ORANJ

ADDENDUM TO REPORT ON SUBSIDIZATION
(Survey Questions with Summary of Responses Received from 15 CCRCs) December. 2009

Introduction

When answering survey questions assume that (1) when residents initially applied for admission they were able to demonstrate that they had adequate financial resources to cover admission costs, monthly charges, and personal obligations for their lifetime in the community and that (2) after admission they made a good faith effort to preserve their financial resources until it became apparent that they might outlive them, and they had then applied for subsidization from their CCRC.

1. Is it your CCRC’s policy to retain residents who may outlive their resources?
Response: All CCRCs report having a program in place to provide financial assistance to residents who are outliving their resources.

1A. Is that policy documented and, if so, where?
Response: In the Residence and Care Agreement (RCA), in the Disclosure Statement, and/or in the Residents Handbook.

2. How are your CCRC’s subsidization policies and procedures communicated to residents?
Response: In the RCA, the Disclosure Statement, the Residents Handbook, and/or during meetings with residents.

3. What specific steps does your CCRC require be taken prior to providing subsidization, such as investigating the availability of financial support from Medicaid or other outside sources?
Response: Generally, a resident is required to (1) demonstrate financial need, (2) spend down most of available financial assets, including any capital refund due, (3) seek financial assistance from other potential resources, (4) possibly move to a smaller apartment, and go on Medicaid, as applicable.

3A. To what extent does your CCRC assist residents in this regard?
Response: By overseeing subsidization processes, assisting residents with applying for and obtaining outside assistance, and reviewing information provided by the resident.

4. What funds are used by your CCRC for subsidization, such as restricted funds set aside for that purpose?
Response: 11 CCRCs have established restricted funds; the other 4 draw from general funds, from interest from Board restricted funds, or from outside charitable fund sources.

4A. Has your CCRC designated a staff member to publicize, solicit for, and track these funds?
Response: 5 CCRCs reported “Yes,” 2 CCRCs responded “No,” 5 CCRCs responded that Parent Company is responsible for benevolence funds, and 3 CCRCs responded either “Not Applicable” or made no response.

4B. Who controls these funds, disbursements from them, and how are they invested?
Response: For 13 CCRCs the Management/Governing Board or the Parent Company controls disbursement and investment of the funds. For 4 of these CCRCs, joint committees, including residents, exercise some control over disbursement of funds. 2 CCRCs responded either “Not Applicable” or made no response.

4C. What primary financial sources are used to establish and maintain these funds?
Response: A variety of responses from 10 CCRCs, including solicited and unsolicited donations, gifts, bequests, charitable gift annuities, proceeds from stores and gift shops, and periodic fund-raisers. 5 CCRCs responded with “Not Applicable,” responded that general funds are used for subsidization, or made no response.

4D. To what extent are residents involved with your CCRC’s subsidization program?
Response: Generally, only to assist with fund-raisers and to make donations. Only 4 CCRCs reported having residents on joint committees which exercise some influence over benevolence fund disbursements.

4E. What steps has your CCRC taken (such as actuarial analysis) to ensure that sufficient subsidization funds will be available to cover projected needs?
Response: 4 CCRCs reported using some form of actuarial analysis, 4 CCRCs reported that this is a parent company responsibility, 1 CCRC would use general funds to provide subsidization if their benevolence fund was depleted, and 6 CCRCs reported no specific plans other than to monitor/solicit funds as necessary or made no response.

4F. Is it your CCRC’s policy to seek recovery of subsidy funds from a resident’s estate?
Response: 9 CCRCs responded “Yes,” 3 CCRCs responded “No,” and 3 CCRCs made no response.

5. What percentage of your total resident population is currently receiving some amount of subsidization?
Response: 5 CCRCs reported “None,” 4 CCRCs indicated “A few” or “Under 0.5%,” 1 CCRC reported “5.5,% and 5 CCRCs made no response or declined to respond, considering the information confidential.

6. Does your CCRC require updated financial disclosure information from residents following admission, and, if so, how often?
Response: 5 CCRCs responded “No,” 2 CCRCs responded “Yes,” 4 responded “Yes, on a case by case basis, as for residents on subsidy,” and 4 CCRCs made no response.

7. What additional comments or questions do you have regarding subsidization?
Response: 8 CCRCs made additional comments, generally expanding on their prior answers, as by underscoring that residents have not been required to leave for financial problems not their own fault, or indicating that they were developing subsidization policies and procedures, or noting that they had once considered using association funds for subsidization.