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CCRC Actuarial Data Access by Residents
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Jennifer J. Young
6/15/2020 12:00 PM
Forgive the delay in reply.
My CCRC currently has no direct debt. The reason I use the word "direct" is that when its owner was solely the county's hospital system there were various bond issues and re-fi's as noted in older Disclosure Statements.
In 2013 the county hospital system merged with a larger one, Cone Health, headquartered in Greensboro. (Greensboro is in the county adjacent to our county.) So we now owned by the larger hospital system. Cone Health soon retired our (the CCRC's) debt and then issued some tax exempt bonds on their own. The corporate allocations then starting taking significant upticks in our community's financials. I would say our CCRC represents about 2% of the total health care system's operations, but that's based on my own simple math via the combined audited financial statements for the whole enchilada (Cone Health) that appear in the Disclosure Statements.
The variations permitted in the Disclosure Statement product has frustrated me all along. You'll not find a carve-out for our particular CCRC in the financials of our Disclosure Statements because we're part of a bigger hospital/ acute care system's financial picture. Its the audited financials of Cone Health as a whole that one sees. Here's an example of how the true picture can be buried:
My current CCRC was built by the above-mentioned hospital system when a hospital on the 42 acres was scraped. It opened in 2003. An 81-bed public nursing home was also constructed, in a building physically attached to our separate, 48-room Health Care Center for Villagers (12 AL, 12 MC, and 24 SNF). The legal entity for this entire site combines the financials for both operations. Doing so was probably acceptable until the nursing home started operating in the red, with its red dominating the CCRC's black. I kept ragging to mgmt. that in the narrative of the Disclosure Statements they should explain the set up and elaborate on the difference. Finally, in early Feb of this year (barely pre-Covid) the 81-beds were sold off to 2 For Profit SNFs in the county. North Carolina is a Certificate of Need state, so this meant the assets sold were the bed "licenses," not the building. The families of most patients acted quickly to move their loved ones …. very wise and before we even knew about the pandemic. Our staff gave them very personalized assistance. It was announced that the building was to be empty by 8/31/20. There are only 6 patients left as of this writing. (Of course, we residents asked to be part of the brainstorming as to what to do with the empty building.)
But our financials in the upcoming Disclosure Statement will be for fiscal year ending 9/30/19 …. so the upcoming Disclosure Statement, dated March 1, 2020 and not yet published, will show the pre-sale state of affairs. Naturally I'll be looking for a narrative explanation, since the Disclosure info deadline was 2/29/20 (5 months after end of fiscal year) and after the sale was made. I'm not betting the farm that any explanation will be there.
Being owned by a non-profit hospital system can be a double-edged sword, especially now with hospitals losing millions.
Here we sit, a debt-free CCRC with 99.5% occupancy in IL, empty fields, two empty cul de sacs, and an empty former SNF building. And we are a speck in the bigger Cone Health picture, definitely NOT part of their core business of acute care. As I tell my fellow residents, "Stay tuned."
3/16/2020 6:37 AM
Jennifer, of course, you can use the examples I've cited at your meetings... they are public information accessible by anyone with a computer.
I presume that your interest in the actuarial study for your CCRC is so that you can get a sense of the future solvency/feasibility of the community.
I have found the "Official Statement" (if recent) and the Audited Financial Statements on EMMA (Electronic Mutual Market Access) to be valuable adjuncts to an actuarial report when assessing future solvency (see: https://emma.msrb.org/ ). The Fitch/S&P bond ratings and reports are also useful if you read between the lines (these reports, like the actuarial report depend heavily on management input). Data on EMMA is restricted to the nonprofit CCRCs with bond financing.
The relevant "Disclosure Document" in EMMA is most easily accessed if you know the CUSIP number of a bond that has been used to finance the CCRC. I don't know which CCRC in NC you are interested in, but as an example Aldersgate in Charlotte has two outstanding bonds with CUSIPs 65820YLM6 & 65820YNG7. The CUSIPs for other CCRCs are often (but not always) found in Form K of the 990 (which can be found using Guidestar (https://www.guidestar.org/search ).
Jennifer J. Young
3/13/2020 7:38 AM
Wow, you really studied the posted Disclosure Statements. Yes, it seems there is a wide range of what is provided in Disclosure Statements ... as you pointed out. I don't know the remedy; however, if it's okay with you I'll bring up this topic at our state residents association's meetings, using the examples you cited. A rep from the DOI usually attends our annual meeting -- a meeting for all residents -- which is in October each year. In the spring there is a special meeting for community reps (therefore, not as many attendees). I doubt that it will be held this year. In any event, if the opportunity presents itself to describe the wide disparity of descriptions, I'll ask. Thanks for pointing this out.
2/4/2020 8:59 AM
Jennifer, thank you for alerting me to the fact that the North Carolina Department of Insurance posts the CCRC disclosure statements on-line (i.e. at https://www.ncdoi.gov/documents-disclosures ). I am particularly interested in how CCRCs frame their actuarial report disclosures since we are striving to require CCRCs to do an actuarial analysis here in New Mexico.
