Is it time to move her?

She's not coming out of her room because you are making yourself into her home entertainment center. And slowly, you are making yourself crazy. As long as the ALF is not saying she needs a full on NH, you are OK. So back off a little, our counselor said to go ONCE a week. Back off gradually and you may see her get out of her room more. She has trained you to be at her beckon call.
Untrain a little.

OK, her dementia has progressed to where she needs supervision for meals and a timed toileting program. Either the ALF can handle that or they can't. Some nursing homes won't do that much either, you need to make sure they would agree to that in the care plan. You might have to compromise and settle for diapering and frequent changes.

How exactly are the frappes leading to UTIs?

Just a note on the UTI's. My Mom takes cranberry tablets each day and it seems to work. No UTI's for over a year. Do you have a "senior linkage line" or other agency that could help you "shop" for another facility. If it's not time now, it may be soon. It would also help you feel like you're doing something to fix the situation. Food luck.

From what you are saying I surprised ALF has not said she needs to move to nursing care. But it sounds as if she is getting help from many family members that are relieving staff responsibilities.

Assisted Living Facilities vary widely in the services they are willing to provide and the criteria for living there. Have a heart-to-heart conversation with the social worker where MIL is. Do they feel they can continue to meet her needs? Are there additional services they could provide, at an additional fee? Does she like it there and want to stay? Who has her POA? What is your husband's role? (I assume she is his mother.)

A facility at a greater level of care will be more expensive. Is that a factor?

What are her impairments? Have they gotten worse while she is in the ALF? How long has that been?

Provide more information and you'll probably get more specific suggestions.

I'm a health nut and in the mornings I make a shake with raw spinach, blue berries, frozen strawberries, honey and rice milk (you could use whole milk for the nutrition and substitute honey with D-Robose available at the health food store). Toss in some ice cubes and yum. Even my 102 yo mother drinks them. It's not a frape, but it's delicious. Maybe that would satisfy her while giving good nutrition. (D-Ribos is one of the essential building blocks for the formation of ATP which is a necessary building block of the body. This can be depleted by physical stress and deplete the ATP in the heart & skeletal system.It is used by body builders to assist in muscle recovery. I think it should help the elderly build healthy cells in the heart & skeletal system)

My MIL's AL, is like a hotel. No way do they have patients in your mom's shape. But, the NH that my own mother is in, keeps her clean and dry and everyone goes to the dining room. There is a special table where a CNA, sits with everyone that might need assistance. I think that your mom does need moved to a good NH. She probably feels inferior to the rest of the residents.

What do you know about the "next stage facility"? If it's a good one, and you think she would do well there, it's worth giving it serious thought anyway, isn't it? It certainly doesn't sound as if she's gaining much additional quality of life from soldiering on in ALF, and if the staff are even co-operating properly with your varied, pretty full schedule I should imagine they're getting a bit fed up with it.

I met with the ALF care coordinator and her doctors yesterday.... it was a long day. She has another UTI, which I knew only drinking Frappé from McDonald's will do that to you!

We are making changes to plan of care to fill these gaps. In addition, physical and occupational therapy for the next weeks. I discussed my concerns with the doctor and coordinator and she is fine. The ALF is confident they can still take care of her and she doesn't need a nursing home just yet. The doctor stressed that if she doesn't move more she will be there faster, but right now no. I also had my husband call his family to discuss the changes.

To everyone - a few discoveries I made. My MIL has been calling other relatives and asking them to bring her Frappé. If they say Yes, she says make it 2. I'll put the 2nd one in the fridge. If they say no she would start crying, telling them I've started being mean and not do things for her. Or she missed her grandkids and I don't let them come up. Some of the people called my husband, who didn't tell me because "I know it's not true and your busy enough" or they felt bad and did it. This was her entertainment. I made a schedule for the immediate family - my FIL visits on Sunday, I take supplies, need items on Tuesday, my husband on Thursday and the kids on one of these days. I can't fix my SIL and her family. Other members randomly visit. I check with the nurse every week to see how's it going. I was told we were a rare family that visited often and it was nice we were involved.
All I can do now is see how the changes work and move forward.

Just a note that the AL although want to provide you with care they are first and for most a business trying to make money so they will want to keep a resident that pays full price as long as possible.

Honestly it sounds like she is ready for a nursing home type setting. Before my FIL passed away this past Feb we had to move him from an AL memory unit to a nursing home. They kept telling us that they could care for him but as much as I wanted to believe it and loved the facility I could see that they really couldn't do what was needed he was there for 18 mos and within one month he had to be in diapers because the dementia just made it so he didn't even know he had soiled himself.

In Sept 2013 he was having breathing issues and a trip to the hospital was what it took for us to finally open our eyes and know we had to start looking for a new care arrangement. We were fortunate to find a great facility that had a bed for a Male become available right when we needed it but remember it can take as much as a couple of years to get a bed. If I were you I would start looking and get her on a wait list and if a bed becomes available then move her.

The nursing home we choose provided more medical care, required FIL to go to activities even if he just went and fell asleep at the activity. Assisted him with eating as near the end he had to have everything cut up very small so he wouldn't choke on the big pieces he was stuffing his mouth with.

Remember a lot of what she does is part of the disease and reason just isn't there. I would get rid of the phone and TV in her room Replace the TV with a Radio - it really isn't necessary for either as most places have a common space where they can go to watch TV. And if she needs to contact someone she can have the staff call on their phone. This way the staff can monitor how much she is requesting frappes etc. And everyone caring for her is in the loop of what she is doing.

After going down this road with my FIL I am definitely going to do things a lot differently for my MIL (who also has dementia and several other mental issues)
right now so long as she can toilet herself and bath herself with out soiling her pants and as long as she can use the microwave to reheat the meals I make in advance for her she and she isn't wandering aimlessly around the town can stay with us in our home. She is 80yo and if you meet her you think nice little old lady but that isn't always the case most of the time she can be very mean especially to me her primary care provider. I know we aren't going to try everything suggested to us for medical care either. We did that with FIL and he had a long and miserable and painful death that I wouldn't wish on anyone. If he had been a dog I would have put him down rather than have him go through that. So for MIL no more mammograms or other tests like that because we aren't going to do any major surgeries or treatments.

With her mind going as fast as it is even with meds I give it, if we are lucky, 2 more years at home and then she will need nursing care and she will go right to the nursing home her husband passed away in. One thing we did learn is that a lot of what we paid out of pocket for in the AL would have been covered by Medicare if it had been a Nursing Home so no AL is happening with MIL.