11/7/2007 2:27:00 PM Medicaid patients at Victoria House plan eviction protest
Victoria House volunteer ombudsman John Estes (left), residents Kay Harper, Catherine Houtz, Millie Embody, Rendean Mattern, relatives Doug Campbell, Rona Anderson, Leatha Smith and resident Norma Garvin crammed into Harper’s room last Friday to discuss a protest to 11 residents being asked to leave at the end of January because the company that owns the assisted-living facility will no longer accept Medicaid patients. – Photo by Allison Arthur
One by one they rolled their wheelchairs into Kay Harper's room at Victoria House on Friday to talk about the "bomb" that had been dropped on them the day before.
Eleven residents of the assisted-living facility were told individually last Thursday that they need to move by Jan. 31 because Assisted Living Concepts, a Wisconsin-based national public company traded on the New York Stock Exchange, is no longer accepting state Medicaid at the Port Townsend facility.
As of Feb. 1, the facility will accept private-pay customers only.
Four residents and several relatives crammed into Harper's room Friday to plan a protest.
"It's terrible," said Harper, a longtime Victoria House resident and outspoken care critic who invited Catherine Houtz, 81, Norma Garvin, 88, Millie Embody, 87, and volunteer ombudsman John Estes to her room.
All expressed concern for the future. Several called the company's decision abusive.
By the end of the hour-long conversation, they decided they would sit, stand and unite at 1 p.m. Saturday, Nov. 17 out front of the facility and protest the corporation's decision.
And they'll invite people in Port Townsend to join them.
Laurie A. Bebo, the CEO and President of Assisted Livings Concepts, said yesterday a protest won't change the company's decision to end its contract with the state to provide care for people who have exhausted their savings or simply are poor.
"It's certainly a right folks have. However, it is a decision that has been well thought out and not one we'd change our mind on. It's very legal. We have every legal right to opt out of a contract. You can't force a provider to participate in a contract," Bebo said.
Bebo oversees 208 assisted-living and independent-care facilities across the United States, 21 in Washington, including the one in Port Townsend.
Bebo said the issue at the Port Townsend facility is that there are people on Medicaid who need to move on to a skilled nursing facility but have declined to do so.
"They pose a challenge and a concern to us as far as our staff being able to take care of their needs," Bebo said of certain patients. "Although we've worked with the state to transition [them], they've declined to move them to another facility," she said. She could not elaborate on how many people on Medicaid fit that category because of federal laws prohibiting private healthcare information from being made public.
"I can't exit the people who are inappropriate without ending the entire contract. I think that's unfortunate, but that's what we're left with," the CEO said.
Ombudsman Estes questions whether Bebo is really talking about Harper, who has multiple sclerosis and uses an electric wheelchair and whose physical challenges have not slowed her down when it comes to speaking her mind.
"This is the one person they have been trying to force to move," Estes said bluntly when told that Bebo said there were Medicaid patients who required more care than what the assisted-living center could provide and the state was declining to move them.
"Kay Harper's needs haven't changed. Her level of care has not increased since she moved in," Estes said. "The others don't need extra care," he said.
Estes said that whenever Harper's care is assessed, the company insists her care is "above and beyond" what it can offer. And he doesn't buy that.
Bebo acknowledges that there are people who need assistance all day long with transfers or help, and that such care is "outside our basic care package."
Bebo said it would cost the state more to move people into a skilled nursing facility. She said the average rate for a private-pay assisted-living resident is about $100 a day. The average Medicaid guest pays $68 a day. A nursing home is paid $110 a day by the state, Bebo said.
"Medicaid reimbursement is not covering the cost of caring for Medicaid residents, but that's not the driving reason for ending the contract. The reason for ending the contract right now is that there are people who are truly inappropriate for our level of care, and I have the responsibility of ensuring the safety and quality of care of all my residents and the safety of my staff," Bebo said.
Disappointed
Back in Harper's room, Estes expressed disappointment.
"We're very, very disappointed that the company has chosen to take this action," said Estes. Estes read the philosophy page of the company's website, which states that the mission of Assisted Living Concepts is "to enhance our residents' quality of life by creating a homelike setting that fosters independence, dignity and choice."
Estes questioned how ending the contract with Medicaid, a state-assisted program, meets that philosophy.
Estes also questioned why the company is willing to move the residents to another assisted-living facility it owns in Kelso but can't care for them where they are now, in Port Townsend.
"If they can move them down there, they should keep them here," Estes said.
Bebo said she wasn't sure how many people from Port Townsend could be transferred to Crawford House in Kelso.
Bebo said the company has provided a three-month notice, two months more than the state requires, in order to give people time to make the transition to other facilities.
In the meantime, residents were coming and going from Harper's room, talking with each other about their feelings and thoughts and sharing concerns about the future.
"There are many people who don't have alternatives. I can go to Kai Tah [Care Center], but that's not my choice," said Harper, who graduated from Quilcene High School in 1957 and has lived in Jefferson County all her life. She doesn't want to move to Kelso.
Rendean Mattern, who moved into the facility in 2002, has no relatives and no one coming to help her. Like others, she's concerned about the future, to the point of not really wanting to talk about it.
"Stress isn't a nice thing. I call it abuse," said Leatha Smith, whose mother, Millie Embody, is one of the 11 being asked to leave.
Earlier promises
Doug Campbell said his 96-year-old mother, Luella Campbell, was a private-pay patient for 18 months. As of Sept. 1, she became a Medicaid patient.
Campbell said that when he talked to administrators before deciding on Victoria House, he was assured that she wouldn't be forced to leave if she exhausted her financial resources and had to go on state aid, as many elderly people do.
"That was paramount to my decision to move her here," he said, noting that the administrator of another facility declined to make that commitment.
"It's criminal," Campbell said of what residents were calling an eviction notice. "What other Westernized country does that?"
Campbell was planning to call television stations and meet with attorneys this week to see if any action can be taken to stop the move.
"This is only the tip of the iceberg. Wait until the [baby] boomers hit 85," Campbell said. "We're going to have all kinds of people in the street."
Residents also said they find the timing interesting because carpeting was just replaced and bathrooms were recently repaired.
Some questioned whether the company wanted to move the state-paying patients out in order to free up rooms for wealthier private-pay patients that might be moving to the community.
But it wasn't just the Medicaid patients who are upset.
True Heart, whose 95-year-old mother-in-law is a private-paying patient, said the assisted-living community is in upheaval because of the news.
"I'm concerned she'll be traumatized," Heart said of her mother-in-law. "It's affecting the entire place."
"How can anyone feel secure?" Heart said.
At the end of the meeting Nov. 2, several residents questioned what would happen if they refused to leave the facility some of them have called home for almost a decade.
"If they refuse to leave, the Landlord Tenant law goes into effect," said Estes.
As for Harper, she doesn't want to go to Kai Tai Care Center because she won't be able to make quilts or bake bread or be as active as she is now in her cozy room filled with photos and friends and telephones ringing off the hook.
And so she is organizing a protest, a protest that the owner of the facility says won't change her decision to end a contract accepting Medicaid patients like Harper.
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