Robert Wright, J.D., M.P.A. Mitchell, Blackstock, Ivers, & Sneddon 1010 West Third St. Little Rock Arkansas 72201 501-378-7870 rwright@mitchellblackstock.com These materials are for instructional purposes only, and are not to be relied on for legal advice. Legal counsel should always be consulted for specific problems or questions.
Individual Incentives Individual Incentives ALF Financing ALF Financing Policy Changes Across the Country Policy Changes Across the Country Regulatory Impact on ALF Regulatory Impact on ALF Development Development Community First Choice Community First Choice
Why? Why? ◦ Aging boomers Aging boomers ◦ Rebalancing Rebalancing ◦ Housing market collapse Housing market collapse Facilities offer to buy homes if they don’t Facilities offer to buy homes if they don’t sell within a specified timeframe sell within a specified timeframe Facilities hire real estate agents to help sell Facilities hire real estate agents to help sell homes homes Discounted rates in initial months Discounted rates in initial months Work with banks for bridge loans or offer Work with banks for bridge loans or offer low-interest loans low-interest loans
States States ◦ Michigan Economic Growth Authority - Michigan Economic Growth Authority - $2.5 million $2.5 million in tax credits in tax credits to renovate a former to renovate a former metal processing metal processing center and center and pharmaceutical pharmaceutical company company ◦ Maryland Department of Maryland Department of Health and Mental Hygiene Health and Mental Hygiene – grants for conversion, acquisition, construction rants for conversion, acquisition, construction Federal government Federal government ◦ HUD Assisted Living HUD Assisted Living Conversion Conversion Program Program ◦ SBA loans SBA loans Local government Local government ◦ Northampton, MA Northampton, MA – Tax Increment Financing ax Increment Financing ◦ City zoning codes City zoning codes Private capital financing Private capital financing
Arkansas Development Finance Authority Arkansas Development Finance Authority Assisted Living Incentive Fund Assisted Living Incentive Fund $5 $5 million in economic stimulus funds via million in economic stimulus funds via DHS DHS One project was financed One project was financed DHS put on hold early last year DHS put on hold early last year
Trends Trends ◦ Disclosure or reporting requirements Disclosure or reporting requirements ◦ Changed life safety or physical plant standards Changed life safety or physical plant standards ◦ Major changes to Major changes to survey procedures survey procedures ◦ TB testing requir TB testing requirements or infection control ements or infection control ◦ Revisions to Revisions to admission/retention thresholds admission/retention thresholds ◦ Changes in medication management rules Changes in medication management rules ◦ Changes in staffing requirements Changes in staffing requirements ◦ Changes in resident assessment requirements Changes in resident assessment requirements ◦ Address handli Address handling residents’ property or funds ng residents’ property or funds
ACA 20-10-703 ACA 20-10-703 ◦ “ Assisted living Assisted living service services”—ho ”—housin ing, meals, laun g, meals, laundry, dry, socialization, transportati socialization, transportation, o on, one e or more p or more pers rsonal onal services, limited nursing services, limited nursing services services EVERYTHING ◦ “Limited nursing services”—acts that may be performed by “Limited nursing services”—acts that may be performed by licensed personnel while carrying out thei licensed personnel while carry ing out their professi r professional al ELSE IS THE duties, but limi duti , but limited to those ted to those acts that acts that the the department department RESULT OF OLTC specifies by spe ifies by rule rule . Acts that may be speci Acts that may be specified by d by rule as rule as allowable limited allowable limited REGULATIONS! nursing nursing services shall services shall be for be for persons who meet persons who meet the the admission criteria admissio criteria esta establi blished hed by the departme by the department for for fac facilities o ilities offering ffering assisted living assisted living services, shall not services, shall not be be complex enough mplex enough to re require quire twenty-four hour nursing twenty-four hour nursing supervision supervision, and may inclu and may include such e such services as services as the the applica applicatio ion an and care of routin d care of routine dressings e dressings an and care of d care of casts, braces, and splints casts, braces, and splints
CFC CFC services only available to individuals who services only available to individuals who are eligible for institutional level of are eligible for institutional level of care care The state regulations for RCF The state regulations for RCF and ALF Level I and ALF Level I mean they cannot participate in CFC mean they cannot participate in CFC OLTC’s rationale is that RCFs and ALFs Level I OLTC’s rationale is that RCFs and ALFs Level I don’t have the staff or training don’t have the staff or training But that’s because the regulations don’t require it But that’s because the regulations don’t require it Comparison with Elder Choices and DD Group Comparison with Elder Choices and DD Group Homes? Homes? Would promote least restrictive setting and Would promote least restrictive setting and reducing nursing home admissions on reducing nursing home admissions on the the lower end lower end
Recommend
More recommend
