By Lillian L. Hyatt, MSW, Resident of a CCRC and 
AARP Policy Specialist on CCRCs
What are CCRC manager’s priorities? Seniors who have been thinking about entering a CCRC or seniors who are currently living in such a facility should be aware if huge marketing budgets for unnecessary and expensive programs take precedence over delivering needed and promised services to CCRC residents.
It is very important to know how the money seniors pay to move into a residential care facility (RCFE) is spent. Usually a large portion of their life savings will be utilized. Will the money be spent wisely to benefit residents or to pay for marketing executive salaries? Some startling examples of such wasteful expenditures came to my attention and I could not get an answer to my questions about the costs involved.
I recently got a flyer that informed me that a “wonderful” computer program was being launched to update residents on the latest computer gimmicks. This costly effort, including camera shoots to promote the program, is possible for only a tiny portion of our elderly with limited ability to use this program. Demographics have changed markedly in Continuing Care Residential Facilities (CCRC). People are being admitted with serious health challenges and mental impairment. When I entered in 2000, the age limit was 84. Today, in 2013, admission is granted to seniors over 90. Money needed for health care staff is being spent foolishly on programs to promote marketing and filling vacant apartments and beds in the mental care facility recently built by my facility.
Deceptive titles for staff often mislead residents into a false sense of security. For example, the director of engineering in one instance had no engineering degree. Someone given the title of director of resident services allowed residents to assume that a social worker was employed when, in fact, that person had no social work education or experience.
An article in the Legal Network News published by the California Advocates for Nursing Home Reform (CANHR) explores the issues of liability and accountability of Residential Care Facilities for the Elderly (RCFE) ownership and management. According to this article, “Many RCFEs are small and are owned and operated by individuals or small businesses … because of this it is important to name the corporation, LLC or other defendants. With ownership comes responsibility.”
Every concerned person helping the elderly make decisions should take the time to study Title 22. Under Title 22, the owners of a licensed corporation are directly responsible for what goes on at the facility, as they make decisions regarding who to put in charge at the facility, make decisions regarding marketing strategies and make decisions regarding the allocation of the facility’s financial resources.
“Code of regulations sections 87456 and 87457 require that the license of an RCFE is also responsible for assessing a resident to determine his or her needs by conducting a preadmission appraisal which assesses the resident’s individual service needs …”
From my own personal experience, failures occur when the resident’s condition changes over time. The facility is reluctant to give the needed services and will force a resident to insist that their needs be met. My initial evaluation 13 years ago was “A very healthy alert woman.” I am now legally blind and severely disabled and must use a walker at all times to do necessary tasks. My facility is very reluctant to meet my current needs and I must fight for every service I require to stay independent.
In conclusion, Title 22 provides that “individuals or small corporations that are the licensees of RCFEs in California cannot claim ignorance as an excuse for not knowing, or not following the law. Being a licensee comes with the obligation that they know what was required at the facility and the obligation to make sure that the requirements of Title 22 are carried out.”
