Assisted-living residents cry foul

Lakeland House in Athens stops accepting Medicaid; 13 people forced to move

By Kaci Harris

Seven years ago, Bonnie Arthur made her home at Lakeland House in Athens and hoped to never leave.

But at age 92, she found herself looking for another home.

Arthur was told in December that Assisted Living Concepts (ALC) — corporate owners of Lakeland House, an assisted-living facility in Athens — terminated its Community Based Alternative contract with the Texas Department of Aging and Disability Services (DADS). Arthur, and the facility’s 12 other residents on Medicaid, were told they had a choice to either become private pay residents or find other living arrangements by Jan. 31.

Arthur moved out Jan. 19.

Pam Summerall, Arthur’s daughter, was not happy.

Summerall said she was made aware of the upcoming termination in a meeting with Lakeland House Director Becky Edwards. She said she received an official letter from ALC in late December.

“When we moved my mother into Lakeland, I was told that she could live there here on out,” Summerall said. “I feel like I was lied to.”

State officials they worked to help residents find other arrangements.

Cecilia Fedorov, a press officer with the Department of Aging and Disability, said the state immediately contacted residents to lend its assistance for those who were left looking for other living arrangements.

According to the DADS Web site, the Community Based Alternative contract provides a “cost-effective” alternative to living in a nursing home for the elderly or disabled.

To qualify, a person must make an application with the Department of Aging and Disability, according to Fedorov. DADS, in turn, puts the applicant on a waiting list. When the person’s name comes to the top of the list, DADS screens the person for financial eligibility.

“CBA allows them to receive the services they need in a home-based setting rather than an institutional setting,” Fedorov said. “Financial eligibility is required, but is determined by the Texas Health and Human Services Commission.”

Medicaid pays for CBA services, which include adaptive aids and medical supplies, adult foster care, assisted living and residential care services and consumer directed services, among others, according to the Web site.

That changed near the end of 2006.

“Assisted Living Concepts has expressed an interest in not accepting Medicaid at all,” Fedorov said.

Lakeland House is not the only ALC-owned assisted-living center. Strake House, located in Conroe, ceased accepting the Community Based Alternative contract in December 2006.

“The difference with the Conroe house is that they are in an area where the Star Plus Program is offered,” Fedorov said.

The Star Plus Program is a combination of three health maintenance organizations. The program is not available in the Athens area, Fedorov said, but there is a list of other programs on the DADS Web site available for this area.

“Each facility owned by ALC has an individual contract with Community Based Alternative,” Assisted Living Concepts CEO Laurie Bebo said. “And the termination was a corporate decision made within the national company level.”

Bebo said the decision to no longer accept the CBA contract was made at some, not all, of its facilities. There are a total of 42 assisted living facilities in Texas.

Essentially, facilities that accept Medicaid patients are reimbursed from the state for a portion of fees owed. In this case, Bebo said the contract was terminated at Lakeland House because rates to live there went up, but reimbursements did not make up the difference.

“Every year the rate increase slows down,” said Mike Jacksic, Divisional Vice President for the Central Division of ALC. “The reimbursement rate from Medicaid doesn’t fully pay for the services provided.

“We (ALC) are hoping the state takes a look and reformats their services.”

If Medicaid doesn’t cover the cost to deliver services, staff can’t be employed and the private-pay residents pay the price, according to Bebo.

“It’s not fair to private-pay residents to further support the program,” Bebo said. “We want to continue to deliver a high-quality product.

Bebo said when the cost of doing business increases, “Somebody has to pay those things.”

Bebo said she understands any change for the elderly can be disruptive.

“This is ultimately not the last stop for residents,” Bebo said. “Most people will probably still end up living in a nursing home environment.”

Among the residents forced to find alternative housing, 11 moved into other facilities, according to Fedorov. Two said they would move in with family members.

“I don’t understand why they couldn’t just ‘grandfather’ those presently in the house and not accept CBA from then on,” Summerall said.

In the end, Summerall said she doesn’t have anything negative to say about her mother’s care or treatment at Lakeland House.

“It was nothing short of great. I feel like there are a lot of truths that need to be revealed through corporate,” Summerall said, noting that some private-pay residents were not happy that some of their friends had to move. “I am also concerned that this will have a downfall effect on those who are private pay.”

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e-mail kharris@athensreview.com