NaCCRA Forum: Governance of CCRC/LifePlan Communit

Synopsis As Introduced:

Amends the Life Care Facilities Act. Provides that a resident is entitled to be represented by at least one resident voting member on the board of directors or equivalent governing body of the resident's provider. Requires a provider with more than one facility to seat as a member on the provider's board of directors or equivalent governing body at least one resident from each of the provider's facilities in the State. Provides that a resident has the right to self-organization. Prohibits reprisal by a provider in response to specified activities. Requires a provider's board of directors or equivalent governing body to (1) hold quarterly meetings to discuss specified subjects and (2) consult and discuss with a facility's residents or the representatives of a facility's residents any proposed action that might significantly affect the well-being of the facility's residents or the financial stability of the facility before taking the proposed action. Requires the Department of Public Health to ensure that providers comply with the provisions by instituting a penalty for noncompliance. Effective immediately.

Jim Haynes

Thanks for posting this. It is an interesting bill. How did you happen to know about it?

Jim, do you have a link to the specific language of this bill. I assume it this is in Virginia.

I ask because it is vague saying it prohibits reprisal by providers for specified activities, so there must be more detail available. Where can we read that?

What is great is this is like the Bill of Rights that residents in assisted living in PA have, but this is not for those in Indendent Living. This Virginia legislation is leading the way for use to learn about and see about in our own states.

Linda Kilcrease

Resident of a CCRC

Oh, I see it is in Illinois. https://www.ilga.gov/legislation/BillStatus.asp?DocTypeID=HB&DocNum=4180&GAID=16&SessionID=110&LegID=137008

But it is not effective from what I see - moved to committee as in the attached image.

Linda Kilcrease

Resident of a CCRC

Someone in Illinois told me: ". LeadingAge, the lobbying organization for Life Care management, has registered an appearance in opposition to the bill on behalf its members. No resident of a Life Care facility has entered an appearance in favor as yet." This is heard before committee this Wednesday.

Linda Kilcrease

Resident of a CCRC

Residents need to know about a new policy if this becomes law. My guess is bad CCRCs will find a way around this.

Do I recall correctly that NaCCRA supports legislation like this?

Yes, we support this

Jim Haynes

Can you point me to an explanation of NaCCRC's position that I could share with other residents here in Illinois?

LeadingAge Illinois represented by Jason Speaks has registered opposition to the bill HB4180 (Illinois House). It might be of interest that Ryan Gruenenfelder of AARP has registered as a proponent of the bill. The administration of our community, Westminster Place, Evanston, IL. has said he opposes it for two reasons: 1. It is a conflict of interest for a resident to be a member of a board that governs over it and 2. Non elected board members would not be insured. I am assuming that means that because the resident on the board would be chosen by the residents (and not the board), that resident would not be liable if the corporation were sued. Any help on this would be great.

Great article below, "Liability and the Board: What Governing Teams Need to Know".

First, think of all the volunteering that residents do for the CCRC. They are everywhere as free labor. Are they covered by insurance? This opposition is a way to try to not give residents any power, keep them off the board. The AARP has the money and knowledge to fight this.

Liability and the Board: What Governing Teams Need to Know – Nonprofit Risk Management Center

Excerpt: Every state in the United States has a volunteer protection statute that limits in some respect the personal, legal liability of volunteers. Some state volunteer protection laws only protect directors and officers serving nonprofits, while others protect even narrower categories of volunteers, such as firefighters or other emergency service personnel. The federal Volunteer Protection Act of 1997 is similar in some respects to the state laws, but sometimes offers more robust protection. In states where the VPA offers greater protection than the state law, volunteers in that state enjoy the broader protection of the federal law. One legislative purpose of the VPA was to shift responsibility for harm caused by volunteers away from volunteers and over to the nonprofit organizations they serve.

Linda Kilcrease

Resident of a CCRC

Thanks Linda. This is a very thoughtful article. But it does not deal directly with the issue of insurance for resident board members. I believe there are at least some CCRC that have residents on their boards. I assume they are covered by the same insurance as other board members. It would be helpful if we could have confirmation of specific examples of this.

I've written the author in the hopes she might clarify some points. I wrote:

There is now legislation in several states that could require or suggest that these non-profit CCRC companies have some residents as members of the board of governance. A few CCRCs have that now. A bill by the state of Illinois has registered opposition by the state’s chapter of the industry’s leading organization.  AARP is registered as a proponent. An Illinois CCRC company opposes it for two reasons: 1. It is a conflict of interest for a resident to be a member of a board that governs over it, and 2. Non-elected board members would not be insured.

