Assisted-living facility tries to evict 99-year-old woman on Medicaid

The notice came in early May, two days after her 99th birthday: Cordelia Robertson was going to be evicted.

The assisted-living facility she loved, the place she called home for a decade and where she had exhausted her life savings, was kicking her out.

Robertson hadn't broken the rules at Franklin House. Instead, after paying her own way for years, she ran out of money and had to enroll in Medicaid, the government program that funds health services for low-income people. But the facility, in Sumner, didn't want more Medicaid patients.

"I truly believe my mother has not been given a fair shake," said Gene Robertson, one of Cordelia Robertson's four children.

Claiming Cordelia Robertson owed thousands of dollars, the Wisconsin-based company that owns Franklin House last month filed an eviction lawsuit, which the family's lawyer believes is the first of its kind in the state.

But the crisis for the Robertsons is one of scores of such predicaments across Washington, according to Louise Ryan, the state's long-term-care ombudsman.

It's a problem that is expected to grow as assisted-living facilities grapple with a financial reality: They earn less from Medicaid than they do from private-paying clients.

A lawyer for Franklin House, which is owned by Assisted Living Concepts (ALC), did not reply to two phone messages. ALC is a public company whose stock trades on the New York Stock Exchange.

Not able to move

Robertson is in no shape to move, according to her family. Over the years, mild dementia has turned more serious, to the point where she often doesn't recognize her own children.

But they are determined to fight, not only for their mother but for other elderly people facing the same situation.

"She would have done anything for us, and we're going to do anything for her," said Gene Robertson.

Ten years ago, Franklin House seemed like a great option, in part because it was just two miles from Gene Robertson's house.

Under his mother's current contract, room and board is $149 per day.

Over about nine years, Cordelia Robertson has paid Franklin House about $330,000, the family said. "She now has zero money," her son said.

For years, he has worried that his mother would outlast her money, so he repeatedly asked the manager about it.

Each time, according to Gene Robertson, the manager assured him that enrolling in Medicaid, if it came to that, would be a "seamless transfer." His mother would even get to stay in her own room.

With that assurance — and since Robertson was comfortable at the facility — her family kept renewing her contracts. Without that assurance, she likely would have moved.

In May 2007, Robertson received a letter from the facility stating that it had reached its maximum number of Medicaid beds, and that in the future, residents who convert to Medicaid might not be able to stay. Gene Robertson began to worry.

Around this time, Assisted Living Concepts, the sixth-largest assisted-living company in the country, was reducing its Medicaid beds, according to published reports.

Exact numbers are hard to come by but, in general, facilities earn less from Medicaid clients than from those who pay themselves.

According to Bill Moss, director of the state's Home and Community Services Division, assisted-living facilities get between $65 and $163 a day for each Medicaid patient, depending on the level of care.

Jeff Crollard, a lawyer for the family, figures it would be around $100 a day for Robertson.

The industry says it doesn't make money on these clients. Instead, each Medicaid client costs a facility $25 to $28 per day, according to Gary Weeks, executive director of the Washington Health Care Association.

Moss is skeptical that facilities lose money on Medicaid residents. He believes they just don't make as much as they would on private pay.

Whatever the figures, the disparity has become a real problem for residents.

In the past year or so, dozens of Medicaid clients around the state were told they would have to find new places to live, according to Ryan. Some of these patients were forced to move more than 100 miles away to find a facility that would accept Medicaid.

No more money

Amid all this, Cordelia Robertson ran out of money last September. She arranged to enroll in Medicaid, but the company said it wouldn't accept Medicaid patients.

Each month since then, the company has charged her her contracted rate, and says Robertson has racked up a sizable debt.

Earlier this year, Gene Robertson testified before the Legislature about the situation. A bill was later signed into law saying that if a facility wants to terminate its Medicaid contract with the state, it can't simply kick out its Medicaid clients.

The law, however, can't help Cordelia Robertson. ALC isn't terminating its contract; it's just reducing Medicaid beds.

By May, the company said she was nearly $20,000 in arrears. It filed an eviction notice and had scheduled a hearing for Tuesday.

But at the last minute, the company canceled the hearing. The battle isn't finished; the company still says Cordelia Robertson owes the money.

She can't be removed unless the company proves its case in court. Crollard, the family's lawyer, thinks she has a good chance of winning.

Crollard says other elderly people are vulnerable, too. "The underlying issue is not going to go away," he said.

Maureen O'Hagan: 206-464-2562 or mohagan@seattletimes.com