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Is this the norm? My dad pays 350 a month for med management. They just raised his care cost by 500 dollars and I was told one of the fees was because they have to assist him with his Spariva inhaler. This was news to me since he had always taken it himself. They told me sometimes his hands are week so they have to push the disk for him. He then showed them that he could take it himself and I am waiting for word back as far as if they are removing that fee. Even if they do assist I would assume that would not be an extra charge. They also added a charge for incontinence care. He had a stomach bug a few weeks ago and he did soil himself a few times due to that. He is unable to get to the toilet himself due to mobility issues so we pay for transfers and he sometimes waits 45 minutes after he presses the call button to get someone to assist him but other then the bug he calls for a transfer and toilets himself. It’s very frustrating. I spoke with the executive director last week (she just started the same week he moved in) and am having another conference call with her tomorrow so would love to hear some feedback

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Can you assess his spiriva use by being there when it is given just to confirm? There are patients who become weak and unable to trigger a device. Speak to his doctor about this. It is an anticholinertic and there are many alternatives to this drug that are just as effective. If an alternative can possibly be a nebulized solution, check with management to see if there is an added cost for this to be given before you ask the physican. Nebulizers are difficult to keep clean and take longer to deliver.
To answer your other question about rising prices, yes it can happen. When my mom's incontinence got worse, her monthy bill went up by $800. But it only happened one time and any annual increases were not as significant.
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Med management is just that for his medications. They order and distribute them and keep records.

My Moms AL had steps and Moms care was #4 the highest level of care. ALs are just that, they assist. The person should be able to do most of their ADLs. The more that needs to be done for them, the more fees will be included.

I just watched a video showing how to use this inhaler. Its fairly easy but there is a certain way it must be used. He has to breath a certain way for it to work. The capsule does have to be placed correctly or it won't be pierced. Needing help in any way there will be a charge.
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These charges go by "levels of care" and any movement from one level to another adds a certain cost. Refer to your admissions manual or discuss with administration what the levels of care consist of.

The facility itself makes the levels of care and the careplans. You have the choice basically to accept their assessment or to move. There really isn't a whole lot of wiggle room in all of this. And this amounts really to the number of caregivers and the amount of time that must be spent with the resident.

You sure can discuss with management; that's about ALL you can do unfortunately. I am surprised that assistance with the inhaler, if it is routinely given, not PRN (as needed; as requested) isn't a part of medications, as this takes moments only. I am NOT surprised at the needs for management of incontinence if that continues to be an issue.

I wish you luck and hope you'll update us.
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Most charge a basic monthly fee. Any additional services are considered ‘extras’ and they charge for them. Prices can add up quickly if you use these services on a regular basis.

When you initially viewed his facility, did they go over these costs with you?

When I toured a few assisted living facilities for my mom years ago, they went over the basic costs and the extra expenses. They also said that some of the ‘add on’ fees were negotiable.

If I were you I would try to negotiate with them for the lowest cost. I suppose that it would depend on who owns the facility?

Is your father’s facility run by a corporation or privately owned by a group of individual investors? A corporation may be less likely to negotiate with you.
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Amanda1996 Mar 11, 2024
We went over all of the costs prior to signing they contact. They do a la cart. My confusion is with why use of the inhaler would not be included in the med management. With the ED being new I’m wondering if she in misinterpreting the policy. It is a cooperation, I have been able to negotiate a few things so hoping for the best when I speak to her again today.
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