To add to this,

1. CCRC communities have resident volunteers working everywhere as free labor. I wonder if any of them are covered by general liability or other insurance. 
2. My own CCRC community in Pennsylvania is forming a new alliance with another CCRC. This other CCRC is the "Sole Corporate Member" (like a parent organization). A “member” of a nonprofit organization is an entity or individual that generally has certain rights concerning that organization. Those rights are usually delineated in the governing documents of the organization, and often include the right to: (1) elect or remove members of the Board of Directors ... QUESTION: It seems like the corporate member could elect a resident. In my example, it is one person, the President of the "parent" CCRC, who “elects” a new board member. And their own CCRC has 2 residents sitting on their board with voting rights.

Linda Kilcrease

Resident of a CCRC

As I hear more about Leading Age, they seem to be more directed towards CCRC's management staff, rather than the residents of the CCRCs. Am I correct that Leading Age gets most of their revenue from vendors and CCRC management?

With regard to the objections to Illinois Bill HB4180, what specifically is the conflict of interest cited by the administrator of Westminster Place? 

The conflicts I can see for a nonprofit CCRC are (a) the interest of an individual resident vs. that of the entire community, including future residents and (b) the interest of present residents vs. that of future residents.

I think that it must be acknowledged that residents are the primary stakeholders in the community and thus deserve to have a vote in how the community is managed.

To avoid the apparent conflict of interest, it is important that the resident representative abide by a code of ethic and are appointed based on election every year or two.

If they effectively represent their fellow residents, it can make the Board a more effective unit and make the community a happier healthier place.

John, all board members serve the best interests of the CCRC. Even a resident board member. They do NOT represent residents.

Linda Kilcrease

Resident of a CCRC

Yes, LInda, I think that's a critical point. And in our case, the resident Board member is selected by the Board and its Nomnating Committee. In my opinion, that person really should not be elected by the residents.

Nancy Eddy

nbeddy@gmail.com

Linda,

You are quite correct. Every Board member does have a fiduciary responsibility to the community. However, residents have a very particular knowledge of how effectively the community is being managed. Since they are the constituency who is financially supporting the community and the people who are living there their voice should be heard.

We have lived for many years in a cooperate apartment. That type of building is managed by a profession management group that is engaged by the directors who are all resident/owners elected by their fellow residents. This type of organization works very well. In that case, as in CCRCs, the residents have committed substantial financial resources to the community and are very concerned that it is well managed.

I agree with Linda, Nancy, and John. The resident board member has to focus on the best interests of the community to maintain financial viability. It is right that the board selects and appoints the resident member.

My community uses the Residents' Council to vet people who are interested in serving. They interview up to 10 candidates and submit names of three residents to the ED. Their names are submitted to the Board Governance Committee who interviews the candidates and makes a recommendation to the full board.

Some folks complain that the resident directors do not tell us what is going on. But they are acting as full board members and do not speak about the discussions or actions of the board. It is hard to explain to other residents that although they are residents, they are not on the board to represent the interests of the residents. Their job is to carry out the duties of care as outlined in this article.

Providers have been objecting to residents on the board for years. They don't like change. I have heard an ED say that they control the board. No wonder they don't want a resident on the board. An effective board should welcome another perspective. Age should not be the issue. Many board members are retired themselves. The only difference is where they live. Resident director can contribute to an understanding of the culture in the community as well as bringing skills and experience to strengthen the board.

Maryland does require a resident on the governing body. Maryland Law

http://mdrules.elaws.us/comar/32.02.01.19

Ann MacKay

MaCCRA President

The bill in Illinois has passed out of the House Committee and will go the the floor of the House for a vote.

Ed Welch, please contact Neil Quinn at neilkevinquinn@gmail.com

Regarding the "conflict of interest" argument disingenuously being used by some CCRC managements to avoid transparency, or in opposition to the Illinois bill, please everyone read the March/April 2021 issue of NaCCRA's LifeLine newsletter, particularly the letter to the editor at the back of the issue.

The conflict-of-interest argument is ridiculous. I say this as a lawyer and also as someone who served as President on 2 HOA Boards. The law was clear: I didn't have a conflict-of-interest. In a CCRC, where we don't have an ownership interest as in an HOA, there is even less of a reason to think we have a conflict-of-interest. In fact the CCRC Boards chosen by the owners of the Non-Profit, have a bigger conflict-of-interest, if there is one.