Are there any restrictions on how much an assisted living facility can increase care costs per month?

A new company took over my mom’s AL and was looking for ways to either move her to MC (higher price) or increase her services. I had cancelled all of her extra pay services and got her a private carer for 4 hours every day because 1. The services were not being performed -due to staffing and 2, they were not being done well or thoroughly. I got her to another place and many other people left as well. Because the private caregivers went with her, they helped her socialize and showed her the ropes. It was a better fit since her former place had no written plan to let me know what we were going to end up with. I suspected they knew but were hanging on to their residents until they didn’t need them. I specifically stated in writing what the caregiver staff were doing and that their services were not needed since I was providing them. The only thing they provided was the pills. I got my staff to do the eyedrops too.

No. ALs have to compete in the market for workers and their biggest cost. They have to offer an attractive wage to get staff. And on top of that, the cost of everything else has gone up drastically too. Food. Utilities. Toilet paper. The AL isn't going to run at a loss. And if it's a good one that has a waiting list, when your mother runs out of money someone will take her place within a week. We're facing the same headwinds with my FIL. I feel your pain.

Thank you for posting this question. It is yet another good reason I will be staying away from Assisted Living facilities. I've known I never want to be in a nursing home for long-term-care. (I spent 5+ years in one taking care of my mother.) I would have considered Assisted Living for myself as I age, but now I will stay put in my home. If I die or live in squalor, so be it. That is preferable to feeding the profiteers.

Aside: I am attempting to start a "caring community" in my area, where people striving to care for themselves healthfully, also strive to help each other - with information, sharing equipment, helping as they can, developing relationships with a nursing agency and other helpers, etc. I see this as a model that could be useful for many of us entering our last laps.

This is a big problem in our society. We are conditioned by doctors and relatives to think it is not ok to die. So we get overtreated which prolongs our lives only to end up being cared for by others.

I would agree that you need to read the contract that is currently in force to make sure this is legal.

This is a generalization, but for the most part in terms of "senior" housing/medical facilities, government regulations only come into play when the facility is accepting government funds (aka Medicare/Medicaid). This gets most ALs off the radar because they so rarely accept Medicaid and Medicare, being a health insurance, does not pay for room and board. ALs that accept Medicaid usually severely limit the number of beds they reserve for Medicaid because the Medicaid payment is so low compared to what they can get for private pay residents. So you need to be very careful listening to the marketing speech that says " oh, when your Mom runs out of money, we accept Medicaid" because what may not be said is "if we have a dedicated Medicaid bed available at that time". If they don't have the bed.... out you go!

LTCs do accept Medicare/Medicaid (federal funds) so the government at least looks at what they charge but if they can provide spreadsheets and invoices during their audits (which are not as thorough or as frequent as I would like but that is another story as the government can't get experienced accountants because the government can't match the salaries of accounting firms) they may get a bit more in Medicaid funding but it will never match private pay. Medicare is going to pay the approved sum for approved skilled nursing/rehab (also less than private pay).

In all honesty, their costs probably have increased dramatically as everything has gone up. When eggs when from $2.00 per dz. to $4.89/dz many of us simply decreased our use of eggs but you can't do that in an AL or LTC so you can imagine what that kind of increase on the level of feeding 80 people can do. Now they have (supposedly) increased the amount they pay to try to attract LPNs and RNs although in NJ ALs do not have to have an RN on site as long as they have 24 access to one but they have to pay her (or her agency) something for the access. I have yet to see them increase the amount of money they pay CNAs who do the real "grunt" work (changing diapers, feeding, doing laundry) or the kitchen staff. So yes............. they remain incredibly understaffed in some key positions because the income that doesn't flow to the owners goes to administration, marketing and maintaining the beautiful buildings. I don't deny the owners a profit.... I just would like to see the profit a bit more evenly distributed.

If shes consuming no new or additional services, what on earth is a doubled monthly care fee FOR, exactly? The AL needs to give you a breakdown of fees each month, which are probably not all "care" related but include a rent increase too.

Check her contract, but private pay ALs can pretty much do as they please w regard to costs. My folks spent about $400k in a 7 year period which means they depleted their life savings .... nobody can manage on just a monthly fixed income in AL! Unless that income is astronomical, savings must be tapped into.

What does your contract say?

Is there a provision that speaks to this?

They have all increased their fees and it is painful for the elderly who are on a fixed income. When covid hit and took the lives of so many people, if forced everyone to take stock of their lives and stare the possibility of their own demise in the face. Vast amounts of working age people have decided that they don't want to spend what time they have left doing a job they don't like. It has crippled the work force. Healthcare facilities are having to pay people double what they used to just to get them to come to work. Nurses that used to make $30 hr are now getting $60-80 hr. A medical assistant who used to make $18 hr is now getting $28 hr. So I get why hospitals and nursing homes are having to increase what they charge for services, but that doesn't change the fact that our elderly have no way to increase their income to pay it.

My cousin who is a nurse told me that when it comes time to put my dad into MC to make sure I have a one year contract to start, not month to month, to avoid this scenario. Like a rental lease, they can’t just raise the cost in the middle of the existing contract. Then when that contact expires, negotiate the next one for 2 years to lock in the rate. Worth a try.

Most ALF and MC facilities are privately owned business models that are not governed by laws in the way that nursing homes are. Often the contract on admission describes the circumstances under which raises can be made in either cost of care levels or cost of room. For instance, in my brother's ALF his fees would go up with any increase in care level needs, and then at least yearly with 3 to 5% raise the norm. Add to this, raises could happen with special circumstances (rampant inflation, covid, etc.).

In most instances they can do raises as they deem appropriate and necessary, and the resident has to decide whether to stay or to move to another facility.

POA may request a meeting with administration to discuss any raises; this may help.