The Oregon Caregiver Fall/Winter 2016

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The Oregon Caregiver Fall/Winter 2016 8
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Feature
Because many people move to the Oregon
coast to retire, Skaar says that there is a
false perception that coastal retirees are
well-off and can afford to pay for their care
needs. In fact, most of the CARE residents
are low income and have lived on the coast
the majority of their lives. Those who do
have sufficient funds often move back to
their pre-retirement home cities. “They
spend their retirement years on the coast
until they need assisted living and then
they move back to Portland, or wherever
their children have located. They’re not
really from here, so they don’t stay here,”
she said.
Those who do stay in the area once they
need care typically rely on Medicaid
to fund their care, but Skaar says that
regardless of their financial situation,
residents are well cared for and loved by
the assisted living staff.
“We become their family,” she said.
“It’s crucial that we love our residents,
because in many cases we’re the only
ones who see them most days.”
Staffing the communities is a difficult
task, and, ideally, each of these two
communities would have 20–22
employees depending on current resident
acuity levels. But in a small tourist-
centric town many potential employees
find that working at local restaurants
and hotels pays more than working as a
caregiver for a mostly Medicaid-funded
assisted living community.
Currently, the recruiting process is an
uphill battle. Skaar said they try to focus
recruitment on the work environment
instead of the monetary compensation,
and their current recruitment campaign
features the tag line “Feels like family.
Come work with us and be one of
the family.” She said, “We’re always
advertising in all the media that exists out
here. We have at times offered recruiting
bonuses to staff that are in the building if
they can bring someone in who will stay.”
To maintain the employees they have,
Kilchis House offers training and
opportunities for advancement. Skaar
said, “They start as a caregiver on the
floor and we do our in-house training.
Assuming they do well, enjoy it, and are
interested in more responsibility, they can
then be trained to administer medications.
Typically, those who excel at medication
administration go on to be a resident care
coordinator.”
Another challenge is funding. Skaar
estimates that 80 percent of the residents
at Nehalem Bay House and 90 percent
of the residents at Kilchis House are
Medicaid funded. “At this time, we break
even, on a good year,” she said.
With the recently passed minimum
wage increases coming over the next six
years, Skaar is questioning how they will
continue to make it work. “The challenge
is that foundations and private grants
don’t see it as a non-profit you would
make a donation to, because they see it as
a business that people pay to be served.
They don’t realize it costs a lot to provide
24/7 care,” Skaar said.
With such a high percentage of Medicaid
residents, CARE sees firsthand how
Medicaid rates haven’t kept up with
the rising costs of care. “During the
recession, from 2008 to 2013, we were
flat funded. They did not give us a rate
increase for five years. Now they’re giving
us a rate increase of 2.5 percent for the
last three years, so we’re way behind in
terms of what the state pays for compared
with the true cost,” she said.
Being a non-profit helps reduce this
burden. The CARE properties are exempt
from property taxes and income taxes.
“That does put us in a better position
than most to run the communities the
way that we do, but we’ve now hit that
mark,” she said.
Skaar said the funding challenges have led
to conversations with their legislators, and
she is hoping to get the attention of the
state legislature in the upcoming session.
“If we were in Portland and could choose
to have a smaller percentage of Medicaid
residents, then those people paying the
market rate could help make up the
difference,” she said.
“It’s a big challenge and it’s one we’re
looking at right now,” said Skaar. “How
do we preserve these communities? We
don’t know if we can.”
» Kilchis House/Nehalem bay house, cont.
Two Kilchis House residents.
“We’re way behind
in terms of what
the state pays for
compared with the
true cost.” — Erin Skaar,
Executive Director of CARE