OCA - Oceania Group - retirement villages

[minimoke]

Look at selecting residents from the operators point of view: follow the money trail It is actually the NZ government that is providing most of the care funding. If a wealthy applicant wants a position in care, there is no way they will be as wealthy as the NZ government. The government bases funding on need. So a rich applicant in a 'not so bad position' will be admitted behind a more disabled less wealthy patient taking up a government hospital bed. Looking at it from an OCA perspective, OCA do not have the choice of who they admit for care. They are also not being compensated for operational cost increases by the government. The squeeze is on for care bed providers. And there aren't enough rich private clients prepared to pay over the odds to make a difference.

SNOOPY

I'm not sure you are getting the picture.

If an aged person needs a hospital bed then every aged person has equal access to that hospital bed regardless of wealth. But to be in hospital they need to be pretty sick.

After hospital there are essentially two choices. Return to home with appropriate home based care services put in place. Or be assessed as requiring a certain level of residential care.

You now split this second option in two. If a person decides for themsleves they want to go into residential care they pay all costs - no government funding. Alternatively if the health system assesses them as needing residential (basic) care they are then eligible for a DHB / Government residential care subsidy to pay for that care. To get a Residential Care Subsidy you need to pass a means test and essentially be "poor" )if you call having less then a quarter of a mil in assets poor).

The likes of OCA dont have a choice of who they admit for care. Agreed - (except a person has to be eligible for NZ health care). But they do have choices in that they can decline an aged person if they dont have a level of care bed available at the level of care required. So say for example they only have "ensuite attached" beds available then the "poor" person wont get that bed because the govt subsidy wont pay for the extra. The "poor" person will need to look elsewhere for a bed.

Given teh $250k means test threshold I think you will find there is an enormous pipleline of "rich" private clients who will be prepared to pay over the odds to make a difference in their care in the later stages of their life.

One day , if we ever get the latest census data we might have a better idea of the total number of owner occupied homes and the age demographic - but from old data we know there is an aging population and we know too many of these people are holding onto their own property - causing a housing shortage.

Heres a bit from the Ministry of Health
How does a person apply for a residential-care subsidy?

Not everyone is entitled to funding under the Social Security Act 1964.
A person must first have a needs assessment from a DHB or DHB funded Needs Assessment Service Coordination agency (NASC). If the needs assessment determines that the person requires long - term residential care indefinitely and the person wishes to apply for a Residential Care Subsidy, then the DHB or NASC will provide the person with a financial means assessment application form to complete.
The Ministry of Social Development (through Work and Income) then carries out a financial means assessment that considers the person’s assets and income, and any gifting that has occurred.
The financial means assessment has two components:

1. An asset test
2. An income test.

If the person has assets above the applicable asset threshold then the person is liable to pay for the costs of their care up to the maximum contribution.
If the person’s assets are equal to or below the applicable asset threshold, they qualify for Government funding (the residential care subsidy) to pay for most of the cost of their care. An income test will then determine what the person must contribute to the cost of their care. The level of subsidy will depend on the type of care the person is assessed as requiring.
A weekly personal allowance and an annual clothing allowance are paid separately to the person. are holding onto properrty which is resulting in a housing shortage.

[minimoke]

The flaw in your argument is extrapolating the exemplary care of your father and your superior stewardship of his care to the general population. The threat to the likes of OCA is that they will be told by the government who to accept as care patients and they will be unable to say no. If every parent had a child who was as savvy with money as you and they had built up a nest egg like your father has then 'no problem'. But not every care patient is so fortunate.

SNOOPY

That wont happen. The likes of OCA are private businesses and our goverenments tend to keep their noses out of business - at this kind of level. What may happen, is that in granting resource consent , or becoming a govt approved provider a "village" may need to provide a certain minimum number / ration of "basic" care beds to be be available for those who are eligible for the residential care subsidy. Maybe a bit like how some residential subdivisons have ot provide a certain number of "affordable homes" in the scheme.

If this happened its unlikely such beds would be allowed to sit around empty - so the owners may charge government a base rate for holding an empty bed.

