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The facility says she gets a discount on extra services in Personal Care. Total @ $450 per mo value. The expense of round the clock nurses aid is $600 for 3 - 8 hour shifts per day The family paid for night shift and daughter cared for Mother 16 hours per day. when Mother was injured by the facilities P.T., she fell, got knocked out, was placed in Observation by the Emergency Room at the Hospital where she fell out of bed and broke her nose. Back in the Health Care Center with 8 hrs of Nurses Aids per night and daughter at 16 hours, she was not seen by the assisned Dr. She was not treated for her sore shoulder and rib injury or the cold she developed. Daughter asked the Nurses to have the Dr. prescribe over the counter for the cold. He refused and when daughter called his office she was told not to call again and on their emergency line s- he was told it was not an emergency. Mother had developed pnemonia and daughter called 911 to get her out of the Health Care Unit. She was diagnosed with pnemonia and treated for the same in the hospital. After 3 months back in her Independent Living Apartment with daughter, she could walk 200 yards w her walker, shower herself, etc. On a pretext she was commanded to the Emergency Room/ Health Care Center to get her out of her I.L. Apartment and into the Personal Care Unit. The Emergency Room Dr stated on the record that there was no need for Mother to go to the Health Care Unit or to be placed in Personal Care. The Administrators wanted daughter (POA of Health Care) to sign a contract for admittance to P.C. but would not let her read or hold the contract in her hands. Daughter wanted to read it herself overnight and take it to an attorney if necessary. Administration flipped the pages saying what was allegedly in the contract. Daughter has not seen a copy which was signed by an out-of-town family member although requesting the same from the Facility and the family member. Daughter was not permitted to stay overnight with Mother, After 3 falls with the P.C. Nurses and Aids services being negligent, daughter came in for 16 hours with an overnight Nurses Aid for 8 hours for 3 months. Mother could no longer walk herself or even balance while sitting up. Her thinking was also impaired. Mother has started clear thinking and expression but not yet walking with her walker or with a cane as she did before the onslaught of forced action to get her out of her Independent Living Apartment. She is in a wheelchair outside her room. She needs help in 3 or more qualifiers for Nurses Aids. I have the original agreement for the $1,000 extra per month for insurance and the documents where Mother's facility agree to the original benefits and the have received the extra $1,000 per month for the same since they bought the facility out of bankruptcy... . . In addition there is a Health Care issue of great significance. Mother has not been given her eyedrops on a regular basis. She has Glaucoma and for her eye health this is a significant issue. She has had a deterioration of the eyes since being treated in P.C. Are any of these issues legal matter for an elder law attorney. We have this documented. Ther is more that could be discussed confidentially. Thank you for any feed back.

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Extra money,which in this case is $1000 per month, was akin to a discount on extra services that would have been more expensive without said discount. Now facility wants to cut back on these services, but not a decrease on this premium.

All these facilities are passing the buck and covering their a**es in the event something bad would happen, they would not be sued.
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I've been trying to figure out the insurance aspect of this, I think I finally understand.
Your mom paid a $1000/month premium which was supposed to cover the added cost of nursing care in the future, and now the care she has been provided is not up to par. So you hope to sue to either make them honour your understanding of the original intent of the insurance or to recoup some of that money, but you don't have the original documents so you can take them to a lawyer to see if you have a case, and the facility will not provide a copy.

