AC Thompson and ProPublica is back at it again with his vendetta against assisted living and Emeritus Senior Living.
AC Thompson and ProPublica is back at it again with his vendetta against assisted living and Emeritus Senior Living. On December 31, 2013 AC Thompson and ProPublica published the next installment in their apparent on-going effort to disembowel Emeritus Senior Living. This trash campaign serves to make assisted living more expensive and less available while frightening and confusing seniors and their families. In an article titled Churn of Assisted Living Deals, An Island of Misery Thompson tells the story of a 57 bed assisted living community located in McMinnville, OR.
The very short version of the story is this:
- The property was owned and operated by Sunwest before they collapsed. According to the article, the property was experiencing significant problems while owned by Sunwest.
- In 2010 Emeritus acquired this property as a part of a package of 144 Sunwest Communities. While Emeritus clearly acquired a tremendous package of assets they also acquired a rat’s nest of operational problems that naturally come with distressed properties.
- In the fall of 2012 the property was sold to the REIT HCP, but Emeritus maintained the management contract for the community.
- Into 2013 there continued to be operational problems, including a threat by the state to shut the community down.
- Finally, sometime in 2013, Emeritus turned the day-to-day operations over to Aidan Health Services, a small company out of Salem, Oregon.
Unpacking the Story
First things first. There is no doubt there were problems with this building and, to a greater or lesser degree, the problems continued after Emeritus took over the community. That being said, the way Thompson has told this story is unfair:
- Hurting the industry in general and Emeritus specifically seems to have become AC Thompson’s life purpose. He believes federal regulation would make it better, which means he has not taken a serious look at the skilled nursing industry.
- I suspect that, in his mind, Emeritus is emblematic of the industry and could never be good enough no matter what they did or didn’t do.
- LAST JUNE, MORE THAN SIX MONTHS AGO, THIS COMMUNITY HAD A DEFICIENCY FREE SURVEY. Yet there is no mention of this in his article.
- He quotes a number of experts, typically taking just a sentence or two, making me wonder what the context and qualifiers were.
- The most outrageous things that happened, and are his story leads, are things that happened almost 10 years ago. Way before Emeritus was involved in the communities.
- He says: “The episodes of violence and neglect inside the McMinnville facility, if sad, are not particularly unique.” This is simply misleading, episodes of violence and neglect in assisted living are unique. They are rare.
- He makes a big deal about the number of sale transactions in the industry that take place each year. In truth transactions like this are primarily a financing vehicle that has little or nothing to do with community operations.
Did Emeritus Act Fast Enough?
Knowing that in June they had a deficiency free survey this becomes the overriding question. From August, 2010 to June, 2013 seems to be a long time and yet . . . turnarounds are difficult and expensive. You need to start by seeing if you can work with the existing staff. If that doesn’t work you need to find new staff, something that is particularly difficult in a small town. Given that hindsight is perfect there is no doubt they could have done a better job. But I am not so sure, given the specific circumstances, it would have been a lot better. Perhaps particularly import is to appreciate that the community didn’t go from a disaster in 2010 and in one fell swoop become deficiency free in 2013. It was improving all along the way,with some setbacks as you might expect. Prior to the 2013 survey there were other times when the building was in substantial compliance.
Teachable Moment
It is not real clear in the story but there were/are two governmental agencies involved in this mess: Oregon State licensing and Adult Protective Services (APS). The reason APS was involved was that the community had significant resident-on-resident violence. It appears that , when this happened, there was less than perfect communication between the senior community, meaning Emeritus, and the two government agencies. It is a natural thing: no one wants to self-report problems, particularly if they are already under the gun with the regulators and yet, after talking to Emeritus today, it sounds as if, they got themselves behind the 8 ball with the regulators and APS. My big takeaway in this whole story is transparency, transparency, transparency. With residents, families, regulators, the press, the public and, well, everyone. When we fall on our own sward it is much less likely that others will continue to attack . . . . unless things have gotten too far down the road. I hate these stories because they hurt real residents, real staff, real seniors and real families. Finally, this is a pretty small senior community that serves almost exclusively a low income group of seniors. To Emeritus’s credit, if money were most important they probably would close the doors and cut their losses but, instead, they are doing all they can to fix the problem and serve their residents. Steve Moran
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Steve:
With the repeated resident on resident violence, it potentially could have been a community taking state Medicaid residents, which is more common than not to have residents with mental health issues.
With that said, I have seen this over the last 14 years with very few options for providers to deal with these issues, as the options are minimal at best.
Allan you make a great point. Somehow we have gotten to the point where we somehow think it is reasonable to demand perfection which of course is impossible. The statement that providers have few options really resonates.
Steve
Steve,
Thank you for taking such a public stand on this. I agree, transparency is the key across the board. Emeritus is a strong organization, with a strong mission and values. This industry is based on human beings taking care of human beings, on rare occasions issues come up. How we address them, correct them, invest in compliance and compassion training is critical not only to a particular provider but to the industry. This type of one sided reporting serves no one.
