Small Is Beautiful . . . Board and Care Seeks Recognition; Representation
Published on Sun, 03/27/2016 - 8:54pm
By Pam McDonald
[This is the first of a two-part series describing a new association in California for small Board and Care owner-operators.]
In the early 1990s when California first required educational certification for assisted living administrators, groups seeking to train and represent them popped up and disappeared regularly. After about a decade, this activity stabilized and essentially stopped. But this year, a new California senior living association has been launched.
California Board and Care Association
Called the California Board and Care Association (CBCA), its aim is to improve and support the redheaded stepchildren of senior living – small, typically 6-bed, personal care homes. Officially designated in California as Residential Care Facilities for the Elderly (RCFEs), they are also called adult family homes, board and care, residential care, and personal care homes.
And while many people think “board and care” and “assisted living” are two separate levels of care, in actuality, they are more brother and sister than unrelated families. “We have a lot of work to do to raise awareness about board and care,” says Mylene Lee, President of CBCA. “The general public and, even many senior care professionals, don’t know much about who we are, what we do, or how we do it.
Assisted Living vs. Board and Care Homes
As in many other states, California’s assisted living (AL) communities and board and care (BC) homes are licensed and governed by the same state laws and regulations. They both serve seniors age 60+ and are non-medical facilities so they are not required to have nurses, certified nursing assistants or doctors on staff.
Communities referred to as "Assisted Living" usually have 50+ residents who live in private apartments with private bathrooms. Board and Care is typically a 3+-bedroom home with space for group activities and dining. Residents may have their own room, but often share a room and a bathroom.
AL and BC both serve seniors who prefer not to live alone or whose families prefer it. Both types provide the same basic services – rooms; meals; housekeeping; leisure activities; supervision, storage and distribution of medication; and assistance with activities of daily living, like dressing, bathing, hygiene, eating, and mobility.
In 2012, according to the National Center for Health Statistics, assisted living, which includes board and care, was the Number #1 source of long-term care services in the United States with 22,200 paid providers. Overall nearly 59,000 paid care providers served about 8 million residents. In addition to the 22,200 ALs, there are 15,700 nursing homes, 12,200 home care agencies, 4,800 adult day care centers, and 3,700 hospices.
The California HealthCare Foundation found that in 2013 there were 7,455 licensed RCFEs in the State with 145,225 beds. The percentage of these communities by size is:
1-6 beds 80%
7-14 beds 4%
15-49 beds 6%
50-99 beds 5%
While board and care has the most facilities, assisted living has the capacity to serve twice as many residents. The breakdown for capacity shows:
48% have 100+ beds
24% have 1-6 beds
18% have 50-99 beds
8% have 15-49 beds
2% have 7-14 beds
The monthly rates charged by AL and BC can also differ significantly. The California HealthCare Foundation noted that rates range from $933 per resident per month to $8,445 (with the median at $3,710). Unfortunately their report does not indicate if these rates are for rent and basic services only or whether they also include care. Nor does it provide averages for each type of care.
Small Is Beautiful . . . Board and Care Seeks Recognition; Representation – Part 2
Published on Sun, 04/03/2016 - 10:03pm
By Pam McDonald
[This is the second of a two-part series describing a new association in California for small Board and Care owner-operators. See Part 1 here.]
The significant differences between large assisted living communities and 6-bed board and care homes are the number of residents served and the revenues and resources available. This means there are distinctly different operational practices for each.
California Board and Care Association President, Mylene Lee, says, “Understanding these operational differences – and, therefore, the most helpful kind of support – is what will enable CBCA to best serve its members.
“As an owner-operator of multiple board and care homes for over 12 years, I’ve belonged to several industry associations, but I felt alone and not well-supported. The leadership of those groups did not necessarily own small communities. They wanted quite a bit of money for services I didn’t particularly want. But, all of CBCA’s board are owners, which give us the perspective to really assist and champion our members.”
CBCA Initial Focus
Currently CBCA has 36 members who own 76 board and care homes. They also have 14 associate partners, vendors including home care, hospice, pharmacy, landscapers, etc. Initially, the Association will concentrate on:
A united focus on improving board and care throughout California;
A coordinated approach to resources and reduced costs through economies of scale; and
Providing support, training, technology and professional development.
Mylene says making sure Association members understand and comply with regulations is a priority. “We want to get as close as possible with our regulators. That’s why our guest speaker at this month’s meeting was the Licensing Program Manager of the Sacramento Regional Office.
“We want greater familiarity with our evaluators so our members won’t be afraid they’ll ‘get in trouble’ just by talking with Licensing. We will keep them up to date on regulations, answer any questions they may have, and even contact Licensing on their behalf,” Mylene states.
CBCA Membership Benefits
Among other benefits of CBCA membership, Mylene lists:
monthly meetings with knowledgeable speakers
breakfast networking meetings
a talent bank of caregiving staff
discounts or special programs from referral agencies
prospect bank and commission-free referrals
information and referrals to affiliated vendors
professional development and training from experts to streamline practices and maximize profits
temporary management so owner/operators can go on vacation
updates and explanations of changes and additions to licensing regulations
tools for compliance
in-service training of staff
Life Enrichment Activites Program
Also in development is a “life enrichment” activities program – that will include an activities director and, when membership reaches 300, a dedicated bus – to make outings to restaurants, movies and shopping, as well as excursions, more economically feasible.
Mylene believes that at least among the Association’s members, board and care homes serve the highest acuity residents. She says, “We offer seniors lower rates, but can provide better care. A 1 to 3 staffing ratio is common. Also we don’t have to describe our environments as homelike – which is what most seniors want – because our communities actually are homes.
“It’s time,” Mylene concludes, “for owner/operators of board and care homes to be heard, to be recognized, and to be valued. CBCA really understands what board and care operators need and desire so they are able to be the better, smarter, more innovative business owners, licensees, and administrators of this generation.”