tag:blogger.com,1999:blog-7401779784696246932024-03-14T07:27:08.821-07:00Stop Victoria House Eviction!Port Townsend, Washington: 11 residents of the Victoria House assisted living facility face eviction due to a change of policy: the corporation managing the facility suddenly decided to stop accepting Medicaid.
Outraged? Join our action group.shunradanhttp://www.blogger.com/profile/10202919798792998073noreply@blogger.comBlogger38125tag:blogger.com,1999:blog-740177978469624693.post-8812624992354966582008-04-01T16:19:00.000-07:002008-04-01T16:47:14.029-07:00Governor Signs SB6807On March 28, 2008 Governor Gregoire signed SB6807, Part 1 and 3. She vetoed Part 2.<br />Below is a synopsis of Parts 1 and 3:<br />Part 1: Under the terms of the legislation, a facility's voluntary withdrawal from the Medicaid program cannot be used as a basis for the transfer or discharge of residents from the facility. A facility cancelling its Medicaid contract will be required to retain any current residents (1) who were receiving Medicaid on the day before the effective date of the cancellation of the Medicaid contract; or (2) who have been paying the facility privately for at least two years and who become eligible for Medicaid within 180 days of the date of the cancellation. Notwithstanding withdrawal from the Medicaid program, the Medicaid contract will be deemed to continue in effect for the duration of these residents' tenancy.<br />Part 3: The legislation contains an "emergency clause". Under the terms of the "emergency clause" the provisions governing a facility's withdrawal from the Medicaid program will go into effect immediately upon signature by the Governor.<br /><br />I have learned that Assisted Living Concepts (ALC) has notified the State of Washington that they are cancelling their Medicaid contracts at all of their facilities in the state effective 6/24/2008. This notice was dated 3/24/08. We think that the Medicaid residents in these facilities will be covered by the above law because it states that it applies to residents receiving Medicaid on the day before the EFFECTIVE DATE of the cancellation of the contract (not the date of notice). <br /><br />Thanks again to all of you who worked toward the passage of this bill.Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com1tag:blogger.com,1999:blog-740177978469624693.post-39183343021893025122008-03-11T13:48:00.000-07:002008-03-11T13:52:36.572-07:00Great News!!The LTC Ombudsman generated bill SB 6807 to provide protections for people on Medicaid who live in boarding homes has passed both the Senate and the House and is ready for signature for the Governor. This could not have been done without all of the work of many family members, residents and ombudsmen who have been affected by the ending of Medicaid contracting at West Woods & Victoria House and by the other family members who were promised the ability to convert to Medicaid and then when the time came were denied. The testimony, calls, letters and media attention provided by all of you had a meaningful impact on the legislators.<br /><br />Thank you for all of your help!<br /><br />The bill is a good start toward ending of Medicaid discrimination in our community based settings, in summary it does three things: <br /><br /> (1) Prohibits a boarding home from transferring or discharging a current resident on the basis that it is voluntarily withdrawing from the Medicaid program.<br />(2) Requires notice to persons beginning residence after the effective date of the act that the boarding home is not participating in the Medicaid program and the person may be transferred or discharged if they are unable to pay the facility charges.<br />(3) Requires full disclosure in writing to residents and potential residents or their legal representative the facility policy on accepting Medicaid as a payment source. The policy shall clearly and plainly state the circumstances under which the facility will care for persons who are eligible for Medicaid upon admission or who may later become eligible for Medicaid. Disclosure must be provided prior to admission, and the facility must retain a copy of the disclosure signed by the resident or their legal representative. The facility policy on Medicaid as a payment source as of the date of the resident's admission to the facility shall be considered a legally binding contract between the resident and the facility.<br /><br />I'll keep you posted with regards to when the Governor will sign the bill; it would be great for supporters to come to the bill signing.Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com1tag:blogger.com,1999:blog-740177978469624693.post-34069153482812575712008-02-21T15:54:00.000-08:002008-02-21T16:03:37.047-08:00Good News!The wheels of State have been grinding away and I'm happy to report that<br />HB 3204 - "protecting residents in Boarding Homes who are on Medicaid" passed out of the House last week 95-0. It now needs to go to the Senate for a hearing and continue the legislative journey. I'll keep you posted as the bill travels. Thank you for all of your support to move the bill along!Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com1tag:blogger.com,1999:blog-740177978469624693.post-67652657920573847472008-02-02T08:13:00.000-08:002008-02-02T08:17:26.623-08:00Oops! Error in Senate Bill #In the post titled "February 4th is a Critical Day" there was an error in the number of the Senate Bill. The correct number is 6807. The bills are correctly numbered in the posting titled "Big News".<br /><br />Sorry for the error.Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0tag:blogger.com,1999:blog-740177978469624693.post-55000725796540381082008-01-31T08:44:00.000-08:002008-01-31T08:46:39.727-08:00Plans for February 4thIf you would like to go to Olympia on Monday, February 4th for the Senate Hearing at 1:30 and you would like to carpool with others that are going, please call Sue Estes at 360.379.4418 or John Estes at 360.385.9577.Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0tag:blogger.com,1999:blog-740177978469624693.post-40567081154562600472008-01-30T16:45:00.000-08:002008-02-02T08:13:24.824-08:00February 4th is a Critical Day!The Senate Health and Long Term Care Committee is holding hearing about SB 6807 which will prevent "eviction" by cancelling Medicaid contracts.<br /><br />The hearing is at 1:30 pm in the J A Cherberg Building (Senate office building) in Hearing Room 4.<br /><br /><strong>It is important that we have a strong show of support. </strong>If you can't attend, send an email or make a hot line call.<br /><br /><strong>Please help!</strong>Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com1tag:blogger.com,1999:blog-740177978469624693.post-55170571661998816982008-01-30T16:16:00.000-08:002008-01-30T16:30:01.954-08:00Leader Article on Victoria House<strong>MEDICAID EVICTION LAW EYED</strong><br /><a href="mailto:aarthur@ptleader.com">By Allison Arthur, Leader Staff Writer</a><br />1-30-2008<br /><br /> Kay Harper will leave Victoria House on her own terms and not those of the corporation that owns the Port Townsend assisted-living facility.