Reviewing the NC documents, one readily notices that the quality of the disclosures vary widely from CCRC to CCRC. For example,
Aldersgate provided a complete copy of the actuarial report by AV Powell Actuaries (see: https://files.nc.gov/doi/documents/continuing-care-retirement-communities/aldersgate-2019.pdf pg 172-282 with a summary on pg 185-186). This report concluded the community was in satisfactory actuarial balance (and a SAB seal was attached). At first I was surprised by the SAB seal since Aldersgate currently has a substantial deficit in net assets (-$14M as of September 2019). The disconnect can be explained by the fact that the actuarial analysis was performed in 2015 when net assets were modestly positive, $0.4M.
SearStone provided a copy of the summary prepared by Continuing Care Actuaries. The summary did not address whether or not the requirements to receive a SAB seal were met. But it did conclude that SearStone is in adequate financial condition to meet its obligations (as of 2019); see: https://files.nc.gov/doi/documents/files/searstone-retirement-community-2019.pdf pg 128-131).
Sharon Towers provided a short paragraph apparently drafted by management stating that an actuarial opinion was obtained (on April 15, 2019). The actuary was not named, however, the statement concludes that The Presbyterian Home at Charlotte has the capacity to meet its contractual obligations. A very weak endorsement, in my opinion.
I find it troubling that management has the ability to bias the assumptions used to generate actuarial reports, that management determines what is released and how it is framed, and that the reports persist in subsequent annual disclosures without commentary detailing subsequent events that might have compromised their relevancy.
Jennifer J. Young
1/24/2020 9:22 AM
I will relate my own experience of this past year .... I watched NaCCRA's streamed presentation by A.V. Powell. As I recollect, his visuals were later made available on NaCCRA's website. I noted references to his firm's SAB "seal" designation which is an indication that the entity studied met A.V.'s criteria. In my mind any organization that obtains that seal should "tout" it.
I knew some things about my CCRC -- it used and uses A.V. Powell for actuarial studies. Even though North Carolina regulates the CCRC industry better than many other states, it does not REQUIRE actuarial studies. However, if a community does have an actuarial study done, it must report that fact in the annual Disclosure Statement. Disclosure Statements are a required product produced by the communities themselves, per state regulation. These statements are sent to and reviewed by NC's Dept of Insurance and posted on line for all to see. These reports provide narrative information about the organization, info on its Board of Directors, information about its debt, copies of the contracts offered, lists of services provided, the latest fiscal year's financials, and financial forecasting.
Based on my newly-obtained knowledge about A.V. Powell's SAB "seal," I emailed him to inquire about whether my community had attained it. Unfortunately for me, his answer was that his client was management, not the residents. I therefore needed to make my inquiry of management.
9/27/2019 1:46 PM
The vision of the American Academy of Actuaries is that financial security systems in the United States be sound and sustainable, and that actuaries be recognized as preeminent experts in risk and financial security.
The American Academy of Actuaries' mission is to serve the public and the United States actuarial profession.
To accomplish this:
As the public voice for the United States actuarial profession, the Academy provides independent and objective actuarial information, analysis, and education for the formation of sound public policy;
The Academy provides for the establishment, maintenance, and enforcement of high professional standards of actuarial qualification, practice, and conduct;
The Academy advances actuarial practice by informing and educating its members on public policy and professionalism issues and current and emerging practices;
The Academy identifies and addresses issues on behalf of the public interest on matters in which actuarial science provides a unique understanding;
The Academy increases the public's understanding and recognition of the value of the actuarial profession;
The Academy provides opportunities for professional development of its members through volunteerism and service to the profession;
The Academy facilitates and coordinates response to issues of common interest among the U.S.-based actuarial associations; and
The Academy coordinates the representation of the U.S. profession globally.
The American Academy of Actuaries is a 19,500-member professional association whose mission is to serve the public and the U.S. actuarial profession. The Academy assists public policymakers on all levels by providing leadership, objective expertise, and actuarial advice on risk and financial security issues. The Academy also sets qualification, practice, and professionalism standards for actuaries in the United States.
5/16/2019 1:45 PM
AV Powell in his discussion of actuarial reports addressed this issue. (see: https://vimeo.com/321573705 min 28:10 - 30:30)... his main point was that it is a complex document and can be easily taken out of context to support an unintended conclusion.
Wade A. Taylor
5/8/2019 12:39 PM
Does anyone have any experience with residents accessing Actuarial reports if required by State Regulation? I live in Texas and recently requested a copy of my CCRC’s latest Actuarial report under The Texas Open Records Act. The Actuarial Report is required tby the Texas Department of Insurance regulations on a periodic basis.
My request has been forwarded to the Texas Attorney General’s office for a legal opinion on release of the information to me.
Just wondering what the experience of other residents in this regard might be.
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