Find a
Nursing Home
Residential Care
/ Assisted Living
CCRCs Medi-Cal for
Long Term Care
Elder Abuse
/ Financial Abuse
Find an Elder Law Attorney

Ethical Questions for CCRC Administrators:
One Sided Information
Does Not Serve CCRC Residents’ Interests

By Lillian L. Hyatt, M.S.W., and a Resident of a CCRC

Excerpted from the Summer 2005 The CANHR Advocate newsletter

Should Continuing Care Residential Community (CCRC) administrators demand that CCRC residents give them letters of opposition against proposed legislation? Should these signed petitions demanded from residents be given to their CCRC administrators to be sent to a provider trade association, which in turn, will send legislators those petitions? Can CCRC residents make an informed decision about any legislation when the only information given to them comes from a CCRC provider trade association? Will residents be petitioning to undermine their own interests in favor of the interests of the CCRC providers?

One–sided information about legislation has been the consistent pattern of action practiced by the California Association of Homes and Services for the Aging, (CAHSA), the trade association representing the not–for–profit organizations that own and operate over 80% of California’s CCRC’s. In some CCRC’s, the residents’ California Continuing Care Residents Association (CALCRA) chapters are discouraged by CCRC administrators from being formed. No notices of CALCRA meetings are allowed to be distributed to residents via the in-house mailboxes. CALCRA gives accurate, unbiased information to residents regarding legislation, and fiscal and management policies that help residents understand such complicated issues. Administrators often use Residents’ Councils as platforms; and Council presidents, who are supposed to represent the residents, become pawns to promote the care provider’s agenda. In one CCRC, an attempt was made to form a CALCRA chapter in 2002. The Resident Council president announced: “We don’t need CALCRA here!” That announcement appeared in the residents’ bi-weekly newspaper. The pressure put on residents succeeded; the CALCRA chapter was never formed.

CAHSA’s misrepresentation of the facts and control of the process ensures that residents do as they are told. The Residents’ Council President, usually a respected and trusted fellow resident whom the administration has co-opted, will follow CAHSA’s and the CCRC administration’s guidance on most issues. The common ploy used by CAHSA is to state, “If this legislation, rule or regulation is passed, it will take money out of your pockets;” or “It will change the way you live in your Independent Living Unit, and turn your home into a nursing home.” For example, residents in a Northern California CCRC recently confronted their Executive Director about unethical behavior at a Residents’ Council meeting. Every resident in that facility had received a communication from CAHSA’s President and CEO asking them to deliver their letters and petitions in opposition to SB 244 (click here for details on this bill.) to their CCRC administrators who then would give them directly to CAHSA to be passed out to elected officials.

The actions of the CCRC Executive Director constituted a conflict of interest in the view of a majority of CCRC residents in that facility. By this routing, a CCRC administrator would know which residents had “followed orders” and which residents had not. In that CCRC, there is an active CALCRA membership with access to truthful and complete information about the bill. At other CCRC’s, where CALCRA is suppressed, this kind of information is not permitted to be distributed.

This manipulated process deprives the “captive, vulnerable” CCRC residents of their right to contact their legislative representatives privately. They have unwittingly given up that right by acquiescing to the request from CAHSA to give communications that ought to be private to the CCRC Administrator for inspection. CCRC administrators must understand that ethical questions are raised by this abusive use of their power.