To be old, frail, and evicted

A peek at the National Public Radio story board this morning shows All Things Considered is planning on a story this evening on “assisted living evictions.” No details are provided, but that’s what Google is for.

As near as I can tell, this subject starts in New Jersey where the most vulnerable among us are, as usual, the victims of apparent greed, according to

The investigation by the state Department of the Public Advocate comes after complaints from residents who spent tens of thousands of dollars paying for assisted living. When the residents prepared to switch to Medicare after draining their life savings, the company involuntarily discharged them.

From there it became obvious this is something of a nationwide problem, the Wall Street Journal reported. Long-term residents of facilities are being replaced by short-term residents. There’s more money in it.

Those on Medicaid bring facilities as little as half what they can get from residents who pay out of pocket, with private health insurance or through Medicare, the federal-state health program for the elderly.

No one counts evictions nationwide. But formal complaints about nursing-home discharge practices have doubled over a decade, to 8,500 nationally in 2006, making it the second-biggest category tracked by the federal Administration on Aging, trailing only complaints about unanswered calls for assistance.

Part of the problem is that assisted-living facilities are often below the radar of regulation. And old people’s needs change over time, often to the point where a facility almost can’t afford to care for them, anymore. That’s something that often doesn’t get mentioned in the glossy brochures. Here’s a view of things from a couple of consultants for the long-term health care industry.

A typical disclosure provides details on services included in the base rate and a listing of additional services available for purchase. More importantly, the form “should” include critical information regarding staffing patterns, staff licensing and staff training. Equally important, the form should disclose what changes in health status will result in a discharge or transfer. While the resident, the family and the facility may all agree that aging in place is the optimal goal, full disclosure assists everyone in the decision-making process and eliminates future surprises regarding the facility’s capacity for delivering increased services.

For nursing homes, Minnesota has been a battleground for a few years now. The Tower Timberjay, for example, pointed out the situation in an article just last Friday.

The decisions to reduce beds and increase the levy are both driven by economics. State payments to nursing homes have not kept pace with rising costs. In three of the past six years, nursing homes saw no increases by the state.

Although the state approved a modest cost-of-living increase for fiscal year 2009 and agreed to re-evaluate the rate cap for the first time since the 1990s, the gap between revenues and expenditures remains daunting. More than 50 percent of nursing homes in northeastern Minnesota are posting losses of minus five percent per year or greater, according to a 2007 study of the industry.

The situation is critical, and it’s not getting much attention. I’m guessing there are News Cut readers who are living this situation. If so, I’d like to hear from you.

  • cortland

    the base of the republican party who make up the agenda for the republican party for the last 8 years have have no interest in the welfare of the elderly in minnesota. i know, i have been on a nursing home doard of directors for the last 3 years. i feel sorry for the average person working in a nursing home. their financial compensation has been frozen to about 1% increase per year for the last several years. when there was a surplus, the republican leaders said it should be used to lower taxes, (on the rich). when there was a deficit, the republican leadership said, (we have no money). the health insurance rates have been going up over 10% per year, and the coverage has been decreasing. conditions are not good in this state for the working class for the last years of republican rule.

  • anne

    It doesn’t necessarily have to be an eviction either … my mother was gently nudged out of an assisted living facility when she got to be too much for the staff to handle. After trying to have her committed at a regular mental health facility, she was sent to the Grace Unit at Hastings for evaluation. She was diagnosed there with mid-level Alzheimers (yes, she’s senile, no, she’s not crazy).

    As it turns out she needs 24 hour supervision and the place where she had been living did not have room for her in the memory care unit. She’s now at a very good facility where they have promised me she will not be turned out when she runs out of money.

    A few questions remain: Why did the original place not know what was going on? If she had money or insurance would it have turned out differently? What happens to someone like my mother who has no children/family to help out?

  • whenIm64

    /What happens to someone like my mother who has no children/family to help out?/

    @ anne

    What about YOU?

  • Alanna

    @ whenIm64

    I believe she meant someone who was like her mother, but without children or family to help.

  • Lily


    Actually, Alzheimer’s disease and mental illnesses are much more similar than you probably want to know. Brain illnesses strike at different points of the life span.

    MN’s nursing home care is steadily going down hill. The funding has been flat for years, as the Department of Human Services tries to steer folks into community based )ie, cheaper) care. Unfortunately, care in teh community is not always best for folks, epsecially those with dementia. There simply are not enough good options. What the republicans seem to forget is that ANYONE can end up needing nursing home placement. When that happens, the care will be provided by low paid, mostly immigrant populations.