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Completed report

June 2026 statement review: Mary Alvarez, Riverbend Oaks Assisted Living

We reviewed four documents for Mary Alvarez's June 2026 statement from Riverbend Oaks Assisted Living, which totals $8,575.00. Three charges, adding up to $1,300 per month, are not clearly supported by the paperwork provided: a care-level charge that doubled from May with no updated assessment in the documents, two separate medication fees where the contract lists one combined service, and a $250 maintenance and community fee that appears on no fee schedule. None of these is necessarily an error. Each one deserves a document before it is paid. The questions, email draft, and call script below ask for exactly that.

Confidence

medium

Billed total

$8,575

Monthly change

$740

Files reviewed

Fair Cost Context

A monthly total of $8,575 for assisted living with memory support is within the broad range many families pay in the United States, but the right comparison depends on your area. The bigger question on this statement is not the total. It is whether each line is supported by the paperwork: the care-level charge doubled in one month, two medication fees appear where the contract lists one, and one fee is not on the fee schedule at all.

National surveys generally place assisted living base rates between roughly $4,500 and $7,000 per month, with memory support adding about $1,000 to $1,500. Those are broad national figures, not quotes for your market, and the documents reviewed do not include local pricing.

Typical assisted living and memory support rates in the facility's metro area
Whether the facility published a 2026 rate sheet or annual increase letter that was not uploaded
What nearby comparable communities charge for Level 4 memory support

Line-Item Findings

high

Care level doubled with no updated assessment in the documents

Evidence: The June statement bills Care Level 4 (memory support) at $1,480.00. The May 18 notice shows the prior charge was Care Level 2 at $740.00. The resident agreement says care-level changes follow a written assessment, but no assessment was included in the documents provided.

Why it matters: This single change adds $740 per month, which is $8,880 per year. Facilities normally document care-level increases with an updated assessment, and the family is entitled to see what changed in Mary's care before paying the new rate.

↳ Ask: Can you send the updated care assessment that supports moving Mary from Level 2 to Level 4, along with its effective date?

Potential savings to verify: $740

medium

Two medication fees where the contract lists one combined service

Evidence: The June statement lists medication management at $585.00 and medication administration at $310.00 as separate lines. The fee schedule attached to the resident agreement lists a single combined medication service.

Why it matters: If the contract covers one medication service, the second line of $310 per month may be a duplicate or a new fee that has not been added to the paperwork. That is $3,720 per year worth confirming.

↳ Ask: What does each medication fee cover, and where does each one appear on the current fee schedule?

Potential savings to verify: $310

medium

Maintenance and community fee appears on no fee schedule provided

Evidence: The June statement includes a maintenance and community fee of $250.00. This fee does not appear on the fee schedule or anywhere in the resident agreement provided.

Why it matters: Recurring fees should be traceable to a fee schedule or a written notice. A $250 monthly fee adds $3,000 per year, so it is worth asking when it was added and what it covers.

↳ Ask: Where is the $250 maintenance and community fee listed, and when was it added to Mary's account?

Potential savings to verify: $250

Contract Flags

medium

Agreement calls for written notice and an assessment before care-level increases

Evidence: Section 4 of the resident agreement states that care-level changes take effect after a written assessment and 30 days notice. The May 18 notice gives 14 days before the June 1 effective date, and no assessment was attached.

Why it matters: If the agreement's notice period and assessment step were not followed, the facility may agree to delay the new rate or apply a credit for June while the paperwork is completed.

↳ Ask: The agreement mentions 30 days notice and a written assessment for care-level changes. Can you walk me through how those applied here?

low

Charges are tied to the attached fee schedule

Evidence: Section 7 of the resident agreement says monthly charges follow the attached fee schedule and that fee changes are communicated in writing. The fee schedule provided is dated 2025 and may not be the current version.

Why it matters: If a newer fee schedule exists, it may explain the medication and maintenance lines. Asking for the current version is the fastest way to settle two of the flags above.

↳ Ask: Can you send the current fee schedule that applies to Mary's June statement?

Questions to Ask

1.What changed in Mary's condition or care plan to move her from Level 2 to Level 4, and can we see the updated assessment?
2.When did the care-level change take effect, and how does that line up with the 30 days written notice the agreement describes?
3.What does medication management cover that medication administration does not, and where is each listed on the current fee schedule?
4.When was the $250 maintenance and community fee added, and where does it appear in the resident agreement or fee schedule?
5.If any charge cannot be matched to a document, will you adjust the June statement or apply a credit next month?
6.Can you email the current fee schedule and any notices on file for Mary so our records match yours?

Dispute Email

Subject: Documentation request: June 2026 statement for Mary Alvarez, Room 214

Dear Riverbend Oaks Business Office,

Thank you for the care your team provides to my mother, Mary Alvarez, in Room 214. I am writing about her June 2026 statement, which totals $8,575.00. Before we pay, I would like to request supporting documentation for three charges.

1. Care level charge. The June statement lists Care Level 4 (memory support) at $1,480.00, while May listed Care Level 2 at $740.00. Could you send the updated care assessment and the written notice that support this change, along with the date it took effect?

2. Medication fees. The June statement lists medication management ($585.00) and medication administration ($310.00) as separate charges. The fee schedule we have lists a single combined medication service. Could you clarify what each charge covers and where each appears on the current fee schedule?

3. Maintenance and community fee. We could not find the $250.00 maintenance and community fee on the fee schedule attached to the resident agreement. Could you point us to where this fee is listed and when it was added?

We are glad to pay every charge the paperwork supports, and we will review whatever you send promptly. Please reply by email, or call me at [your phone number].

Thank you for your help.

Sincerely,
[Your name]
On behalf of Mary Alvarez, Room 214

Call Script

1.Ask for the business office, and write down the name of the person you speak with plus the date and time.
2.Say: I am calling about the June 2026 statement for Mary Alvarez in Room 214. There are three charges I would like to understand before we pay.
3.Ask for the updated care assessment behind the change from Level 2 to Level 4, and the written notice with its effective date.
4.Ask why medication management and medication administration are billed separately when the fee schedule you have shows one combined medication service.
5.Ask where the $250 maintenance and community fee appears on the current fee schedule, then ask them to email everything discussed so you have it in writing.

Escalation Paths

Business office

Start here. Share the questions in this report and ask for the supporting documents in writing. Most billing questions are resolved at this level, often within a billing cycle.

First stop for any billing question

Executive director

If the business office cannot provide the documents or does not respond within two weeks, request a meeting or call with the executive director and bring this report and your notes.

If the business office does not resolve it

State long-term-care ombudsman

Every state runs a free long-term-care ombudsman program that helps residents and families with billing and contract concerns. Find yours through ltcombudsman.org or your state's aging services office.

If the facility is unresponsive or you want a neutral advocate

Limits and Caveats

This report was generated by AI and may contain errors. Verify every figure against your own documents.
This is not legal advice. The flags above are facts to verify with the facility, not conclusions about wrongdoing.
The review is based only on the four documents uploaded. Documents we did not see, such as newer notices or fee schedules, could explain some of these charges.
This sample report describes a fictional facility and resident, created so families can see what a completed report looks like.

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