12 August 2008

"What Did I Do Wrong?", 99-Years Old & Evicted!

Yesterday during the course of my evening drive home from work, I heard the story on NPR of a frail, (80-pound), and terribly confused and devastated 99-year old who is being evicted from her assisted living home of the past 10-years.

How could this be? You ask.

Here’s how.

After a lifetime of doing things the right way and saving $350,000, Cordelia Robertson, at age 89 entered into an assisted living facility near Seattle, Washington operated by Assisted Living Concepts. Her son says the company promised him that if her money ran out (the industry phrase is “spend out”), she could use Medicaid.

The company does not dispute that this was their policy at the time, but now says the policy has been changed. Last May, the month that Cordelia turned 99, and after her life savings were depleted, Assisted Living Concepts sued her to get her to leave. Cordelia is not alone.

Assisted living offers a comfortable alternative to nursing homes with private apartments and a staff providing cooking and cleaning for older people who are able to maintain that level of self-sufficiency. They need assistance, but not constant attendance. The industry is booming, but, it is also purging resident’s who deplete their savings and move into Medicaid. Even after a "front-end" agreement to accept Medicaid once the resident's savings and ability to pay the full rate is gone.

Assisted Living Concepts operates assisted care facilities in 20 states, including Texas, with about 1800 current Medicaid residents. According to company CEO, Laurie Belo, the company filed for bankruptcy twice in the 1990s. Belo told interviewers from ElderLawAnswers that the company is moving toward serving only private-pay residents in order to avoid future bankruptcy.

The fact emerges, however, that even with Medicaid recipients in its facilities, Assisted Living Concepts earned 24% more in the fourth quarter of 2007 than for the same period in 2006. The Assisted Living Concepts purge of elderly Medicaid recipients was begun in April 2007.

No one suggests that such facilities operate as charities, but it is obvious that they can operate at a respectable profit margin while maintaining a certain percentage of Medicaid residents. In fact, when applying for its license to operate in New Jersey, according to the NPR story, Assisted Livings Concepts promised to provide for up to 30 percent of its residents in that state being on Medicaid.

It did not meet that commitment and state agencies are investigating.

One would have to read a lot of Dickens in order to find as loathesome a villain. Indeed, I doubt that one could. It is a ghastly cynical business to deplete a person’s life savings, and then disrupt their few remaining days by evicting them from the home they’ve known for ten years; leaving them frightened and confused, and begging of their families for an explanation of, “what did I do wrong?”.

Obviously, the wrongness does not lie with Cordelia and other elderly men and women who are being thrown out of their assisted living apartments. The wrongness lies with an industry which reneges on its promises and put profits before honesty and humanity. And, ultimately, the wrongness lies with public policies and governmental agencies which fail to provide realistic standards and oversight to regulate and rein in this growing industry.

I find it just another indicator of how poorly prepared we are for the full social and economic impact of the “baby boom bubble”.

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