She's been in the same place for 2 years. Every 6 months they do an assessment and increase the care tier she falls under. The latest is a 350% increase from when she moved in. I don't believe she is receiving a 350% increase in care.
Prices are so affected by location, competition, etc, that it's barely worth talking about them. However, the level of care you are being charged can be (and should be) a very transparent process. The director should be able to share with you the scoring tool used to determine care and your Mom's score. That score determines her level of care. Typically in AL, some amount of care is factored into the base rent. Then, depending upon a resident's score, levels of care are added. Those rates are published (or should be) so you can always know exactly what your Mom should be charged. The exception to this is if your Mom requires so much care that she exceeds the highest level. At that point, a 'custom' care level is created based on the assessment. The important thing here is that you ask to see Mom's assessments so you can compare the scores from when she moved in until now. You can also see how she scored in each area. You may or may not agree and those can be a points of discussion with the director.
Our mother is in year 2 of MC. They did increase the rate, just calculated it to 4%. It was identified as rising costs and wage increases. Anyone out there paying 5k for MC - I am jealous!!! But there have been other postings who indicated $12-14000!!!
I do know that she has 1 hour of "personal" care build in, then we would get charged if she goes over that (I did ask, it would be around 1k+/- per month for each extra hour.) To the best of my knowledge, she still does not need help with getting around, etc. We did, for 2 months now, get an extra cleaning charge. She's had some accidents on the carpet in her room - hoping to get her to use the pads I bought and check for UTI, but she dismissed the pads at this point. She makes it to the bathroom but wets everything and has to change, which makes me suspect UTI not incontinence - secondary problem is her denial in weight gain and the need for larger clothes. The current clothes (I just dropped off some, but she A) doesn't need any more, has plenty here and at home and B) checks the tags and says oh these are large, I don't wear large!) are too tight and may be difficult to take off when she needs to go!
Anyway, what others suggested is what I would do - get fine detail on WHAT has changed, what the extra charges are covering, etc. Assumption is you have POA and arrange the payments, so they can discuss this with you. If not, bring mom along, even if she doesn't understand anything. You are just there as advocate! They should be communicating that anyway. When we got the 4% increase, they put explanation out there with the new bill without us asking about it.
Unfortunately, the brunt of this all falls on you. When my mom was in a SNF, I got a list of expenses each month. Surprisingly enough, it was pretty easy to read for a “lay person” like me. But, I did go over it with a fine tooth comb. Years ago, my MIL showed me a summary of charges for my FIL, also in a facility. There was a charge for THREE large bottles of Colace, a stool softener, over the month. She told me that wasn’t the first time overcharges had happened. After seeing that I always asked for an explanation of any charges I didn’t understand. I didn’t do it in a snarky or accusatory way, but the facility knew I was, shall we say, “aware” of the rundown of expenses and would question anything I didn’t understand. Care Conference meetings are invaluable in a facility to find out what’s going on.
My dad is in an AL specializing in memory care. He started around $3800/month and is at $5400/month. He was due for a $200 increase but for some reason it hadn’t changed. Hospice does his showering twice a week. He is in wheelchair and needs help with everything. He was one of the first residents to move in and his contract has a condition that his rate cannot change more than once in 12 months.
Maybe you could find another place where the prices are more reasonable. Wouldn't hurt to check around. When she runs out of money, she can go on medicaid.
You have a lot of good advice here already but I just wanted to add on about a lady I knew that decided she preferred eating alone in her room and began ordering her meals that way at a hefty extra charge for each meal. That lasted one billing cycle lol.
If the facility goes by evaluation "points" for activities of daily living, they add up quickly. Example: Toileting & incontinence - 0 points if no assistance needed, 2 for reminders, 4 for assistance required or incontinence up to 3 times daily, and a jump to 7 if assistance required... 4 or more times daily. And that is just 1 of 8 difference categories. Top level in all categories could give you 65+ points to add to charge.
We don't have all of the facts here - but if $4050 was increased by $1050 to a total of $5100, then it sounds like her dementia has progressed to the point where she is almost at nursing-home care or "enhanced assisted living." Five grand is pretty inexpensive for that level of care in most places in this country.
But as others have said, you need to sit down with a director and ask for an "accounting" of the various levels of care, what they entail, where your mother falls on their level chart, etc.
My mom is at ALF. She is in a wheelchair all day. She needs help after she goes poop and she need somebody to be in the room when she showers. I pay 3600 a month for that. The food is crappy the help is worse and they don’t speak English. You have no choice but to pay what they ask for or move. I’ve done both and it’s a hassle.
$1050 for memory care, Jeanne? That figure seems very low, no?
Sarmar, your mother may not be receiving 3 and a half times as many hours of care, but she may now need the support of much more highly trained people - with all the costs associated with that.
Factor in inflation, sector-specific cost increases, and - if we're determined to be cynical - the increased difficulty of finding anywhere better for her; and you can see where the steady ratcheting up in fees comes from.
But go through the assessment item by item and verify that she is only being charged for services she does use. There's no rule that says you can't argue!
Many facilities have space for family to stay to visit. Check into that option to see if you could stay for a few days or even a week so you can see how mom is on a daily basis. And of course meet with the care team for a face to face explanation.
i would look around & ask them if they do that to i would not take that maybe notify the better business bureau or something ..how can they figure 350% anyway &they propbably think if you can pay if you are .i say prove it to & if they dont then you really need to shop & before you leave tell them to stick there 350% up there --you know
I just looked up stats for my state (Minnesota). The average cost of assisted living in the largest metro area is $4050 a month. Memory care is about $1050 a month, on average. Even if your mother declined to the point where she needed full dementia care (except for the security feature) the increase you quote seems extremely high.
