With billions of dollars being funneled into senior care communities, it is no surprise that scammers have weaseled their way into the industry. And though the government is cracking down on these crimes, they aren’t able to stop them.
And it isn’t just billions of dollars being invested in this industry, but billions of dollars are stolen in assisted living scams each year. One such situation happened in Miami, Florida, where the owner of multiple senior living communities was brought up on charges by the DOJ for scamming over a billion dollars through the facilities he owned.
Assisted living scams come in various forms, some from an executive-level, whereas others are far more personal.
One of the reasons residents of assisted living homes are targeted is because assisted living facilities are not as heavily regulated as a nursing home. The rules and regulations only govern assisted living centers at a state level and not on a federal level.
So when considering a care facility for yourself or a loved one, it is vital you not only find one that will meet all appropriate medical needs but one that is also trustworthy. The good news is that there are several ways to protect yourself or a loved one from falling victim to an assisted living scam.
One of the best ways to guard yourself against scams is to educate yourself on what these scams look like, how they work, and how to avoid them.
Assisted Living Scams
- Unnecessary Medical Services
- Tax Credits
- Bait and Switch
- Contracts
- Understanding the Level of Care
- Medications
Unnecessary Medical Services
Scenario: Assisted living facilities are set up to provide certain medical care level services, so it is not unusual for seniors to be billed for additional services or medical equipment.
Scam: Many seniors residing in assisted living communities no longer take care of their finances independently. The caretakers who manage their bills don’t always know the exact day-to-day care one receives in an assisted living facility. When statements start showing up for additional medical services or equipment, most assume the charges are valid.
How to Avoid It: Be sure that whoever manages the assisted living invoices is reading through the invoice each month and follows up on any unfamiliar or new charges. Also, if you are handling a loved one’s finances, it is critical you check that the medical services on the invoices are being provided before paying the bills.
Additionally, be sure that the medical services provided are necessary and not frivolous to pad the bill. For example, not all residents require their blood pressure checked daily or need aid in their personal care. These services are the things that facilities charge above and beyond the regular monthly rate.
Tax Credits
Scenario: A senior receives a government check for a tax credit, such as the 2020 stimulus payment. And upon receiving the check, the assisted living facility staff insists the check be signed over to them.
Scam: The facility claims that if the resident is on Medicaid, the tax credit is considered a resource and the assisted living center’s true property.
However, anything that the government labels as a “tax credit” is not considered a legal resource, and the facility cannot claim it on behalf of the government. And though these centers may state they are working with the other groups in taking these funds, in truth, these assisted living homes were keeping the money.
How to Avoid It: Before signing over any check to the facility or staff member, talk to a trusted family member or financial attorney. Remember, any payment made by the government under the title of “tax credit” is not considered a confiscatable fund.
Bait and Switch
Scenario: You or a family member goes to an assisted living home to see if it is the type of facility for them or a loved one. When they arrive, they are shown a room and talk to one or two residents, and things look pretty good.
Scam: Once the resident moves in, it is clear that the level of cleanliness, care, and attention is not the same as they saw during their visit.
Sometimes an assisted living facility may even claim that their staff has undergone specific training and certification courses or that they employ higher-level caregivers only to find out that they are understaffed and underskilled.
How to Avoid It: When checking out the facility, ask a loved one to come along to help observe and take note of anything that may not be agreeable or is out of line with what you have been told about their services.
Ask to see if you can get a full tour and not just the one or two rooms they have shown you.
Finally, if it is a facility you are still interested in, drop in unannounced for a follow-up visit, and see if there are any differences from when you first toured the home.
Contracts
Scenario: When you find an assisted living community that you like, you are required to sign a contract. The contract at an assisted living center is far more extensive than a regular apartment rental lease.
In addition to the normal rental agreement topics, the contract will include things such as care level, health and wellness services, and liability.
Scam: Many things can be woven into a contract or left out, and many assisted living centers’ contracts are full of legal jargon to ensure they are best protected or, in some cases, to best scam others.
Some of the more common scams involving contracts include:
- Rights to the residence if the tenant is hospitalized for a set period. For example, the resident goes to the hospital for 14 days, and the care facility rents their room to a new person. Now the resident that went to the hospital has nowhere to live and is financially responsible for their contract.
- Some contracts will include the facility’s lack of responsibility for the resident if they come to harm or even death when in their care. And some contracts go so far as stating that you waive your right to pursue them legally.
- Contracts may also include hidden fees not brought up in the original conversation regarding the cost of living in their facility.
How to Avoid It: Before signing any contract, ask a legal professional to look it over to ensure the contract properly covers the resident. Also, if the facility is attempting to pressure you into signing, then and there, it might be best to move on and look for a different home.
Understanding the Level of Care
Scenario: Most assisted living facilities offer a variety of care levels to ensure they meet the residents’ needs. With each higher care level, the price increases.
Scam: You sign up for a specific level of care, but then you get sick and require additional services. However, when you are well again, the care level charges do not drop back down, and instead, you are charged continually at the higher level.
How to Avoid It: If you or your loved one falls ill and added medical services are required, be sure to follow up with billing immediately, after you are well, to ensure they drop the care plan back down to where it should be.
Most assisted living homes will not pay back or adjust charges for previous months. Left unnoticed these charges could be a thousand or more per month.
Medications
Scenario: A resident of an assisted living home requires medications. In most assisted living communities, the facility manages the medications for their residents. The cost of these medications and their administration are charged to the resident.
Scam: Instead of getting the full dose of medication, the resident may only receive a partial dosage or none at all. The unused portion of the pills is used or sold by the staff responsible for caring for the resident. Some medications go for a lot of money on the black market.
How to Avoid It: If you are unsure if you are receiving the proper amount of medication, start tracking the doses and times you are given your prescriptions, then consult your physician to determine if things are adding up.
Even if you don’t suspect fraud, it is still a good practice to keep your own notes on what and how often you are taking medicine, so when consulted at a doctor’s appointment, you will be able to share this information.
If you suspect or know the medication is not being given, it is vital to immediately contact the facility’s head administrator.
The facility made promises to provide appetizing meals, units cleaned weekly, weekly laundry and fails to deliver. Administration is nonresponsive to inquiries and requests. My mother is paying for these things and is not getting it. I expect them to provide them for her. The facility feels dark and depressing and unclean. There is not enough staff to care for all the residents needs. What can I do as family member to see that we are getting what we pay for. I have tried to talking with the director to no avail. They have no problem increasing monthly rates. Some rooms are damaged and dirty. On inspection they close the doors to those units….Sigh!