A Personal Experience
My grandma Carol had a stroke in the summer of 2022. At 89, Carol had been living in her own home in Bothell when I got the call that she was in the hospital. Sadly, her stroke impacted her so much that we quickly realized as a family that she was not going to be able to go back to her beloved home as she hoped. As a placement agent myself, I thought surely I would be able to help my dad and aunts and uncles find a great place for her. It became clear that an agent from Silver Age other than myself would be best to help when family members started to have differing ideas about what they each thought would be best for Carol. I still played an active role in helping my family, but ultimately, we enlisted the help of Susan Watters from Silver Age to help educate and empower my family and help get everyone on the same page for the big decision.
Finding the Right Home
After touring a couple of adult family homes that met Carol’s care and financial goals, her POAs decided on a home that checked all of the important boxes, including rarely allowed extra flexible evening visiting hours. It was a home located in the Eastgate area of Bellevue that Silver Age knew well. The providers had been in business for the past 18 years and served other Silver Age families. There was a ton of peace of mind knowing that Silver Age had first had experience with the home. It was run by a loving couple and their skilled and caring caregivers had been with them for a long time. It also allowed for a conversion to Medicaid pay after a two-year private pay period. This meant Grandma’s care was secured for the future. Phew, we all felt great about it. Grandma ended up discharging straight from the hospital to her new home. She adapted quickly to her new home and caring environment, she bonded with the sweet caregivers, and her daughter was able to come and visit with her every evening and tuck her into bed.
An Unexpected Twist
Just a few short months later, we got the call that the providers of the home were going to be retiring from the business and selling the home. Ugh, our hearts sank, and our minds raced with all kinds of questions. Who would the new providers be? Would we like them? Would they honor the 2-year spend-down agreement? Would they share the same values as Grandma and be able to create the same warm environment she had settled into.
An Adult Family Home change of ownership is called a CHOW for short. Homes are required to give two potential notices. The first, according to WAC 388-76-10106, is a 60-day notice about ownership changes. The second, per WAC 388-76-10535, is a 90-day notice if there’s a shift in policies.
The home also must ensure a “safe and orderly” discharge to an appropriate setting so the resident can not just be discharged to the street. If the new owner is ending a Medicaid contract, that doesn’t mean the residents can be discharged until a new spot is secured and agreed to. Thank goodness, in my grandma’s case, the new owners agreed to honor the Medicaid agreement that was in place and allow her to continue her spend-down. They were nice enough people, but within a period of a few weeks, the home had a different feel to it. The heart of the home was missing. My aunt, who was stopping by each evening, didn’t take to the new owners, and ultimately, after a lot of back and forth between family members, significant stress, and words that shouldn’t ever have been spoken, it was agreed to move Carol into my aunt’s house and hire private duty caregivers.
Lessons Learned
Why am I sharing this story? As a placement agent myself, with all my wisdom and years of experience, I think, “Oh my goodness, my family should have been able to avoid this!” I even recall asking the provider couple before Grandma moved in if they had plans to retire anytime soon. I knew they had been in business for a long time and could have been burned out, especially after the pandemic. They said they didn’t. When pressed later as to why they said they didn’t, but they did, they said, “well we aren’t retiring; we’re going to be opening a coffee shop.” I was mad about this at first. The truth is, there are no guarantees with care providers. The senior care industry is so human and dynamic. Even with larger facilities such as assisted living communities, the unexpected can and does happen.
At Silver Age, we often have the “no guarantees” talk with our clients. I am grateful this happened to my family and not yours. I am sharing this so that you can add more specific questions to providers about their plans to change ownership, sell, retire, or quit. It is a good idea to find out if they are renting or own the place and have a good sit down to get to know them personally. I want you to be empowered and avoid surprises if at all possible.