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Continuing Care Retirement Communities, What You Need To Know

posted Jul 9, 2014, 7:25 AM by Steven Chung

Continuing Care Retirement Communities, What You Need To Know

By Martha Batista, CEO
Senior Living Advisory Group of Scottsdale

July 9, 2014

Compare Senior Living Options

When it comes to long term care and senior living, we are so extremely lucky to be living in an area of the country that offers so many different options.  Chances are that you will be able to find exactly what you need and want here in the Valley of the Sun.  However, with the many options to choose from, also come confusion and often frustration.  To make the right decision, it is important to educate yourself on what each option offers and the financial commitments attached to them.  One question that comes up frequently is whether a buy-in option makes sense. And the answer is…it depends.

First, let’s make sure we all understand what a buy-in is and is not.  In broad terms, there are two types of communities – those that offer a rental model, and those that require a buy-in.  The rental model is easy to understand.  You pay a monthly fee that includes your apartment rent and your care services.  You will pay a relative small, one time only, community fee at the time of move in, ranging from $2000 to $4000.  Your monthly fee will most likely increase every year by 2% to 3%, depending on the community.  As your level of care increases (i.e. if you move from independent to assisted living, or from assisted living to memory care, or just need additional services), your care costs will increase, sometimes significantly.   This is the big unknown for most people and the major challenge in preparing a financial plan for the future.

A buy-in community takes away this challenge, but at a cost.  A buy-in community is also known as a CCRC – Continuum of Care Retirement Community.  And there are different types as well, but let’s keep it simple for now.  A CCRC offers different levels of care on the same campus, starting with independent living, assisted living, memory care and skilled nursing and rehab.   The most attractive attribute of a CCRC is that your monthly fee will not change as your level of care changes.  The only increase you will see is the usual 2% to 3% on an annual basis.  This makes planning much easier to do.  However, this “peace of mind” will require a substantial amount of money upfront, ranging from $70K to over $600K, depending on the community and size of apartment you choose.  The term “buy-in” is a misnomer because you are not really buying an asset like you would buy a house.  What you are buying, in a sense, is an insurance that your cost will be stable no matter the level of care that you will need in the future.

So the question is: how do you decide which type of community is right for you?  For some, the answer to this question is very easy – they simply do not have the financial means to afford a buy-in.  For others, is not as simple, and the answer depends on many factors:

  • Your health today – a buy-in makes sense for people that are still healthy, active and can enjoy true independent living for a while. You want to take advantage of all the community has to offer.
  • Your current age – doing a buy-in in your late 80’s or early 90’s may not make much sense. In general, the longer you can stay in the community, the better return in your investment you will get.
  • How you expect to age – this one is a tough one to assess but some people have a good idea that they may need care services or even memory care down the road. They may have a family history or have already received an early diagnosis. If you expect to need care services down the road, a buy-in option should be a consideration.
  • Single or a couple –because of the way the financials are structured for a buy-in, a couple may be able to obtain a faster return on investment than a single person. 
  • How you feel about the community – in our opinion, if you are doing a buy-in, you must absolutely love the community. You should be able to see yourself living there for the rest of your life. It’s a big commitment, and once you sign that contract, it is not easy to back out.
  • Financials – there are many numbers to consider when making the decision and this is an area where we recommend you reach to professionals for guidance. It is important to compare the economics of a CCRC buy-in versus that of a monthly pay-as-you-go option. For example, the figure below is an analysis we did for a couple in their early eighties. Given their situation and particular set of assumptions, our analysis helped the couple understand that the economic break even would be about 4 years with a buy-in option versus the next best alternative; in this case, a month-to-month senior living community or an assisted living group home. This gave them the confidence to choose the buy-in option even though it required a substantial upfront “buy-in” fee.

Client Example of an Economic Break Even Analysis

CCRC break even analysis
 

Every situation is different and it would be foolish to prescribe an algorithm by which seniors and their families can quickly determine what is the best option for them.  We believe that educating yourself in all aspects of what is available and becoming a smart consumer is the best course of action, whether you do it by yourself or speak with your professional Senior Living Advisor.

Senior Living Options – 5 Steps to Planning Ahead

posted Jun 2, 2014, 1:08 PM by Martha Batista   [ updated Jun 5, 2014, 3:32 PM ]

Senior Living Options – 5 Steps to Planning Ahead

Martha Batista, President & CEO
Senior Living Advisory Group of Scottsdale

June 2, 2014

Earlier this year, we had the honor of presenting to the Arizona State University Retiree Association (ASURA). This is a group of active retirees consisting of former Professors, Deans, Administrators, and staff members of ASU.  We engaged the group for over 2 hours on how to think through choosing the right senior living options on a broad range of scenarios and situations. Today, we still continue to receive positive feedback from the attendees. 