From LinkedIn Groups
What is wrong with this guy? I have to seriously question why he seems to have a vendetta against Emeritus.
By Jay Banks
From LinkedIn Groups
Frankly, I think that there is a more interesting focus for this story, and one I have seen over and over. A prior owner, in order to keep beds full, has admitted/contracted with residents who are completely inappropriate for the facility. Sometimes, that’s psychiatric patients and other times just nursing home residents with extraordinary needs. These patients/residents live at the intersection of needs that can’t be met by the system and beds that need to be filled. I wish ProPublica would focus on the first issue as well. I know the state of Illinois has worked to address the problem of psychiatric patients in LTC; I’m not sure how that is going.
If the purchasing entity is not able or willing to quickly move and replace them, and tries to shift the population to one that is more appropriate through normal attrition, it has to risk this sort of outcome. The alternative is a period of financial loss as the old population is moved out before introducing a more appropriate one. It is a difficult process. With that said, Emeritus has the resources to support the transition with relative safety, if it identifies the issue and chooses to do so. That should be part of the cost that they build into the transaction. Clearly, they calculated and claimed a substantial profit.
And, as you say, if they are open with the state about their challenges and efforts, they will be much better off.
By Kathy Wire
Stephanie: Your comment is spot on. The Thompson article was so one sided as to destroy any credibility. Thompson has positioned himself as someone who is trying to make things better, yet it truth he makes things worse for everyone.
Steve
From LinkedIn Groups
Interesting that the photo chosen seems to depict a rabid dog. The media are like Pit Bulls when it comes to reporting, biting in to all the negative and never letting go to release the positive. Thank you Steve for clarifying that Senior Care Providers do good things every hour of every day.
By Carri Jarvis
If by “pit bull” you mean tenacious, loyal, athletic, and possessing an unbounded sense of humor and joy, then yes, all of the people who own pit bulls working as police dogs, therapy dogs, drug-detection dogs, service animals, etc. would agree.
It really saddens me to see this continuing. Especially a focus like this. I think communities that are willing to care for Elders that are low income and have special needs should get our support more than our criticism. The truth it with this population you do get a lot of mental health issues and other behavioral issues that we don’t see in some of our larger private pay communities. These communities are harder to manage all together. First, you have the funding issue. You have to care for them on a much tighter budget. Second, you have to find staff that want to care for special needs individuals, often in a community that is not as well cared for and does not have the tools and supplies nicer communities do, and often for a lower wage than they could get elsewhere. From the Administrator to the caregivers, these employees are often missional minded, and are a rare find. The fact that this community has turned around over the last 3 years should be celebrated. Their staff deserve a pat on the back and our support, not to be attacked. Somebody needs to strike back at this reporter. His behavior is unacceptable and there is no good that can come from it. He needs an education on what long-term care used to be, before Assisted Living was an option.
I agree with you Karilee!
I also believe that ongoing training for staff who are dealing with more challenging behaviors should have more training. They should have specialized staff to work with this type of population. And for residents with challenging behaviors, it is even more important for the staff to have specialized training, and for the care plans to reflect any extra time needed for residents who require special techniques to work with them effectively.
Steve- I’m sure that if you put a magnifying glass on any senior care facility, you would find some mistakes. But in my 20 years of working with older adults, I’ve found that most of the staff who work with seniors are very caring and compassionate. I think the best thing that can be required of senior care providers is ongoing, quality education. Statistics say that 50-80% of residents in long term care facilities have dementia. I think there is a wide range in those numbers because many of the residents have not been diagnosed or have been given the wrong diagnosis.
When companies spend the time and energy to train the staff adequately, and then hold them accountable for respectful interactions with residents, the care of seniors would improve and be consistent. I think there is such a focus on profits, in some facilities, that they do not give adequate support to the staff for taking the time they need to work with residents. And when you add the government 5 star rating to the mix, it puts even more pressure on the staff to get things done as quickly as possible.
We need to turn the focus to quality care of residents, and quality training of staff.
I think enough is enough. From what I’ve read, Emeritus doesn’t deserve the ongoing negative press it has been receiving. I applaud Emeritus for handling the attacks
on them with dignity and professionalism.
Prior to working in the field of assisted living, I operated more than thirty homes under contract with various Community Mental Health Boards. Working with adults with intellectual disabilities and mental illness can be very challenging but the training resources available to us were unlimited and specific to the residents we served. These supports and the specific and individualized training needed in the assisted living environment are difficult to find and can be very expensive, not to mention that by the time a community realizes it needs training or resources it lacks, it may already have a problem that inevitability grows larger before being managed. I am grateful for my background in the mental health field as it provides me with another tool for providing excellent services to residents by providing them with exceedingly well trained staff.
So again, Emeritus deserves a break from these negative attacks and should be praised for taking on and turning around a troubled community. As providers of service, we should be supporting Emeritus and their efforts as what is happening to them, could happen to any one of us. If you think otherwise, I hope the bubble you live in never pops!