We need to stop shooting at each other.
If you are a regular reader you know that I am a big fan of the Not-For-Profit world of senior living providers and the organization LeadingAge. I have been wrestling with whether or not to publish this article this week while at the LeadingAge Washington State annual convention where I am presenting a breakout session on story telling. When a friend sent me a link to the article Do Consumers Understand the Not-For-Profit Difference? in the May/June online issue of LeadingAge Magazine I was frustrated. Maybe I have it wrong but, as I read the article, it sounds as if they are tossing the for-profit senior living providers under the bus. The Not-For-Profit Advantage Not-For-Profit senior living providers have at least four significant advantages:
- Even when they have a financial margin they do not have to pay taxes.
- They don’t have shareholders or owners who expect a financial return on their investment.
- They have the ability to legitimately request donations from residents, families and the public.
- There is a certain cachet that goes with being a not-for-profit.
Shouldn’t that be enough?
Does the not-for-profit world really need to paint the for-profit providers as being somehow less caring, less competent and less compassionate? I can’t even begin to imagine that either ALFA or AHCA would ever, ever publish or say anything to disparage the not-for-profit world. . . . and there are things they could say. Just one example but a big one: They could be asking why not-for-profit organizations that mostly build and operate very high end, expensive Senior Living campuses should be afforded these advantages. Should there be a quid pro quo for the tax break, providing some level of low income housing? Unfair Comparison The article spends several paragraphs very specifically trashing for-profit skilled nursing providers over quality issues. There is no doubt that the data conclusively demonstrates better care in not-for-profit skilled care. But interpreting the data is everything. Many, maybe even most, not-for-profit skilled nursing communities are a part of a continuum of care campus and take way more private pay and Medicare patients than Medicaid patients. Until they are willing to do a quality comparison that factors in the number of dollars per patient days the relative organizations receive it is a grossly unfair comparison. The Same Big Issues We should be working together. It is wrong that one group is so willing to shoot another a group in the gut. Regardless of ownership status the industry faces the same challenges:
- Bad operators that do damage to residents and the industry, and there is no doubt this includes a few not-for-profits.
- Many, many elders choosing to stay at home rather than pick senior living (maybe because we are not united?).
- Not doing a good enough job of providing residents purpose in their lives.
- Not providing an adequate variety of senior living options.
Please, please, please those of you who are LeadingAge Members, put pressure on your leadership to stop shooting at the for profit providers. It is not the way to serve seniors in your community and it is not good for the industry. If I am honest a market segment that is all about mission should not be the market segment that goes negative. Finally I do agree that talking about the mission is a powerful differentiator and should be a part of the not-for-profit narrative, something we will be talking about this week, but not in a way that questions the integrity of the for-profit side of the industry. Steve Moran
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In exploring costs of creating a senior living community that would allow caregivers and residents to both live in the same community, I found that the amount required to maintain the expenses of following regulations to be prohibitively expensive. I also found that the government’s issues with doing just that to run into a fear that their money would not be going directly to the care of elders, even though quite a bit is paid by residents themselves. Those four reasons don’t make or break a for-profit provider. If one looks closely at Nursing Home Compare, they will find that some for-profits and some not-for-profits share the same troubles of correct staffing, correct financial management and maintaining quality of life for their elders. My personal experience of dealing with an elder in long term care yields a definite bias against family involvement in their elder’s care (some rightly so, I’m sure) as well as stories I’ve heard from other family members. One not-for-profit improved when it sold to a for profit company. I don’t begrudge the not-for-profits their advantages. Many of them have been not-for-profit for many years. I was pleased to see the new guidelines from Medicare regarding Home and Community based services, detailing how a community may still receive needed services. It will yield a new option against the extreme costs of long term care.
Not shocking considering the Leading Age CEO’s response to the Frontline hatchet job was to essentially throw for-profits under the bus.