Your mother and POA should definitely have a right to a copy of the original contract, but it seems to me that $12K per year was awfully expensive long term care insurance, there must still be something missing from this puzzle.
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This was kind of confusing to read, but if I understand it - your mother has been paying 15 years for services she didn't need, and now needs, but they are not providing and the facility is not working with you?
First, IL residents are not monitored. It is expected that they are continent and can self care. When they are unable to care fully for themselves, administration recommends moving to AL. IL cannot force a resident to do anything they don't want to do. (I'm not sure I understand why you had to pay $1000 extra for 14 years for services she did not need or use! The "insurance" thing sounds odd to me since she isn't getting what she supposedly paid for for 15 years)
Based on what you are saying, it really sounds like you should be looking for another facility who will communicate and work with you to design a care plan (and monitor her more closely)
Regarding falls: it is very difficult to monitor a senior 24/7 even with alarms put on chairs and beds. If there is dementia, it is really really difficult. (We went through that with our mother - her dementia was bad enough that she didn't understand she had to wait to get help, and that she couldn't even stand up alone. Even with alarms, velcro belts, and putting her right in front of the nurses station, she still fell a couple of times because she moved FAST.)
Even in AL, if your mother is strong enough to get up and walk without assistance, they can't force her to wait for help, or to use a walker if she doesn't want to.
No facility can assign an aide to be with her every single minute unless you pay for a full time aide, day and night. The thing is with getting old - you have to go to the bathroom in the night and that is a dangerous time for them, dim lights, slightly disoriented after waking, and not as many aides around - especially if she is strong enough to get up on her own. Alarming the bed is the only answer to that.
If I were you, I would research other facilities.
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If you feel the place she is living is not doing a good job or giving value for the money then you might investigate moving her elsewhere. Since your brother signed the contract I assume he has POA, is he open to that?
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freqflyer - you sound like my brother or the Administration regarding that elderly fall. Elderly shouldn't fall. It is up to a loving soul to see that they do not fall just as it is to take care of a baby before they can take care of themselves. More attention should be given to elderly who are a fall risk.

Administration at Mother's facility did not take alarm when Mother had 3 falls when she was in there care upon first moving her to Personal Care. I asked for an incident report, they did not give it to me. It was negligent for the Nurse to bring her back to the room and leave her in front of the TV at a time when Mother could not get in and out of the wheel chair herself. Mother was afraid and frightened when I walked into her room. She was on the floor Thanking God I got there. She had been on the floor for some time. In busy Personal Care Unit the Nurse didn't know that Mother could not ambulklate herself or that a fall was likely. Mother was bedridden at that point but could be taken by wheelchair from her bed and taken in to breakfast. She should have been brought back, used her bathroom and then taken back and tucked into bed. Elderly fall and there injuries can lead to a downhill slide to untimely death from effects of a fall. I've seen that happen to a friends parent when she had a Nurses Aid forr the day and the Aid was called out to another resident while she was scheduled to be with my friend's Mother. His Mother wandered out of her Independent Living Apartment and fell down a flight of cement stairs. When discovered she was put back in bed, She and his Father were moved b y the family to another facility. In a subsequent fall at the new facility she was xrayed and it was found that she had broken her shoulder and her break healed the without treatment she shoukd have had bringing her complications.
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To JeanneGibbs. There is a long list of unreasonableness: 1} Overusing her Medicare every time she had a dizzy spell and subsequent visit to the emergency room, the Administrator advised a Visiting Nurse, 2 Physical Therapists, 1 Occupational Therapist. After the fist "Care" program Mother had enough. The facility blamed me that Mother did not want to participate in their program. Mother and her Dr. said, it was too much. It wasn't my decision. I was the messenger. Mother was injured in PT, fell and knocked herself out, went from the hospital emergency room to Observation where she fell and broke her nose, went to the facilities Health Care Center where she was denied treatment from the assigned Physician. A cough became Pnemonia for lack of any care from the Dr. He never showed up. She was there 3 weeks. I was told to quit complaining and not to call the Dr. for her, that it was not an emergency. Finally we called 911. She had pnemonia. After a hospital stay she went back to I.L. with me and our kitty cat. When we had a Nurses Aid for a Dr. appointment I finally made for myself, I was falsely accused of leaving Mother in a soaked bed. Mother has never had an incontinence problem. The bed was dry when I left her with the first Nurses Aid that watched Mother the first 1/2 hour. There was a second Nurses Aid that made the complaint to her supervisor. I was blamed without checking with the first Nurses Aid or myself. The first Nurses Aid subsequently told me that Mother was in a dry bed when I left and when the second Nurses Aid showed up and she left. It was a made up story, a pretext to get my Mother out of her Independent Living Apartment to the Health Care Center and then into Personal Care. Mother was recovering from the mishaps/negligence - she could walk 200 yards with a walker, she showered and dressed herself, things were going good. She went downhill in the forced move. In her first few days in P.C. she has 3 falls when she was being taken care of through their services. At that point, we obtained private Nurses Aids for a 8 hour night shift and I stayed with Mother 16 hours a day. We were glued to her to make sure she had no falls. She is recovering. She cannot take care of herself as she did before the forced move. Now I stay with her 12 hours a day. At night the nurses aids in PC check on her every 2 hours. (They do this with all the residents in P.C.) She can get to the bathroom and back herself. We pray every night that she stays safe and for healing. Mentally she is healing faster than walking again. She can walk 50 yards with a walker when she is feeling good. Otherwise, she uses a wheel chair.