The aged care industry is getting to be pretty big - and that equals a pretty big lobby group. The last thing any government wants is aged care providers to shut up shop. Government do not want elderly people clogging up hospitals.

Gotta remember "health" is a ticking time bomb. We have huge waves of obese / diabetic / elderly building. Alongside a shrinking number of "young" tax paying people to pay for it. Private sector and charities (like Nurse Maude) will be the future

[fish]

I accept your point BP. You can analyze the problem on a statistical basis and show that there are enough people out there with assets or income to fund their care at the end of life. But statistics do not determine the life expectancy of specific individuals. There are very few people who know exactly how long they will last. The idea of spending your last buck as you draw your last breath is a fantasy.



The flaw in your argument is extrapolating the exemplary care of your father and your superior stewardship of his care to the general population. The threat to the likes of OCA is that they will be told by the government who to accept as care patients and they will be unable to say no. If every parent had a child who was as savvy with money as you and they had built up a nest egg like your father has then 'no problem'. But not every care patient is so fortunate.

SNOOPY

you are quite right snoopy-not every care patient is so fortunate.
My understanding is that it can be difficult to get into a basic bed-and even when a person gets into the bed the government makes you pay until you get to a certain threshold.
If dhbs make it impossible to make the required investment to build standard beds this will get worse or less will be provided for those occupying a standard bed-eg porridge for breakfast,peanut butter sandwich for lunch.Weak cheap cups tea etc but ample food and calories-you would have no choice.
But if you are a little savvy and watch others paying for a more luxurious life you might consider upgrading.
Why let the dhbs force you to accept such a life.
Why not spend every cent you have enjoying better care.
If you are alive when money runs out you go back to the standard bed.
For most people the reality is that this wouldnt happen-your relatives would just get less inheritance

[Snoopy]

After hospital there are essentially two choices. Return to home with appropriate home based care services put in place. Or be assessed as requiring a certain level of residential care.

You now split this second option in two. If a person decides for themselves they want to go into residential care they pay all costs - no government funding. Alternatively if the health system assesses them as needing residential (basic) care they are then eligible for a DHB / Government residential care subsidy to pay for that care. To get a Residential Care Subsidy you need to pass a means test and essentially be "poor" (if you call having less then a quarter of a mil in assets poor).

The likes of OCA don't have a choice of who they admit for care. Agreed - (except a person has to be eligible for NZ health care). But they do have choices in that they can decline an aged person if they don't have a level of care bed available at the level of care required. So say for example they only have "en-suite attached" beds available then the "poor" person wont get that bed because the govt subsidy wont pay for the extra. The "poor" person will need to look elsewhere for a bed.

Given the $250k means test threshold I think you will find there is an enormous pipeline of "rich" private clients who will be prepared to pay over the odds to make a difference in their care in the later stages of their life.

That wont happen. The likes of OCA are private businesses and our governments tend to keep their noses out of business - at this kind of level. What may happen, is that in granting resource consent , or becoming a govt approved provider a "village" may need to provide a certain minimum number / ration of "basic" care beds to be be available for those who are eligible for the residential care subsidy. Maybe a bit like how some residential subdivisions have to provide a certain number of "affordable homes" in the scheme.

If this happened its unlikely such beds would be allowed to sit around empty - so the owners may charge government a base rate for holding an empty bed.

The aged care industry is getting to be pretty big - and that equals a pretty big lobby group. The last thing any government wants is aged care providers to shut up shop. Government do not want elderly people clogging up hospitals.

I am not so sure that the principal separation between 'luxury' and 'basic' is having an en-suite washroom and toilet. I would be interested to see any documentation that defines luxury in this way.

I am not even sure it is practical to have two levels of luxury at one site. I mean, think about it. Every day you are going to have to prepare two breakfasts, two lunches and two dinners, doubling the catering logistics. Then can you imagine the arguments:

"Hey - she stole my almond croissant, and left me with her toast and Marmite"

Worse would come at lunch where a battle line would be drawn between the 'blue cheese on asparagus' and 'boiled bean' brigades.

