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My 89 year old MIL has a myriad of health issues...COPD, A-fib, high/low BP, lung cancer survivor, macular degeneration, hearing loss, anxiety, depression, arthritis, mobility issues. She lost her husband of 68 years in Dec. 2018. My 93 year old FIL had been her caregiver for a number of years, which allowed them to live independently in their home. As a result of my FIL's passing, our family moved quickly to find her an assisted living community. She moved in to her new AL apt. home in early January. The home she shared and most of her belongings were sold in an estate sale. My MIL was agreeable to these steps, knowing it was the best course available. That is not to say that it wasn't difficult. There have been many adjustment pains, but for the most part, my MIL adjusted remarkably well for the first 3 months. Her depression and anxiety increased dramatically within the last month. She began falling (sometimes multiple times per day). She was constantly calling my husband and I, wanting us to come to her apt. at all hours of the day. There were multiple ER trips for labored breathing. We came to realize that it was not COPD related causing the breathing issues, but her anxiety. Medication for both anxiety and depression has been initiated w/in the last month. She was admitted to a wonderful rehab hospital for 2 weeks as her AL facility could not let her continue to stay in her apt. due to her frequent falls. My MIL had to adhere to 3 hrs of therapy daily at the rehab hospital. She did well the first few days and then wanted to do little but sleep. She pretty much told my husband (who has POA) and I one day that she was done. She didn't want to engage in therapy, eat or drink. She just wanted to die (she has voiced this numerous times since her husbands death). The next day, there was no mention of the previous conversation and she had gone to therapy and eaten and drank. She has been confused, but does seem to be improving somewhat mentally. The rehab hospital increased her depression medication. Upon discharge today, she is not at a level to return to her AL community and will be admitted to a skilled nursing facility. We hope this skilled nursing stay will give us some time to figure out our next plan of action. Her current AL community is Level A...we were unaware of the different care levels until recently. We are not sure if she will be able to return to her current AL and if so, for how long? We are required to give 30 days written notice if we move her out. In the meantime, we are paying $3100+ per month for services/housing that she is not receiving. We feel it might be best to move her to another AL community that could provide the additional services following the completion of her skilled nursing stint. Thoughts, suggestion, guidance would be most appreciated.

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I would encourage you to look at a higher level AL or possibly a MC. My father's MC was able to add services (at additional costs) for almost anything until the resident needed some type of skilled nursing more than 4 hours per day. So if a resident needed breathing treatments for COPD or just a daily check out by an RN to monitor diabetes or CHF, that was available. You could also add a personal aid/companion for several hours a day. They only accept people who are one person assist transfers but after you were there, they tried to provide the resident's increasing care needs and delay a transfer to SNC as long as the resident participated in the group. My father wasn't much for group activities, but he did come out of his room to sit on the porch, and he got out of bed to sit in a rocking chair in his room. I was concerned when Dad started making repeated short hospital trips to treat his CHF that the MC would want him to transfer out but the director told me that as long as we were willing to pay for the additional help he needed and Dad only needed medication and careful watching he could stay. The additional fees were only substantial in the last three months of his life and even then the total cost was less than skilled nursing.
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Kukinana Jun 2019
Thanks so much for your insight. Please excuse my ignorance, but what does MC stand for? This is a whole new world for me!
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Why don't u leave her in skilled nursing. ALs are limited to what they can do.
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MC stands for Memory Care Unit.  It can be a stand-alone facility or it can be one of the "units", "Hallways", "Floors" in a Long Term Care (LTC) facility.  Many LTC have different types of nursing "units":  Skilled Rehab, Memory Care, Long Term Medical care.  A Memory Care Unit usually is staffed by nurses, medications aides and CNAs who have completed specific training in how to deal with people with memory problems such as Dementia or Alzheimer's.  The door to the unit is either locked or the door closes (and locks) when a resident wearing a "wander" device activates the door to close thus preventing the resident from leaving the unit unsupervised.  You can Google "Memory Care" and you will find lots of information about this type of care. 
Click on blue ribbon "Care Topics" and you will find a list of topics related to assisted living, long term care and memory care.
The website "caring.com" has good information about assisted living and memory care.
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Give notice to the Al today. Do not pay another month.
Be ready to get her things right away.
Tell Mil she is just having a temporary setback and she can recover!
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