We still cannot get a copy of the contract from Administration. It was sent to my brother who lives out-of-town and he signed it and sent it back. I asked him to be alert and if it was sent, not to sign it as they would not let me take it home to read over and/or take it to an attorney for their advice. He said he did not keep a copy. He is out-of-touch, does not visit, hardly calls. Didn't remember her on her 99th birthday. I called him so he could wish her Happy Birthday. He has no clue.
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cwillie The Senior Care Facility has an Independent Living Section, A Health Care Unit, a Personal Care Unit(formerly Assisted Living with less services), and a Memory Unit. The extra $1,000 was paid (on top of her fee for the apartment, cleaning and dinners she paid for for 14 years) while Mother was living in Independent Living - insurance for full time nursing assistance if she was unable to care for herself. At $25.00 per hour that is $210,000.00 per year. A friend of Mothers paid $1,000 per month to an outside Insurance Agency and she remains in Independent Living with round the clock Nurses Aids. She had a career as a nursing administrator in the military, and she mentors me that Mother should have been provided with round the clock Nurses Aids through the facility under the insurance Mother has paid in to.
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Actionable? No. For $400 a day she could be in a very nice nursing home, which is where she should go. Keeping her in IL or PC is NOT the same as skilled nursing, not even close. The burden of responsibility here is the person with POA.
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daughterlu, once an elder starts to fall on a regular basis it doesn't matter if they are living in a continuing care facility or at home. It is almost impossible to be glued to the hip of an elder. You could go to answer the telephone, and sure enough the elder will fall in a blink of an eye. That is just what elders do.

Yes, it is important to have those eye drops for glaucoma, but there are times when the patient doesn't want them. As long as your Mom is of clear mind, she can refuse those drops [which will burn for a second once the drops are placed in the eye].

My Dad moved from his Independent Living apartment into Assisted Living, he didn't mind it was a smaller suite, he was happy knowing he wouldn't be paying for the extra levels of services, as those were included in the Assisted Living monthly room rate. He really enjoyed all the extra attention.
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She was in Independent Living for 15 years and then she was forced into the Personal Care unit of the same facility. Is that correct? From what you say that sounds like a reasonable move.

You certainly shouldn't sign any contract without reading it and being able to show it to your lawyer!

What is it mother is being refused? What kind of action do you want to take?
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I found you post very difficult to follow. I'll summarize what I believe it says, correct me if I am wrong:

Mom has been in an Independent Living apartment for 15 years and has been paying an extra $1000 per month for extra services - Personal Care.

Mom's IL has a new owner and they have not been willing to honour the Personal Care contract, or their care has been sloppy and inadequate.

Mom's health has changed significantly in the years she has lived there and she needs more supervision that the IL is allowing/providing.

Does that sum it up properly?

I'm surprised the IL has accommodated your mom as much as they have. (unless this is also a Continuing Care facility?) Most IL's that I know of will evict immediately when a resident needs such a high level of care, it sounds as though your mom would be better suited to Assisted Living or maybe even Skilled Nursing care.
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