After lunch it would be traffic chaos as all the 'poor' were wheeled down to the end of the corridor to the shared toilet. More work in distance for the carers to cover. More work for the carers cleaning when those in the queue that 'couldn't hold on' soil the common corridor while waiting. Those in the 'cheap rooms' might end up costing more to look after in both time and cleaning products?

Come 'diversional therapy' time, the 'poor' would have to be locked in their room for an hour to make sure they did not benefit from the upper class entertainment. Extra sound proofing would need to be added to the doors of the poor, to ensure there was no leaking to the lower class of music or vocals.

I tend to think that at the extra care end of residency, luxury is more about more help with basic needs. Given no operator is offering a one staff member to one resident ratio, resident demands must of necessity be rationed. So a better staff to resident ratio and allowing more time for basic tasks, like eating in the dining room for instance , could make a real difference to 'quality of life'.

I am intrigued that by building en-suites only, you can exclude the poor from your residential care village. Is this hypothetical speculation, or is it really true?

I know one village I have looked at had a 'luxury room', luxurious because it was sold with a fine view of the manicured garden. The only problem was the bushes had grown up immediately outside the window so the view was largely obscured. Nevertheless I commented to the resident about the view and it turned out she was blind! So much for 'luxury' making a real difference in that case. In this particular facility it turned out 4/5 of the extra care units had been terned 'luxury units' and carried a daily premium surcharge. Whether that was done to (mostly) keep out the riff raff is a question I didn't have the presence of mind to ask. Incidentally, in this facility all rooms were en suite. Perhaps it might be easier to keep the riff raff out of the way 'day to day' with an en-suite configuration?

SNOOPY

[100101]

There again if people use their vote wisely services and pensions can gain a semblance of protection. Look how Winnies Super Gold Card and the basic pension has survived thus far.

[minimoke]

Snoopy.

I suspect Couta can put your issues to bed much more succinctly than I can. I think first you need to understand "Basic" which is the level of care the DHB contracts to the accredited care provider. I have cut / paste from the Min of Health again below for you.

Again from my personal experience. My day had an ensuite in c shower and toilet. My father in law (in a much cheaper local place) has a shared toilet and a separate shower down a corridor.

As far as meals are concerned they were essentially the same. Nutritious but not exciting. I guess as you get old and demented your palate gets less fussy. My dad loved blue cheese so as a treat I woudfl arrange for him to have some on his birthday and christmas - and there would be a charge later on his account. Wine / beer was out of the question - interfered with the meds.

My dad used to get bundled in to a van and taken to a local cafe for a coffee or just a sit in the sun for his diversionary therapy. I doubt that those who didn't go minded - they were in care after all. My father in law has gone nowhere. Both have had people come to play music, sing.

People in care go to the loo at any old time in any old place. Queueing isnt the issue. Thats why if they get to the point they cant wait incontinence nappies are provided.

We paid a bit more for the room with the view. It was superior to the one on the other side of the corridor which had a view over corrugated iron roof of the floor below. My dad got the sun through 2.5m long window, looked over a garden and across a lane to manicured properties. My father in law gets a 400mm wide window and its on the gloomy side of the property.

The other point about luxury, which you allude to, is not the luxury experienced by the resident - often they dont have the ability to experience it. It is the "luxury" the family wants to provide so when they visit or are away they can feel they the surroundings are the best they can provide. The reality is that these places are "gods waiting rooms". If you had a choice of your parents waiting in a sub-standard (by your own personal standards) or waiting in a "luxury" place what would you choose. i suspect those worried about the inheritance would choose the lesser.

Anyway below is wha tteh DHB contract to provide and dont provide.

The services covered by the subsidy (contracted care services) include:

• Food services
• Laundry
• Nursing and other care
• General practitioner visits
• Prescribed medication
• Continence products
• All health care that is prescribed by a general practitioner
• Transport to health services.

The Age Related Residential Care contract with district health boards requires rest homes and hospitals to tailor services to meet the needs of each resident. They cannot charge subsidised residents for services that are covered in this contract. The services a person can expect should be set out in the admission agreement or private contract they sign with their rest home or hospital.
The services that are not covered by the subsidy (that are not contracted care services) include:

• Specialist visits (not publicly funded by the DHB or ACC)
• Transport to other services or outside social functions
• Toll calls (made by the resident)
• Private phone or cellphone
• Newspapers, books and magazines (personal)
• Personal toiletries
• Recreational activities, where those are not part of the normal programme
• Hairdresser
• Dietitian, podiatrist or other services that have not been prescribed by a doctor or are not funded by the DHB
• Spectacles, hearing aids and dental care.

