Jeff Herman wants his 92-year-old mother to keep living at the Sunrise assisted living home in Buckhead. His mother wants to stay. Sunrise wants to keep her too.
But even though no public money is involved, the state of Georgia also has a say in the matter. The state believes that Myrtle Herman isn’t mobile enough to stay at Sunrise and it is trying to force her to leave, an action that would push her into a nursing home.
For 16 years, advocates for elderly Georgians have said the state needs to change the law that makes elderly people move against their will. But every year, state lawmakers, under pressure from a powerful nursing home lobby, have refused.
That might change this year.
A bill that would for the first time create an official “assisted living” designation in state law appears to have momentum at the Capitol. The outcome of this year’s debate on the issue has implications for every Georgian whose spouse or parent is becoming frail as well as for an entire baby boom generation that is entering retirement. For Jeff Herman and others who want their family members to stay in the facilities that have become their homes, a change can’t come soon enough.
“They’re not only doing a disservice to the elderly people, but to all the families of the elderly people,” Herman said. “I have stayed awake at night wondering if today is going to be the day that the state is going to come in and force Mom out.”
Unlike many other states, Georgia law does not recognize assisted living facilities. They are licensed as personal care homes. That designation was created years ago, before the concept of assisted living was widespread. Personal care home rules were set up to regulate small facilities that usually cared for just a handful of elderly or disabled people in a homelike setting.
While nursing homes are authorized under state law to deliver a range of heavy-duty medical and personal services, personal care homes aren’t allowed to do much. Unless the state grants a waiver, residents must be able to take their own medications and be mobile enough to get around in an emergency. Getting a waiver is far from a sure thing. A Department of Community Health review of waiver requests from 2009 found that the state approved about a third of the requests that were related to a resident’s condition.
Under bills approved by committees in both the House and the Senate, Georgia would create the new assisted living designation for facilities with 25 beds or more. While those facilities wouldn’t be allowed to do as much as nursing homes could, they could have medication aides on staff who could give residents pills and insulin shots, which isn’t allowed today. And the rules would permit residents to stay even if they need some assistance getting around, as long as the facility has enough staff to keep its residents safe during a fire or other kind of emergency.
The legislation (HB 405 and SB 178) is not a done deal. But both versions of the bill have cleared committees. The Senate is expected to pass its version during a vote scheduled for Monday. Even the nursing home lobby has given its blessing.
“We are finally catching up with other Southern states in allowing Georgians the choice to age in place,” said Kathy Floyd, a veteran lobbyist for the AARP who has personally pleaded with legislators for years to give Georgians this alternative.
The nursing home lobby has long argued that extremely frail patients simply couldn’t be kept safe in personal care homes. In some cases, patient advocates say, the concerns are real. But money was also a significant issue in the debate.
“It’s a turf war,” said Sen. Renee Unterman, R-Buford, a supporter of the bill who is chairman of the Senate’s Health and Human Services Committee. “All of these companies are fighting over this certain pool of people. It’s business.”
Most residents of assisted living, including Myrtle Herman, generally pay for their own care without any government assistance. But taxpayers often cover nursing home care through the Medicaid program.
The chances for a change in the law improved as the power of the nursing home lobby waned and as baby boomers began to deal with their elderly parents and contemplate their own future.
Rep. Sharon Cooper, R-Marietta, chairman of the Health and Human Services Committee in the House, said people moving into retirement today are living longer, more active lives and they want to stay out of an institutional setting. “The idea of going to a nursing home, even though nursing homes have changed a great deal, they just can’t stand the thought of doing that,” she said.
George Glisson-Munier said that personal choice is all his family is seeking.
Glisson-Munier’s father, who has Alzheimer’s disease, is a resident at an assisted living facility in Kennesaw. He is in danger of being forced out because he can no longer walk on his own or propel his wheelchair. Glisson-Munier said staffing levels at his assisted living facility allow his father to get as much attention as he would get in a nearby nursing home, if not more. Plus, the staff got to know Huey Glisson before his disease took its toll, when he shared jokes and stories about his past.
“This bill is truly about a family making decisions about what is in the best interest of their loves ones versus the government doing that,” said Glisson-Munier, who came to the Capitol to push for the bill. “While I’m appreciative of the government and the community’s concern about safety for the elderly, I still feel like it shouldn’t override my ability to fulfill my father’s wishes.”
To Jeff Herman, who is a physical therapist, the idea that his mother would be safer in a nursing home is not convincing. In fact, he believes quite the opposite.
Myrtle Herman spent time in nursing homes after recovering from falls, he said. She ended up with infections and bed sores and sometimes was not kept clean. The chance of his mother getting trapped in a fire at Sunrise seems extremely unlikely to Herman. But he’s almost certain of a bad result if his mother is forced to leave.
At Sunrise, Myrtle Herman has her own room that is set up comfortably with family photos and remembrances from her long life. Her son goes to the facility every day during her meals.
“If mom went into a nursing home,” he said, “she would be dead in a month -- absolutely.”
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