My LO has been in an AL for 2 years. He's wheelchair bound and starting to have some mild memory loss. A few weeks ago we received the bill and noticed the care level increased (which would jump his cost from $7000/month to $8000/month) There was no letter or discussion explaining why and no one called to explain why. Is this normal practice in the AL industry? This AL is part of a large corporate chain. It just seemed so shocking to me. I know they reassess patients every 6 months. I had been under the assumption that a pending increase in care level would be presented to the family a couple months ahead of when it will go into effect with a detailed explanation of the reasons.
I called the director and asked for an explanation and really didn't get anywhere. She didn't think that they did anything unusual. I asked if they could provide his most recent assessment and show me how it compared to the previous assessment and explain where he declined and needed more care. She said their scoring system is proprietary and they don't share those details. She said they just noticed more cognitive decline and memory problems and they he is requiring more personal care and assistance. I haven't been able to visit, so I can't verify much of this.
How have others been informed of care level increases? Does this seem unusual to get nothing in writing and nothing in detail about assessment scores?
No, I don't think this is right. I've had two different facilities for my mom. The first ALF had been privately owned by a husband and wife until they retired and sold it to a small company. I received a letter about a month in advance letting me know there would be an increase in her rent and the reasons for it. At that facility, the increases were for everybody and it was a 3% increase.
The new facility she is in now and in the memory care unit does a care plan with a point system which determines how much we will be paying. They are very open and upfront about everything. They give me the care plan, which I have to go through and sign off on. If I want something added to the care plan, they make a note of it. Since they have been minor things, it hasn't affected the amount we pay but I could see that the points were higher. I also keep them in a file folder on our computer for documentation and reference purposes.
I know what it's like to talk to Administrators/Directors and not getting anywhere. In that case I would contact your local Ombudsman - they are a liaison between you and the facility where communication is going nowhere on your own. You should be getting copies from the facility i.e. his care plan, assessments/scores.
I understand about not being able to visit so you can't verify or see what's going on. As soon as my mom's first facility went on lockdown March 13th, I thought "oh no, I'm not going to know what they are doing or not doing," - it went all downhill from there.
I hope you are able to get help in having your concerns addressed - good luck!
Care levels are often very well documented and laid out. When my brother went into his VERY GOOD ALF they were. Each level was described, with instances of behavior, mobility, dressing, showering, medications, eating, levels needed what costs. Notification was given when level went up and WHY level went up.
That said Assisted Living is really a corporate entity often enough that decides how they will run. The best ones give you pages and pages when you sign on to go through describing everything. Even the raises were described for us; the fact that when the money was gone, so are you (to put it not so nicely). So they vary as to how good they are at telling you how it will be.
Truth is they are a business and you are the client. If you are a troublesome client, then business is good enough right now that they hope you will move on "where you will be happier" (as they like to put it) and they can cherry pick the best person for your studio or rooms incoming.
It's tough, but it is how it is. An adversarial relationship with family will only make it worse. Sad that so many things cannot be fixed.
And no, often they do not put in writing anything but that the care level is being raised because of increased needs. They do not get into "this specific" and "that" which can be argued. It is basically their way or the highway. They will often discuss with you on the phone what they are seeing that takes up the time of their caregivers (and this is the question of course).
I still think the method by which they raise care levels is jarring. For example, the law requires them to give us 60 days notice of an increase in RATES (like annual inflation adjustment - 5-6% for example.) We have to get a form and sign and return that we acknowledge the rate increase. But, apparently, no such notification process is required when they move a resident into a higher care level, even though that might increase the overall bill by 20% in one fell swoop. It seems they can just update your bill without even notifying you first. I'm really surprised there aren't regulations for AL, that require they give you at least a 60 day notice for care level increases.