[minimoke]

Snoopy.
Just to give you an idea of the difference between basic and luxury.

The Maximum contribution rate for care was $1,015 a week. This is the "basic" care package and would be payable by the DHB if the aged person met the asset test threshold. For that you get the stuff I listed above

We were paying $1,483 a week for the "luxury' package or $212 a day. Add to that things like a haircut ($18) or non - prescription eye drops at $14.50. It was the weekly consumables that soon mounted up as well.

Basic fact of life - getting old and needing care is not a cheap way of going. May as well go out in style!

(These arent OCA rates - not sure what they charge)

[Snoopy]

Below is what the DHB contract to provide and don't provide.

The services covered by the subsidy (contracted care services) include:

• Food services
• Laundry
• Nursing and other care
• General practitioner visits
• Prescribed medication
• Continence products
• All health care that is prescribed by a general practitioner
• Transport to health services.

The Age Related Residential Care contract with district health boards requires rest homes and hospitals to tailor services to meet the needs of each resident. They cannot charge subsidised residents for services that are covered in this contract. The services a person can expect should be set out in the admission agreement or private contract they sign with their rest home or hospital.

The services that are not covered by the subsidy (that are not contracted care services) include:

• Specialist visits (not publicly funded by the DHB or ACC)
• Transport to other services or outside social functions
• Toll calls (made by the resident)
• Private phone or cellphone
• Newspapers, books and magazines (personal)
• Personal toiletries
• Recreational activities, where those are not part of the normal programme
• Hairdresser
• Dietitian, podiatrist or other services that have not been prescribed by a doctor or are not funded by the DHB
• Spectacles, hearing aids and dental care.

Snoopy.
Just to give you an idea of the difference between basic and luxury.

The Maximum contribution rate for care was $1,015 a week. This is the "basic" care package and would be payable by the DHB if the aged person met the asset test threshold. For that you get the stuff I listed above

We were paying $1,483 a week for the "luxury' package or $212 a day. Add to that things like a haircut ($18) or non - prescription eye drops at $14.50. It was the weekly consumables that soon mounted up as well.

OK, so all those diversional therapy extras are not part of any basic package. Yet the basic care package is quite comprehensive,in the sense that all of your really basic needs (apart from clothing) are covered. It does make one think though, about all those folk stuck on a minimum care package with no extended family looking after them. It would be a very basic existence, that is for sure.

That contribution rate of $1,105 is what the provider gets? I think when it comes to 'billing the client' the residential care provider would add on whatever the after tax payment of NZ Superannuation comes to. In round figures, around $250? So the overall 'basic bill' from the resident client's perspective would be $1,355m per week.

For the luxury option:

$212 x 7 = $1,484

That works out at a premium of $129 per week. That is enough to make a useful difference to the resident's in care experience.

The interesting thing I see in that 'list of the basics' is that they are all services. There is no prescriptive information on how big a room needs to be, or whether there is an en-suite. This suggests to me that the likes of OCA cannot escape their 'public duty' by claiming that their rooms are not 'down to scratch' for potential residents subsidised for only basic care. That means the scenario where the likes of OCA will be assigned a 'poor' -in dollar wealth terms- patient for permanent care is a real one. And to go back to what the chief executive of Parkwood, Mark Rouse, said in the Kapiti News article that I originally mentioned, care beds are not being funded at a rate that can absorb increases in running costs over the last year. This means that an outfit like OCA, that runs a very high percentage of care beds, could be in real trouble going forwards. That is the way I see things anyway.

SNOOPY

[winner69]

Share price down to 103 today if you guys hadn’t noticed

Not that good eh

[trader_jackson]

Share price down to 103 today if you guys hadn’t noticed

Not that good eh

only looked at ARV today, never mind sum others.