Senior Living Planning Steps
After our presentation, we shared some further thoughts on what steps to take now to plan ahead.  From my own personal experience, I would encourage you to consider the following 5-key planning steps for the future.

1.    Legal matters – get your legal matters/papers in order. This means updating your will and estate plans, advanced directives, etc. and, most importantly, making sure you have the right documents in place in case you become incapacitated due to dementia or any other debilitating illness. You should have three power of attorney documents – Financial, Health and Mental Health. Work with an Elder Law Attorney (pick one, if you don't have one) to help you.

2.    Financial matters – think about how you would pay for long term care. If you have a long term care insurance policy, dust it off, read it and make sure you understand it. Some LTC policies are very old and may or may not cover the costs of assisted living facilities (since they did not exist 30 years ago). If you do not have LTC insurance, then it’s time to do a little LTC planning. Consult with your financial advisor or someone that could advise you on the new LTC products that exist today, such as a benefits consultant. 

Also, if you are a vet, research available benefits that you may be eligible for, such as the Aid and Attendance benefit that provides assistance for LTC costs. In addition, research the Medicaid programs in your state. They may provide a safety net for you if you run out of funds. A good elder law attorney can help you with all of these matters. Gather whatever paper work you will need to apply for these benefits in the future. For example, to apply for Aid and Attendance, you will need your original discharge papers. Many adult children struggle to find the required paperwork when dad or mom no longer can.

3.    Family matters – Talk with your family or close friends about your wishes on aging and care. Would you like to remain at home as long as possible? If so, hiring a private caregiver or a home care agency will be the first step. If you would like to look at outside the home options, describe what sort of environment you would most enjoy. This will help your family or loved one make decisions for you in case you can’t.

4.    Get educated – speak to a professional advisor (like us) to get educated on senior options and develop a high level plan. For example, you may want to move out of the home sooner rather than later into an independent community that has continuing levels of care on the same campus. You can then enjoy the retirement lifestyle and then utilize the care services offered in the same community when you need them. Understanding your options now is a key component in the planning process.

5.    Simplify – Having learned from experience with my mom and dad, I would encourage you to simplify your life as much as possible. Downsize – gift, donate, or sell your “stuff” that has been accumulating for the last 40 years. Do it now while you still have the energy! This will help your family, and you, tremendously down the road.

We look forward to hearing from you!

Anatomy of a Well Run Residential Care Home (aka Group Home)

posted May 17, 2014, 8:19 PM by Steven Chung   [ updated Jun 5, 2014, 3:01 PM by Martha Batista ]

May 17, 2014  Martha Batista, President & CEO

We have visited hundreds of Residential Care Homes (group homes) in the Valley and have come to appreciate those that offer exceptional care and are run like a fine Swiss time piece. So, what is the anatomy of a well-run group home? Just like a healthy and fit person must focus on several aspects of life to achieve wellness (diet, exercise, meditation, etc.), a well-run and thriving group home exhibits unique characteristics in its owner, manager, caregivers, processes and other critical indicators.



The Owner

A well run group home has a very involved owner who is not just concerned about the business aspects of the group home, but is integrated and knowledgeable about everything that happens on a daily basis. We prefer an owner that is not a caregiver. The reason is because a caregiver should primarily only do one thing…care for the residents. The owner has a lot more responsibilities that cannot easily be done if she is busy providing the care. An involved owner makes frequent visits to the home, talks to residents and their families, takes the time to meet with perspective residents, continuously develops the skills of the caregivers, follows changes in regulations that effects the operations of the home, and strategizes and plans for how the services of the home can be improved.

The Manager

The manager could also be the owner. A manager is usually in place when an owner owns multiple group homes, or the owner is more involved in the marketing aspects of the business. We find that managers of a well-run group home are very involved and present in the operations of the home. The manager ensures that certain processes are in place and that caregivers are trained and knowledgeable about these processes. They handle escalated family and resident issues as they arise. They make sure that the home has what it needs to provide its services, from the food to cleaning supplies to incontinent products.

The Caregivers

Caregivers of a well-run group home are certified, trained and receive on-going training and development feedback. Also, it is understood (by owners and managers) that caregivers are “where the rubber meets the road”. At the end of the day, the caregivers are the ones that provide the “product” that the family or resident is buying. If is not good, the home will not survive. They are the ones that have the most contact with the resident and the family. Caregivers of a well-run group home are appreciated, respected, well rewarded, and never treated as low-paying employees. We like caregivers who have tenure in the home (this also indicates that the owner/manager is doing a good job maintaining a stable caregiving team). The main responsibility of a caregiver is providing care, not cleaning, not cooking, and not shopping for food. A home with multiple caregiving shifts or with a support staff, like a cook or administrative assistant, allows for these other essential but non-caregiving tasks to be done by someone else than the caregivers.

