For Middle Class, Senior Care a Tough Sell

By Beacon Staff

Much remains the same inside the walls of Kalispell’s Friendship House, the state’s first elderly day care center established in 1978.

But outside, things are changing fast. And the Friendship House is having a hard time adapting.

That’s why the assisted living facility recently made one of its biggest changes in years with the hiring of a new director, Jim Atkinson, who took over on May 21.

Faced with an aging baby boomer population and a rapid surge in assisted living centers statewide, Atkinson is charged with the task of keeping a low-income elderly care institution – a rarity in Montana – profitable, or at least cost-effective. But right now, in its 30th year, the Friendship House is in a financial crunch and Atkinson wants to get it back on track without raising the center’s low rates.

“For low income people, where do they go?” Atkinson said. “That’s why this place is going to be very critical here very shortly.”

State officials with the Montana Department of Public Health and Human Services (DPHHS) say the number of assisted living centers in Montana has increased immensely since the DPHHS Licensure Bureau was established 17 years ago. The Licensure Bureau inspects and certifies health care facilities in the state, giving them appropriate licenses that range from adult assisted living to child day care.

“What’s remarkable with assisted living is how fast they have added beds and gained popularity in the last 10 years – it’s phenomenal,” said Kelly Williams, administrator of the DPHHS senior and long-term care division.

Before the Licensure Bureau was created, most people used nursing homes, which are monitored by the federal government, not the state, said Harry Dziak, who has been with the bureau since its inception. He said at first there were only 16 assisted living centers in the state. Today there are roughly 185.

The Friendship House offers both assisted living and day care, which means it provides long-term overnight living along with day services that families can use hourly or for as long as they wish. When adults are taking care of their elderly parents, they often run into scheduling difficulties and need somewhere where their parents can spend time. It could just be for lunch or the full day.

Fay Fisher relaxes for a moment in the living room of Friendship House in Kalispell.

Friendship House is licensed for 20 long-term residents, including disabled adults, but Atkinson said it comfortably holds 18. Day care is available on an hourly basis between 7 a.m. to 8 p.m. so long as the proper medical forms and paperwork are completed. Short-term care is also available for 24 hours at a time up to one month. Disabled adults of any age are also welcome.

Sherry Panariello, Friendship House’s former director of eight years, said the facility has the lowest rates in the valley. Dziak estimates the average monthly rate statewide is $2,800 to $3,000, though many charge much more than that. The Friendship House’s rates start at $1,329.

“That’s a heck of a deal,” Dziak said.

Many elderly people, Atkinson said, didn’t have health insurance programs or good pension plans during their working careers and today are left with very little. Even with the help of family members, $1,329 can be hard to come up with every month, let alone the $3,000 or more at other places.

Dziak said that since assisted living is a private business his agency doesn’t have any control over rates.

“If you raise your rates you have to give a 30-day notice, but we don’t deal with money,” Dziak said.

He said affordability is a major concern, especially since baby boomers are reaching their 60s. Middle class people simply can’t afford most facilities, he said, and unless families opt for the less enticing and more institutional option of nursing homes, there are few options for lower income people.

While nursing homes often participate in Medicaid and Medicare programs because they are federally governed, only a small number of state-certified centers get Medicaid waivers, Dziak said. Many elderly people only need certain levels of assistance, not a full-time nursing home.

“I think affordability is an issue for middle-class people,” Dziak said. “I don’t know if I would be able to go into an assisted living facility.”

In 1978, Marion Finley, while taking care of her own mother, created the Friendship House, originally located where Flathead Industries is today on the corner of Main and Idaho streets. Her goal was to keep older people out of nursing homes and provide them with a place to socialize, participate in activities and eat during the day. There was no place like it in the state.

The Friendship House moved in 1985 to the beautiful old Miller Mansion, built in 1901 on Second Avenue West, where it still is today. The building is in good shape and is surrounded by thick patches of lilacs, picnic tables and benches. The environment inside is as cozy as it is outside. It’s hardly institutional, with a home-like atmosphere where residents come and go throughout the day.

Connie Whaley take s a poker chip from Amanda Williams to cover a Bingo number while playing the game with other Friendship House residents.

Fay Fisher, a full-time resident and Flathead native, has been in the Friendship House for two years. She’s spry and witty but has needed assistance ever since she began falling while living alone. The Friendship House, she said, perfectly meets her needs, as she is free to roam to Sykes or Blacktail Mountain Books as she pleases, or just pour a cup of coffee and chat.

“I’m very, very comfortable here,” she said. “They take such wonderful care of their people.”

For a low-income facility to survive in Montana, Atkinson said it has to start at the grassroots level. He joked about “getting money and robbing banks” to describe his role as director, but in truth he does plan to incorporate a businessman’s approach in order to compete in an increasingly competitive nonprofit environment. Using an aggressive networking and marketing campaign, Atkinson will actively seek an assortment of grants and donations. He will also hold more fundraisers.

Once a Kalispell mainstay, the Friendship House has gotten pushed to the backburner by the influx of assisted living facilities in the valley, Atkinson said. Full-time resident numbers are down and he said many of the newer places offer features that the Friendship House can’t, such as bathrooms in each room and elevators.

But Atkinson knows his center has the lowest rates and an intimate setting not found at bigger establishments. It’s a matter of getting the word out, he said.

“We need more exposure to the community,” Atkinson said. “At the same time we need more community involvement. It’s going to take time, but we’re going to get there.”

Fisher will be watching closely – it is her home, after all.

“I just wouldn’t be here without all of the good care and everything they’ve done for me,” Fisher said. “I tell you, it’s a whole new life.”

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