USA Today Raises Concerns About Covid-19 Fees for Assisted Living Residents

A USA Today article on long term care facilities charging higher service fees during the coronavirus pandemic shines another spotlight on the rising expenses incurred by providers — and raises questions about whether assisted living operators are unfairly passing on costs to residents.

The article focuses largely on a resident at Legend of Mansfield, a Legend Senior Living community in Mansfield, Texas. This resident tested positive for Covid-19. Subsequently, her bills dramatically increased, according to the article. Among the charges were $115 for each day she was positive, over $800 for care coordination, and $1,200 for supplies including a “coronavirus control chamber” where staff don and doff personal protective equipment, according to the article.

These fees applied to Legend communities in Colorado and Texas. The Wichita, Kansas-based operator operates 42 communities in six states.


Legend disputes some of the claims in the USA Today article, Director of Marketing Paul Hansen wrote in an email to Senior Housing News. Care coordination charges include levels, time, services, and other expenses related to delivering services.

He also stated that the $1,200 charge was not for the construction of the control chamber alone. A letter that Legend sent to residents and their representatives explained that the charges were for the chamber as well as care supplies such as oxygen saturation monitors and stethoscopes that would be used exclusively by a resident with Covid-19. The control chambers, which Hansen calls “isolation chamber enclosures” built outside apartment entrances of Covid-19 positive residents, are constructed from metal, wood and plastic, along with other materials.

And the operator communicates with residents and their families frequently regarding Covid-19 practices, services and protocols, and fees, Hansen wrote.


“Any residents who are subject to additional services or care charges are always communicated with individually,” he added.

The article drew attention to the fact that $1,200 is the amount that many people received in federal stimulus, but Legend said that this was coincidental. Furthermore, Hansen stressed that Legend’s priority is ensuring the safety of its residents and, to date, less than 1% of its total resident population has tested positive for Covid-19.

The USA Today article also included a call from The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) for federal funds to help assisted living communities curb their costs as the pandemic persists.

“Our association has repeatedly asked the Administration to provide emergency aid to assisted living communities due to our especially vulnerable population. Meanwhile, other industries like airlines have received financial assistance. It’s time for federal and state governments to rally around long term care and give them the resources they need to protect our seniors’ health and financial wellbeing,” the industry association wrote in an email to SHN.

Expenses and costs have skyrocketed across the industry since the pandemic spread wide in late March. Last month, The Springs Living CEO Fee Stubblefield noted that it expects to spend up to $500,000 to mitigate the spread of Covid-19, and spent 80% of that total through mid-May. AHCA/NCAL and other industry groups have lobbied for federal assistance in ramping up testing in assisted living facilities, a burden which is currently shouldered by providers.

The industry could see an adverse economic impact of up to $57 billion resulting from the pandemic over the next 12 months.

While raising rates could be difficult in the current environment of Covid-19, some industry leaders have said that providers will need to find a way to appropriately charge rents to cover expenses. And, it is conventional in assisted living to charge residents more as their care needs escalate.

“As is common in assisted living, Legend’s care charges fluctuate and are based on an individual resident’s needs reflected in levels of care as well as ancillary items and services consumed by a resident — a practice that helps make assisted living affordable for so many Americans. Individual residents in long term care who have Covid-19 often do require increased care and services that are commonly charged to patients, not unlike hospitals,” Hansen said.

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