Posts tagged 'Assisted Living'
There are stories about individuals and families having some issues with services through Medicaid because of misunderstandings with providers or not understanding their coverage. Sometimes mistakes are made and must be fixed. The majority of the time providers try to work with Medicaid recipients to provide the best service they can.
In New Jersey, however, there is a company that has been in the news lately for doing just the opposite. This story has been touched on before, but there are more details continuing to come out.
The company, Assisted Living Concepts, based in Wisconsin has a large number of assisted living facilities. As in any business, some things work well and turn out right and some things sometimes do not. There are many excellent assisted living companies throughout the country who work hard every day to balance their budgets, help the residents – whether on Medicaid or not – and deal with issues – especially financial ones – that come up.
Unfortunately, at least in this case, Assisted Living Concepts has handled a situation with eight of its facilities in South Jersey in a harmful and totally inequitable way. In these particular facilities, Assisted Living Concepts had a number of individuals staying there and receiving service who were paying for their services out of their life savings. The individuals say that they were told that if their savings ran out, they would be switched to Medicaid and could stay where they were in Assisted Living Concepts facilities.
Instead, when their savings were totally gone – because they had been paid to Assisted Living Concepts for their care – they were told that they had to leave. A complaint was made and a few weeks ago the Public Advocate began an attempt to review records to see how many more individuals were – or had been – in this position with Assisted Living Concepts.
The case has gone to Superior Court, and a judge will decide on whether the records will be released for review. The case is difficult because, though all Assisted Living facilities are supposed to keep 10% of their beds for Medicaid recipients (in New Jersey), some are exempted. The lawsuit being brought by these eight evicted residents has to do with the promises that were made to them that after they used their funds – in one case over $300,000 - they would be able to stay and be switched to Medicaid. These promises were broken, and it is not known how many other promises to other individuals were handled the same way.
It is important to get to the bottom of this so that individuals who are most vulnerable are not taken advantage of in this (or other) ways, but are protected by the system and by the individuals and organizations who are supposed to serve them.
When elderly individuals go into along term care facility or a similar facility and self pay, the cost can be astronomical. Making sure that the person is comfortable, well cared for, in a clean environment and positive atmosphere is not a low budget issue. What happens, though, when a private pay individual converts to Medicaid?
Well, one would think that because all of the payments are now guaranteed, albeit possibly lower, that these facilities that have been raking in money from these individuals and their families, that they would leave grandma, grandpa or aunt Minnie in comfort and without worry without changing a thing.
Unfortunately, this doesn’t always happen. In fact, there is an investigation taking place in New Jersey regarding the company Assisted Living Concepts, owner of eight assisted living homes in southern New Jersey. The investigation was started by the Public Advocate for the state, who has filed papers against the company because of their alleged practice of discharging the elderly when they change from self pay to Medicaid.
Public Advocate Ronald K. Chen is asking for the names, admission and discharge summaries, as well as contact information for every resident of the company who is or has been a Medicaid beneficiary.
Chen says that the investigation was sparked because there is an indication that this company “is placing elderly vulnerable residents at risk by displacing them from their homes in violation of ALC’s state license. Our primary concern is to protect the safety well being and peace of mind of these residents.”
The representative of Assisted Living Concepts, Laurie Bebo, who is also the CEO of the company, refuses to cooperate with the subpoena and states that the company does not have any Medicaid conditions in their license; therefore, they do not have to honor Medicaid patients.
Chen says that state licenses for all eight facilities stipulate that at least 30% of the residents of each of the facilities are to be Medicaid eligible and no resident would be discharged because or if they spent all their money.
Assisted Living Concepts operates more than 200 assisted living residences in 17 sates, containing more than 8,000 units, so this is no small issue. New Jersey may just be the tip of the iceberg.
When elderly individuals go into a long term care facility or assisted living facility and self pay, the cost can be astronomical. Making sure that the person is comfortable, well cared for, in a clean environment and positive atmosphere is not a low budget issue. What happens, though, when a private pay individual converts to Medicaid?
Well, one would think that because all of the payments are now guaranteed, albeit possibly lower, that these facilities that have been raking in money from these individuals and their families, that they would leave grandma, grandpa or aunt Minnie in comfort and without worry without changing a thing.
Unfortunately, this doesn’t always happen. In fact, there is an investigation taking place in New Jersey regarding the company Assisted Living Concepts, owner of eight assisted living homes in southern New Jersey. The investigation was started by the Public Advocate for the state, who has filed papers against the company because of their alleged practice of discharging the elderly when they change from self pay to Medicaid.
Public Advocate Ronald K. Chen is asking for the names, admission and discharge summaries, as well as contact information for every resident of the company who is or has been a Medicaid beneficiary.
Chen says that the investigation was sparked because there is an indication that this company “is placing elderly vulnerable residents at risk by displacing them from their homes in violation of ALC’s state license. Our primary concern is to protect the safety well being and peace of mind of these residents.”
The representative of Assisted Living Concepts, Laurie Bebo, who is also the CEO of the company, refuses to cooperate with the subpoena and states that the company does not have any Medicaid conditions in their license; therefore, they do not have to honor Medicaid patients.
Chen says that state licenses for all eight facilities stipulate that at least 30% of the residents of each of the facilities are to be Medicaid eligible and no resident would be discharged because or if they spent all their money.
Assisted Living Concepts operates more than 200 assisted living residences in 17 sates, containing more than 8,000 units, so this is no small issue. New Jersey may just be the tip of the iceberg.
