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Nurse says she has authority to order services, whether or not the family agrees and that residents will just be billed. She says the private aide hired by the family cannot help resident with showers, “per California law”. Is this true?
This place calls itself “independent living” and only other option is locked-down memory care. Turns out the nurse just decides what “assistance” a resident may need…without enough/any input from family (or even from spouse who shares the apartment).

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This sounds like Assisted Living if the next step is Memory care. Independent living, in a community setting, the person has to completely independent. Usually meals are included, activities and outings. They live in apartments or in my Aunts case a cottage.

If this is Assisted Living, the Nurse is correct in that services are provided by the AL. In my Moms AL there were care tiers 1 to 4. My Mom was 4 and paid the most for her care. Room and Board were $2k a month as was her care equalling 4k a month. Since these services are provided, why is family hiring a CNA?

Yes, you need to read the contract. I also agree that there is liability involved by bringing in a CNA who is not part of their staff.
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Reply to JoAnn29
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You need to look at the care contract at this IL facility.
You need to ask said nurse to show you the law.
Facilities have a right to make their own rules. If you don't like a rule you have the right to move. But as to laws I think the truth is being stretched or manipulated a bit from what I am hearing here.

Your senior may be placed wrongly at this point, and IL isn't what's going on now, do you think? I would think more now about what sort of care will be needed now and in future. Good luck to you.
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Reply to AlvaDeer
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If it truly is Independent Living, the "nurse" is incorrect. Family members can always help.

There is a strong Ombudsman system in California, please take advantage of it to ask for their help and advice, this is why they are there.

See the website for the California Department of aging to locate your local office.

https://aging.ca.gov/Contact_Us/
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Reply to Moondancer
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Showering has a risk of slipping and falling. It may be that the facility's insurance won't cover liability for an injury if it is caused by a person not employed and trained by the facility. Or the facility's license might have a similar restriction. Something like that.

As Grandma 1954 said, check the contract. There probably is assisted living in between independent living and memory care. Are you sure that the couple aren't already living in the Assisted Living rather than the Independent Living section?
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Reply to MG8522
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Many facilities have restrictions as to who can come into the facility and care for a resident. This may be due to liability.
You would have to look at the contract/lease documents to see what the requirements are.
Generally there are 3 levels of care facilities
Independent. Staff usually is prohibited from helping a resident.
Assisted Living. Staff will help with ADL's as needed. the more help that is needed the higher the cost usually is. Many facilities have a "tier" system.
memory Care,, Generally for people with cognitive diagnosis and since the facility is usually locked anyone that may be at risk of leaving.
Some facilities also have Skilled nursing and Rehab.

The scenario that mention if the spouse is unable to help with ADL's it makes sense that an aide be available to help when it is needed.

to determine if this is California Law you would have to check. You could contact the Ombudsman's office and they would be able to tell you what is permitted and what is not.
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Reply to Grandma1954
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