<br /> Harper announced yesterday during a meeting of residents that she will leave Feb. 15, not Feb. 1. The latter was the deadline the Wisconsin-based multi-state company that owns the facility had given her and others to depart because it canceled its Medicaid contract with the state.<br /> The plight of 11 residents in Port Townsend and 21 residents of another facility owned by Assisted Living Concepts in Tumwater has caught the attention of state legislators, three of whom introduced legislation last week that would prevent companies from doing what ALC did.<br /> Assisted-living facilities that want to close their doors to people on Medicaid would not be able to evict existing residents such as Harper if House Bill 3204 is enacted.<br /> Kevin Krueger, regional administrator for the state Department of Social and Health Services (DSHS), said the bill would ensure that people on Medicaid are "grandfathered" if any facility terminates its contract for people on state aid.<br /> "If this bill were to be passed, if they terminate their Medicaid contract, they would have to grandfather those who are now on Medicaid. Why not let them attrition out?" Krueger said of allowing people to age in place as long as possible, moving only if their care needs changed.<br /> Without such legislation, Krueger said there are "very real and valid fears" among those in boarding homes that what ALC did at Victoria House in Port Townsend and West Woods Assisted Living in Tumwater could be repeated throughout the state.<br /> ALC owns 21 similar facilities in Washington and 208 assisted-living and independent-care facilities across the United States.<br /> "This was a corporate decision, a business decision," Krueger said. He said he had met with a corporate representative and it was clear from that discussion that the company planned to terminate all Medicaid contracts for poor people at all facilities in Washington in order to accept private-pay residents who pay more for their care than the state does.<br /> Laurie A. Bebo, the CEO and president of Assisted Livings Concepts, said yesterday that she would consider dropping the state contract should the bill move forward and before any legislation could take effect.<br /> "We would have to seriously consider pulling out [of Medicaid contracts] before it goes into effect," she said. "To have a contract where there is no exit clause doesn't seem to be fair and reasonable to both parties."<br /> Bebo accepted a call from The Leader while a reporter was at Victoria House to interview Harper and take photos of her making the announcement of her departure.<br /> Victoria House Administrator Wayne Pattison initially said photos couldn't be taken inside the facility without written permission of the residents. Residents then verbally agreed to have their photos taken with Harper, which ombudsman John Estes noted in the minutes of the meeting.<br /> Pattison got on the phone with Bebo, then offered The Leader a chance to talk to Bebo after he was advised she had not returned recent calls for comment.<br /> Bebo had said in November that the reason the company wanted out of its contract with the state was because there were some Medicaid clients in Port Townsend who needed to move to a skilled-care nursing facility and were refusing to do so.<br /> "They pose a challenge and a concern to us as far as our staff being able to take care of their needs," Bebo said in November.<br /> Krueger noted that ALC could have discharged anyone whose needs it could not meet. He noted that only one of the people who moved from Victoria House went to a nursing home.All of those given notices to depart by Feb. 1 did so, except Harper.<br /> Harper, whose son Nick Harper was lauded as Port Townsend Business Leader of the Year on Sunday, leased a house on McPherson Street that a friend, Patty Crutcher, found for her after reading about Kay's plight in The Leader.<br /> Kay Harper, who had been at Victoria House for 10 years, said last week she was glad to be leaving and going where she is wanted. She will need support at her new home.<br /> "It's mine. I'm going to be in charge. There won't be people running around telling me what to do. You always feel like you're in somebody's way. I do things. I make bread and pass it around," Harper said.She repeated that sentiment yesterday when she announced her departure.<br /> "Doris, I'll miss talking to you across the hall," Harper said. "I'm going to be back to see you. Nobody really ever gets rid of me."<br /> Several residents and those who have watched Harper over the years said her departure will be a loss for the residents. Harper also had led a protest in November against ALC's actions.<br /> "She's been a voice for the residents," said Dee Pumplin, whose father has been at Victoria House for five years.<br /> And John Boles said that while the corporation didn't like what Harper had to say, she was "always watching out for people."<br /> Bebo said Harper's departure plans had been worked out between attorneys and she was comfortable with that decision even though it missed the Feb. 1 deadline.<br /> "It was an unfortunate situation, but I think most people found alternatives nearby and I hope this doesn't happen again," Krueger said of what happened in Port Townsend and Tumwater and his hopes for the legislation, which he said likely would be controversial.<br /> (Contact Allison Arthur at aarthur@ptleader.com.)Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0tag:blogger.com,1999:blog-740177978469624693.post-27536901503504157462008-01-30T11:56:00.000-08:002008-01-30T15:57:22.712-08:00Big News!!We have bills before the State Legislature to end what happened to residents in Victoria House!<br /><br /><strong>HB 3204</strong> and <strong>SB 6807 </strong>will prevent discharge of residents from boarding homes due to their Medicaid Status.<br /><br />Link to HB 3204: <a href="http://apps.leg.wa.gov/documents/billdocs/2007-08/Pdf/Bills/House%20Bills/3204.pdf">http://apps.leg.wa.gov/documents/billdocs/2007-08/Pdf/Bills/House%20Bills/3204.pdf</a><br /><br />Link to SB 6807: <a href="http://apps.leg.wa.gov/documents/billdocs/2007-08/Pdf/Bills/Senate%20Bills/6807.pdf">http://apps.leg.wa.gov/documents/billdocs/2007-08/Pdf/Bills/Senate%20Bills/6807.pdf</a><br /><br />There will be a hearing on Monday, February 4th at the Legislature in Olympia. The time and location will be posted as soon as I have the information.<br /><br /><strong>Folks, we need to make some noise on this!