Does your parent's assisted living charge for "extras"?

My sister and I now have the unenviable task of finding an AL home for our mother. She's 97 and can no longer live on her own.In the last two weeks we have found that picking a home is like buying a used car and all the people involved with these homes would be excellent used car sales people. They will not tell you anything unless you ask specific questions and everything seems to fall under "that's included." Maybe it is but DOES IT COST EXTRA? That's what they don't want you to know until you get the bill. So as I study this situation I'm making a list of all the things to ask specifically about and only after I feel I've covered all possible items will I consent to take tours at the homes we are interested in.
Also I would recommend that you go online to "Caring.com." These people have helped me in this matter so much and I can't say enough good about them. The service is free and worth every minute you talk with them. Very knowledgeable people. IF you get confused and frustrated with all this I suggest a small rum and coke. Good luck.

When my mom was in IL it was part of a "Tiered Community" that went from IL to AL to NH and had a hospice wing. There was a set list of fees for extra services.

If she did not go down and to the other building for lunch and had it delivered it was $ 5.oo. This rate was for IL and AL only. For mail and packages, they were left at the open pigeon style mail box area. If they needed to be delivered inside her apt or inside a room, it was $ 1.00 and if they needed to open mail or a package another $1.00 and my mom had to sign a release. Dealing with mail is considered a normal ADL so if they can't do it, then they can be asked to pay for the time for someone to do it. That makes sense for IL but is really pushing it for AL but what can you do? Now UPS would deliver boxes to her door of her 3rd floor apt. Maybe see if that can work for you.

I have never heard of such fees. Hopefully this will not catch on throughout the industry, although I think if enough people complain about it, then the AL communities will

Pete - well its interesting re-reading my answer from 2012! Rum & coke, rotflmao, I'll think you'll find a case of your favorite adult beverage will be needed. Plus go ahead & buy that tabletop ice maker at Home Dept.

I have a suggestion…..(my mom entered IL & NH in her 90's) your mom’s 97, correct? If so perhaps think to get mom MD orders for “skilled nursing needed” so mom can admit into NH & not AL. Unless mom at 97 is the rare still totally walking unaided & very active with no chronic diseases nonagenarian WITH all sorts of $ (like 200K+), she is going to run out of $ in short order. Mom may get into AL but there are either going to be all sorts of add on’s to her AL menu of costs or she/you/Sissy get the dreaded “30 Day” letter. Letter is “we just love love LOVE your mom but she needs a higher level of care” and you have 30 days to move her & find a NH. Unless of course, this place has an affiliate NH and will have the AL/NH MD sign off for SNF orders.

RE: $$. Does mom have oodles of $? My experience is that IF they live long enough they run out of $, caregiver runs out of ability & family runs out of nice & ends up applying for Medicaid for them. Costs of care is huge (8K - 15K a mo NH). Flat outlive their $. This was it for my mom. She went into IL at "tiered" facility. Problem was as mom needed more care, medical director of AL/NH section would NOT budge on approving mom needing skilled, it was only going to be private payAL. Her old gerontologist - which she continued to see as she was in IL - did write the orders for "skilled" and I was able to get her placed into a NH Medicaid pending bypassing the whole AL phase.

What I found (& I'm pretty jaded on all this now) is that AL are the profit center for senior care and there is pressure to keep elders in AL (private pay) when they could be in a NH (and possibly be on Medicaid). Most AL do NOT participate in Medicaid or do so on a very narrow basis. Medicaid although a joint federal & state program is managed by each state uniquely. Medicaid for NH is "dedicated" funding so the states have to pay (if a facility participates & the elder meets skilled care criteria). BUT Medicaid for AL is done on a waiver program. Most states do NOT do AL waivers at all; others have it so that it is a very limited program which downstreams to an even more limited # of facilities that participate. Or only certain types of AL beds on Medicaid waivers. Like for TX, 2 types of AL beds: CCF = continuing custodial care, so no Medicaid & like 80% of all AL are these; or CBA - community based alternative care, which Medicaid will pay for but has few participating vendors and limited beds. This is why you often hear they need to be in AL for 2 years or so before they can get a Medicaid bed.

2 years your mom is 99.

Most NH admits come from a post hospitalization "rehab" orders. Rehab is a Medicare paid benefit, so they sequeway into a NH easily; find they need higher care so stay in the NH. But if your mom is coming from living in IL or at home, she may not have the fat medical chart to show at-need for "skilled" care. If so you will need to get creative
in getting her eligible for a NH. Not simple but can be done. Good luck to you & Sissy!

Years ago, we had inquired to various assisted living facilities for my MIL and were amazed at how they nickel and dime you on every "extra" assistance. Think it is very common unfortunately.

so far i have not seen any extra charges for my father's assisted living. his level of care is moderate to maximum assist. his care level is included in the cost per month. as far as personal items, depends, ensure, and toiletries, i buy those at costco. his facility has charges for outings (pinics, diners out, baseball, hockey, etc). he has a personal activity account that i deposit money in as needed.
as yet i have not rseen charges against this account for deliveries of meals and packages.

My 89 yr old Mom is in AL here in MA. When I started visiting different facilities I asked about extra charges. One charged $10 to bring a meal to the room (sick or not). Another allowed only 1 hour of service per day and there was a list they worked from: it was X minutes to bring someone to and from the dining room, Y minutes to help with dressing and bathing, etc. If more than 1 hour was used, the charge was an additional $5o per hour. In fact, the aides actually had stopwatches so they could time their visits when someone asked for help. It was appalling. The AL where Mom is now doesn't do any of this. The only extra charge is for laundry services: $1 for wash, $1 for dry. (They are pay machines.) The staff does this overnight.

Balapins. That sounds crazy. AL is so expensive. I thought a was paying for "Assistance" Some days my Mom would need more than an hour, but usually not. I can't imagine the aids with stop watches.

Good news where my Mom is the head nurse put a stop to it. She said that many of the residents were incapable of carrying large packages and she was worried about the liability if it caused someone to fall.

Hi there, my 80 year old mother goes for respite care to a local assisted living facility. It is a beautiful place, and there are always extra fees. I'm looking at the fee chart they gave me right now. She goes for 5 nights this month, then she will be going for one week per month. It is only 100 per day, including meals..which I find to be really cheap. They have a day care for 12.50 per hour. Medication management is 275 per month, or prorated per day for us. They offer security pendants for a 125 one time fee, their room service fee is 3.00 per meal, the pet fee is a 250 one time fee, internet fee 10 per month, and there are fees for the beauty shop. They will even offer a companion for 10.00 per hour to play games, read, etc. We are in central Florida, and this is common practice, but we expected it.

Mom's memory care provides one on one caregivers for $25 an hour and these folks do nothing sometimes not even on the same floor as their charge - I bring in private caregivers from an outside agency for a few bucks less an hour - I had no idea this would be necessary when I chose to place mom at this top of the line facility nearly a year ago