Why are there so many extra charges when it should be included in rent?

Exactly. Read your contract. I'm assuming this is assisted living, where fewer things are included in the initial payment. Nursing homes still generally charge for haircuts. I do believe personal laundry is often extra, as well. Find out ahead of time so there are no shocks.
Take care,
Carol

A good AL or SNF will spell out for you what services are included in the rent. They want your expectations to be accurate.
AL facilities typically have a base level of care (determined by an thorough checklist of a resident's ability to perform the activities of daily living). If a resident requires more care than that, there are usually 'care levels' available for an additional fee. Caregivers keep track of the care they provide and communicate with families when that care has increased significantly so that, again, families don't get any surprises.
Things like haircuts are rarely included. AL owners try to strike a balance between not being perceived as 'nickel and diming' their residents, but also not having to increase their rates to include more 'basic' services. Logically, a person would want to pay a low base rate and only pay for services that they use beyond that, but psychologically, people tend to like the idea that everything is included (even though that means they are paying for services they aren't using). Oddly, consumer research shows that people tend to think of included services as 'free'.
In the ALs that I am familiar with, families may provide additional services on their own in many instances. For example, you (or someone you choose) can cut your dad's hair, you can buy the wipes. If your AL doesn't include it, you can choose to do the laundry, too. You can often contract your own caregiving, too.
p.s. $3,800 per month would be considered a bargain for AL where I live.

In Canada, or at least in Ontario (provinces have different fees) we are subsidized so that long term care (basic) is $1,674.14. Haircuts and manicures are extra, but that's about it! (and if you run out of money, there is extra subsidy available...which is why we don't mind paying taxes!)

I like this analysis the includes that thought that people regard included as free. That is an important thing to keep in mind. That is why i still pay for my phone texts one at a time for 20 cents. Until three bills in a row go over the limit for the smallest plan, it still is a good deal to pay nothing for the months I use nothing.

First don't worry about the laundry or haircut, be concerned about the big ticket items. The room and level of care cost should be your primery concern. Negotiate the cost of the room, it works. We have also found out that you should get the cost of the highest level of care . If these two numbers fit your budget your set, if not, renegotiate. Sometimes places will discount the room cost and evaluate your loved one at a low level of care to meet your budget . Be careful, levels of care go up quickly. Ask if there are any room specials, corporate owned facilities always has specials and if not walk. They will find one in the next day or two. Look past the frills (carpet,plush couches,magnificient entrances) your paying for all that. Just think, when was the last time you paid full retail for anything. Long term care should not be different. Remember AL and NH are a big business and the ones that give us the best care at the best price get my vote.
Read Cindi's blog at it is about her visit to a AL facility.

If you have already spoken to the administrator about the extra charges; you may want to consider going up the food chain and speak to someone in the corporate office about your concerns. In addition, in most states, an independent ombusman is assigned to each facility that can assist you in resolving your issues. The facilty itself should have the contact info of the ombusman for you. Keep watching the bills and make sure your dad is receiving the best possible care. Go 'noles!

Thanks so much to everyone for your help. It just does not make sense to me that my mom's memory care rent is only $100 less than my dad's assisted rent. It did not start out that way but with each anniversary month, there was an increase from the privately owned company. I negotiated the last two years but still, in the last five years, the rent has gone up $1,000 a month. The woman who now works in the corporate office told me that I am LUCKY to ONLY pay what I do and that I must have been grandfathered in at a lower rate! The nerve! I am still going to call the corporate office to re-negotiate my dad's bill because it does not equate to my state's average. Like I said before, my dad is ambulatory but needs a shot each morning for diabetes. Does not make sense. Thanks! Go 'Noles!

It doesn't make sense that there's only a $100 difference between skilled nursing and AL, unless there's a big difference in the amenities of the community.
Given the $3800 rate you mentioned, $1000 in rent increases over 5 years is a lot. Did the community change in that time - maybe from 'no-frills' to 'upscale'? In one of the communities I'm familiar with, the rent increase was about $300 over that same time period.
Injected meds usually incur an additional care level because specialized personnel needs to administer them and, with diabetes for example, they require special monitoring.
It's been my experience that being privately owned isn't the factor that determines that you'll be charged more or your rent will increase more frequently.

Thanks for your info. I think I need to call the corporate office and get this off my mind once and for all. I thought, too, that kind of increase over a five year period was crazy. Especially crazy when there was no increase in Social Security or my dad's pension in two years. That is totally unfair for all of us in that situation.

Dont forget about the Ombusman. It is always good to have an independent third party representative.