</strong> Contact your state legislators--contact information is below on this blog. To send a brief message to legislators through an in-state toll-free hotline, call 1-800-562-6000. If you possibly can, be in Olympia for the hearing. If you wish to testify, please plan what you will say and it's perfectly okay to read your testimony. Legislators need to know how this effects residents and their families. Keep your comments succint and to the point and keep them to a maximum of two minutes.<br /><br />We wanted this so now let's make it happen!!Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0tag:blogger.com,1999:blog-740177978469624693.post-46790841669009170442008-01-11T15:48:00.000-08:002008-01-14T15:17:37.650-08:00Ms. Bebo Meets with City Council SubcommitteeOn Tuesday, January 8th the CDLU (Community Development and Land Use) Committee met and the only item on their agenda was the Victoria House/just cause matter. Laurie Bebo attended the meeting and presented information to the council members<br />and responded to questions from the council members. Council members also listened to comments from the public who were in attendance at the meeting. There was little new information provided by Ms. Bebo. She continues to assert that residents needed more care and the State was unresponsive to requests to move residents. Public comments were mostly to refute or correct statements by Ms. Bebo in her comments and in her letter to the City Council. The council members asked many insightful and pointed questions.<br /><br />Many thanks to those of you who came to the meeting to show support for the residents of Victoria House and many thanks to the council members for giving their attention to this matter.<br /><br />The next meeting is on Tuesday, January 22nd at 2:00 pm in the first floor conference room at City Hall.Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com1tag:blogger.com,1999:blog-740177978469624693.post-5016330846531269932008-01-07T09:07:00.000-08:002008-01-07T09:19:16.854-08:00Senior Lobby Day in OlympiaJanuary 22nd is Senior Lobby Day for the State Legislature in Olympia. Sue is making appointments with the Legislators from our district. This is our chance to talk to our legislators about what we would like them to do! If you would like to take part in these visits, please contact Sue by adding comments to this blog or calling 379-4418.Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com1tag:blogger.com,1999:blog-740177978469624693.post-35002794111249464422008-01-07T09:03:00.000-08:002008-01-07T09:07:08.037-08:00Ms. Bebo's Letter to City CouncilJanuary 3, 2008<br /><br />The Honorable Mark Welch<br /> City of Port Townsend<br />250 Madison Street, Suite 2<br />Port Townsend, WA 98368<br /><br />Re: Victoria House, Port Townsend, WA<br /><br />Dear Mayor Welch:<br /><br />We write in response to your letter of December 11, 2007, regarding events concerning certain residents of Victoria House Assisted Living. While we would have preferred to respond sooner, my travel schedule and the holidays have delayed my response.<br />While we appreciate the City Council's concern over the welfare of all the residents in the City, including those residing at Victoria House, some of the statements in your letter appear to be based upon either inaccurate information or state conclusions which simply are unsupported by any facts. In addition to responding to the concerns raised by the Council in your letter, we welcome the opportunity to appear before your council subcommittee and to meet with any council member interested in speaking with us.<br />Victoria House provides excellent care for its assisted living residents. Ours is one of the most regulated industries in the state. Each of our residents (or his or her legal representative) signs a contract and receives written disclosures regarding the level of care that they will receive at Victoria House. These disclosures are required by law and prevent any implied understandings or, more appropriately, misunderstandings, from taking place. Each and every one of the eight (not eleven) residents affected by the termination of the State Medicaid contract received these disclosures.<br />Your letter also suggested that the City has been told that none of the individuals impacted by the decision to terminate the Medicaid contract required transfer because their medical conditions required a higher level of care than that provided at Victoria House. Because your letter does not specify what you were told and by whom, it is difficult to respond to your concern. Medical privacy laws preclude us from discussing the circumstances of individual residents; however, we can say that there had been conversations with representatives of DSHS regarding the condition and the needs of each resident. The record of those conversations is either known or available to representatives of the State and authorized members of the individual resident's families.<br /><br />The Honorable Mark Welch January 3, 2008 Page 2<br />In addition, you should be made aware that over the course of the last year, Victoria House recognized that several of these Medicaid residents were requiring higher levels of care than those provided at the residence. Because of these higher care needs we thought it appropriate for these residents to be transferred to other facilities that provided this higher level of care. Unfortunately, the residents refused to move and we were forced to initiate the Involuntary Transfer/Discharge process required by Washington law. The Involuntary Transfer/Discharge process was initiated because we believed that the increased care needs of a few residents, put other residents and the facility at risk. Because providing the highest level of care to our residents is our paramount concern, we knew we had no alternative but to transfer these residents.<br />During this transfer process, the local DSHS representative refused to support our position. Because of this lack of support, we eventually abandoned the process. Unfortunately, we believe that the local DSHS representative's position had more to do with the vocal nature of the residents involved and less to do with the care needs of these residents. Because of the local DSHS representative's lack of support, we felt that we could no longer maintain a Medicaid contract in the DSHS Region 5 which encompasses the Olympic Peninsula and the Olympia area. It should be noted that in similar instances we have not experienced the lack pf support from DSHS in its other Regions. Accordingly, we have not taken the extraordinary step of canceling our Medicaid contracts in these other regions. Again, while we cannot discuss the specifics of individuals in a public setting, we remain willing and able to discuss our concerns with appropriate personnel from the agency.<br />As we previously explained in our letter to the City Attorney, because we had not received meaningful responses from the agency regarding the care issues we had raised about some residents, we made the difficult decision to terminate the contract. We do appreciate the Council's recognition of the fact that the Medicaid reimbursement rates are inadequate and fail to address the changing needs of residents, making aging in place extremely difficult. Nevertheless, while the reimbursement rates played a part in our decision, it was not the primary basis for our action to terminate the contract.