Assisted Living and Continuing Care Retirement Communities (CCRCs)
Assisted Living
The majority of assisted living members are a part of a continuing care retirement community while some are free standing. Assisted living is state regulated. State regulations vary on who can be admitted and reside in assisted living. Assisted living is primarily private pay.
Continuing Care Retirement Communities
CCRCs offer an innovative and independent lifestyle that is different from other housing and care options for older people. Through long-term contracts that provide for housing, services and nursing care, usually in one location, the CCRC meets a resident’s needs for their entire life.
Find out more by clicking on a link below.
• Provider Tax
• Assisted Living
• Continuing Care Contracts
• Legal Issues
• Operation and Regulation
• Resources and Links
.jpg)
Provider Tax
Currently, CCRCs and MLRCs are exempt from paying the provider tax for their skilled nursing facilities. However, the Governor will likely seek to eliminate the exemptions as part of this year’s budget. If the exemptions are eliminated, the provider tax will essentially be a tax on residents’ retirement savings. This means it is crucial that everyone affected play a role in Aging Services' campaign to maintain exemptions. See a list of resources below.
1. Model letter from Residents
2. Model letter from Families
3. Model letter from CCRC/MLRC Community Administrators
4. Talking points for use in letters or meetings with state Senator/Assembyperson
5. Model letter to the Editor of local newspaper
6. Letter to the Governor from Senator Wolk & Padilla
April 2010 Grassroots Toolkit
.jpg)
.jpg)
Mountain Democrat
July 22, 2010
by Kate WhitehouseJuly 2010
Resident agendaMay 2010
agenda
Resident agenda
Quality Assurance
Fee
(Provider Tax)
Exemption
Provider Tax Resident Advocacy Campaign form
Get involved. Fill in the Provider Tax form and let us know what information you are interested in receiving to learn more about this issue.
Assisted Living Waiver
The Assisted Living Waiver provides a Medi-Cal benefit for assisted living residents in certain counties. Visit www.californiaassistedliving.org for more information.
Advisory Committee Discusses Governance and Fee Language
The state’s Continuing Care Advisory Committee met in Sacramento. The agenda included a lengthy discussion on the proposed statutory language regarding monthly service fee increases. The debate centered on how to adequately define the word “provider” to accurately portray the corporate structure of each CCRC. The committee approved the language as drafted. The Committee also discussed whether or not various quality initiatives like Quality First should be made compulsory. There was no consensus from the committee members to act on this. Download Montly Fee Increase Language. For more information, contact Eric Dowdy at the Aging Services office.
CCRC Statutes
Continuing Care Retirement Communities (CCRCs) are governed by the Health & Safety Code, commencing with Section 1770.
Download the CCRC Statutes
The Continuing Care Contracts Branch of the Department of Social Services is responsible for oversight of continuing care contracts. To visit their website, click here.
Legal Update: RCFE Food Service Not Subject to County Oversight
Joel Goldman, of Hanson, Bridgett, Marcus, Vlahos & Rudy, LLP, provides clarification that RCFEs are not subject to the provisions of the California Uniform Retail Food Facilities Law (CURFFL). Download the Legal Update here.
Return-to-Home Law
In 1998, Aging Services of California sponsored AB 742 (Washington, Chapter 124, Statutes of 1998). This state legislation would guarantee that a resident enrolled in Medicare risk HMO would be allowed to "return home" when that home is equipped to care for them. This legislation was pre-empted by the federal bill, H.R. 5661. Specifically, the Medicare "give backs" portion of the "Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act (BIPA)" which (42 U.S.C. 1395w-22) gives seniors who are enrolled in the Medicare+Choice plan the option to return to their home care facility following hospitalization if the following conditions are met:
- The enrollee elects to return to that facility;
- The home facility must agree to the enrollee's return;
- The home facility must agree to accept the same terms and condition of payment that would apply to an in-network provider under the enrollee's managed care plan.
Should you encounter problems in exercising the resident's rights under these provisions, members are encouraged to contact the plans program manager. Contacts for Kaiser and PacifiCare are listed below:
Sue Herman
Plan Manager
PacifiCare
(415) 744-4908
Anita Kveviel
Plan Manager
Kaiser Permanente
(415) 744-3652
The Department of Social Services, Continuing Care Contracts Branch has made its Annual Report Instructions as required by AB 2550 (Steinberg, Chapter 129, Statutes of 2004) available online. To access the site visit http://www.calccrc.ca.gov/reportingrequirements.h tml. For more information, contact Eric Dowdy at the Aging Services office.
