Senior Living News Wire

Congress is drafting a 6-month continuing resolution that will fund federal programs for the first half of fiscal 2013. Please contact your members of Congress and urge them to include the $425 million the U.S. House of Representatives approved for Section 202, especially the $50 million the House bill contained for construction of new units.  Remind your legislators of how important this is your organization and to the people you serve. If Congress fails to provide funding for new Section 202 construction in 2013, it will likely mean a second consecutive year with no funding for new Section 202 projects, which would be very difficult to reverse in future years.

The Supreme Court’s historic 5-4 Affordable Care Act decision clarifies insurance rules. But the controversial verdict appears to make Medicaid’s requirements and boundaries less certain than ever.

Long-term care operators have had to pay 4% more annually in liability costs over the past three years, a new analysis shows.

The cost of living in a long-term care facility increased steadily over the last year while home care costs have stayed flat, a Genworth Financial survey finds.

Daily vitamin D supplementation prevents fractures in the elderly, but only in higher doses, Tufts University researchers said.

Methicillin-resistant Staphylococcus aureus rates are falling in both healthcare facilities and in communities, suggesting a change in how MRSA is being transmitted and prevented, a cohort study finds.

An overwhelming percentage of nursing facilities reviewed were not compliant with regulations regarding residents who take atypical antipsychotic medications, according to a recent federal report.

McKnight’s Long-Term Care News recently captured six APEX Awards. The tally includes a Grand Award for its website, www.mcknights.com.

A big part of our effort has been working closely with states to begin building new health insurance marketplaces, the Affordable Insurance Exchanges, where Americans will be able to choose private health insurance plans based on price and quality.

Who says one vote doesn’t matter? The Supreme Court preserved the Affordable Care Act because a conservative judge decided that a liberal president’s expanded healthcare program was worth saving.

Nursing home administrators who can’t back up every minute of rehab therapy delivered in their building leave themselves open to auditing, an MDS 3.0 expert says.

Despite ongoing economic uncertainty, financing for senior housing looking ahead to 2013 is becoming more available—but on certain conditions, finance experts agree.

“We’re definitely seeing things loosening up out there,” said Thomas Hanrahan, managing director of healthcare real estate at Capital One Bank, during a Senior Housing Summit event held last Thursday in Chicago.

“It’s the sponsor team that’s key,” he said, adding that there are a “lot of deals” his bank wants to get done with the “right” sponsor. “There have to be the right people behind it, with a track record and depth of management team.”

Prior relationships are important, as well.

“We have a lot of repeat business with existing customers,” said Phillip Kayden, an investment officer at Ventas Inc., a real estate investment trust headquartered in Chicago. “We want to understand who the operator is, how they’re capitalized, and what their track record is.”

Obtaining financing for new construction is still a “challenging time,” according to Hanrahan. “There’s enough inventory out there, and products that can be restructured or recapitalized; it’s such a wealth of opportunity that we haven’t had to go do new construction projects.”

Capital One has been noticing more borrowers coming to the table with their own equity in the deals. “Some are bringing deals they’ve closed with their own money, and they’re coming to us to refinance,” said Hanrahan.

Contributing equity seems to be a trend going forward when it comes to financing continuing care retirement community (CCRC) construction, especially those with nonprofit sponsors, says Michael Zarriello, managing director at Cain Brothers’ San Francisco, Calif. office.

Cain Brothers has been noticing inflows of capital into municipal bond funds in the last 25 weeks, says Zarriello, which means that there’s money around to be invested. The firm says it is seeing “big inflows” into funds for investments in renovation, expansion, refinancing, and even some start-ups.

“[The investors] are driven to [tax-exempt bonds] because rates are very low in other areas that are quasi-safe,” says Zarriello, citing U.S. Treasury bonds’ approximately 1.55% yield. “[They] want to look somewhere else to get a better yield.”

Good projects can get done, he says, including new construction—but the financing for those projects is looking different from how it’s been in the past, with borrowers being asked to contribute equity and have “skin in the game.”

At the end of the day—and looking into next year—a lot has changed in terms of financing, the panelists agreed, but there are some lessons to be learned.

First, communication between borrowers and lenders is crucial, said Zarriello and Hanrahan.

“We don’t want any surprises. Let us know what’s happening; keep us in the loop,” Hanrahan said.

Another big lesson that investors can learn, said Kayden, has to do with asset performance.

“NOI doesn’t always go up,” he said, adding that in 2005 and 2006, underwriting leases for newly-acquired properties didn’t have much room for “slippage.”

“In our leases, rent goes up year to year,” he noted. “If you’re not growing NOI, you have a hard time keeping up with that escalator.”

Written by Alyssa Gerace

This answer is directly from Centers for Medicare & Medicaid Services: “We have no regulation that requires medications to be ordered for specific clock times. Our surveyors check to see if staff give medications according to the order. If an order is for a.m., and the facility policy is to give a.m. at a certain clock hour, that is what we would check.

A deep sense of loneliness is not just an indicator of a person’s mental health — new research says it also can be linked to greater risk for death and functional decline.

Nursing home residents often are deprived of consensual sexual relationships due to concern for their safety and a lack of sufficient formal policies dealing with these relationships, new research finds.