Marilou Rochford felt good bringing her elderly mother, Mary "Betty" Merklinger, to the Chapin House assisted-living facility in Rio Grande several years ago.
She and her three brothers had checked out several assisted-living centers, but Chapin House gave her the feeling it could be her mother's home.
It helped that the staff reassured Rochford that her mother could stay there for the rest of her life, she said. When her savings ran out, the staff said, they would simply roll her into the Medicaid program and she could stay on as a resident, uninterrupted.
But last fall, five years after her mother moved in and more than $300,000 later, Rochford said, Chapin House staff told her and her mother that the corporate policy of the Milwaukee company that owns the facility, Assisted Living Concepts, had changed. The company would no longer accept Medicaid, the staff said, which meant Rochford's mother would have to move out.
Rochford, of Lower Township, lobbied on her mother's behalf, and eventually, the state Public Advocate's Office stepped in. Today, Merklinger, 84, remains a resident at Chapin House, and Public Advocate Ronald Chen is investigating whether other residents at Assisted Living Concepts' eight South Jersey facilities may have been improperly discharged or threatened with discharge because their savings ran out.
Rochford said that even though her mother is still at Chapin House, she worries about those residents who may not have their own advocates.
"You see people that never have a visitor," Rochford said. "What's going to happen to them? They're just going to get kicked to the curb."
Chen is scheduled to appear in Superior Court on Thursday to seek help enforcing a subpoena his office issued against Assisted Living Concepts as part of the investigation.
Chen argues some residents have contracts - both written and verbal - indicating they would be allowed to convert to Medicaid after a period of using private funds.
Chen also argues that in Assisted Living Concepts' application for a certificate of need, a document required by New Jersey before a company builds an assisted-living facility in the state, the company stated that no resident would be discharged because he or she had spent their entire savings.
"Our investigation indicates that this company is placing vulnerable elderly residents at risk by displacing them from their homes in violation of ALC's state license," Chen said. "Our primary concern is to protect the safety, well-being and peace of mind of these residents, and we have worked closely with [Department of Health and Senior Services] as we conducted our investigation."
Laurie Bebo, president and CEO of Assisted Living Concepts, disagreed with the public advocate's characterizations.
"There are no qualifiers or requirements on our license whatsoever," she said.
Bebo added that her company has been in discussions with DHSS to discuss the kinds of protocols and policies the company will have in place for the future regarding Medicaid.
"We have always followed the policies and procedures required in New Jersey and we look forward to resolving any concerns as soon as possible by working with the Department of Health and Senior Services," Bebo said.
Bebo said she could not address the concerns or allegations of specific residents. But she acknowledged the company has discharged residents in the past for a variety of reasons, including rolling over to Medicaid.
She said that while the Public Advocate's Office says some assisted-living facilities are required to have only as many as 30 percent of their residents be Medicaid recipients, about half of the residents at Chapin House receive Medicaid.
She added that since the company entered into discussions with DHSS in March, it has not sought to discharge anyone until its policies and protocols have been reviewed.
DHSS is also investigating the issue, said spokeswoman Donna Leusner. State regulations do not prohibit assisted-living facilities from involuntarily discharging residents, but do require them to give residents 60 days' notice.
Sen. Jeff Van Drew (D., Cape May) is working on legislation to prohibit assisted-living facilities from involuntarily discharging residents because they have converted from private pay to Medicaid.
Laurie Facciarossa Brewer, a spokeswoman for the public advocate, said the public advocate is investigating how widespread the problem may be.
"Our concern is that many other residents of all ALC-owned facilities in New Jersey have been, or may be, facing an involuntary discharge under similar circumstances," Brewer said. "We are seeking this information with the intention of using it to help residents remain in the place that they call home."