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Bickford Senior Living Executive Vice President Alan Fairbanks believes the writing is on the wall for private-pay assisted living.
To Bickford, the “sins of the past” include senior living operators not being proactive enough with meeting the care needs of their residents, and not being quick enough when adapting to the new
paradigm of value-based care.
Bickford is furthering this vision with a home care line it launched last year.
Added : April 30th 2022 at 09:07:44
Good, Bad and Ugly
americans would like nothing more than to live
in their own homes in their old age. Can short-
term care insurance help them do it? The plans have a good, bad and ugly side worthy of a Clint East- wood movie and require a squinty-eyed analysis to gauge their value.
On the plus side, “short-term care plans fill the need for those who want some protection, but are too old, too unhealthy or cannot afford long-term care insur- ance,” says Jesse Slome, director of the American Asso- ciation for Long-Term Care Insurance. The downside is short-term policies only cover care for one year or less, limiting how much they pay out per day or week.
Although the policies are more affordable than long- term care insurance, you also get less for your money. For example, a short-term care policy in Illinois cover- ing $1,050 of home care a week for up to 52 weeks would cost a 65-year-old woman $63 a month, accord- ing to AALTCI. If that same policy also covers nursing homes, the cost is $125 per month, but that care is con- sidered a separate benefit that pays only up to $200 per day for 365 days after a 100-day waiting period. By comparison, a long-term care policy would cost that same applicant $175 a month if she is in good health or $258 a month if she has some health conditions and pay for roughly three years of care at home or 18 months in a facility, after a similar waiting period.
The good. Short-term care plans do have one big ben- efit, though: “People will have an easier time getting in- sured,” says Slome, adding, “It’s a great planning option for those who only want a home care benefit.” The pol- icies accept applicants at much older ages than long- term care insurance, potentially up to age 89, and have
22 | KIPLINGER’S RETIREMENT REPORT MAY 2022
simpler medical underwriting. To screen applicants, the applications mainly use yes or no health questions, such as “Have you had a heart attack in the past 24 months?” or “Are you currently using a walker?”
For women, the unisex pricing is particularly attrac- tive, whereas long-term care insurance policies typi- cally charge women 40% more because their average number of claims is higher, says Slome.
The bad. Those advantages aren’t enough to con- vince Skip Skolnik, founder of Skolnik Retirement So- lutions in Elyria, Ohio, that the policies are worth get- ting when the median annual cost of a private room in a nursing home is a little over $100,000 and a home health aide is more than half that amount. “It’s like try- ing to cover a gaping wound with a Band-Aid,” he says. Someone with financial assets of $200,000 or more “could cover the costs themselves for a few months,” he says. “The real risk is a need that lasts years.” People with more limited assets typically qualify for Medicaid and don’t need extra private insurance, he adds.
Even Medicare will cover short-term care at home and in a facility in some situations. For example, if you need home care to recover from a specific injury or ill- ness, Medicare will pay for a home health aide for up to 60 days and could even extend that period if the care is deemed medically necessary. As a result, you may al- ready have a chunk of this short-term need covered.
The ugly. Short-term care policies aren’t easy to find. A number of states, including California, Florida, Mas- sachusetts and New York, ban the policies from their insurance markets in part because the benefits are con- sidered too skimpy. Even if you live in a state where short-term care plans are sold, most insurers don’t want to deal with them. “Short-term care is not on any- one’s radar,” says Patrick Simasko, elder law attorney with Simasko Law in Mount Clemens, Mich.
Only some insurers—Aetna, Medico and Standard Life, for example—offer short-term care policies, says Slome; his association’s website (aaltci.org/stc) can refer you to others. In addition, he says, “there are very few agents versed in these policies.” Because most people who look into short-term care have health problems, Slome recommends using an agent who understands this type of insurance and the underwriting for it.
Someone who can afford and qualify for more gen- erous long-term care coverage is probably better off getting that instead, but despite their limitations, short-term policies do serve a purpose, Slome says. “Most people have nothing for this type of coverage. A year is better than nothing.” K DAVID RODECK
Added : April 29th 2022 at 16:02:10
Hi, I'm Jack Cumming. The best source for what brings me here is found in the article posted recently in Generations Magazine. I'm an actuary by vocation and qualification and an historian by education (see History as a Preparation for a Career in Business).
