Tuesday, November 27, 2007

Editorial from The Daily Olympian

The following is an editorial from The Daily Olympian newspaper in Olympia. It also appeared in the Peninsula Daily News as a guest editorial with this introduction:
Assisted Living Concepts is also evicting 11 residents on Medicaid at Victoria House in Port Townsend on Feb. 1.
Only private-pay residents are to be accepted after that date.
Laurie Bebo, ALC's CEO and president, has said the company is ending its contract with Medicaid because there are several residents at Victoria House who need more care than the facility can provide.
Bebo said some of the Port Townsend residents could be transferred to Crawford House, an ALC-owned facility in Kelso. Four of them are moving to Seaport Landing, another assisted-living facility in Port Townsend.
Bebo said the company's action at Victoria House does not affect Medicaid-covered residents at ALC's Prairie Springs assisted-living facility in Sequim or Laurel Park in Port Angeles.
But she also noted to the Olympian that her company is in transition to private-pay housing only.

Seniors face eviction because of funding gap
Keri Brenner
At 86, Bertha Allen was living out what seemed to be her golden years encircled by friends, family and caregivers at West Woods assisted living center in west Olympia. Then, the bottom crashed out.
On Oct. 15, 89-year-old Ray G. Allen, Bertha's husband of 66 years, died unexpectedly during a visit with their daughter, Judy Allen, 52. Two weeks later, on Nov. 1, West Woods sent Bertha and 19 other Medicaid-subsidized residents eviction notices, effective Feb. 1. "I am devastated that one person can play God and close all these places," Allen said in reference to Laurie Bebo, chief executive of West Wood's corporate owner, Assisted Living Concepts Inc., based in Menomonee Falls near Milwaukee.
Bebo, whose company operates 208 facilities in 17 states — including 21 in Washington — said the company could not continue to absorb the cost of caring for Medicaid clients without raising rates for private pay residents or cutting annual raises for workers. Bebo said the average private pay rate is $102 per day, compared with the average Washington Medicaid reimbursement rate of $67 per day. Assisted living centers are designed for people who don't need the intensive care of a nursing home but who still require help with bathing, meals and other daily activities. "We're not trying to make money on Medicaid residents," Bebo said. "We're talking about trying to cover the cost of caring for Medicaid residents." The company is in transition to make all of its facilities nationwide into solely private-pay housing. The transition has resulted in the eviction of hundreds of elderly residents elsewhere, including Texas, Nebraska and Indiana, according to published reports. Bebo said the company is not accepting any new Medicaid residents at any of its facilities.
"I think it's just corporate greed, pure and simple," Judy Allen said. "Somebody's got to stand up to these people." Bebo, however, says that it is a matter of not being able to provide the care for people at the reimbursement rate that Medicaid pays. The state is at fault for not paying the full cost, she said. "I don't think it would be fair to our private pay clients to have them subsidize the cost of the Medicaid patients," she said. "Would it be fair to tell our nurses, 'Sorry, you can't have a raise this year, because we have to pick up the slack for Medicaid?' "
Robin Ivey-Black, whose father Howard Ivey, 84, also is being evicted from West Woods, said many of the other assisted living centers she has called in the area have waiting lists. She is trying to place her father in an adult group home, but she said he is not taking the news well.
Howard Ivey ran away from West Woods after his daughter told him about his eviction. Center officials found him and took him home. But a day later, he developed a rash and had to be taken to an emergency room. His daughter says she is avoiding any discussions of the pending move.
"I ask that the state, federal government, West Woods, somebody, figure out a way so that family members can stay," Ivey-Black said. Bebo said the company has offered to place West Woods residents at its Kelso facility, but is only guaranteeing their stay there for about a year, she said.
Kevin Krueger, regional administrator of the state Department of Social and Human Services home and community services unit said caseworkers are scrambling to find homes for the 20 West Woods residents — as well as another 11 residents displaced at an Assisted Living Concepts facility in Port Townsend. "I'm afraid some people may have to be placed outside of the county," Krueger said. He said the state had no advance word from Assisted Living Concepts on its problems with Washington's Medicaid reimbursement rate. Since the state's two-year budget has already been set, the timing is off to start lobbying for more Medicaid funding, he said. "Frankly, I wish this decision the company made had been handled better," Krueger said. "We don't like to place people in facilities, only to have to move again."
Paul Tosch, the Thurston, Lewis and Mason county coordinator for the state's long-term care ombudsman program, said elderly people who suddenly have to move can experience a debilitating "transfer trauma." "Our position is that when these people spent down their private pay (resources) and qualified for Medicaid, the company accepted them for whatever Medicaid could pay and promised they would be allowed to stay," Tosch said. "We feel the company violated that promise."
According to the National Association of State Budget Officers, Medicaid funding has become a major budgetary issue for many states in recent years. The program, on average, takes up 22 percent of each state's budget, the association says. But Bebo said some states, such as Wisconsin, have stepped in to pay the difference in the cost of care for Medicaid patients.
"The Medicaid program has become such a shortfall for us for what it really costs to provide care for Medicaid patients," she said. "Unless the state steps in, providers like us are no longer able to accept Medicaid clients and still stay afloat."
Keri Brenner covers Thurston County and Tumwater for The Olympian. She can be reached at 360-754-5435 or kbrenner@theolympian.com

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