August 29, 2013

Handling of St. Joseph's discharges criticized

The Portland assisted-living facility has shown disrespect and hasn't provided clear details about the future, families say.

By Kelley Bouchard kbouchard@pressherald.com
Staff Writer

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Albert Michaud, 84, and his wife, Rita Michaud, 86, have been in long-term care after being hit by a car years ago.

Photo courtesy of Audrey Rolfe

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Rita Michaud, one of only six private-pay residents at St. Joseph's, has been paying $6,444 a month, said her daughter.

"They have to charge private-pay residents more to cover costs," Erb said.

The funding gap also has forced many facilities to put off much-needed renovations for years, Erb said. It's no surprise that St. Joseph's board of directors decided to renovate the assisted-living unit in the 40-year-old facility, he said.

Forty-one percent of MaineCare-dependent assisted-living facilities need to be renovated or replaced, according to the Muskie School of Public Service at the University of Southern Maine.

And yet, Maine lawmakers have raised MaineCare reimbursement rates for assisted living only once in the past eight years -- a 1 percent increase for fiscal 2011-12, Erb said.

Underfunding MaineCare's long-term care services is shortsighted, Erb said, because the "cost shifting" has the unintended consequence of driving up the number of people on MaineCare.

"When assisted-living facilities charge private-pay residents more, it causes people to spend down their assets more quickly, and then they end up on MaineCare too," Erb said.

EVENTUALLY, ASSETS DEPLETED

That's where Rita Michaud is heading, like many seniors.

Michaud has been at St. Joseph's for nearly two years, her daughter said. She moved in after she and her husband, Albert Michaud, 84, were hit by a car several years ago while crossing a street in Old Town, where they lived for decades. The teenage driver was talking on a cellphone.

Their injuries were severe, putting them in rehab for months and accelerating their need for long-term care, Rolfe said.

Albert Michaud's health problems are more severe than his wife's, so he's in the skilled-nursing unit at the Barron Center in Portland, where he's covered by MaineCare.

Rita Michaud has spent about $130,000 of her own money on the only private, recently renovated room at St. Joseph's, Rolfe said. She shares a bathroom with other residents. Most rooms have two beds, and two rooms share a bathroom.

Now, with about $60,000 left, Michaud must try to find a facility that will accept her as a person who has dwindling resources and will soon depend on MaineCare.

"To go to another (assisted-living facility) will be difficult because she doesn't have the upfront cash she once had," Rolfe said. "It really narrows our options tremendously. We don't have the resources to start all over again."

Rolfe said her mother, who has Parkinson's disease, has increasing medical needs and may now qualify for long-term care at the Barron Center, where her parents would be reunited.

CONFLICTING ANSWERS ON FUTURE

Rolfe said she's frustrated, however, that St. Joseph's has disregarded all of the money that her mother has paid and refused to guarantee her a spot in the renovated assisted-living unit.

Rolfe disputes claims by Gail Winchell, St. Joseph's administrator, that she doesn't know how the unit will be reconfigured, how many rooms it will have or how residents will be selected.

Winchell didn't respond to a request for comment Wednesday.

Rolfe said she spoke recently with a representative of Catholic Health East and Trinity Health, the recently merged national nonprofit that operates St. Joseph's for the diocese. The consultant told her that the unit will be renovated into private rooms with private bathrooms, and that current residents will have to reapply if they want to return.

"Why wouldn't my mother's investment be honored?" Rolfe asked rhetorically. "I think they know exactly what they're doing. Once renovations are complete, they have a lot of motivation to fill those beds with private-pay residents."

A regional representative of the Maine Long-Term Care Ombudsman Program visited St. Joseph's on Wednesday to talk with residents and family members, said Brenda Gallant, executive director of the program.

Gallant said her staff will visit St. Joseph's weekly and be available to help residents and family members with the search for new accommodations.

The ombudsman program and the licensing division of the DHHS also will make sure that St. Joseph's follows state laws in discharging residents, Gallant said.

That includes notifying assisted-living residents 15 days before discharge and making sure they have safe and appropriate places to live, she said.

Regardless of statutory requirements, Rolfe said, St. Joseph's is falling short.

"It's not a good plan to begin with," she said, "and it's not being well executed." 

Kelley Bouchard can be contacted at 791-6328 or at:

kbouchard@pressherald.com

Twitter: @KelleyBouchard

 

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