CLEARFIELD – At Tuesday’s board meeting, the Clearfield County Commissioners learned from representatives of the DuBois Continuum of Care Community Inc. (DCCCI) that the operation of its independent living apartments, Village View, is in jeopardy with the state claiming it’s an illegal assisted living facility.
Administrator Gary A. Peters said in 2001, the DCCCI started the process for the opening of a Continuing Care Retirement Community (CCRC). The DCCCI handled the matter with advisement from the state’s Insurance Department, the licensing body for CCRCs.
“We basically wanted to provide an opportunity for low-income people to live in that sort of environment,” he said.
DuBois City Councilwoman Diane Bernardo said that year the DuBois Nursing Home received funding from and worked cooperatively with the state’s Department of Public Welfare (DPW) as part of the “Program for Alternative Community Care.” The program, she said, was sponsored through the County Commissioners Association of Pennsylvania (CCAP).
According to her, the goal of the program was to reduce the number of licensed nursing home beds, convert those beds to independent living and provide alternative care services. She said as part of the program, participating nursing homes were encouraged to work with the Area Agency on Aging to offer Medicaid waiver services to Independent Living tenants.
Bernardo said the DuBois Nursing Home converted approximately 30 nursing home beds into 14 independent living beds in 12 apartments. She said this helped to increase the number of Medicaid Nursing Home Diversion slots by 41 in Clearfield County.
Known as Village View, Manager Deb Harris said it was first located in a wing of the DuBois Nursing Home. In January, she said Village View relocated to provide tenants with more space and modern accommodations. Due to its desire to complete these upgrades, Harris said the DCCCI closed one unit of its personal care home and renovated the third floor space of the DuBois Village.
Beforehand she said they had discussed its proposed relocation with representatives from the DPW’s Bureau of Adult Residential Licensing, which licenses personal care homes and assisted living facilities. She said the DCCCI received the DPW’s approval prior to its final decision to relocate the independent living unit, and the DPW adjusted its Personal Care license to reflect the reduced bed capacity.
“Now, the DPW, the licensing body for personal care and assisted living as defined in Pennsylvania, has decided Village View is operating illegally as an assisted living facility,” said Peters, “because residents of the area are receiving what they’re calling other supplemental health services.
“Village View is the central point to our CCRC license. Under the DPW definition of assisted living, it would apply to every senior housing entity in the state. It’s our belief that the DPW wants to promote its own version of assisted living, which is to deliver skilled nursing services.”
According to him, the DPW wants facilities to be equipped with the necessary staff and equipment to install in individual apartments. He said there aren’t many facilities, such as this, in the state and none in western Pennsylvania, as it’s not an economically viable option.
Peters said the DCCCI has received a citation from the DPW, which has held off on imposing a $500 fine and an additional fine of $200 for each day it continues to operate illegally. He said the DCCCI was advised to proceed with applying for an assisted living license or to cease its operations.
He said DPW thinks its version of assisted living would save the state money. He said this wouldn’t be the case, explaining that Village View’s five tenants who receive the Medicaid Waiver Services would be placed in nursing homes, which would cost the state an additional $191,000 each year.
“Residents of nursing homes are unable to care for themselves and need a lot of assistance,” said Peters. “So why should people who can be forced into nursing homes and cost the state so much more money?
“We set this up with guidance from the DPW and advisement from the Insurance Department. We’re operating completely legally.”
According to Harris, although Village View is located at the DuBois Village, it has a separate entrance and staff. She said the DCCCI doesn’t inter-mingle its staff, and it’s licensed through the state’s Health Department to provide home care services to tenants and to the community.
She said tenants can purchase other services, such as for help cleaning their apartments or grooming themselves. And, they get two meals each day, which is included in their rent. She said, “No one gets 24-hour care. We’re not even there 24 hours; we’re there eight hours. It isn’t any different than if we go down the street and do it.”
Harris explained that while located at the DuBois Nursing Home, the DOH conducted routine inspections of the nursing home. After relocating to the DuBois Village, she said the DPW came in for its routine inspection this spring and started “sniffing around” the area that houses the 23 Village View apartments.
According to her, if the DCCCI had to operate Village View as an assisted living facility, its current tenants wouldn’t be able to stay there. She said they wouldn’t be able to afford the expenses, as it would be a monthly difference of thousands of dollars. Peters said if categorized as assisted living, it wouldn’t any longer be a CCRC without starting something new of an independent nature.
Bernado said she’s advocating for Village View, as her mother lived her final days there. She said her mother stayed in a nursing facility to gain strength and then went to Village View. There, she said church services were an elevator ride away and other tenants offered companionship.
She said her mother had a supportive cast around her, which stimulated her due to the “priceless experiences.” She often called her mother and got no answer, as she was off visiting with her fellow tenants, exercising with them or attending a magic show. She noted the Village View not only served DuBois, but also Clearfield, Grampian, Mahaffey, Punxsutawney and other nearby communities.
“What price is going to be put on the mental health of our elderly?” asked Bernardo. “They are not like peanut butter. You cannot just put them on the shelf.
“[The DPW] wants to put them in a room with two beds, a bathroom, a TV set and a roommate . . . I saw my mother get physically better, but emotionally it was a different story. When she moved into her apartment, I saw a change in my mother.”
Bernardo was appalled by certain representatives at the DPW, saying they have their rules and regulations and might have visited grandma, but they obviously haven’t lived it. She said they must stop the DPW’s nonsense and asked who would be advocating for them when they’re elderly.
Peters said the DCCCI has filed an appeal with the DPW but hasn’t received its response yet. Harris said they asked the DPW to expedite the process for its tenants’ sake and due to it having six apartments available that it’s holding off on renting out.
“In 2001, they decided this concept, this idea was the way to go,” said Commissioner Mark B. McCracken. “I’m not sure what’s changed since then, but we need to get to the bottom of that.
“Beyond the human costs, it’s not recognizing the fiscal side here. It’s going to cost more to do what they want, and the human cost is even greater.”
The commissioners agreed to submit an inquiry to the DPW, as well as to seek assistance from the CCAP. The commissioners also plan to address the matter in an upcoming meeting with state officials.
