Can an assisted living facility give you a new price without a 30-day notice?

This question was certainly an eye opener especially to those on the fence about needing to put a loved one in assisted living care. I do remember when we visited several assisted living facilities, they gave us a list including a one time enrollment fee, basic fees (depending on level of care) and amenities with tack on fees. Also, the cost for the 4 levels of care varied quite a lot. The administrators mentioned fees could change "every 6 months, however, normally fees are evaluated the beginning of each year." I would check with an elder attorney and perhaps the Department on Aging in your State. The cost for your mother, depending on care, should have been thoroughly evaluated and explained prior to any "legal" papers signed before mom moved in. It's protection for both---your mother and the assisted living facility. If nothing can be done, I would certainly suggest moving your mother to a different facility. This could be a huge red flag. Never heard of a $2,000 fee needing paid within 10 days! Good luck. My prayers and thoughts are with you.

An point-based assessment is the norm in Assisted Living. I'm curious about how your Mom's AL determined her care level prior to assessment?

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 am a volunteer elder housing advocate.

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.

I just discovered that my ex-husband's costs for a private room in the nursing home, which include a 10 hour a day personal sitter, amount to $11,000/month. Both my kids are praying that he doesn't live longer than his resources, which are nearly $1 million (eldercare attorney said they would last ten years, he is 82 with dementia but otherwise healthy). Even so, it is a strain on them, as they feel obligated to visit him every day (I am lucky to see them and the grandchildren once a month). Since both my children work full-time this is quite a strain on them. I really think we are living too long under conditions that none of us really want. Once I can no longer drive, I think I will also quit taking preventive medications for blood pressure and cholesterol. My father died of a heart attack at 63, and I am beginning to think he was lucky! I know that my second husband's death from a major stroke at 72 was better than his living in a nursing home unable to swallow, walk or even watch TV or read (his central vision was destroyed). All of us on this board are silently thinking, am I prepared if or when this happens to me?

When your Mom moved into Assisted Living, the facility must have given her or you paperwork.   Read over the Lease to see if there are any clauses that say if your Mom has been re-evaluated and needs a higher level of care, then the cost will go up.

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.

This is a really good question. I got a call from my mom's assisted living and they said mom had been reevaluated and would go from level 1 to level 3. So that would mean an increase of $1000 a month. And the day she left the message (on the 23 of January) the increase would begin. I will definitely find my paper work and check out the fine details. Another thing strange happened. When we checked out the facility we were sold on the place because of the head lady was so excited and we were very impressed with her and her knowledge. The month mom moved in we got a letter that the same head lady resigned. Weird!!

To add to my answer from a couple weeks ago, I figure if my Dad was still living at home, it would be costing him $20,000 per month for around the clock caregivers.... plus the cost of Dad paying real estate tax, utilities, buying groceries, and other maintenance on his house.

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 :)

This points system, although it may be common, is one reason we turned down a place we toured. We called and asked their price for memory care and we thought "wow, that sounds reasonable for our area" so we went over to tour because we needed to work something out soon. Made the rookie mistake of doing the whole tour and then going over costs (ie wasting over an hour talking to the very nice manager). When I wanted a price list of 'extras' not included in the base price and she started talking points and it depends and we evaluate and it could be this and it could be this and probably the maximum is this and we reevaluate and it's hard to say and this is the range etc etc etc. We promptly told her they are out of our budget. If her 'possible' costs were going to be $2000 over the base price they gave us over the phone to get us to come in and tour, then just think what it could be 24-36 months down the road! And with all these maybes, they can just reevaluate and you never know what their perception is going to be. We promptly dismissed that place. Someone had told us about all these 'extras' that can be astronomical -- $25 a day to walk the day, $30 a day to administer meds, etc! We did like another place was was really nice and they had a 'everything is included in the price' except a couple of small things. However, their memory care only had maybe 13 residents and a wait list of 7! So no way we could get in there for quite some time. Nicest memory care I have toured and the price was not outrageous. In the end, we went with a board and care very close to our home that has been in business with the same staff, including a physician, for 15 years. Everything in included in their price, until diapers are needed (which are extra cost). They may evaluate her annually and discuss if her care has increased. We aren't worried about surprises or management changes. It takes so much research, tours, advocacy, being on your toes and then that isn't even enough! I cannot believe Mia has gotten an enormous increase with only 10 days notice!

*Arleeda* bless your heart for your thoughts and concerns in your post. I understand. I fear our age group will have nothing to look forward to but more worries and concerns.

If you happen to be lucky enough to live in or near Mt Pleasant Tx, I suggest checking out The Lodge Assisted Living and Memory Care. They took my dad, who could barely get himself from his bed to the bathroom, for 110.00/day. They gave him his pills, checked in on him every two hours, day and night, and took good care of him. They are a beautiful facility, only two years old, and have a memory care wing (cost more then 110.00 a day though but still reasonable). They also have aging in place, meaning that, dad could stay there even if he got worse and needed full care though costs would go up then.

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.