Assisted Living facility trying to force my Mom onto pricey 'medication management'

[Gotadimple]

$450 is the *minimum* charge per month. That's for 1 visit per day. 2 visits per day bumps it up to $620 per month. 3 or more visits per day is $850 per month. On her current regimen in skilled nursing, she gets 3 visits per day for meds, and they want to continue that regimen in assisted living.

Maybe I can convince them to lop off the stool softener or the omeprazole (a antacid), but if not, the're gonna get the maximum profit out of me, $850 per month.

John Galt,
She has anemia and needs her OTC iron pill. Omeprazole is not an antacid it is an OTC (or prescription strength) proton pump inhibitor that acts to reduce stomach acid and prevent an ulcer. The iron pill can create a hard stool, so the softener probably is a good idea. This one is to keep her comfortable.

Check with your mother's physician - she may/may not need all of these.

 

[MichaelB]

If only one of her meds is prescription whey does she need separate visits for each med? Can’t they all be given in one visit?

Skilled nursing is a different environment from assisted living. In ALF residents require less care and can do more things for themselves. There are more skilled aides and fewer skilled nurses, so the cost of scheduled assistance typically is lower.

Simple meds administration in an ALF should not cost as much as in a skilled nursing facility, and the resident should have the option to self administer supplements.

 

[pacergal]

Taking iron with omeprazole may reduce her iron uptake, omeprazole may have the same effect with Synthroid, so at minimum your mom needs to take omeprazole separate from the iron, colace and Synthroid. So that is "two" medication visits right there. And colace helps with the constipation from iron, so you don't want to stop that.

Are there family members nearby who would consistently arrive twice daily to assist Mom with her meds? If the care home won't let her use her own med reminder pill container, that is the only way I could see you not having those charges, if your Mom does have some memory difficulties.

 

[retire to nature]

Wondering what other service charge is there? is there any nursing care format of charge? or because a nurse is staying the assisting living facility, it is more expensive than other facility or pay higher due to signed for the service. If it is, 3 times of oral med should be involved in the service charge.

 

[John Galt III]

Update. I had her doctor take off all the meds from the med list, except for synthroid. End result is that Mom is only taking synthroid now, and the nursing director here agrees that Mom is able to take her synthroid properly, so there will not be any 'med management' gouging of Mom going on until they think up something else.

Too tired to add details. I feel relieved, but not ecstatic. Will fill in the blanks later.

Cheers.

 

[retire to nature]

She moved from ind living in this ccrc to assisted living in Aug of last year, because she felt weak, and had other problems. She has bladder cancer, which bleeds sometimes and makes her anemic. Has gotten 3 transfusions in the last 6 months. Drs are talking about palliative care and hospice care. Mom is not in either of those yet.

I can see why the nursing home recommend the management. So for her condition, she can bleed internally unnoticeable. So if she are weak, she gets a fall, it will injure her and the assist living record.

I was a hospice nurse too. Actually, if the dr recommend, i would take advantage of it. It will do nurse visit, IHHS visits, social worker visit, religion visit etc.

The requirement is for 6month or shorter, but I have seen many pts stays for years. every 6month, they evaluate, there is a discharge from hospice care too.
And 3 transfusion for 6month is pretty big bleeding for me. The iron pill is not much help.
If she doesnt get any strong tx, I think it is hospice case.
And admission to hospice with good time is nothing harm.

 

[youbet]

I had her doctor take off all the meds from the med list, except for synthroid. End result is that Mom is only taking synthroid now, and the nursing director here agrees that Mom is able to take her synthroid properly, so there will not be any 'med management' gouging of Mom going on until they think up something else.


.

Who will be responsible for seeing that she has a supply of Synthroid? You or the facility? I'm assuming you. With only a single prescription to keep track of and filled, shouldn't be hard or time consuming.

 

[youbet]

$850 works out to $27 per day. Three visits at 10-15 minutes is about 1/2 hour labor, maybe more. Add in liability insurance and record keeping...I wonder if it really is a big money maker for them?

Yeah, I agree. "Gouging" might be a bit of an overstatement of the situation. Visiting a client's apartment 90 times a month and delivering pills (or pills crushed and mixed with pudding, etc.), plus acquiring the meds and keeping records, for $850 doesn't sound out of line for most assisted living situations.

In OP's DM's case, the meds are straightforward and there is only a single prescription to keep track of and in supply. Others, I'm sure, are much more complicated.

But it sounds like OP has been able to assume the responsibility and has gotten the med list down to a single med. He and his DM can handle the situation themselves so no need to pay anything for someone else to do it when the cost of the med management would be the same for them as for folks with much more complicated situations.

 

[pacergal]

Update. I had her doctor take off all the meds from the med list, except for synthroid. End result is that Mom is only taking synthroid now, and the nursing director here agrees that Mom is able to take her synthroid properly, so there will not be any 'med management' gouging of Mom going on until they think up something else.

Too tired to add details. I feel relieved, but not ecstatic. Will fill in the blanks later.

Cheers.

sounds like a reasonable solution.

 

[boont]

I have been through this with my brother. The home is controlled by her doctor. If he tells them she can "self medicate" they will bow to that. I got my brother out as soon as I could and he is back home with a paid care giver. If this is possible for you, I would suggest it. Ours gets free food and rent on a room in the house and a reasonable salary in exchange for his care. We also pay another person for worker relief of the principle one.

 

[SecondCor521]

Interesting.

My Dad was in AL for about a year, and when he moved into AL, the facility required he turn over medication management to them for both prescription and non-prescription medication. Even simple OTC stuff like antacids and ibuprofen were supposed to be removed (we didn't follow this rule; we probably should have).

The amount of medication management plus other stuff - laundry, shower assistance, etc. - all went into a point system which translated into a monthly care fee. So the med management was included in that but just became part of the overall charge.

I always got the impression that it was a liability thing for the facility and non-negotiable. If we didn't like it I think our option was to find another facility. Some families keep their loved ones at home, and that could be an option although not for my Dad with everything else he has going on.

We also worked to reduce his medications - he's 88 and doesn't need to worry about things like cholesterol - so he's down to I think three or four medicines all taken at the same time.