I believe that we are stronger together than we can be as individuals and that our lives gain meeting in helping each other.
Added : February 8th 2022 at 10:42:51
To start to answer the question of how legislation might give financial assurance to CCRC residents, the CCRC Guaranty Model Law is one of the more complex of the CCRC Model Laws, though the purpose is simply expressed. It’s gone nowhere because LeadingAge suppressed it, even though I believe that it would be positive for an industry (the industry that LeadingAge represents) that struggles with financial machinations and trust issues.
Bank deposits and pensions are guaranteed by “pre-assessment” Federal programs. Life insurance and insured annuities are guaranteed by “post-assessment” laws in every state. The securities industry has Federal authorization but operates more like the state-level insurance precedents.
The problem with “pre-assessment” is that when the “trust” moneys run out, they become post-assessment. Moreover, once those funds build up, some politicians have proven to be tempted to divert the funds entrusted to the guaranty purpose to other well-intentioned causes. Also, the mitigating interventions are carried out by Federal officials which are not always what is needed and which can be affected by understaffing.
An example, is the bank turmoil with substandard mortgages during the 2008 financial crises. You’ll recall the bank failures and closures from that era. Insurance companies had the same financial exposures, since mortgages are a key part of most insurance company investment portfolios, yet there were few insurance company failures. The Model State Law approach, while it initially appears complex, proved more effective.
The reason is simple. Banks have no incentive to be each other’s “keeper” since the Federal government is behind them and, presumably, can just print more money if needed. Because of the post-assessment (i.e., the industry is assessed to make up the shortfall when a company fails) structure, the insurance industry has incentives to intervene early to minimize losses and to spare the industry the costly assessments otherwise needed when an insolvency is allowed to deepen before intervention. In the absence of early intervention, losses can mount rapidly and exponentially.
To support the early intervention, insurance companies are authorized to collaborate to minimize losses. That requires exemption from Anti-trust rules, and it’s also the source of the complexity, which incidentally makes sense once one grasps the overall concept and the alternatives.
Thus, I favor action at the state level. That can be started in a single, more enlightened state. Liberals can favor it because it protects vulnerable consumers. Conservatives can favor it because it enhances the credibility of the industry, because it looks to private interests to minimize loss, and because it shields the public treasury. It has failed for CCRCs because LeadingAge knee-jerk views all regulatory legislation as contrary to its provider member interests. That view is shortsighted, but as LeadingAge showed with the CLASS Act, an organization like LeadingAge does not always act wisely.
Note that the links are key to full understanding of this material. At one time, NaCCRA’s Board, for the most part, had that understanding and was advancing the Model Laws despite pushback from LeadingAge. Even then, though, there were some Board members who were resistant for fear that greater regulation might cause higher fees in the CCRCs where they lived or because they imagined that their provider executives were heeding their personal advice. That advocacy is no longer part of NaCCRA, though it could be. I also have the impression that NaCCRA now thinks in terms of the Federal Government and may not be fully aware of the uniform Model Laws approach as a more attainable alternative. It would be an uphill slog to get NaCCRA back to where it was and, at this point, that might be counterproductive.
So, to answer your question. The Guaranty Law is not now a bill, because of LeadingAge’s opposition. Congressional leaders view CCRC residents as having sufficient sophistication that they should be able to find common ground with providers. Since LeadingAge excludes qualified residents from its Board and policy councils, the voice for residents’ consumer interests is muted. That’s unlikely to change since Congress has many concerns, is more sympathetic to the indigent than it is to CCRC residents who have to prove wealth as a condition for move-in (in other words, the residents should have known better), and Congress defers to industry associations as repositories of expertise for serving their consumers.
WACCRA and New Mexico residents have shown that residents are more likely to find a sympathetic ear at the state level than at the Federal level, and any state can act a law and initiate a process to have that law become a Model Law which other states can (and most often do) adopt.
Added : January 29th 2022 at 15:14:03
A close relationship with nature – beach, ocean, lagoon, trails, uplands, calderas, and more – is central to the balanced work, play, life that we love. Can we make maintaining that serenity in balance a central theme? What do others think?
Added : January 18th 2022 at 10:18:35