My 94 year mother is in an assisted living facility and I just got the bill for a shocking $700 per month increase starting May 1. This is a 19% increase. How can I argue with them? I know that they are doing more work taking temperatures and swabs of each resident daily I believe, delivering meals to each resident to prevent communal dining, but is this reasonable? Have their costs gone up 19%? Has anyone else had a similar experience? Maybe someone who works inside an assisted living facility?
I'd ask for a copy of the care plan before and after the increase.
My mom's care costs about $ 8,000 a month, and another elder I know was paying $ 14,000 a month per his son, who handled the bills. Elder care is expensive.
Although it is expensive and out of reach for many, it is less expensive than bringing in 24/7 assistance. If one can and wants to provide in-home care with or without outside help, it certainly can be much less expensive, but many of us are seniors and/or have our own disabilities, or just can't deal with the various conditions the person might have.
I try to factor it out for others. 8k/m works out to about $11/hour, for 24/7 care. Granted most don't need 24 hour "assistance", but it has to be there regardless. Some (admin staff) make more money, the ones who do the "real" work get a lot less money, then there's everything else between (maintenance, facility costs including utilities and insurance, kitchen staff, food, etc.)
What some forget to factor in, IF they can find a less expensive in-home care scenario is you need to factor in all the costs of the residence too - house/apartment/condo, food, utils, etc - if they live in your home, then the actual housing cost isn't factored in unless you spend $ on making space for them.
While there are dangers living in a facility (like now!), including falls, those dangers exist at home as well. Since one would have to use special ways to prevent wandering, there's that concern, as well as utensils, tools, appliances, cleaning products, stairs, etc.
It isn't ideal for those of us who have to use a facility or struggle to provide home care, living in general isn't always ideal either. It is what it is.
I do think a small increase given their tasks are now increased would be "reasonable". OP's original 700/m (changed to 300 later?) would be $23/day. Given that providing meals in a dining area is less work than providing meals room-by-room, and any testing done plus PPEs, this is not too bad.
In my mother's case, I am a bit miffed, because they don't warn me ahead of time regarding extra laundry or supplies. Two months ago it was FOURTEEN (14!) extra loads of laundry and a couple packs of wipes! Really? For a 96 yo who at this point doesn't walk or stand? Not like she's rolling in the mud. She's in briefs but not really incontinent yet, just in case of accidents/can't get help to bathroom in time. Okay, so first month was a surprise for all - turns out to be night-time bed wetting due to UTI. Second time bed wetting started, nurse had it checked, so not too bad. I got the statement for May, and sure enough EIGHT extra loads and several packs of wipes, despite having delivered 3 packs in a month. I questioned it and asked if this is not UTI, then what's the issue. If it is, why no notice and no Rx for me to pick up? It adds up and also messes up the budget I have for mom's money/bills.
Took several days to get a reply, but testing/Rx in order... So, given response previously from the biller, cut off is around mid-month, so I KNOW there will be MANY extra loads because it started before mid-month, was NOT addressed before the end of the month (4/30 to be exact, so there are about 15 days plus a few for treatment to work.) I expect that next statement is going to have multiple laundry loads and maybe more wipes added. THAT should have been addressed after one, maybe two, nighttime incidences of bed-wetting. The NURSE knows this and stated it to me before! THAT annoys me - I could understand a slight increase if their duties have to be increased, but THIS should have been managed/addressed.
I hope this helps.
Mike
I do wonder if all the requirements are adding a lot of cost to their operation. But even then this is a risk they took on. I guess no one could have predicted this, but why should they pass the cost onto you.
What does the contract you signed have to say about this? Are cost hikes allowed without adequate advance notice?
My daughter will tell u that private pay and Medicaid recipients are treated no different. But My Mom paid privately for 2 months and shared a room. When she went on Medicaid, I was told they were transferring her to a 4 bed room. The excuse was, her room was being made into a single room. I didn't argue because she was failing and was only in her room to sleep.
I wonder if these people realize that Medicaid doesn't pay for that beautiful AL they could have had. That they will end up sharing a room with a stranger. Like u said, maybe $50 a month for their personal needs. Only 2k to their name. And what will those spoiled kids do, maybe visit every so often.
I also hope that these people end up in some less-than-ideal facility for all their wheedling. We did do the trust, POA, will business with mom when dad was failing, but mainly facilitated it as she wanted to do it. I didn't fully understand it all, other than it does protect her as the surviving spouse. The place dad ended up in was not a place I would have chosen. Many times she said she could care for him better at home, but she never made a move to make that happen.
Fast forward to mom starting to show signs of dementia. We had to revisit a few things, set up a new trust, etc. In hindsight, some of these provisions are good, as they can protect the person from themselves. However when the attorney told me to contact him if/when she needs a nursing home, I balked. Apparently the "plan" is exactly what you mention - preserve the assets for the children/heirs. My feeling is if someone has the funds to pay, they should pay. Inheritance is never guaranteed. Could I use that money? Sure. But, my parents saved, and after dad passed many times mom indicated potential plan to move to AL when she needed it. Of course she did nothing about "clearing" out stuff and when dementia started, NO WAY would she consider moving anywhere because she was "fine, idenpendent and can cook/take care of herself." She wasn't and couldn't.
She is in private pay, a place we chose after viewing a few local to where 2 of us live. Her place is nice and they take relatively good care (my other comment covers recent lapse in checking for UTI, but otherwise, no complaints!) We sold her condo (was in life-estate, so most of the money went to us, but we put it all back in the trust for her care.) Should she need NH in the future (she's 96+ now), my plan is to cover the cost as long as we can before resorting to Medicaid.