<br />While we cannot disclose the identity of our former residents or where they have transferred to, we can share that half of the residents impacted transferred to other assisted living facilities. However, the other residents identified by us as requiring a higher level of care have been unable to find placement in other assisted living facilities because those facilities are unable to care for their needs. Indeed, these residents have been informed by the other facilities that they are inappropriate for assisted living and in fact require skilled nursing care or specialized dementia from a nursing home or dementia care facility. Thus, Victoria House is not the only Assisted Living provider that believes that these residents required higher levels of care.<br /><br />The Honorable Mark Welch January 3, 2008 Page 3<br />Finally, your letter implies that Victoria House promised that it would somehow become a "permanent home" for these Medicaid residents. We would like to clarify that only in very rare cases does an assisted living facility become a "permanent home" for an elder resident. In our opinion, assisted living facilities are part of the Long Term Care continuum. As a resident's conditions changes, his/her housing and care needs change. The suggestion that Victoria House promised to keep these residents indefinitely is unsubstantiated and at odds with the notion of the continuum of care.<br />We take the care of residents, and their rights, very seriously. Again, that was one of the reasons why we have written contracts, written disclosure statements, and frequent communication with the families of residents. As a result, the suggestion in your letter that the decision to terminate the Medicaid contract was in any way retaliatory is incorrect, unsubstantiated, and extremely unfair. There are mandatory reporting requirements for any unethical or unsafe conduct observed or suspected. There are anonymous hotlines to assist the residents in reporting any such accusations. The State Ombudsman's Office is available to advocate for residents. The fact is that we have received no complaints or communications alleging that the termination decision was retaliatory or has affected quality of resident care. The people who work at Victoria House, many of whom live in your city, work hard to provide quality care. They do not deserve to have their efforts disparaged.<br />As we previously reported in our letter to the City Attorney, the majority of the residents affected by termination of the Medicaid contract have successfully made arrangements to pursue care in other facilities. We remain committed to making the transfers as seamless as possible and we are working with the families of the residents to achieve that goal. We look forward to the opportunity of meeting you and answering any other questions that the Council may have.<br />Very truly yours,<br />Laurie A. Bebo<br />President and Chief Executive OfficerSue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0tag:blogger.com,1999:blog-740177978469624693.post-7180216689174220702008-01-04T13:44:00.000-08:002008-01-04T13:56:59.089-08:00Ms. Bebo Writes to the City CouncilMs. Bebo has written a letter to the Mayor and City Council in response to their letter to her. We are having technical problems in copying the letter for posting on the blog. There is not much new in the letter. Ms. Bebo still maintains that residents in Victoria House needed a higher level of care than available there and the state would not make other plans for them. The letter contains several inaccuracies and misrepresentations. The letter will be posted as soon as we are able to do so. <br /><br />Stay tuned.......Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0tag:blogger.com,1999:blog-740177978469624693.post-77814485892179499432008-01-04T10:40:00.000-08:002008-01-04T12:13:41.321-08:00Meeting with City Council SubcommitteeBelow is an excerpt from an email from John Watts regarding the meeting:<br /><br /><em>Michele Sandoval, Chair of the Council CDLU committee, confirmed that the “Victoria House/just cause eviction” matter is on the CDLU agenda for Janaury 8, at 2PM at City Hall. Council on Dec. 3rd determined to send a letter to ALC and to refer the matter to CDLU to review options.<br /><br />This also lets you know that Laurie Bebo, CEO of ALC, will be coming to Seattle and will attend the CDLU committee on Jan. 8.</em> <br /><br /><strong>Hey folks, please</strong> <strong>come</strong> to the meeting and show your support for Victoria House residents and others who might in the future be subjected to unfair eviction.<br /><br />The meeting will be in the first floor conference room of “new” City Hall. Public comment is allowed.Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0tag:blogger.com,1999:blog-740177978469624693.post-62421348941432725642008-01-02T16:09:00.000-08:002008-01-02T16:17:47.142-08:00Update on the Victoria House ElevenI'm sure that you are wondering what has happened to residents who are facing eviction from Victoria House. As you know, one is deceased. Seven have moved to other accommodations. From what I have heard, most of them seem to be satisfied with their new living situations.<br /><br />Kay Harper remains at Victoria House and is considering her options.<br /><br />Two residents may be staying at Victoria House under the Low Income Housing Program. (I am pleased if these two individuals are able to stay at Victoria House. I'm just wondering--again--why these two particular people and how it is possible for them to stay and not other residents.)<br /><br />I'll keep you posted on further changes as they occur.Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0tag:blogger.com,1999:blog-740177978469624693.post-66771505460967821802007-12-12T15:34:00.000-08:002008-01-02T16:29:57.263-08:00City of Port Townsend Writes to Ms. BeboI'm so sorry about the delay in getting this letter up on the blog. We have had technical difficulties plus holidays plus vacation. Anyway, here it is and I think you will find that it is worth waiting for. Please send the mayor and council members notes with your appreciation. There is a link to them below to the right.<br /><br /><br /><em>December 11,2007<br />Laurie Bebo President and CEO Assisted Living Concepts, Inc. W140N8981 Lilly Road Menomonee Falls, Wl 53051<br />Re: Victoria House, Port Townsend, WA<br />Dear Ms Bebo:<br />As Mayor and on behalf of the City Council of the City of Port Townsend, ! am writing to express the City of Port Townsend's deep concern about the way Assisted Living Concepts, Inc. ("ALC") has made eleven residents of Victoria House innocent victims of an apparent dispute that ALC is having with the State of Washington concerning Medicaid reimbursement rates. The treatment of these individuals is contrary to our community's values as a place that cares for its people, and inconsistent with basic principles of caring and kindness.