AL facility in CA wants to add a service to my friend’s care plan. We both disagree. What rights and recourse do we have?

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AL facility in CA wants to add a service to my friend’s care plan. We both disagree. What rights and recourse do we have?

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I am my friend’s POA so I end up signing things on her behalf, with her consent and review. The nurse (LVN) at the AL facility says she wants to add Escorting Services to her Care Plan, but my friend says she asks to be wheeled to the dining room only occasionally. The facility refuses to document how many times she asks for this service, so it’s hard to know how often she uses it. It’s an additional $500.00 x mo added to an existing $6,000.00 monthly cost for rent and services. I begged and pleaded with the nurse to not include it in the plan, but she won’t budge. Can I refuse to sign the new Care Plan Contract? If so, what could be the consequences?

Assisted Living Care Decisions Care Plan Elder Law

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Consequences are that she is given a 30 Day Notice to move out. And that is something that you as her POA really need to be aware of and how her being in an AL (rather than a NH/SNF) does not have the safeguards for how they can force her exiting. Fwiw NH/SNf as they take Medicare in some fashion, are mandated to have any exit done in a way that there is a continuity of care and as a NH has skilled nursing, they have to be discharged to another NH, to a hospital, to a rehab facility or to their home with a care plan set up. But for those in an AL, these safeguards are not required as technically it’s “assisted” care so the resident can and should be expected to be able to do for themselves with perhaps some help or assistance on occasion. So an AL can actually discharge a resident to a shelter. That’s bad optics so what AL do is find an erstwhile reason to call EMS to take the resident to the ER/ED of a local hospital then refuse their return. Often the AL will say “looks like they may have had a TIA Transient Ischemic Attack” as they are super subjective in how they “present”. If I were you I’d be on the alert if this type of move is done by this particular AL….. like chat with other residents families and friends to get a full vibe of how this place operates.

So what to do?? If she has not had an assessment done, that what I’d suggest to do. As it can independently establish what her capabilities are. But there is the issue that IF your friend asks for this extra fee assistance, even if she in theory and by her assessment can wheelchair on her own, then she is stuck having this fee placed on her bill every month.

Also an assessment will give you and her an idea of IF she actually may be needing or is at the cusp of needing skilled care aka in a Nursing Home. Cause if she is, y’all really need to speak with an atty familiar with the MediCal system as it runs very veeeeeery differently than LTC Medicaid in all the other states. Like no asset limit but income max is low and if hers is over the income amount she will have to do things to lower her $ so she is legitimately not over-resourced for income. And it’s not a DIY.

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Reply to igloo572

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Brookdale did this VERY thing to my father, who's room was about 250' from the dining room and he needed help with his wheelchair ONCE. As soon as Brookdale bought out the lovely AL my folks were in, the nickel and diming started HARD, while the quality of everything crashed. The food became nearly inedible, the caregivers took forever to respond to a call light, you know, the Cutting Costs While Raising Rates Program. I did have recourse, thankfully. It was to move my folks out of the corporate owned business model into a privately owned AL that was heads above in every way, and quite a bit less expensive to boot. I suggest you do the same.

Best of luck.

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Reply to lealonnie1

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Brookdale is imho all about being visually appealing to families under duress.

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Why is it she needs to be wheeled occasionally? ALs charge for any assistance they need to give. Moms had 4 levels of care and Mom was #4 the highest level of care. If your friend does not want to pay for this, then she has to wheel herself down for meals. I know some ALs that charge to bring food to your room. Maybe if she is far away from the dining room, she can request a room closer.

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Reply to JoAnn29

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OMgoodness.
This is a problem.
Escorting service is needed according to the facility.
1st question: Is this something you CAN refuse?
Because at the ALF where my brother was, if needed this could not be refused. It was up to the ALF to assess whether or not you needed this.
Now let us assume that you CAN refuse it?
What's the next step. Do we assess by weight and if to many meals are missed then it is again added? Or do we assess by number of meals missed? And if missed were they missed because she simply cannot eat three meals a day anymore (few seniors can).

I don't know.
Complex question here.
And if we are talking 1/2 grand a month I guess I am wanting an answer.
I would meet with the administrator at the facility regarding all of this. My brother never ate three full meals in his life. At his ALF he often skipped either breakfast, lunch or supper--HIS choice--at any given time.
I would want an explanation on this.

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Reply to AlvaDeer

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They do evaluations for this exact situation. If your friend is going to ask for this service she will be charged for it. Her idea of once in awhile may be completely different than how they define it. I guess you could ask not to hav3 this service but then she can’t expect it either.

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Reply to lkdrymom

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AL facility in CA wants to add a service to my friend’s care plan. We both disagree. What rights and recourse do we have?

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