The Department of Social Services, Continuing Care Contracts Branch has released a draft copy of their protocols when conducting licensing visits of independent units in CCRCs. The Department will be taking comments and will inserrt the final product into the Evaluator's Manual. To access a copy of the draft protocols, click here. To view Aging Services' comments, click here. For more information, contact Eric Dowdy at the Aging Services office.
A memo issued on July 29, 2005 from DSS’ Policy Development Bureau seeks to clarify statutory requirements for admission agreements and the use of “point systems.” Specifically, the memo is meant to provide Licensing Program Analysts (LPAs) with consistent criteria for evaluating these two areas. The issues addressed in the memo include: 1) clarity of language used in admission agreement, 2) explanation of terms such as “occasional, frequent, routine, extensive, repeated, many, numerous, recurrent, etc.”, 3) consistency of the treatment of documented points across all facility staff, 4) clearly defining activity descriptions, such as “wake-up assistance”, 5) clearly delineating the resident’s right to decline services (and thus not accruing points), 6) ensuring the points do not conflict with residents’ rights, 7) clearly identifying point maximums, 8) identifying appropriate staff to determine behavioral related point assessments, 9) disclosing frequency of totaling points, 10) disclosing whether or not points will be re-evaluated, and 11) ensuring a tracking system auditable and in place.
The most recent manual updates are listed below. A complete set is available on CCLD's website (scroll down to Residential Care Facilities for the Elderly).
According to the Department of Justice and the Community Care Licensing Division, 96% of fingerprint clearances should be available within 3-5 days when using Live Scan. Staff with client contact and volunteers must be cleared prior to their presence in the facility. Common issues that cause delays include missing court information, applicant born prior to 1945 requiring a manual file search, and missing or incorrect data submitted with the fingerprints. The following information is provided to assist you in checking on status of your applicants:
Checking on Status of Fingerprint Submission
You should allow a minimum of seven days before making a status inquiry. Applicants should check first with the DSS-Care Giver Background Check Bureau since the Department of Justice sends results directly to the applicant agency.24-hour Automated Telephone Service Available: 916-227-4557. If DSS does not have results yet and digital Live Scan fingerprints were submitted, you can use the automated telephone system to check on your submission. You will need the following information: (1) your date of birth; and (2) the 10-digit Automated Transaction Identifier (ATI) number that appears at the bottom of the Department of Justice form requesting Live Scan fingerprint background checks. The ATI number always appears in the following sequence: 1 LETTER; 3 NUMBERS; 3 LETTERS and 3 NUMBERS.There is no automated system for checking on paper fingerprint card submissions. To check on card submissions or if you have specific applicant submission problems, contact the state Department of Justice's Applicant Processing Program at (916) 227-3823. Because of the volume of calls received and time needed to research each request, there may be delays in responding to your inquiry.Additional Information:
DSS Legislation Online Research Tool
Each year, the Community Care Licensing Division of the Department of Social Services updates the Evaluator Manual to reflect recently chaptered legislation. This information serves as guidance for Licensing Policy Analysts for the period after the new statutes take effect and before regulations are adopted. In addition, this information provides policy guidance in areas where regulations are not necessary.
The Evaluator Manual updates from 1998 through 2004 have been compiled and posted on Aging Services' website. The information is available for browsing by topic, year, or author. The site will be updated annually to reflect recently chaptered legislation. To access the Research Tool, click here.
Technical Support Documents
DSS' Technical Support Program has several self-assessment guides available. To download, click on the name of the document below:
HIPAA: An Introduction
Allan Jergesen, Esq. of Hanson, Bridgett, Marcus, Vlahos & Rudy, LLP provides members a general introduction to HIPAA including background of the HIPAA legislation, and several components that make up HIPAA. Click here to access the complete text in PDF.
Links
-
Map and listing of all Aging Services of California member CCRCs and MLRCs in California
-
Department of Social Services
|
Eric Dowdy |