Processes

The existence of established processes is the fourth dimension of a well-run group home. Processes such as what to do in an emergency, handling resident or family complaints, investigating a fall or a medication mishap, ordering medications, handing off from one caregiver shift to another, etc. are well understood by everyone involved in the operations of a group home. The flow of information is critical for the well-being of the residents.

Other indicators

Deficiencies –Arizona conducts annual surveys of the licensed communities and homes in the state and publishes the “deficiencies” found. The number of deficiencies is an indicator of how well a home is operating and managed. A high number (10 or more) may indicate lack of good management. However, one must also pay close attention to what the deficiencies were. A deficiency dealing with medication management is much worse that a deficiency dealing with some sort of documentation (in our opinion). In addition, one must also pay attention to how long it took the home to fix those deficiencies. A home that took care of the issues in a timely matter is much better managed than one that took months to resolve the issues.

Physical aspects of the home – does the home appear well taken care of? Is it clean? Is it clutter free? Are there unpleasant smells? A well maintained, clean and clutter free home indicates management’s attention to detail that can extend to everything else done in the home, including how medications are managed to how residents are cared for.

Insurance – One of the most important questions (among many) that we ask a group home’s owner or manager is if the home carries liability insurance. If the answer is no, we encourage them to buy this insurance. It is important that the home be protected against unfortunate events that may cause it to be financially unstable.

These are just a few of things we look for when we visit a residential group home.

For more information: please call 480-788-8680

Announcement: Local Assisted Transition offices are now part of the Senior Living Advisory Group in Arizona

posted Apr 29, 2014, 9:39 PM by Steven Chung   [ updated Jun 5, 2014, 10:00 PM ]

Announcement: Local Assisted Transition offices are now part of the Senior Living Advisory Group in Arizona 

Thursday, April 28, 2014

The local Phoenix and Scottsdale owners of Assisted Transition, a national senior living and care referral franchise, are now the independent owners of the newly formed professional “Senior Living Advisory Group” here in the Valley. The entire corporate Assisted Transition franchise was acquired by a competing national senior living placement franchise earlier this year.

Owners of the Phoenix office, Alice Starzinski and Sandy Benson, together with owners of the Scottsdale office, Martha Batista and Steven Chung are very pleased to form the Senior Living Advisory Group here in the Valley. More importantly, the collaboration will continue to provide the same level of professional and personal client service to families and seniors and also continue to be a trusted partner to communities and homes all over the Valley.

“We are thrilled to be collaborating with our Scottsdale counterparts in the formation of the Senior Living Advisory Group,” said Sandy Mendez Benson, former owner of the local Phoenix Assisted Transition franchise. “We have wanted to branch out on our own and continue to offer the same quality services we offered as franchise owners, only we now have more flexibility.”

The Senior Living Advisory Group offers professional advisory and placement services for seniors or their families who are looking to transition to independent living, assisted living, memory care communities, or residential care homes. The personalized services offered by the group include an in-person assessment of the client situation, researching of relevant options that meet specific needs, financial/budget analysis, and connection to other trusted senior professionals such as elder law attorneys, in-home care providers, Medicare and VA benefit experts, move managers, realtors, and other professionals.

“We know personally how overwhelming the process can be for a family to sort through the details of finding the right place for a senior or loved one. With nearly 1500 communities and care homes in Maricopa County, the experience can be daunting” said Martha Batista, Founder of the Scottsdale office.

Senior Living Advisory Group’s goal is to make every aspect of the transition process as stress-free for families as possible, and their services are at no cost to the family or the senior. With offices in both Phoenix and Scottsdale, the Senior Living Advisory Group will continue to service the Valley-wide Metro area.

For questions, please contact:

Sandy Benson at (480) 626-0390, sbenson@seniorlivingadvisorygroup.com, or

Martha Batista at (480) 788-8680, mbatista@seniorlivingadvisorygroup.com

Senior Living Advisory Group locations:

 
Serving the West Valley:

Alice Starzinski 
Sandy Benson
14001 N. 7th Street
Suite D107
Phoenix, AZ 85023
480-626-8680
 
Serving the East Valley:

Martha Batista 
Steven Chung
7010 East Acoma Drive
Suite 101
Scottsdale, AZ 86254
480-788-8680







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