Colorado Assisted Living Association (CALA)

In a study published January 5th, 2010 in Business Week Lifestyle

Senior Resident

it was reported that “Assisted living facilities for older people are most often located in areas with higher levels of income, education and home values”.
It goes on to say that “These findings aren’t surprising because private dollars have fueled the growth of assisted living facilities, write the researchers. However, the findings do mean that people with lower incomes, minorities and those living in rural areas have fewer living options as they age”.

However, what was not reported in Business Week, but was discussed deeper in the actual report published in the January 2010 issue of Health Affairs was the fact that:

“To date, states have been slow in expanding Medicaid coverage for services in assisted living facilities. Many states have small programs under which Medicaid pays for personal care and medical services in assisted living, but few assisted living residents receive these public supports” the report continues “Although there are important noncost considerations in expanding Medicaid-financed care in assisted living (such as strong consumer preference), any proposed expansion is accompanied by important fiscal caveats.” The report further states that; “ Assisted living has the potential to serve as a cost-effective substitute for higher-intensity nursing home care for some people. Yet policymakers are concerned about the moral hazard likely associated with offering people an array of long-term care services, especially attractive options such as assisted living. A key issue from a state budgetary perspective is whether assisted living coverage can be structured to increase substitution away from Medicaid-financed nursing home care while minimizing substitution away from unpaid care by family and friends.”

Operating an assisted living home is like any other business, if you can’t make enough income to pay the bills and the employees you can’t keep operating, no matter how good your intentions are.

Colorado is one of the states that fund assisted living services through its Medicaid wavier program. This is a great program for those who need but cannot afford assisted living services. However, recent state budget cuts and increased licensing fees may threaten that program. It has been my experience that there are more elders on or applying for Medicaid and looking for assisted living beds then there are quality beds available. I believe that this is a direct result in the facilities cutting back on the number of beds that they are allocating to Medicaid as a result of state funding cuts. It’s always a difficult choice when it comes to public funding for social services but I believe there are ways that this could be done without increasing the funding short fall. Some of those choices are not popular and none would happen over night.

First we need to tighten down on the financial qualifications of those applying for Medicaid. Protecting assets in a “trust” for anyone other than a spouse or dependant child should not be allowed. The Elder has worked hard and saved to provide for their retirement not for the benefit of their adult children. We also need to increase the penalties for those in a position of trust (including the adult children) that convert the elders funds to their own use. To many times we have seen elders that run out of funds to pay for their care and cannot qualify for Medicaid because the family has misappropriated funds. This form of financial abuse often goes unpunished.

We also need to look at the best use of the Medicaid funds. By lowering the reimbursement to assisted living facilities serves to redirect elders to more expensive (two to three times the cost) nursing homes. As reported in Health Affairs, “Assisted living has the potential to serve as a cost-effective substitute for higher-intensity nursing home care for some people”. I would add, for many lower income seniors.

–by Thomas Kinrade, President

That’s a question that I asked myself six months ago. CALA had been around since 1982, it was conceived by a group of small assisted living providers on the Western Slope to “Assist, Promote, Inform and Educate” the assisted living community. CALA has had its moments of greatness, hosting some great conferences and working for the betterment of the assisted living community. During 2009 something exciting started to happen. A few providers and some associate members looking for a catalyst for promoting the assisted living community discovered CALA again.

I was a member of CALA in the past and when I was approached to become a member again I asked myself this question: “What’s in it for me?” I’m sure that’s a question that we all have asked and that’s okay because I won’t expect anyone to join an organization or invest in a project that didn’t have a return. With that in mind, I ask you these questions:

Have you ever wondered?

• Why is the CDPHE doing what it is?
• Do you know what really happened at the state ALF advisory meeting?
• Do you know what the surveyors are looking for this month, week or year?
• Have you ever wondered when that rule was changed?
• Do you know what is happening in the State and/or Federal Government and how it affects you?
• Do you know why Medicaid rates are being cut?
• Have you wondered how or when a rule got passed and why you weren’t aware of it?

Maybe you’re just looking for answers to questions like:

• Where can I get more training for my staff?
• How can I get more residents?
• How do I get a web site?
• What’s the latest technology available for assisted living homes?
• What are Facebook, Twitter and Linkedin and how can I use them?
• What other ideas are out there that could help my business?
• How can I cut cost and save money?
• Who can I call for advice or just to bounce some ideas off of?

 Are you frustrated with what you see as problems with the assisted living communities?

• Do you have new ideas that would make all of our communities better?
• Are you driven to make life better for our aging population?
• Do you have skills and talents that are going untapped?

 If any of those questions or other questions like them have ever crossed your mind then, at the risk of sounding pushy, you need CALA. CALA is a community that is coming together to help each other to Assist, Inform, Promote and Educate.

CALA needs you:

We at CALA continue to ask “How do we deliver more value and how do we show the value we currently offer to our members?” CALA represents only assisted living communities and associates that serve those communities; we have no paid employees.  Everything that CALA does for your community is done by folks just like you. We know that you have talents, skills and ideas that we can use, become a member and if you’re a member become a leader.

(Letter from the President article from the CALA Newsletter-January 2010 issue)