I feel like my mother's AL facility is gouging me. How can I know for sure what her care needs are?

Many/some ALFs have a rate sheet that gives the additional price of each service; ask for it if this ALF has it. The types of service the resident needs determine the "level" of care. Just a few things that trigger an increase are decreasing mobility, increasing incontinence, need for help in transfers from bed to wheelchair and number of helpers needed for the transfer, etc. etc. --- essentially changes in the resident's condition that require additional staff hours or additional skills. I think maybe you see this situation most often in free-standing assisted living facilities that don't have memory care or long-term nursing sections. But 350% sounds out of line. Ask for a detailed explanation and have them work the figures for you. And don't ask only for an explanation by "level" --- find out what needs and services each level requires.

I know nothing about ALF but that does sound like a huge increase. Is it possible that they are increasing the costs to this degree because she actually needs to be moved to Memory care or NH? Sit with them and have them explain the increases she is receiving in services and not just dollars. Perhaps it’s time to do some comparison shopping?

sarmar, I see from your profile that your Mother has Alzheimer's/dementia. With such a disease the person sadly only gets worse, thus more care is needed.

My Dad was in Assisted Living and all the perks came with the monthly rent which was around $7k per month.

Back when Dad was in Independent Living, there was an options chart if Dad needed more things done for him. Example, his "medtech" was costing $30 per day extra for a Staff person to keep charge of his prescription meds and give him the pills required twice a day. That was an extra $10k per year. If Dad wanted his personal laundry done by the Staff, there was an extra charge. If Dad wanted his meals served in his room, that was an extra charge. There was an extra tier care option that would cost $13k per year. So, it can add up.

Assuming you are her POA you are entitled to know exactly what she is paying for. Having a conference with someone who knows what services she is getting (Director of Nursing, maybe) and someone in charge of billing should explain that huge increase.

Have rates gone up for everyone? Is some of the increase due to increasing needs and some just to rising costs? What does the contract say about rising costs?

I just looked up stats for my state (Minnesota). The average cost of assisted living in the largest metro area is $4050 a month. Memory care is about $1050 a month, on average. Even if your mother declined to the point where she needed full dementia care (except for the security feature) the increase you quote seems extremely high.

Did Mother get some kind of a special promotional deal for a few months, and now she is paying the regular rates? This is just hard to understand. It would be interesting to hear the explanation you get.

1050 as an additional charge on top of 4050? That seems low by our local standards.

I just thought about something my brother brought up when we were looking for a place. He lives down south, and found a place he was asking questions of who were charging 'only' $3000, less than half the rate up here. I poked around and reported what I found: this was a 'for-profit' place and the 3k was the STARTING rate, aka the room alone. Everything else was basically ala carte. Laundry? ding. Cleaning? ding. Food? ding. Assistance with ADLs? probably MULTIPLE dings, depending on what assistance is needed! THAT would easily jack up the costs, and if one jumped from a simple level to a difficult level quickly, all those costs would add up! I did not like the fact that it was 'for-profit', which tends to be inflated costs and low wages (not all places are alike, but one has to consider this!)

Our place of choice was NOT 'for-profit', was an endowed place for the elderly and decision was made to tear down the old facility and build a new one with IL/AL/MC. They opened in stages, with MC being last. It was just in time! She was the first to move in. I am guessing others think it is a very good place as it is currently full with a waiting list of 60!

So, again, you need to have an itemized bill and a face to face with someone (admin, billing, whoever it takes) to explain such a huge increase. You don't list dollar amounts , but just using $2000 (way too low I know, just needed to start somewhere) as a starting point, a 350% increase would be $7000. EVEN I would question if it went from 2-4k, but this is ridiculous, unless she went from regular AL to MC AL. THAT is what they should be providing to you WITHOUT Asking.

We don't have all of the facts here - but if $4050 was increased by $1050 to a total of $5100, then it sounds like her dementia has progressed to the point where she is almost at nursing-home care or "enhanced assisted living." Five grand is pretty inexpensive for that level of care in most places in this country.

But as others have said, you need to sit down with a director and ask for an "accounting" of the various levels of care, what they entail, where your mother falls on their level chart, etc.

Each place is different. Read the contracts. I learned quick!

My da's last place couldn't get any more money in care yet raised his room rate every 6 mos (we started at $6200 and was close to 9K by the time it was over). We moved.
So many new places popped up in those 2 years.
Now we're in a place where it's all one fee, no matter the care, for $6300 AL/MC.
This place has a wonderful chef. However the care seems less, so I used the extra money to hire private care sitters when I'm not there. It's still much less than $9K!

When I first found out about how much elders are being charged, I was really livid.
There is no regulation around it, it seems.

After baby boomers, no one will have pensions and annuities and long-term health insurance to be able to afford it. The prices will have to drop....

sarmar: That's a huge increase. Sit down for the ombudsman.