<br />Each of these individuals entered Victoria House with an implied understanding that they would be able to stay unless discharge or transfer was caused by the need for a higher level of care than the facility agreed to provide. Indeed, in some instances this understanding was expressly stated. Yet we have been told that none of these eleven individuals impacted by ALC's decision have experienced changed conditions requiring transfer, despite assertions by ALC personnel or representatives to the contrary.<br />ALC says these residents need more care and blames the State for not responding to ALC's request that they be transferred. Yet it appears that ALC never chose to seek discharge of any of these residents under the criteria authorized under Washington State law. Note that one such criterion is that "the transfer is necessary for the resident's welfare and the resident's needs cannot be met at the facility." (Letter from Robin Dale, Counsel to ALC, dated December 2, 2007 and appended hereto) Had ALC initiated a transfer or discharge as authorized by law, the resident would have had the opportunity to dispute the alleged reason for your action and have the matter adjudicated by a Superior Court judge.<br />Why, we wonder, did ALC choose not to take such action? Why, instead, did ALC opt to terminate its Medicaid contract with the State for Victoria House and one other facility of the 21 that ALC operates in Washington? It would appear that this choice is an "end run" on ALC's part enabling you to avoid demonstrating that the situations of the residents meet the requirements of the law. How can we conclude otherwise? The Legislature crafted a detailed and logical framework for determining whether residents of a facility like Victoria House should be discharged or transferred, yet ALC apparently didn't want to avail itself of those provisions.<br />We also note that you chose to terminate your Medicaid contract at only two of the 21 facilities you operate in Washington. Are those two radically different from the other nineteen? It seems likely that the kinds of clients your facilities attract will be reasonably comparable in communities throughout the state, so we are mystified as to why you felt that keeping a Medicaid relationship was so onerous in two instances but acceptable in nineteen others. Perhaps you would like to explain this as well.<br />We understand that several of the involved Victoria House residents have exercised their rights to complain to the State in the past about conditions and that such complaints may have brought about actions by the State seeking improvements to the way Victoria House has been operated. Some have suggested that your recent termination of the Medicaid contract has more to do with this than your concerns about rates. We hope this is not the case, for retaliation against someone exercising her or his rights under the law is totally inappropriate.<br />Your representatives assert that Washington's reimbursement rates under Medicaid need to be reviewed and increased. We have no opinion on that matter, but we do recognize that this is a legitimate concern and that regular review of such a matter is warranted. But elderly, indigent persons should not be pawns to be sacrificed during such review.<br />To that end, and triggered by ALC's behavior in this instance, we urge the State take prompt action that allows the remaining ten affected clients to stay at Victoria House or to return there, should they so desire. We further recommend reforms to the Medicaid program as follows:<br />• Requiring that any facility entering the Medicaid program must continue to serve any individual accepted for residency, absent changed circumstances warranting transfer or discharge, even if the facility opts not to accept new Medicaid clients;<br />• Requiring a determination by an independent decision-maker in any instance where a Medicaid client asserts that he or she is being discharged or transferred improperly;<br />• Requiring that the owners of multiple facilities in the State have consistent policies such that if they accept Medicaid clients at any of them, they must accept them at all of them;<br />• Strengthening rules pertaining to retaliatory actions against Medicaid recipients who exercise their rights and subsequently suffer adverse action.<br />ALC's actions have caused extensive anxiety, confusion and trauma to the lives of these eleven individuals, their families and their friends. One of them is deaf and blind; getting accustomed to a new facility will be exceptionally difficult for her. Another lost 20 pounds after ALC's decision was announced in early November. A third recently passed away. While it cannot be proved that her death resulted from the eviction, it's certainly plausible that there was a connection; studies have long documented that there are significant adverse psychological and physical effects from involuntary relocation, particularly among the elderly.<br />We urge you to rescind your announced intentions and, instead, to allow the remaining ten affected clients to stay at Victoria House or to return there, should they so desire. At that point you can pursue issues with the State without victimizing innocent seniors. Changed circumstances in the future may give rise to a judgment on your part that transfer or discharge is warranted; should that occur you have adequate remedies under existing law and those remedies ensure that residents are treated fairly and with adequate due process.<br />This letter is written on behalf of the City Council of the City of Port Townsend, which unanimously approved this letter in open session on December 10, 2007. Thank you and all whom we have copied for your consideration.<br />Sincerely,<br />Mark Welch, on behalf of the City Council of the City of Port Townsend Mayor</em><br /><br />Copies of this letter were sent to the Governor, State Representatives for our area and DSHS administrators.<br /><em></em>Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com1tag:blogger.com,1999:blog-740177978469624693.post-27902790237515035062007-12-05T14:16:00.000-08:002007-12-05T16:39:12.658-08:00One of Vic House Eleven DiesIt's sad to report that one of the eleven residents of Victoria House who would have had to move died last Saturday night. She was terminally ill and receiving hospice care. There is no indication that her death had anythng to do with the situation at Victoria House.Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com1tag:blogger.com,1999:blog-740177978469624693.post-55356091622549892522007-12-05T13:14:00.000-08:002007-12-05T16:37:22.692-08:00Is the Glass Half Empty?The Leader must think the glass is half empty to read the headlines on <a href="http://www.ptleader.com/main.asp?SectionID=36&SubSectionID=55&ArticleID=19448&TM=59384.22">their article about the City Council Meeting last Monday night</a>. <a href="http://www.ptleader.com/main.asp?SectionID=36&SubSectionID=55&ArticleID=19448&TM=59384.22"></a><br /><br />Others might not see it that way. The Council <em>IS </em>taking action in sending a letter to the involved parties and sending possible ordinances to committee for consideration. Whether their action will stop evictions <em>DOES </em>remain to be seen. Some think that anything they might do at this point would be too late for the residents hoping to stay at Victoria House. That, too, is unsure at this time. Although residents have been advised that the facility would no longer accept Medicaid as payment effective 2/1/08, the residents have <em>NOT</em> received Notices of Discharge.<br /><br />The article in The Leader had some misleading information (taken from the ALC attorney's letter) regarding the time required for notice. It's not clear how the attorney came up with the three day notice as cited but there is a provision for a resident to be discharged "as soon as practicable" when the health and safety of residents is endangered or when an immediate transfer or discharge is required by a resident's urgent medical needs. A facility <em>MUST </em>give 60 days notice when canceling the Medicaid contract.Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0tag:blogger.com,1999:blog-740177978469624693.post-8541421474955782952007-12-04T08:34:00.000-08:002007-12-04T14:43:10.991-08:00Good response at City Council MeetingThe City Council Meeting last night left the supporters of the Vic House Eleven feeling that we had a good hearing and the Council would like to do what they can to assist in our situation. All members of the council expressed concern about the situation of our residents who have been treated so shabbily. They are unsure what action is within their power to take. They agreed to send a letter to ALC, State Representatives and DSHS strongly stating their concerns about what is happening.<br /><br />City Attorney John Watts provided the Council with two draft ordinances for their consideration. One concerned landlord tenant just cause and the other concerned business licensing regulation that prohibits terminations or evictions except for cause. The council decided to refer the ordinances to the CDLU (Community Development Land Use) Committee before making a decision.<br /><br />It is interesting that ALC had a letter sent to the mayor from a Olympia legal firm stating their position and cautioning against a just cause provision in the eviction ordinance. We were told that an attorney from the firm had planned to be at the meeting but was unable to come due to weather issues. <br /><br />John Estes, Sue Estes, Doug Campbell, Nick Harper, Leatha Smith and Kelly Dodson spoke on behalf of the Victoria House residents. Don Rose, Maintenance Man at Victoria House, spoke but stated that he was not a spokesman for ALC; however, his comments pretty much followed the "company line".Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com1tag:blogger.com,1999:blog-740177978469624693.post-24725115891237182082007-11-29T17:17:00.000-08:002007-11-29T22:29:18.319-08:00Eviction Issue on City Council Agenda for Dec. 3rdIt appears important to show up at the next City Council meeting, November 3rd.<br /><br />We just received a note from <a href="mailto:jwatts@cityofpt.us">City Attorney John Watts</a>, as follows:<br /><blockquote><a href="mailto:mwelch@ptcitycouncil.org">Mayor Welch</a> requested review of possible City options concerning the notices of termination and planned evictions at Victoria House.<br />Attached is the agenda bill for the City Council meeting Dec. 3rd. As stated in the agenda bill, draft ordinances that might address the issue are still being prepared.<br /><br />Thank you and please call with any questions.<br /><a href="mailto:jwatts@cityofpt.us"><br />John Watts, City Attorney - City of Port Townsend<br />250 Madison Street, Suite 2, Port Townsend, WA 98368 </a><br />Telephone: 360/379-5048, Fax: 360/385-4290 </blockquote><br />The attached agenda bill says:<br /><span style=";font-family:arial;font-size:100%;" ></span><blockquote><span style=";font-family:arial;font-size:100%;" >Based on public comments and concerns raised at a recent Council meeting concerning notices of termination and planned evictions at Victoria House, Mayor Welch requested review of possible City options.<span style=""> </span>The City currently has no regulation affecting the situation.<span style=""> </span><st1:place><st1:placename><span style="">Possible</span></st1:placename><span style=""> </span><st1:placetype><span style="">City</span></st1:placetype></st1:place> options are set forth.<span style=""> </span>(In addition to anything the City might do, there may be private legal options, for example, based on express or implied contract or representations that a resident would not be evicted except for certain causes, and/or based on equal protection or discrimination.) <o:p></o:p></span> <p class="MsoNormal" style="font-family:arial;"><span style="font-size:100%;"><u><span style="">Send letter to operator, and to state agencies and legislators</span></u><span style="">.<span style=""> </span>Send (1) a letter to operator of Victoria House objecting to removal of tenants who rely on Medicaid to assist in covering their costs, and (2) separately, a letter to state agencies and legislators to prohibit/regulate the situation.<span style=""> </span>While RCW 70.129.110 provides regulations on discharge and transfer requirements from boarding homes (apparently, Victoria House is a boarding home), it is not clear the regulation prohibits the evictions occurring at Victoria House, particularly if the eviction is based on an inability of the facility to meet the needs of the resident.<span style=""> </span>(A copy of the RCW is attached.) <o:p></o:p></span></span></p> <p class="MsoNormal" style="font-family:arial;"><span style="font-size:100%;"><u><span style="">Enact just cause eviction ordinance</span></u><span style="">.<span style=""> </span>For background, attached is a copy of MRSC staff attorney Paul Sullivan’s comments on such an ordinance, to effect, </span><span style="">state landlord tenant law <u>may</u> preempt and prevent any city action.<span style=""> </span>No other city (except </span><st1:city><st1:place><span style="">Seattle</span></st1:place></st1:city><span style="">) has a “just cause” eviction ordinance. Further, an ordinance enacted now might not apply to a pending <i style="">notice of termination</i> of tenancy issued to a Victoria House tenant (but might apply to an <i style="">eviction, </i>namely, the actual court process required to evict a tenant who does not move in response to a notice to terminate if a tenant).