Robert Wright, J.D., M.P.A. Mitchell, Blackstock, Ivers, & - - PowerPoint PPT Presentation

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

• n, one

e or more p

• r more pers

rsonal

• nal

services, limited nursing services, limited nursing services services

• “Limited nursing services”—acts that may be performed by

“Limited nursing services”—acts that may be performed by licensed personnel while carry licensed personnel while carrying out thei ing out their professi r professional al duti duties, but limi , but limited to those ted to those acts that acts that the the department department spe specifies by 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 nursing nursing services shall services shall be for be for persons who meet persons who meet the the admissio admission criteria 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

EVERYTHING ELSE IS THE RESULT OF OLTC REGULATIONS!

 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