Dear Proactive, Beyond Frustrated and Chagrined: All of your responses fell receptively on my outraged psyche today. I have just received a 30 day notice from the director of my 93 year old Mother's ALF, outlining the cost increases effective January 1, 2013. Room, medication management and level of care costs will increase a total of 50%! This will be the third increase in the fifteen months she has been in residence. We have watched through this past year, major cosmetic upgrades to the interior, while staffing continues to be reduced. I too visit my mother daily to engage her in games, particularly in the evenings as most activity stops at 6:00, however, the need for Assistance (!) continues. I also assist her in preparing for bed as many times her call button is never answered. I hear regular comments from the few compassionate care givers that make me shudder - hours being cut to the bone, punishments for sharing any information with family, medications being administered wrongly, etc. My complaints over the year, earned me a badge of troublemaker. Discussions usually produce denials, excuses, promises, all resulting in maintaining their status quo. I am outraged and fed up, however, with few alternatives. So, I've spent the last hour going through state documents only to find that ALFs are loosely monitored, and mostly self regulated - not in the sunshine. I have made appointments to visit another facility next week, however, their wait list makes for even more uncertainty. I am sure that you all share my feelings of anger and frustration at being powerless to affect change. I know the problems are intrinsic to the industry, however, it is a pitiful commentary on the malaise our legislators extend to the care of our aging population in Florida.