Financial Strugle Closes Large Medicaid Assisted Living Facility
Westchester Plaza in Fort Worth, Texas—the largest assisted-living facility for Medicaid recipients in the state announced in July it will close its doors after 19 years, and gave residents until Aug. 10 to find new living arrangements, according to the Associated Press over 100 people were affected by the closing.
The 12-story building, located at the center of Fort Worth’s medical district, has operated as an assisted living community since 1998. The facility has been advertised as “affordable luxury assisted living,” with each resident occupying a one-bedroom apartment.
The age and size of the building have caused regulatory and financial challenges.
The nonprofit controlled by Sweeney, WGH Heritage, reported a more than $2 million deficit in its most recent tax filing; the organization also reported multi-million dollar deficits in 2014 and 2013.
The company faced even more financial struggles beforehand, as it defaulted on its loans and had to reconstruct $20 million in debt backed by the U.S. Department of Housing and Urban Development.
In 2014, a deal fell through between the company and Irvine, California-based real estate investment trust which had plans of buying the property to build a $108.6 million combined residential/commercial development in its place.
Despite the selling point of “affordable luxury assisted living,” the facility faced operational issues as it was handed a lawsuit based on complaints that it did not have a proper sprinkler system for eight months in 2012, according to Tarrant County district clerk records. As a result, WGH Heritage shelled out $30,000 in civil penalties to the Texas attorney general’s office to settle the suit.
The Texas Department of Aging and Disability Services also investigated complaints against the facility in 2012. Most recently, state regulators investigated a complaint in March, finding that the facility had “failed to follow its internal policies regarding the prevention, detection and reporting of abuse, neglect or exploitation.”
According to a press release, “Despite the ballooning population of low-income seniors and individuals with disabilities, the number of Medicaid-assisted living providers in Texas has steadily declined due to low reimbursement rates, changes in process management of the Medicaid Waiver program, and expansion of alternative entitlement programs”. The release also stated that Westchester Plaza property management would be helping residents find relocation with the help of local groups and “Managed Care Organizations contracted to manage the Star+Plus Medicaid Waiver program.”
Medicaid cuts in the healthcare bill proposals could be brutal for people living in nursing homes
Is this the future of Medicaid funded Nursing Home and Assisted Living in America?
The New York Times reports that 42% of Medicaid spending goes to services like nursing home care. Cutting spending in the program would hit the elderly, or put pressure on nursing home operators to cut back. That rollback in Medicaid funding could particularly hit one unexpected group of people: elderly people living in nursing homes.
Even though elderly Americans get medical coverage from Medicare — that program doesn't automatically cover long-term stays in nursing homes. For the most part, people pay out of pocket for nursing homes. Once that gets depleted, residents start to qualify for Medicaid to cover their stay.
Medicaid covers more than 74 million Americans, including low-income people, families, and kids, as well as pregnant women, people with disabilities, and the elderly. The New York Times detailed the impact of Medicaid cuts on nursing home care in a story , and reports that — even though they only make up 6% of all Medicaid enrollees — those who use long-term services like nursing homes account for about 42% of total Medicaid spending.
Cuts to Medicaid spending could put those services on the chopping block.
"Moms and kids aren’t where the money is," Damon Terzaghi, senior director at the National Association of States United for Aging and Disabilities told The Times. "If you’re going to cut that much money out, it’s going to be coming from older people and people with disabilities."
Senior Homes - What are the Options in Your State
In your search for a place for yourself or a place for mom or dad to live, you are seeing so many different names and terms for various types of senior homes and senior living. These terms and names have changed over the years and what we may have at one time called a 'Nursing Home' or 'Old Folks Home' are now called many other things. At one time thoughts of white-walled, institutional settings we we’re hesitant to visit are now independent and assisted living options offering a wide range of appealing amenities, features and socializations.
Assisted Living, Adult Foster Care, Nursing Home, Board and Care Homes.
The different levels of care available today will depend on you or your loved one's needs, and various options, depending on a senior's health, age and financial status.
What is very important however, is that most if not every state in the U.S. has it's own definitions - descriptions and usually licensing requirements for senior living options. This is where we provide you with an important and useful resource for finding what your states options are.
To discover what senior living options are offered in your state:
Information updated regularly.
When it comes time to choose a home for you or your senior Loved One, you may discover it is a difficult task. Your goal is to find the best home possible yet you may be looking at many, even dozens of homes on a list. How will you make the right decision?
Across the country, thousands of nursing home residents face this situation every year:
"You had to go to the hospital, and when it came time to return home, to your nursing home, you were told you couldn't move back in"
This news is according to an article on the website NPR – National Public Radio.
I was on the forums these past few days and one of the threads was talking about how many days are covered by Medicare in a Nursing Home or Rehab after a hospital stay. The answers were all over the map and quite confusing I must confess, so I thought I would do a post about it to clear things up. I have always told my readers I am no expert, but when it comes to this subject I know it all to well. You see my mom has been in and out of rehab 3 times in the past 2 years so we know the rules by heart.
According to Medicare rules a person must have a qualifying hospital stay of at least 3 days, ( 24 hours) and be in need of further skilled nursing or rehab care in order for them to pay for the stay. The doctor and the physical therapy department at the hospital must agree that the patient would benefit from continued care or therapy at a nursing home or rehab facility.
It is important to note at this point that the patient needs to be an inpatient at the hospital for 3 days, and time spent in observation or the ER does not count. They have to be admitted to the hospital. This is very important!
Insurance companies and Medicare are putting increased pressure on doctors so that they do not admit patients. They have narrowed the guidelines for admittance and now many patients are ending up in observation for 1, 2 or 3 nights and then they do not qualify to go to rehab under Medicare.
If a person has a qualifying stay of 3 days then Medicare will pay for nursing home or rehab as follows:
1. Day 1-20 Covered 100%
2. Day 21-100 partial coverage with a 161.00 a day co-pay
3. Day 101 and beyond no coverage
Many Medicare supplement policies like the one my mother has will cover the copay on days 21-100 so there is no out of pocket for the patient. However this is something you should look into ahead of time so you know your coverage should you or a loved one be in this situation.
During the time in rehab the patient must continue to show that the services provided are helping them to improve. So if at anytime during their stay the team feels they have done all they can for the patient the team is obligated to discharge them, even if they have days left.
Now there is something to be said about having days left over. If the patient leaves rehab or nursing care and they need to be readmitted to the facility within 30 days and have days remaining they will have coverage through Medicare. If they use up all their days then they would have to wait 60 days and have another qualifying hospital stay of 3 days before Medicare would pay for skilled nursing care or rehab again. This would start their 100 day benefit period over again.
I am providing a link here that goes to the Medicare.gov site for skilled nursing care. It has more information for you.
I do hope this information helps you understand the process a bit better. If you have any questions or comments please feel free to contact me or leave a comment at the bottom. We always love to hear from you. Remember you are not on this journey alone.