Category: Mike’s Column

California’s assisted living industry is literally at a critical point—survive or die! The forces determining the industry’s survival or death are minimum wage increases, higher worker’s compensation premiums, liability insurance premiums and the exit of carriers from the state, increased regulations and new laws, rising cost of gasoline and utilities, ineligible employees via the sanctuary state provisions (cannot hire illegals), the push to hire nursing assistants over caregivers, the “medical model” and the push to admit prohibited conditions—I could go on. Can you stand anymore?

The licensee must face reality. The true cost of care in California is beyond the reach of many seniors. However, if the licensee is to survive, the costs of operation must be passed on to the clients. It may be that compassionate care is a thing of the past, or at least a thing that comes at a very high price.

Is anyone in Sacramento listening? Can state senators and assembly members add up the costs of care? Seniors are paying a very high price for services, and if the assisted living industry does not survive, elders in need of care will be forced into nursing homes. Nursing home care—Medi-Cal—will drain the financial resources of the state; no high-speed trains and no welfare for illegals, the state’s agenda.

Some organizations have placed trust in some senators who have betrayed, for apparent political reasons, the elder care industry. Voter pressure must be exerted upon Sacramento’s “leaders” to stop the ridiculous laws that hurt the elders and small businesses caring for elders.

There are two elections in 2018, June 5 and November 6. It is time for advocacy groups that really care about the elderly to put pressure upon elected officials running in 2018 to do something right instead of raise taxes and costs on businesses, especially the assisted living industry. Otherwise, there will be a concerted effort to remove these aloof members of the legislature.

As we head into a new year, sliding past family gatherings, it’s a great time to reflect upon the future of the assisted living industry. Did the RCFE Reform Act give you pause? It allows facilities to accept feeding tubes, staph and other serious infections, stage 3 and 4 wounds. Why this law?
A manager at DSS answered that question and it should not shock you—the Affordable Care Act (ACA). Despite all the controversy currently associated with this federal law, it has forever changed health care in America. Caring for all Americans is great, but the elderly seem to be on the periphery. Instead of being allowed more days for recovery in acute or skilled nursing settings, they are now going to assisted living homes “which are not primarily medically oriented,” and “represent a humane approach,” and “can provide a homelike environment” so states Health & Safety Code 1569.1.
A regional manager recently stated at an assisted living conference, “TB remains prohibited.” That’s true, given the new laws enacted by the California Legislature. Should facilities accept prohibited health conditions, who provides the care should hospice be discontinued and home health runs out of visit authorizations? Your caregivers, who else? The new law requires facilities to assist residents with “accessing home health or hospice,” but does not address any “what ifs” about those services being discontinued, under the ACA, as this care has become too expensive. Your staff will be forced to do stage 4 wound care or tube feedings. But then again, facilities do not have to accept these clients…but you know RCFEs will for the revenue.