Find a
Nursing Home
Residential Care
/ Assisted Living
CCRCs Medi-Cal for
Long Term Care
Elder Abuse
/ Financial Abuse
Find Elder Abuse Attorneys in CA

Outsourcing: Does It Waste or Save Money?
Does It Dilute CCRC Management Responsibility?

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


Excerpted from the Fall 2009 The CANHR Advocate newsletter

There is a general belief that CCRCs are devoted to caring for elderly people who need assistance, support and long-term care. There also is a general notion that CCRCs are primarily interested in providing the best care for the least cost. In fact, the Internal Revenue Service mandates that the services be provided “at the lowest feasible cost.” These days, there is a widespread belief that outsourcing services is cost effective. Actually there has been little study of what outsourcing really costs in the long run. In fact, outsourcing has a cost for the consumers who find themselves in a situation without feelings of confidence.

In a CCRC, the morale of these outsourced employees is undercut by the fact that they have full responsibilities and low pay. In addition, they generally have few benefits and little long-term security. Their employer, caught up in a desperately competitive field, squeezes the employees as a universal practice. As a result, few employees remain permanently on a CCR staff. A difference of a few dollars is sufficient to lure an employee to another employer. It is not generally realized, but security personnel have complex responsibilities. Employees are placed in a job with great responsibilities for the care of CCRC residents, but with generally little training to meet the demands of the job. In many cases, by the time the security employee is properly trained, he or she moves on to a better paying company. These movements are built into a perpetual competitive atmosphere where all players are desperately trying to get ahead - employers as well as employees. Workers are hired for as low a wage as possible and the employer charges the client as much as possible. In many cases, the differential between what the client is charged per hour and what the employee is paid can be as much as twenty dollars an hour! There is little reason for people working under such conditions to have any loyalty to the CCRC since it is not the security guard’s real employer.

In the past six months, my facility has had an almost 100 percent turnover of personnel in our security component. However, only two permanent employees have remained on staff. Two outsourced security guards have remained on staff, one a part-time employee who had a full time job at another security firm, and another who has remained as an outsourced employee for seven years. I have observed the bewilderment of the new recruits as they attempted to understand the complexities of our building’s structure and its elderly inhabitants. There is no relationship between a building that houses a CCRC and an office building with which most of these recruits have had experience.

One week recently, there were two complete elevator breakdowns at the dinner hour. Quite a serious situation in a 25-story building with only one trained security guard and a trainee on duty on Sundays. The experienced guard had to run one elevator manually after the elevator mechanics arrived to attempt to repair the others. The trainee guard manned the camera monitoring the system for the entire building. If during this crisis a resident had a heart attack on the top floor. what capability would staff have to respond? The following Tuesday the exact same scenario was repeated again at the dinner hour! Food staff had to deliver trays by climbing stairs in both the 25-story tower and 7-story atrium building.

Security guards are called upon to relieve receptionists regularly during their breaks. Reception is the nerve center in case of an emergency. It is also where taxis are summoned and where residents’ questions are answered. The person in charge of the reception staff does not train the guards for this task. The person in charge of the security department does. Guards are also recruited from a population with limited ability to communicate in English. Stereotypes about older people are common among security guards who are given little or no orientation about the elderly before being assigned to a life care facility. The stereotypes developed are passed down as guard succeeds guard. As a whole, seniors are viewed as incompetents, whether they are or not. Most elderly people the guards are likely to come into contact with are experiencing some impairment making the guards feel uncomfortable. As a result, the guards tend to lump all elderly people as functioning at that level. Not a formula for a healthy outcome for residents.

The most disturbing element of the entire security guard employment system is that security guards do not go through the CCRC Human Resources Department, as do other CCRC employees. The outsourced company decides who is qualified to work with seniors in a CCRC. The result of all these factors constitutes an acute security risk at a CCRC.

(Ms. Hyatt is a resident of a CCRC and AARP Policy Specialist on CCRCs)