THAT is how it should be. Greedy people like those you mentioned, hopefully they'll get what's coming to them (aka not such a nice place to live.) Also, to my understanding, most AL isn't covered by Medicaid. If it is, I wouldn't want to see the places that accept it. Mostly Medicaid would be for those who need skilled nursing care, aka NH. NH isn't for those with just dementia. The kids will likely end up either having to take them in or paying the cost of AL or MC, if the need arises! Karma...
The assisted living facility should be able to show the justification of the price hike. If they can not get in contact with your state's Attorney General's office. They will crack down on the price gouging. Also reach out to your state's department of aging or health and human services. They may also be able to help.
Good Luck, and stay healthy.
I am an RN and there is extra work involved. Some employees have been demanding an increase in pay. There may be extra things they are doing for social distancing - like having 2 dinner shifts instead of one. They may have hired more cleaning staff and certainly they are using more supplies like gloves and masks. ( or they should be.)
They should be quarantining their patients and changing routines with staff and patients.
If what they are doing is legal and necessary then they should be willing to provide you with a list of their extra expenses related to the covid-19 crisis to justify the added expense.
Beneficiary & Family Centers Care Quality Improvement Organization (BFCC)
888-755-5580
If they can't help call 1-800- Medicare and ask for Inspector General.
Please share!
If it's a medicare/Medicaid facility, even if/when your relative is NOT on Medicaid/Medicare everyone who lives within a CMS (Medicare/Medicaid) facility is, technically protected by Federal laws.
Costs haven't risen during Covid19 protocols. In truth, costs have shifted,
ie: patients and residents are restricted from outside activities, which deleted transportation costs, which opened $$$$ for extra hand sanitizers. The cost of delivering meals to dining rooms is not much different than delivering meals to rooms.
Follow the directives to contact other families about costs, rent-increases, and look at the Assisted Living contract. Then contact the administrator or billing about the price increase.
Sidebar; We have an ongoing in-house scam to bill residents, for a communications package no matter if the resident utilizes the phone, TV or internet, etc. It's an all or nothing "package." Mentioned to emphasize that facilities are always 100% revenue driven places. The technical logistics is where the deception sits, hidden.
Excuses:
1.Your mother's costs increased due to re-classification. Medicare/Medicaid implemented a new payment system in October, which removed therapies as the determinant of monthly charges. (Re-classification did not increase costs, instead it dropped revenue.)
2. We just entered into the 3rd quarter, quarters have zero relevance.
3.COVID19 increased costs. Nope the infamous virus shifted costs, as mentioned previously.
Your Ohio local ombudsman might be helpful, also ... Unfortunately facilities are notorious for barely legal behaviors... When they violate laws ...their unethical responses = "the resident must have misunderstood."
In my opinion, 19% increase is a lot. I looked it up for ur state and I see no law putting a cap on rent increases.
1) Gather records of previous bills.
2) Simply request an itemized bill for the month (s) with the increase, including how you were notified of the increase.
3) Contact your State Attorney General's Office and file a complaint for price gouging. Keep extra copies & originals of all documents. Send copies.
4) At any opportunity, find out if others received Notices of the increase & how much. Are they only charging Self-pay or those with Private Long Term Care the huge increase. Are they charging Medicare? Medicaid?
5) Inform your local State Representatives! Even a personal letter to your Governor.
-- If they are one of the few who dragged their feet on requiring rigorous protections be put in place -- then it will be harder, but you could save lives. Also then the actions they took were pragmatic & needed, but technically optional.
6) Befriend a local or major news reporter. Develope a relationship of trust. You need to file charges and allow an investigation before it comes out in the press. But if you don't hear back in a reasonable time...people are down staffed & working from home. Go public!
It sounds like the extra charge is for basic daily/monthly rate. While they may have extra costs, like PPEs, they should have been using more of them already each Flu 😷 Season. Did they charge extra if a patient was immune comprised... because they should have used extra protection to protect that patient & prevent cross contamination.
Information is gold here! Is the total bill went up for specialized individual care, like extra resperitory therapy, that is allowed. Charging extra cause meals have to be delivered to the room due to CDC or State Requirements...not allowed!
Extra cleaning costs, not allowed! Besides with dining room closed, they are not sanitizing those tables daily.
If they are being price gouged by providers of PPEs or other essential supplies. Then it is their responsibility to file charges with the State Attorney General..not charge patients.
An analogy:
If someone stole there computers, wheelchairs, transfer equipment, and expensive PT equipment, then poured paint of urine on walls & floors it would be costly immediate expense. A criminal offence. A necessity of operations to clean, sanitize & replace immediately.
It would be a crisis for them. It would not be cause for raising standard rate of care!
Also, if they are only charging Self-pay patients for expenses provided to all, talk to an ACLU or private Attorney for Elderly Services. Ask them about pros & cons of going public. Best to have info from other families in any case!
Glad you brought this to everyone's attention! I pray your LO will be safe.
The monthly rate is quite moderate, even after the increase.
But more to the point, the OP has agreed no contract with the ALF. His mother has been in the care of this facility for three months, but for no doubt good reasons of his own he has chosen not to settle on it as a permanent, long term or even medium term placement for his mother.
You can be in a position where price increases are controlled by state law (in some states) and the terms of your contract.
Or, you can have the freedom to move your relative without notice to the ALF and suffer no financial penalty.
But you can't reasonably expect both.
I don't think it is the central issue, here, but the financial costs of the coronavirus - more specifically, responses to it - are incalculable. If the ALF's costs rise by only 19%* by the end of this next financial year I suspect they will be incredibly relieved.
*[They won't. Not a chance.]