The Wealth Effect in Assisted Living

I hesitate to write this newsletter. I know we’re in a political season and it may come across as political.

By no means do I want it to be that way.

This email is not meant to say this is a universal rule. Just something I notice in my assisted living homes. It made me think about how to treat people and how the Universe rewards you.

Here goes.

I own two assisted living homes where everyone pays privately. Either they have a long-term care insurance policy that pays out after years of paying premiums. Or they pay from their own savings and investments.

My other two homes have a combination of people who pay privately and people whose payments are subsidized by Medicaid.

The Medicaid homes are a little smaller than the private pay homes. Medicaid for the most part pays me less than the market rate for the private pay residents. Nevertheless I really strive to provide similar services regardless of how much someone pays.

Many of the extra therapies I do, such as the Bredesen Protocol, are reserved for the private pay residents. I spend a lot of money for those therapies and just cannot afford to do them at Medicaid rates.

We still try to give everyone a nutritious, low-carb diet. Our personal trainer works out with everyone. Healthy lifestyles are very important to me.

Most of the residents and their families really love our program. The vast majority of both private pay and Medicaid residents are wonderful people. We work as a team with the residents and their families to improve the resident’s health.

Every so often, I have a resident, or their family, or both, who are not happy with our services. Over the years I’ve had a few of them.

Practically 100% of them are Medicaid residents. One was private pay. And that private pay resident still was able to work things out in a civil way.

The Medicaid residents pay for assisted living based on their income. Some of them only pay $200. The Government pays the rest. For $200 per month they receive 24/7 care, room and board, a personal trainer, all meals and activities.

Seems like a pretty good deal?

Not to some of them. Some become angry that they do not receive more. This may sound like it’s just my side of the story. However, these disgruntled residents will call Adult Protective Services, the Department of Health, or the Medicaid Administration for Arizona to complain.

The government agencies will do an investigation. We have not had a single investigation result in any actions against our business.

Many of the disgruntled Medicaid residents tell us they are going to sue us. None of them have ever followed through.

I was proud of one of my managers when a resident’s family told him they would sue. They said they would call the police. My manager told them that would be fine. Then asked the family if it would be ok for him to discuss the marijuana he caught them trying to smuggle in to the resident? This was before marijuana became legal in Arizona.

The threats suddenly stopped.

The attitudes of these disgruntled residents make me think of the phrase “Pigs get fat. Hogs get slaughtered’.  It’s ok to work to make money. Or to expect good service for your money. But if you demand too much without reciprocating, such as paying a fair amount, your wealth and happiness will not increase. In many cases it will probably go in the opposite direction.

Over time the universe will not look favorably on you.