I and many others are convinced that once the Baby Boomers hit the assisted living age sweet spot, the nation will be faced with a massive affordability (and maybe inventory) crisis.
During and immediately following ALFA I got a chance to interview a number of senior living leaders but because of an intense travel schedule I have fallen behind with the writing part. Catch-up time is here. I hope you enjoy the perspectives as much as I enjoyed doing the interviews.
One of the leaders I have hoped to meet for a long time is Rod Burkett the CEO of BMA Management a senior living provider in Bradley, Illinois, that develops and operates affordable Medicaid Waiver assisted living communities. I was standing in line to get my name badge and there he was with Wayne Smallwood, executive director of the Affordable Assisted Living Coalition. This is a two part article with Part 1 laying the foundation for affordable assisted living framework. Part 2 will be the actual interview.
Low Income Assisted Living
I and many others are convinced that once the Baby Boomers hit the assisted living age sweet spot, the nation will be faced with a massive affordability (and maybe inventory) crisis. The problem will fall into two buckets:
- There will be Boomers who made good to great incomes which will translate into maximum social security benefits, plus along the way, and mostly by accident, they will have managed to accumulate some IRA and 401K savings that will generate only very small amounts of additional income.
It is likely this group will turn out to be most difficult to serve.
- There will also be massive numbers of seniors who have essentially no assets and minimal or in some cases no social security income. These are the “dual eligibles” meaning there incomes are so low they qualify for both Medicaid and Medicare. Even today, this group is sizeable making up around 85% of the total skilled nursing population.
The Dual Eligible Problem
Historically when a low income individual had a need for anything except very limited nursing care that could be provided via home health, their only way to access those services was by moving into a skilled nursing facility. This turned out to be a bit of a windfall for the skilled nursing facility because those residents required lower levels of nursing care. It also meant the government system was paying a lot of money for a relatively low level of services.
The federal government has a number of waiver programs that will allow Medicaid moneys to be diverted to programs that have the potential of providing better service at a lower cost. One of those wavier program allows states to create a program where a portion of the Medicaid dollars that would have otherwise been used to pay for skilled nursing are used to provide/pay for intermittent skilled nursing, nursing oversight and personal care services in assisted living communities.
The bottom line goal of this particular waiver program is to move or divert appropriate residents from skilled nursing to assisted living where they can get equivalent (or better) nursing care in a higher quality environment and at a lower cost to the government. This becomes a win for everyone except perhaps the skilled provider who lose access to the easiest to care for residents.
Part two will take a look at the 6 trigger points that BMA Management uses in determining whether or not a state or specific location makes sense for a low income waiver senior living community.