Did Mother get some kind of a special promotional deal for a few months, and now she is paying the regular rates? This is just hard to understand. It would be interesting to hear the explanation you get.
Assuming you are her POA you are entitled to know exactly what she is paying for. Having a conference with someone who knows what services she is getting (Director of Nursing, maybe) and someone in charge of billing should explain that huge increase.
Have rates gone up for everyone? Is some of the increase due to increasing needs and some just to rising costs? What does the contract say about rising costs?
sarmar, I see from your profile that your Mother has Alzheimer's/dementia. With such a disease the person sadly only gets worse, thus more care is needed.
My Dad was in Assisted Living and all the perks came with the monthly rent which was around $7k per month.
Back when Dad was in Independent Living, there was an options chart if Dad needed more things done for him. Example, his "medtech" was costing $30 per day extra for a Staff person to keep charge of his prescription meds and give him the pills required twice a day. That was an extra $10k per year. If Dad wanted his personal laundry done by the Staff, there was an extra charge. If Dad wanted his meals served in his room, that was an extra charge. There was an extra tier care option that would cost $13k per year. So, it can add up.
Many/some ALFs have a rate sheet that gives the additional price of each service; ask for it if this ALF has it. The types of service the resident needs determine the "level" of care. Just a few things that trigger an increase are decreasing mobility, increasing incontinence, need for help in transfers from bed to wheelchair and number of helpers needed for the transfer, etc. etc. --- essentially changes in the resident's condition that require additional staff hours or additional skills. I think maybe you see this situation most often in free-standing assisted living facilities that don't have memory care or long-term nursing sections. But 350% sounds out of line. Ask for a detailed explanation and have them work the figures for you. And don't ask only for an explanation by "level" --- find out what needs and services each level requires.
I know nothing about ALF but that does sound like a huge increase. Is it possible that they are increasing the costs to this degree because she actually needs to be moved to Memory care or NH? Sit with them and have them explain the increases she is receiving in services and not just dollars. Perhaps it’s time to do some comparison shopping?
However, the level of care you are being charged can be (and should be) a very transparent process. The director should be able to share with you the scoring tool used to determine care and your Mom's score. That score determines her level of care. Typically in AL, some amount of care is factored into the base rent. Then, depending upon a resident's score, levels of care are added. Those rates are published (or should be) so you can always know exactly what your Mom should be charged. The exception to this is if your Mom requires so much care that she exceeds the highest level. At that point, a 'custom' care level is created based on the assessment. The important thing here is that you ask to see Mom's assessments so you can compare the scores from when she moved in until now. You can also see how she scored in each area. You may or may not agree and those can be a points of discussion with the director.
I do know that she has 1 hour of "personal" care build in, then we would get charged if she goes over that (I did ask, it would be around 1k+/- per month for each extra hour.) To the best of my knowledge, she still does not need help with getting around, etc. We did, for 2 months now, get an extra cleaning charge. She's had some accidents on the carpet in her room - hoping to get her to use the pads I bought and check for UTI, but she dismissed the pads at this point. She makes it to the bathroom but wets everything and has to change, which makes me suspect UTI not incontinence - secondary problem is her denial in weight gain and the need for larger clothes. The current clothes (I just dropped off some, but she A) doesn't need any more, has plenty here and at home and B) checks the tags and says oh these are large, I don't wear large!) are too tight and may be difficult to take off when she needs to go!
Anyway, what others suggested is what I would do - get fine detail on WHAT has changed, what the extra charges are covering, etc. Assumption is you have POA and arrange the payments, so they can discuss this with you. If not, bring mom along, even if she doesn't understand anything. You are just there as advocate! They should be communicating that anyway. When we got the 4% increase, they put explanation out there with the new bill without us asking about it.
But as others have said, you need to sit down with a director and ask for an "accounting" of the various levels of care, what they entail, where your mother falls on their level chart, etc.
Sarmar, your mother may not be receiving 3 and a half times as many hours of care, but she may now need the support of much more highly trained people - with all the costs associated with that.
Factor in inflation, sector-specific cost increases, and - if we're determined to be cynical - the increased difficulty of finding anywhere better for her; and you can see where the steady ratcheting up in fees comes from.
But go through the assessment item by item and verify that she is only being charged for services she does use. There's no rule that says you can't argue!
Did Mother get some kind of a special promotional deal for a few months, and now she is paying the regular rates? This is just hard to understand. It would be interesting to hear the explanation you get.
Have rates gone up for everyone? Is some of the increase due to increasing needs and some just to rising costs? What does the contract say about rising costs?
My Dad was in Assisted Living and all the perks came with the monthly rent which was around $7k per month.
Back when Dad was in Independent Living, there was an options chart if Dad needed more things done for him. Example, his "medtech" was costing $30 per day extra for a Staff person to keep charge of his prescription meds and give him the pills required twice a day. That was an extra $10k per year. If Dad wanted his personal laundry done by the Staff, there was an extra charge. If Dad wanted his meals served in his room, that was an extra charge. There was an extra tier care option that would cost $13k per year. So, it can add up.