The RCFE my mom is currently residing in notified me of a $1,000 increase for monthly basic services. No discussion of level of care, this was entirely monthly rate related. When I responded that I'm required to have 60 days’ notice, the administrator quickly agreed without any further discussion. However, I received a letter today (21 days later) stating the mom's level of care has increased. This was exactly the explanation I was given in entirety, "Max assist with medication administration, max assist with transferring, max assist with bathing and grooming, incontinence care x2, moderate assist with feeding." Oddly the same rate increase of $1,000 due to level of care and not basic services. Along with a copy of the admit agreement stating if it's for level of care, the facility is only required to give two days’ notice.
I just took my mom out of the facility 19 days ago for a birthday lunch. She was able to climb into my car, albeit not easily but able to do so on her own. She ate her entire lunch unassisted, never having to struggle to eat before and has never been in question. My family thought she was doing very well so a claim stating her level of care has risen seems false and convenient.
I disagree with this "assessment" entirely. I contacted the hospice nurse that sees her weekly and they also unequivocally disagreed with this new assessment. I'm going to ask for the hospice reports on my mom’s level of care and look this over before I address this next week when I go visit my mom.
My question is what documentation is an RCFE required to have regarding level of care? All I have is a letter stating the quote from above. No call from Hospice (not surprising since the nurse claims there has been no change in level of care). Nor from the facility that my mom's level of care was changing or even that a 3 week reassessment was taking place. Also, who is authorized to make a reassessment for level of care? If it's solely the facility without any outside oversight, it seems highly contradictory.
I plan to give my 30 days when I drop off the monthly check next week. I have friends that work in this industry and they have suggested not paying the extra.
I'm really at a loss. A $1,000 increase (25%) seems outlandish.
Quick note about my mom. She's diabetic and was on insulin when she was admitted. She is now off injections and takes every pill orally. She does wear incontinence underwear, but can make it to the bathroom if she's wheeled to the bathroom. I have never received any complaint from the facility about her being difficult. The only message I have ever received (from Hospice Nurse) is she's mentally sad and wants to go home. There are no other medical issues as of yet other than an occasional UTI.
Any advice or knowledge of a similar situation would be greatly appreciated. I want to have as much knowledge as I can so I can address what I feel is an unethical situation effectively.
Thank you for your time reading this and for any advice.
Yes, these rules may seem "arbitrary" to families. That is to say, if a person takes a daily aspirin and requires assistance, being given this med by medication RN, then often they pay as much as the person taking 10 medications as different times a day. But in the case of a free standing for profit, non-state/federal funded care facility, they do make their own rules.
Do make an appointment. After that it is looking like you have a decision to make as regards whether to leave this facility or not. Good luck.