Monday, January 19, 2009

Assisted Living companies in bankruptcy: what can a family do?

Every day I see a new article on another assisted living company entering financial difficulties. Some are filing for bankruptcy; many are on the brink.

If you have a loved one in an assisted living community, what should you do? Many families are feeling anxious about their loved ones' care as major companies like Sunwest Management Inc., one of the largest retirement housing providers in the country, files for bankruptcy protection in one state after another.

I know, from my own days as an owner and operator, when money is tight it's hard to focus on care. It's very hard to think about training and energizing employees who may not even be with you next month - or next week.

You spend hours every day looking for areas where you can cut expenses without hurting the people in your care.

As Eric Carlson, the director of long-term care for the National Senior Citizens Law Center said in a recent Denver Post article, "When facilities are losing money, they're tempted to cut staffing below safe levels."

If my own mom were in an assisted living or retirement community that was on the verge of bankruptcy, here's what I'd be looking for:

1) Basic life necessities: Food, water and heating. Stop in from time to time during a meal. Don't call ahead; just drop by. When communities are cutting beyond the point of reason you'll see meal portions reduced, dining rooms understaffed, and food served warm (when it's supposed to be cold) or cold (when it's supposed to be warm). Believe it or not, many companies in trouble delay paying utilities until the last notice, causing risk of basic water, sewer and power. I've heard more than one property manager talk about paying the utility bill out of her own pocket just hours before the shut-off was scheduled; I've never heard of a community getting all the way to shut-off, though. To me, that's a testament to the dedication of most community managers - they'll do everything in their power, literally, to keep the residents well cared for.

2) Talk casually to your loved on about call-lights, if they have them. Ask how long it takes someone to arrive. If the community is cutting too deep into staffing response times will lengthen dramatically. Let your loved one know who else to call if no one is coming to assist in a timely manner (for example, when is it appropriate to directly dial 911; when should they call you so you can ensure care?)

3) Sit in the lounge, living room or lobby and simply observe staff. If the company is managing their financial difficulties appropriately the staff providing direct care to residents - including housekeepers, maintenance staff and caregivers - will continue to be cheerful and talkative while they work. They won't show noticeable stress and anxiety about their own jobs. You should observe polite conversation (instead of stressed frustration and anger); hopefully even laughter and hugs when appropriate.

4) Pay attention to cleanliness and maintenance. Deep cuts can result in a building with a feeling of grime instead of polish; a lack of routine maintenance will result in light bulbs dark and toilets that run without stopping. In a busy assisted living or retirement community it doesn't take long for these things to become noticeable.

5) Finally, watch your loved one for signs of stress or anxiety. If he or she stays on top of the news a little anxiety will be normal; more than a little may mean that staff members are sharing their own stress with your loved one. Nothing causes a compassionate resident more despair than hearing, over and over, the trials of the people who provide them with daily services and caring attention.

If my own mom were living in a community in trouble, these are the things I'd watch for. And I'd know, seeing one of more of these conditions appear, that it was time to look for another home for my mom, before the company's difficulties became my own.

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