Friday, August 16, 2013

An embarrassing disgrace

Embarrassing because I'm a citizen of the Commonwealth of Virginia which perpetuates the disgrace.

A disgrace because of the cruelty Virginia inflicts on its impoverished aged and vulnerable residents.

Everyone is familiar with Nursing Homes - at least the concept of them.  To be in a nursing home you must need assistance and meet the criteria as measured on a "Uniform Assessment Instrument" which you can find here:‎.

But there are people who need help but do not meet the criteria for nursing home level of care. There's an intermediate step called Assisted Living  (AL). People who have money can go to a private pay facility and those are very nice.  And expensive (about 60% of the private pay nursing home rate by my observation).

If you don't have money but only 'qualify' for AL?  Well, Virginia says it'll help, and if $1196.00 per month (eff. 7/1/2013) is "help" then, maybe, it does. For 1197 compensation per month (1375/month in planning district 8 -- 'occupied Virginia' next to DC), an AL agrees to house, supervise, feed, entertain, insure, take to doctor appointments, develop a 'plan of care' individualized to each resident and put it in place, have trained and licensed staff (24/7) to do so, and so on.

It cannot be done. Those properties that have almost only "Aux Grant" residents are horrible - not their fault as they can't afford to do any better. The problem is statewide -- see this Daily Press (Hampton VA) article from October 2012, --here--

I am guardian for a number of individuals. About a year or so ago I began refusing to consent to Assisted Living placement if the individual was in a better place.  Two of the people I am now guardian for are at Catawba Hospital - a psychiatric facility owned and operated by Virginia which charges over $1000.00 a day - more if the room is padded. If the people can't afford to pay (the usual course) the state eats it. So the goal is to get them out as soon as possible. And if they have a guardian, the guardian has to consent to placement.  My two people are ready for discharge - to Assisted Living with Auxiliary Grant.  They're in a better place at Catawba than in ANY AL/AG facility, so I'm not consenting.

Yes, I'm costing Virginia $1000 a day (per person!) because the General Assembly is too damned stupid to recognize the need and increase the Auxiliary Grant to a reasonable level. The Auxiliary Grant has not kept up with the costs of care - especially considering that more and more regulations are piled on the AL facility without any funds to pay for it.  According to the Daily Press article linked above, there were 166 patients in Virginia Mental Health Hospitals with this problem as of October, 2012.

I just got off the phone with someone trying to place one of my Catawba patients.  That person is very competent and very good at her job. I told her my position and I don't care who knows it (thus this blog). I told her she's welcome to tell the upper food chain my position and my pleasure at getting back at Virginia for its disgraceful "Aux Grant" program by costing the state many times what they should pay each month by refusing placement. I dare them to call me.  I dare the Governor to call me.

As a guardian I have to advocate for what's best for my wards.  In my opinion the Auxiliary Grant program is the worst for them - it is instead a Cruel Joke (to borrow a phrase from former Gov. Mills Godwin) and won't happen on my watch. The two individuals are safer and better cared for where they are now than in Assisted Living, and unless Virginia comes up with reasonable money for their care, they're gonna stay there.


  1. Just curious, Ross, IF the individual was to transfer to a AL facility, who determines WHICH AL facility they move to?

  2. That's part of my duty as a guardian - to determine suitable living arrangements.

  3. Mr. Hart- I agree completely.. I'd love to tell you about my journey with AG GRANT and the Alzheimers Waiver I obtained for my mother who I am POA/Guardian. She is in a local AL here in my area- In Norfolk.. "Commonwealth Memory Care" It was my ONLY option other than nursing home- for safety reasons my own home caregiver situation had to end- I drive over 40 miles round trip every other day to see that my Mom is cared for properly- as she has late stage ALZ- but is still high functioning.. This facility has numerous violations, staff turnover, my Mother was manhandled and fell in the 1st 60 days- APS report filed.. Since June 13th its operating on a Temp/Provisional license-for 6 mos. The corporation Commonwealth Assisted Living- based over near Charlottesville- refuses to (move her) closer to me to one of their facilities Georgian Manor- Chesapeake.. very closeby, and licensure in good standing.. It was a very difficult process to obtain both grant & waiver funding, then it was very unpleasant to go thru the Commonwealth processing for admissions too- The reasons for refusal by Commonwealth AL Corp. are bogus. No good reasons have been given- There are (no other) competitors or AL facilities I can move her too- they ALL want Private Pay Funding.. even though Moms funds total $2700/mo- The Grant=1196 (Her Share= $628 and AG share=$568) then the ALZ Waiver=$50/day --I have been trying to (Market) this funding combo to other AL facilities nearby me- but I'm hitting a brick wall- I literally am forced to keep her in a clearly troubled facility and have no other options.. Commonwealth CEO Richard Brewer who is also a member of the Board of VA Assisted Living Assoc.. and CFO Nancy Higgs appear not to care. that its causing me expenses as a single mom I cannot afford.. also taking a toll in my entire life- car problems, health problems, emotional problems.. All because I cannot trust the facility to care properly and the (Distance) stress/time w/ frequent visits.. The Provisional license is until December! then what???

    1. Helen - as you know your situation is unfortunately too common. AL facilities that should be shut down are kept open because there's no where to send the residents. Ask any Adult Protective Services worker - they live in fear of an AG/ALF going bankrupt and closing their doors. We've had several in Roanoke close over the years I've done this and it's pure Hell trying to find placement. Unfortunately I'm betting on the provisional license being extended.

      I encourage you to tell your story to everyone and you and they call as many members of the General Assembly in your area complaining about the cruel lack of funding of the Auxiliary Grant.

      Best wishes for your mom.


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