LTC Bullet: CareScouting Assisted Living

Wednesday, February 19, 2003

Denver, CO--

LTC Comment: We've known Bob Bua, President and CEO of CareScout for several years. He's been at the forefront of helping families find the best and most appropriate elder care since publishing a book on the subject in 1997. Today, with Medicaid and Medicare financing of nursing homes and home health care causing dramatic disruption in those levels of care, the mostly private-pay service delivery modality known as assisted living is becoming increasingly important. More on CareScout and the research it's recently conducted on assisted living, after the ***news***.

*** Did you miss the big Society of Actuaries Long-Term Care Insurance Conference in Las Vegas recently? Do big fees and travel expenses stand in the way of your attending critical professional conferences? Here's an inexpensive substitute. Enjoy "Virtual Visits" to major LTC industry conferences and meetings! Check out this NEW FEATURE in the Center for Long-Term Care Financing's "donor only zone." If you are already in The Zone, simply click on this link . You'll find our Virtual Visit to the SOA conference including an overview, evaluation, and session summaries. Don't miss the interviews with and pictures of some well-known attendees. Find out what the movers and shakers of LTCI were up to in Vegas. If you are not yet in The Zone (perish the thought), click on this link to correct that oversight, make your $150 (or more) tax-deductible contribution to the Center, and join the LTC Elite who receive valuable donor-zone content (our five-minute, one-a-day mental vitamins) every work day. As soon as you contribute either online or with a check in the mail, contact Damon at , tell him you've contributed, and give him your preferred user name and password (up to 10 characters each). Damon will confirm quickly and you'll have unlimited Zone access (including the Virtual Visit area) and free LTC E-Alerts, LTC Data Base and LTC Reader emails for a full year. ***

*** The LTC Graduate Seminar in New York City (Manhattan) is definitely on for March 25, 2003 from 9AM to 5PM. Please call or email Amy McDougall at 425-377-9500 or to reserve your place. She'll get right back to you with the exact location, parking, and other details. For information on content, free textbooks, instructor's curriculum vitae, and testimonials, see . ***

*** If you would like to have the LTC Graduate Seminar offered in Milwaukee or Chicago on March 10 or 13 and you can provide a meeting room (accommodating 15 people or more), a VCR/TV, an audio-tape player, and a flip chart or white board, we'll schedule the event, invite participants and comp you two free enrollments. Just call or email Amy McDougall at 425-377-9500 or to set it up. ***

*** Remember the "LTC Choice" campaign underway in Washington State? We covered it in "LTC Bullet: Where the LTC Action Is" on December 12, 2002 and in "LTC Bullet: Let the LTC Revolution Begin" on November 8, 2002 The latest news is that legislation has been introduced in the Washington State Senate to achieve some of the objectives of LTC Choice, i.e. to target Medicaid to the genuinely needy and to create stronger incentives for consumers to save, invest or insure privately for long-term care expenses. You can review the proposed legislation (Washington State Senate Bill # 5730 at: . Center for Long-Term Care Financing President Steve Moses and others testified regarding this bill in Olympia, Washington on Tuesday, February 18, 2003. A Medicaid planning attorney who objected that the law protects certain asset transfers was curtly informed by the Chairman that "we're here to change those laws." Scuttlebutt is that the bill has "traction" and a reasonable chance of passing. ***

*** Donor zone content now goes daily by email to all paid subscribers. Our LTC E-Alerts, LTC Data Base and LTC Reader publications are designed to keep LTC insurance producers and other LTC experts at the forefront of knowledge and professionalism. We track the electronic, trade and academic literature in all LTC-related fields; we choose the reports and articles we think you will find most useful; we distill the information into a quick read (five minutes or less); we add a brief analysis to indicate why we think the information should matter to you; we email you the publication daily; and we archive it all at so you can find back issues when you need them. Our latest donor-only zone content sent during the past few days includes:

The LTC Reader #3-006--Alzheimer's Flows Through the Brain Like Lava
LTC E-Alert #3-013--It's Not Just Social Security That's in Trouble
The LTC Data Base #3-004--Federal LTCI Results and CDC Says 65 Plus to Double by 2030
The LTC Reader #3-007--Do We Need LTCI for the Unborn?

