Mother moved into assisted living on October 19, 2015. Finding it hard to find out the costs of her care.

You can call her doctor and request that he send an order for crushing certain pills by FAX to the assisted living nursing office (ask the AL what is the best number, doctors orders have to come by FAX or snail mail, email is not accepted). You may know which pills you mean by this?? Crushing does require a doctor's order.

I would get POA on her checking account and DPOA for sure, and have the bill mailed to you monthly which means you get detailed account of everything on the bill, including all of her "care plan" add ons, and all of the extras for the past month (FOB calls, prn meds, extra escorts, etc). Then issue the check on bill pay. Using an automatic deduction from the account leaves you out of the loop too much in your situation. They also should be able to email you what is called a "care plan" by email from the nursing department or the home health team staff leader in the facility, whoever has that.

In my dad's assisted living situation, it was set up that I received a bill on the 25th of the month with an itemized statement of the amount of money that would be taken out on the 5th of the following month. Someone should be letting you know of the amount that will be drawn out of your mother's account. I found that there was a lot of work on my part when my dad was in assisted living, although it was much less than when he lived with me. My dad was no longer able to run interference with all the big and little things that came up and it was all on my shoulders. I commiserate with you.

I think I might ask to have a meeting at the ALF and have the team set out in writing what the plan is for her care. You can ask all your questions and voice your concerns. I found that worked well.

If the price went up by $1700, there had to be a major increase in her level of care. Go there and talk to the billing maven. See the head nurse on a regular basis, weekly at first, then monthly. Take away the automatic deduction from the checking account; pay only when you see the bill and approve it.

We signed the contract - the room was not ready - mother went into the hospital, and was in rehab - reassessed her, and it had been a reasonable price, and then they upped it by $1,700. They have not given us a copy of the revised contract, and obviously are not going to. Mother hates to get showers, but she does want one once a week, and it is something she would remember, so I think it is just the place. Also, yesterday the aide told her they could not longer crush her pill without an order from her doctor. They had been doing this since the middle of October. The girl in the evening crushed her pills, so I just do not know what is going on. I take care of mother's finances, and I watch everything. They even had different dosages of medications, and that's why I asked the RN to call me after writing her a letter, and have heard nothing. Mother can barely see, only shadows. I have to look for a lot of things for her, so she does not have any contraband. This is our first rodeo with assisted living, and I don't have a problem getting things done if they will let me know what needs to be done. I thought things would level out, and it would end up being less on me, but I have been doing more now than before. We had care at the place she was before, and they gave me a written contract on a yearly basis. These people have not except initially. This month they lowered the price by $360. Since it is taken directly from he checking account, I sort of need to know if this price is going to go up and down. I don't want to place all of her money in her checking account because it will earn no interest. She is 95 years old. I'm 63, married with no children, and I thought I would be enjoying retirement sometime soon. Just not what I expected.

You have a copy of the admissions contract, right? It should all be spelled out on the contract what the monthly fee is and what the level of care is. You are the contact person listed on the admissions forms, right? Or did someone else take her there and sign the papers?
They can only give meds by written order, even aspirin, and yes if it needs crushing the MD has to write that on the order. If she needs bathing assistance, again it needs the MD order. That's state health dept .regulation. Have a sit down with the head nurse. Make sure there are PRN orders for any over the counter medications.
What we found is that mom would refuse a shower and tell the aide " I already took one", a total lie on her part. She had a nasty looking sponge with black mold on it that we threw away. She kept steak knives in her purse to avoid the NO sharps rule. She had nitro pills in there-- we gave them to the nurse. You will find contraband on a regular basis.