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Home Switch

Medicaid residents look for new homes as assisted living facilities switch gears

January 20, 2023
in Switch
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NORTHGLENN, Colo. — Late last year, Kim Muniz received some bad news regarding her brother’s assisted living facility and began scrambling to find him a new place to live.

Her brother, Mike, has been living at Northglenn Heights, an assisted living facility north of Denver. Medicaid benefits are paying for his stay, but a letter in November stated that the complex would no longer accept Medicaid residents. All current Medicaid residents would have to move out by March 17.

“We fought to get him into this place,” Muniz said. “Now we’re fighting to keep him there. It’s kind of sad.”

Muniz said she’s scouring the internet and sending her brother places to call, but nothing is coming together. She even considered selling her house to move closer to another facility, but determined that is not an option due to the current housing market.

“He’s in a panic,” Muniz said of her brother. “He’s thinking he’s going to be homeless, he’s going to be living in a shelter. You know, he’s thinking about what bridge he’s going to live under.”

Muniz isn’t alone. Denver7 has learned several assisted facilities throughout the Denver metro area are either reducing their number of Medicaid residents, cutting out Medicaid altogether or shutting down entirely.

One big issue is the reimbursement rate these facilities receive from Medicaid. Residents who are paying privately often pay more than $2,000 more per month than the center gets for Medicaid residents over the same period, according to Nicole Schiavone, president of the Colorado Assisted Living Association.

Schiavone also operates multiple assisted living centers in the area that only take Medicaid residents and said she’s not able to pay the same rate to employees, which makes it difficult to stay at full staff. Inflation is also increasing her costs while the Medicaid reimbursement isn’t keeping up.

“The money’s not there to give us a fair reimbursement to pay the high costs of staffing, the high cost of insurance rates and increases and just inflation in general,” she said. “A lot of providers want to provide the service, they just can’t.”

The COVID-19 pandemic also played a big role in decimating staff, and many facilities have not been able to recover. A September 2021 survey conducted by the American Health Care Association and National Center for Assisted Living showed that 77% of assisted living providers said their workforce situation has gotten worse over the previous three months and 96% of facilities were facing a staffing shortage.

This decline in beds for Medicaid patients is also impacting private pay residents who “spend down” their savings at an assisted living facility before switching to Medicaid. Now, some of those people are being told there won’t be a bed for them once they switch to Medicaid.

That’s the situation Warren Conober is seeing as he now searches for a new home for his 88-year-old father, Warren Sr.

Conober’s father has lived at Northglenn Heights for two years and spent roughly $120,000 on his care.

“As he’s looking to get on Medicaid, they no longer accept it, so I know he’s going to be evicted once he gets on Medicaid,” Conober said. “These individuals are basically losing their house. They’re losing their friendships, they’re losing their care and without any support of where they can go.”

Northglenn Heights did not return requests for comment.

The Colorado Department of Health Care Policy and Finance provided a statement on the situation that noted the state is contacting Medicaid members or their families to help with a transition and encouraged people to reach out to hcpf_hcbs_cmescalationinbox@state.co.us with questions.

But for families like Conober, it’s a stressful time filled with unknowns.

“It causes a large strain, because at the end of the day, I’m having to take care of my father, who’s taken care of me for so many years,” he said. “ And I don’t know what to do. That’s the struggle.”

FULL HCPF STATEMENT:

“The Department is aware of several Assisted Living facility closures that serve both Health First Colorado members (Medicaid) and private pay residents. These facilities have shared a variety of reasons for their closures including workforce shortages, the increasing value of real estate, the overall cost of doing business, and the ongoing impact of COVID-19 in residential settings. Our Department is working very closely with the Colorado Department of Public Health and Environment, its Long-Term Care Case Managers, and its Regional Accountable Entity Care Coordinators to ensure each individual is safely moved to another care setting of their choosing. 

We are contacting each Medicaid member or their families to develop transition plans that identify all physical, mental, and behavioral needs for a holistic approach through the transition process. Our goal is a timely transition, but we also want to ensure the right fit for the member that takes into account their individual needs. 

Assisted Living settings that accept Medicaid payment, are a critical residential setting option for older adults and people with disabilities. Because of this, our Department has increased daily rates by nearly 75% since 2018.

We have another budget request before the state  legislature with an additional request of $3.6 million for Assisted Living services for this year. However, we understand there are external factors influencing these facilities’ business decisions, beyond the Medicaid reimbursement. The Department is prioritizing the successful and safe transition of all individuals impacted by these unfortunate closures and encourages anyone covered by Health First Colorado who is being evicted from their facility to email us at hcpf_hcbs_cmescalationinbox@state.co.us.”

The Follow Up

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