<span style=""> </span>Any ordinance would apply citywide (and not just to Victoria House).<span style=""> </span>For Council consideration, a draft ordinance modeled on the </span><st1:city><st1:place><span style="">Seattle</span></st1:place></st1:city><span style=""> ordinance will be provided to Council before the Council meeting.<span style=""> </span>(It is suggested any ordinance, if approved, only apply to any apartment or building with 5 or more tenancies, and not to every rental arrangement.) <o:p></o:p></span></span></p> <span style=";font-family:arial;font-size:100%;" ><u><span style="font-size:12;">Enact a business licensing regulation that prohibits terminations or evictions except for cause</span></u><span style="font-size:12;">.<span style=""> </span>For Council consideration, a draft ordinance will be provided to Council before the Council meeting.<span style=""> </span>It is suggested the ordinance, if adopted, would apply to any apartment or building operator with 5 more tenancies, and provide that any violation of an ordinance provision concerning termination or eviction could result in an apartment operator’s business license suspension and/or penalty.<span style=""> </span>For example, if a licensee wrongfully terminated or evicted a tenant (namely, terminated or evicted without just cause), then the City could suspend the licensee’s business license and/or fine the licensee.<span style=""> </span>(Any suspension or fine would require appeal rights, and involve the City in appeal hearings on whether a violation triggering licensee suspension or fine occurred, namely, whether just cause existed to terminate/evict a tenant.)<span style=""> </span>Such an ordinance might be deemed equivalent to a landlord tenant regulation, and therefore might (per MRSC above) be preempted by state law.<span style=""> </span>Review of other </span><st1:state><st1:place><span style="font-size:12;">Washington</span></st1:place></st1:state><span style="font-size:12;"> cities’ codes failed to find any similar provision. </span><br /></span></blockquote><span style=";font-family:arial;font-size:100%;" ></span>shunradanhttp://www.blogger.com/profile/10202919798792998073noreply@blogger.com1tag:blogger.com,1999:blog-740177978469624693.post-91781288130331582482007-11-29T15:13:00.000-08:002007-11-29T15:18:33.021-08:00Good news from the State OmbudsmanI got an email from Louise Ryan, State LTC Ombudsman, today and I want to share her message with you.<br /><br />It reads: "...<em>the media attention has got legislators attention and there is interest in a legislative fix. I'll keep you posted once I have more news. Keep up the good work and encourage resident's & family to keep making noise."</em><br /><em></em><br />Let's keep up the pressure!Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0tag:blogger.com,1999:blog-740177978469624693.post-65670991905034685022007-11-29T14:26:00.000-08:002007-11-29T15:31:02.504-08:00Kevin Van De Wege Town Hall MeetingThere will be a Town Hall Meeting with Kevin Van De Wege on Friday night (yes, tomorrow night) at 8:00 pm at the Tri City Center in Chimacum. A couple of the family members of the Vic House Eleven plan to be there to take up the issue of the eviction. They would like others to be there to show their support.<br /><br />This is a good chance to ask one of our Legislators to take action on behalf of residents like ours who need them to protect our vunerable elders from being at the mercy of corporate decisions.Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0tag:blogger.com,1999:blog-740177978469624693.post-13644669234586480172007-11-29T14:14:00.000-08:002007-11-29T16:10:42.149-08:00Bebo responds to Sue's editorialWednesday's newspaper <span style="font-style: italic;">The Leader</span> printed Sue's letter previously posted on this blog. They edited out the sentence at the end of the third paragraph about retaliation. They also added a response from Laurie Bebo which follows:<br /><br /><em>(Laurie Bebo, president and CEO of Assisted Living Concepts Inc., responds: Although we cannot get into details about individual residents, we have documented monthly care conferences in which we have asked the state to find skilled nursing placement for several residents. The state has offered (through the case manager in attendance) to provide us with higher reimbursement, and our response has been that's not what we're asking for. The resident needs to move to a skilled nursing facility to have the additional oversight, care and medical assessments necessary to meet their needs in a quality way. This, of course, is more costly for the state than any reimbursement they are offering us. To end our Medicaid contract is anything but financially lucrative for Victoria House. We have simply put the care and safety of our residents and staff above the negative financial implications of ending the Medicaid contract. Although we are not interested in growing our Medicaid population, our plan was to reduce our Medicaid population through natural attrition. As people pass away, need to move to a higher level of care or simply move to a different community, we would slowly exit the Medicaid program. The state's unwillingness to see the appropriate placement needs of the residents has created this unfortunate situation.There is a process for discharging residents in the regulations, but the state has to agree. The state has not agreed to move out any one of our Medicaid residents all year. The proof in whether these residents are appropriate for assisted living is in the fact that several were denied for assisted living placement and will have to go to a skilled nursing facility when they leave Victoria House. Some residents will appropriately be placed in assisted living - these are the same residents we offered to take at one of our other houses if they didn't find placement nearby. The other residents that will have to move to a skilled nursing facility (SNF) need to recognize it is in their best interest to do so, as their needs are such that the SNF care environment will best accommodate them. Most residents have already been accepted in a nearby assisted living or skilled nursing facility of their choice. We are confident the last couple of residents can be placed in a skilled nursing facility as well. I agree with Ms. Estes that the Medicaid reimbursement rates are too low for assisted living. I look forward to further work being done in this area as well as in the area of appropriate placement.)</em><br /><em></em><br />It becomes rather disheartening to deal with folks who always have an answer and it doesn't seem to matter if it is factual or accurate.Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com2tag:blogger.com,1999:blog-740177978469624693.post-34115765838213214102007-11-27T15:42:00.000-08:002007-11-27T22:04:58.534-08:00Editorial from The Daily OlympianThe 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:<br /><em>Assisted Living Concepts is also evicting 11 residents on Medicaid at Victoria House in Port Townsend on Feb. 1. </em><br /><em>Only private-pay residents are to be accepted after that date.</em><br /><em>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.</em><br /><em>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.</em><br /><em>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.</em><br /><em>But she also noted to the Olympian that her company is in transition to private-pay housing only.</em><br /><em></em><br /><strong>Seniors face eviction because of funding gap<br /></strong>Keri Brenner<br /><span style="font-style: italic;">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. </span><span style="font-style: italic;">Then, the bottom crashed out.</span><br /><span style="font-style: italic;">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. </span><span style="font-style: italic;">"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.</span><br /><span style="font-style: italic;">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. </span><span style="font-style: italic;">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. </span><span style="font-style: italic;">"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." </span><span style="font-style: italic;">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.</span><br /><span style="font-style: italic;">"I think it's just corporate greed, pure and simple," Judy Allen said. "Somebody's got to stand up to these people." </span><span style="font-style: italic;">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. </span><span style="font-style: italic;">"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?' "</span><br /><span style="font-style: italic;">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.</span><br /><span style="font-style: italic;">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.</span><br /><span style="font-style: italic;">"I ask that the state, federal government, West Woods, somebody, figure out a way so that family members can stay," Ivey-Black said. </span><span style="font-style: italic;">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.</span><br /><span style="font-style: italic;">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. </span><span style="font-style: italic;">"I'm afraid some people may have to be placed outside of the county," Krueger said. </span><span style="font-style: italic;">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. </span><span style="font-style: italic;">"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."</span><br /><span style="font-style: italic;">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." </span><span style="font-style: italic;">"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."</span><br /><span style="font-style: italic;">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. </span><span style="font-style: italic;">But Bebo said some states, such as Wisconsin, have stepped in to pay the difference in the cost of care for Medicaid patients.</span><br /><span style="font-style: italic;">"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."</span><br />Keri Brenner covers Thurston County and Tumwater for The Olympian. She can be reached at 360-754-5435 or kbrenner@theolympian.comSue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0tag:blogger.com,1999:blog-740177978469624693.post-48183402319559816592007-11-27T15:31:00.000-08:002007-11-27T15:42:27.957-08:00Attorney to meet with Vic House ElevenSteve Robins, Lead Attorney for NW Justice Project in Port Angeles, will be in Port Townsend on Thursday to meet with Victoria House residents and families who are affected by the cancellation of the facility's Medicaid contract. This will be their first meeting to get acquainted, gather information and plan strategies. We're not sure what will happen in the long run but we're glad to have legal representation and get started with our case.Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0tag:blogger.com,1999:blog-740177978469624693.post-14239437418589140202007-11-21T16:47:00.000-08:002007-11-21T17:23:37.928-08:00Letter to the Editors<span style="font-size:100%;">You might be interested in reading my letter to the editors of our local newspapers. Here it is:<br /><br /></span><span style="font-style: italic;font-size:100%;" >Recently both The Leader and the Peninsula Daily News had articles on the decision by Assisted Living Concepts (ALC) to cancel their Medicaid contract which is tantamount to eviction of the residents living there who rely on Medicaid to assist in covering the cost of their care. Reporters contacted Laurie Bebo, President and CEO of ALC for her comments. Ms. Bebo indicated that the main reason for the decision was that there are residents who require skilled nursing care and have refused to move to another setting. I would like to respond to that accusation.</span><span style="font-size:100%;"><br /><br /></span><span style="font-style: italic;font-size:100%;" >RCW 70.129.110 provides for the discharge of residents. I won’t bore you by quoting the law but it requires facilities to permit residents to remain in the facility unless certain requirements are met. One of the reasons that a resident may be discharged is if their needs cannot be met in the facility. Before the facility discharges a resident they must attempt to avoid the discharge through reasonable accommodations and a 30 day notice is required if accommodations do not resolve the problem. Believe me, if ALC had sufficient reason to discharge residents they claim should not be in their facility, they would have done so.</span><span style="font-size:100%;"><br /><br /></span><span style="font-style: italic;font-size:100%;" >It just so happens that several of the residents who will be evicted are outspoken about the shortcomings of the facility. Can you say R-E-T-A-L-I-A-T-I-O-N?</span><span style="font-size:100%;"><br /><br /></span><span style="font-style: italic;font-size:100%;" >Bebo states that the low reimbursement rate is not the reason for ALC’s decision, but I would like to speak to that issue. The reimbursement rate IS too low. There has not been a substantial increase in many years. The reimbursement rate does not cover the cost of providing care for residents. There are many good providers who have elected not to accept Medicaid residents for that reason. Action by the State Legislators is badly needed to correct this situation. Please contact your representatives and ask them to attend to this matter.</span><span style="font-size:100%;"><a style="font-style: italic;" href="http://act-against-eviction.blogspot.com/"><br /></a></span>Sue H. Estes, Regional LCT Ombudsmanhttp://www.blogger.com/profile/09308578843754465547noreply@blogger.com0