Over the last couple years a disturbing financial scenario has been playing itself out in Assisted Living communities, with the help of their apparent partnership with In-Home Care companies. This scenario is exemplified by a situation related to us recently.
Grandma Ivy loved her new home , XYZ Assisted Living, in the neighborhood area she had lived for many years. Her studio apartment was large enough for her favorite belongings from the two-story home she had to sell two years ago. Friends from the area would visit – she enjoyed the bus trips and many other community activities she was unable to enjoy while living alone. Suddenly all this changed with a stroke, resulting in a 3 day hospital stay, and then off to a Rehabilitation center. She was pleased to learn that she had made enough progress to return to her now favorite home – even though she now would need additional help because of the paralysis on her left side. ”Aging in Place” in Oregon Assisted Living communites is a great concept, established back in the early 90′s. Grandma Ivy was thankful for Oregon’s leadership.
Two weeks later, the financial reality of her return to XYZ Assisted Living hits home. In addition to the $3,450 monthly cost, the facility added another $1,975.00 for the additional care now needed to help bring Ivy down to the dining room, the help with dressing, bathing, room checks every two hours and additional hygiene care. The total bill was now $5,425 per month. Okay, understandable because of all the extra staff labor costs, and yes, still financially manageable.
Along with the bill came though another bomb-shell, almost as tough to swallow as the sudden stroke. Grandma had become a fall risk because of the stroke. Her care plan now required that she have someone in her room throughout her waking day both as a companion and to help make sure she remained safe. We were informed that some of the residents had very much enjoyed the companionship and services of the ABC In-Home Care company. (Later it was learned that ABC In-Home care also shared the same corporate ownership as XYZ Assisted Living). Their service would enable Grandma to not only stay within her favorite home, but also enable her to be escorted to even more of the activities within the facility, so that she would not need to spend quite so much time alone in her room. The cost for this outside service would only be $20.00 per hour. To keep her really safe, the service would need to provide someone for her for at least 8 hours a day. Total cost for this additional care – $160.00 per day or approximately $4800 per month. Wow. With a little negotiation with the facility on service charges that could be reduced because of over-lapping services provided by the in-home care company, now the total monthly bill would run Grandma a whopping $8,000 per month. The difficult choice now had to be faced – let grandma spend down to a level where she would qualify for us taxpayers to help pay for her care (Medicaid), or help her funds last longer by moving her to a less costly Level 3 Adult Family Home. (The average cost for her care in the AFC home would save Grandma more than $4,000 per month)
Oregon has been a leader in providing seniors appropriate options for care at reasonable rates. Many years ago our state led a nationwide example of establishing the Adult Foster Care, or Adult Family Home program as an alternative to costly nursing home care. This was soon followed by the assisted living model providing even more options while providing socialization opportunities not often available in the smaller Adult Foster Care program. The richness of these options also helped keep seniors off the taxpayer funded Medicaid system as well as saving the state tax-payer millions of dollars.
Is that rich system now being undermined by the more recent partnership and marketing ploy of the Assisted Living & In-Home care business associations. Is this new partnership really worth the cost to seniors and their families financially? Does this collaboration undermine the Oregon spirit of fiscal responsibility, as well as the spirit of senior care Oregon’s leadership developed?
Your Thoughts?
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