The assisted living facility sent a letter saying they are changing to a point system for the extra care costs. Once they evaluated my mom, her price had gone up $2100. Then they wanted us to start paying that new amount within 10 days. Is that right? That is a huge jump!
They did not charge extra for extra things for my dad...it was all inclusive. They were great! Sadly my dad was only there for 6 weeks before he passed away. He was just really beginning to enjoy it. He especially loved the Bingo! He won three weeks in a row (he teased that he didn't think anyone else could see as well as he did). ;-)
Story...shop around. Prices vary greatly from place to place.
Thus, moving Dad into senior living cut the cost in half in his case, even with the later added levels of care. Dad saved for these "rainy days", so I was grateful for that. If he didn't, then it would be difficult to budget.
Dad loved his senior facility. One time I thought about moving him into something larger, but scrap that idea. At 95 it would have been difficult for him to learn the footprint of a new facility, learn the faces of the Staff, and try to make new friends. And what if he didn't like the food? He enjoyed his meals where he was, and looked forward to all the meals :)
Assisted living is expensive and it's no fun realizing that your mom needs more care, which means more expense. $2100 a month is A LOT of money, so it's well worth your while to investigate this further. The first thing I would do is hire a private care coordinator for your mother. This is either a social worker or a nurse who specializes in seeing to it that elders get the care and services that they need. A good elder care coordinator *really* knows how the system works and is a strong advocate. I'm talking from personal experience here, for I used one. I hired the elder care coordinator, but I made it clear that her job was to look after my mother's best interests, not mine or my brother's. The procedure she followed was this: I had an initial meeting with her, where I explained the situation and brought in all the paperwork. We negotiated a flat fee, where she would visit my mother and evaluate her for the level of care that she needed. She then wrote a detailed report, explaining what services she thought my mother needed and why. In my mother's case, the assisted living was claiming that she needed a higher level of services than she actually needed. Next, the care coordinator met with my mother and the family, and explained the situation to us. She discussed how my mother can advocate for herself and how we (the family) can be good advocates for my mother. Then, the care coordinator met with the assisted living (the advocacy part of what she does) and got them to stop the unnecessary care. We ended up hiring the care coordinator to meet with my mother quarterly, so that someone independently reviewed what was going on. The assisted living was effectively put on notice that we (the family and care coordinator) would make sure that mom got the care that she needed, not too much, nor too little. A private care coordinator is not cheap, but I found it to be money well spent.
Viki62: a similar incident happened to me. I found an independent living that was in a great part of town, with lots of activities appropriate for me (and my physical limitations). The lady who ran this place was kind and caring. She spent an hour interviewing me, to see if I would be a good fit for her place and if I thought the place would be a good fit for me. It was a popular place, where openings were rare. When I came to the top of the list, this good manager had just resigned. The new manager had attitude--the "I'm just doin' my job..." sort of attitude. The new manager showed me an apartment that was completely unsuitable--I don't need a wheelchair friendly apartment that had a hallway to nowhere closet. She showed me another apartment that had just been refurbished, but the workmanship was poor. I asked her to explain the terms of the lease to me and how rent was to be paid and she cut attitude. She cut attitude when I told her that I would give her an answer in 48 hours. I loved the location, hated the apartment and REALLY hated that manager. I knew that I was better off staying put. Places can change when there is a change of management. Sometimes, it's for the better; sometimes it's for the worse.
This is why I recommend that families put their loved ones on waiting lists for appropriate living situations. Why? Places change. People move in and out. Staff and management changes are commonplace. Your loved one could discover that the lovely assisted living also has a sneaky bully clique that management refuses to stop. (Bullying in senior living is commonplace. Most places have, had or will have a problem with bullying. Good management is quick to put an end to it. Bad management ignores bullying and it becomes entrenched in the building's culture.) The best independent living, assisted living and nursing homes all have waiting lists, and sometimes they are quite long. Let's say, your elderly parent is in his or her mid 80s and successfully living in the community. You will want to get your parent on the waiting lists for the assisted livings that are appropriate for your parent should he or she no longer be able to live in the community with support. You want to stagger the applications so that your parent comes to the top of the list at a good place every couple / three of months or so. When your parent comes to the top of the list and doesn't need that level of care yet, you ask them to put your parent at the bottom of the waiting list. As your parent becomes frailer, you will add nursing homes to this. This way, when the need arises, you will be able to get your parent admitted to a place you've already checked out. Yes, your parent may have to spend time in a place you didn't check out ahead of time (or a place you don't particularly like), but eventually, you'll be able to get your parent into a better place.
Before you 'lawyer up', sit down with the executive director and the nursing director at your Mom's AL. Here's your agenda:
• Discuss why your Mom was assessed. Did she recently begin to need more help or was this a regular, periodic assessment?
• Review and discuss the assessment. Typically, they're very detailed (can resident brush own teeth, etc...). Do you agree with their determination of Mom's abilities? If not, ask for an explanation.
• Plan a path forward. If ten days is not sufficient, work out payment terms. If your mother can't afford to stay without a negotiated reduction of her rent, work it out.
Before you go to the meeting with the directors, call another AL in your area. They won't be able to tell you how they would assess your Mom without seeing her, but they can tell you what they charge for a similar apartment and what their fees are for their care levels. Make sure you understand the care levels. Typically, the base rent in an AL includes base level of care (less than an hour, though it's typically expressed in points). It can be tough to compare apples to apples without talking it through. Level 1 at Community A may include something that it doesn't include at Community B (for example, Medication Management is sometimes included, sometimes not).
You can also have another AL come in and assess your Mom. That way, you'll get an reliable quote of her rent at another community.
Keep in mind that sometimes ALs are guilty of letting increasing care needs creep up without keeping the family in the loop and then, when they re-assess, it comes as a surprise to the family.
Care is expensive. If a community isn't charging for it, it's either not providing it (clearly a bad thing) or it's providing it and not being compensated (and will eventually be in financial hot water). In either case, it's a red flag and you should take a critical look at whether this is where your Mom should be.
I know when my Dad needed a Med Tech to manage his pills, the extra cost was $1k a month. Then I added on night service, where an Aide would come in to help him get ready for bed, another added monthly cost. But Dad lived in Independent Living. Once he moved to Assisted Living/Memory Care, everything was included in the monthly cost, there were no added levels.