point I suggest focusing on your aunt's care/comfort and let Medicaid focus on her bill. But maybe I'm missing something, since you suggested moving her is the only option.
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Reply to bicycler

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