If you already qualify for The Zone, you can click the following link, enter your user name and password, and go directly to the latest donor zone content and the archives: . To Zone In, mail your tax-deductible contribution of $150 or more to the Center for Long-Term Care Financing, 2212 Queen Anne Avenue North, #110, Seattle, WA 98109. Then email your preferred user name and password (up to 10 characters each). You can also contribute online by credit card or direct withdrawal at . ***


Late extra: "LTC Daily Analysis Briefs. Wanted: Affordable ALFs. CAMBRIDGE, MA -- 02/12/2003 -- (Eli Digital) More and more Americans need assisted living services but can't afford to pay for them. That's a finding in a recent report prepared for Volunteers of America by the Joint Center for Housing Studies at Harvard University. 'While assisted living has become an increasingly popular option with upper- and middle-income seniors, the high costs of the product put it out of reach of low- to moderate-income groups,' the study states. Titled 'Affordable Assisted Living: Surveying the Possibilities,' the report goes on to discuss various policy options and recommended strategies for solving the problem. For a copy of the study, click here ." .  Robert N. Bua founded CareScout ( ) to provide consumer-friendly, comparative eldercare information. In 1997, he published The Inside Guide to America's Nursing Homes: Rankings and Ratings for Every Nursing Home in the US (Warner Books), probably the first quality-of-care rankings and ratings system for every nursing home in America. Next came the development of a comprehensive eldercare database and an interactive software package designed for referral and care management professionals. In 1998, Bua added "," a website for consumers seeking information on nursing homes. Just over a year later, CareScout was established to connect Americans to information, ratings, and products for the full eldercare continuum. In 2002, CareScout developed The CareScout NetworkTM, a national network of nursing homes, assisted living facilities, and home health providers that offer up to 20% off the cost of care.

One of CareScout's latest offerings is a nationwide assisted living database, which Bua claims is "the first ever comprehensive national resource available for information on over 38,000 assisted living facilities nationwide." This AL data base contains facility-level and licensing information, including: facility size and capacity; ownership and staff; services offered, such as skilled nursing care, dementia care, assistance with activities of daily living (ADLs); Medicaid and other payment sources; licensing types; state licensing and regulations. The system permits assisted living searches using over two dozen different criteria, including state, city, county, zip code, or facility name.

Following are some highlights of recent research findings drawn from the CareScout assisted living data base and presented by Mr. Bua at the recent Society of Actuaries LTC Insurance conference in Las Vegas. They show how the capabilities of one licensure type may be very different depending on its definition by various states.

* There are more "assisted living facilities" than certified nursing homes and home health agencies combined in the United States: approximately 38,000 facilities in 50 states and DC.

* There is a single licensure type for 'assisted living' in only 24 percent of states (12 out of 51, including DC): AR, GA, IN, MA, MD, MS, NC, NE, PA, RI, SC, SD

* States use at least 74 designations other than the name 'assisted living.' These include: Continuing Care Facility; Adult Care Home; Neighborhood Home; Adult Day Services Program; Nursing Care; Adult Foster Care; Personal Care Home; Adult Group Home; Adult Resident Care; Enriched Housing Program; Residential Care Facility; Assisted Living; Family Care Home; Residential Treatment Facility; Assisted Living for Mental Health; Home for the Aged; Basic Care Facility; Independent Living Facility; Shared housing; Certified Family Homes; Shelter Care Home; Community Care Facility; Intermediate Care Facility; Supported Rehabilitative Residence; Congregate Assisted Living Facility; Sheltered Home; Supported Residence; Managed Residential Community, and many more.

* 38 states (affecting 70 percent of all ALFs) require assisted living facilities to have staff on duty 24 hours.

* But only 12 states and six percent of all ALFs are legally required to have an RN on duty 24 hours.

* 40 states and 75 percent of all ALFs are legally required to serve three meals per day.

* Only 16 states and six percent of all ALFs are legally required to provide staff on duty 24 hours, to serve three meals per day, and have emergency procedures in place.

* Conclusions:

Don't expect national uniformity regarding assisted living (any time soon).
-No federal regulation is pending because no government funding is available

Don't rely on licensure name designations alone.
-About 1/2 of all states do not even use an "assisted living" designation

Insurers should conduct state-by-state analyses.
-"Residential Care Facilities" in one state usually have different 'legal' capabilities than ones in other states

According to Bua, these research findings beg the questions:

Are LTC insurers certain they are doing enough due diligence at the claims eligibility level?

Are they using state-by-state data to meet policyholder needs; to keep claims down; to develop next generation products?

Bua claims that CareScout's assisted living data base can help LTC insurer's answer these and other questions critical to product design, claims management, and beneficiary satisfaction.