Karen Crumrine's 93-year-old mother, Mary, lived in the same house in rural Clearfield County for more than 50 years before she took a bad fall a year ago and broke her hip.
She spent a few months in a nursing home, then moved to an assisted living facility at the DuBois Continuum of Care Community. In February, she moved into one of 23 independent-living apartments at the care community called Village View.
She uses a walker to get around now, but is otherwise self-sufficient, Mrs. Crumrine said, making her own breakfast, showering without help and taking short walks without assistance. The apartment has its own entrance, and it's a short walk to the dining hall for lunch and dinner.
"She's very comfortable there and she likes it very much," Mrs. Crumrine said.
But she now fears her mother and the other Village View residents will have to move if a dispute between the facility and the state Department of Public Welfare can't be resolved. Following an inspection this spring, state officials said Village View was operating as an unlicensed assisted living facility because it was providing services such as meal preparation and laundry for some of the residents. In a letter sent last month, the Department of Public Welfare said it was imposing a $500 fine and threatened a $200-per-day additional fine if officials didn't either apply for licensure or close the facility within 14 days.
"It's absolutely a head scratcher," said Paula Sanders, a Harrisburg-based attorney with the law firm Post & Schell that represents the DuBois facility. "We can't figure out what it is that DPW believes our client has done wrong."
She has filed an appeal with the department, which put the fines on hold until the two sides reach a resolution. Because the issue is under appeal, state public welfare officials on Wednesday declined to comment on the DuBois situation -- but they are getting sympathy from an unlikely source.
"Basically, what you have is a conflict between what the statute says and reality," said Ron Barth, CEO of Mechanicsburg-based LeadingAge PA, which advocates for seniors. "We are putting regulations on top of regulations and laws on top of laws. Health care is advancing very, very quickly and the laws can't keep up."
The specific law he is referring to states that when four or more adults live under the same roof and require assistance for daily living or health care needs, and they are not related to the home operator, the facility must be licensed as an assisted living residence with the requisite staffing and other requirements.
The purpose is to ensure that vulnerable seniors are protected by requiring that home operators meet certain minimum standards. "That is a laudable goal, but now we have extensive home health services. Services are being provided more and more in less restrictive settings," Mr. Barth said.
Technically, he added, the regulations could apply to senior high-rise apartment buildings, where many residents have their needs met with home health services. Currently, Pennsylvania has 1,350 personal care homes, 280 continuing care retirement communities such as DuBois and 27 assisted living residences.
Village View was designed to provide homes for seniors who might need a low level of help while letting them remain largely independent. "It's good for all of those people," Mrs. Crumrine said. "It's good for their independence and self-esteem."
Debra Harris, manager for Village View, said if the state forces the issue, the facility will close the unit rather than apply for the assisted living license -- and she suspects other facilities across the state would make the same decision. Ultimately, she said residents will suffer if they have to move. Village View rates range from $900 to $1,100 per month, and through state waivers it has been able to offer slots to low-income seniors at a discount.
Industry averages for assisted living or personal care, meanwhile, exceed $3,000 per month and nursing homes can be more than $8,000 a month. "I have 19 people here and they are very anxious," she said. "They truly would not have anywhere to go."
Steve Twedt: firstname.lastname@example.org or 412-263-1963.