A relatively new ordinance in one Michigan city is getting pushback from some senior living communities that are being charged for nonemergency 911 calls. The ordinance, they say, does not distinguish between the offerings of various levels of service and care nor recognize that some settings do not employ caregivers.
The city of Sterling Heights, MI, passed an ordinance last March that charges independent living communities, assisted living communities and nursing homes an $800 fee for a lift assist and a $500 fee for a nonemergency medical response. The Detroit suburb moved to implement the fees after noticing an increase in those types of calls, which they label a “misuse” of 911. The city said that the fees allow some of its costs from these calls to be recouped.
After adoption of the ordinance last March, the city conducted in-person visits to communities and facilities in April to educate them about the fees before enforcement began on May 1. The ordinance states that nonemergency calls to “residential living facilities that are compensated to maintain staff to assist their residents is an inappropriate and unwarranted drain on city resources, which at times has caused delays in response to true emergencies.”
The city pointed out that operators can buy devices to help staff members lift residents if they fall, according to The Detroit News.
A city attorney told the media outlet that the fire department handles more than 240 lift assists annually, on average, in assisted living communities and an average of more than 400 nonemergency medical responses, including calls to transfer residents to the hospital because they ran out of medication.
The ordinance further states that nonemergency ambulance transports are regularly provided by first responders due to “a lack of facility staffing, a disinterest by the facility in addressing these needs for their residents, a lack of proper equipment at the facility, or other reasons that do not warrant or justify the use of city emergency responder resources.”
No caregivers employed
Waltonwood Senior Living contends that the ordinance should not apply to the independent living community at its Waltonwood Lakeside campus in Sterling Heights, which also offers assisted living and memory care. Waltonwood Director of Operations Steven Tyshka told The Detroit News that he agrees with the city of Sterling Heights on charging assisted living communities, but he argued that the ordinance should not be applied to unlicensed independent living, where caregivers are not employed.
A Waltonwood spokesperson told McKnight’s Senior Living that it is committed to transparent communication with residents and their families, “ensuring they understand the specifics of the services we provide at each level of care.”
“We are working to proactively address the Sterling Heights ordinance, emphasizing the clear distinction between independent and assisted living in our communities and navigate these changes effectively,” the spokesperson said. “We are dedicated to upholding the highest standards of care and compliance while also ensuring our residents are informed and supported every step of the way.”
The Michigan Assisted Living Association agreed, saying that independent living residents are “clearly not contracting for any personal care or assistance,” adding that those residents often sign up strictly for room and board.
“It is frustrating that Sterling Heights does not acknowledge the difference between independent living and assisted living,” MALA General Counsel Robert L. Stein told McKnight’s Senior Living.
Not a statewide trend
Fortunately, the Sterling Heights ordinance is not a statewide trend, Stein said, adding that MALA is hopeful that the issue will be resolved “favorably and fairly” for independent living residents.
“We are aware of providers using private ambulance companies in lieu of calling the city responders for these types of services,” Stein said. “This approach is not a permanent solution but offers some flexibility and cost savings.”
In response to the fees, Waltonwood Lakeside informed its independent living residents in November that it would institute an $800 charge to residents who receive a lift assist from the city to recover its costs, according to the Detroit News.
Tacoma, WA, implemented a similar ordinance in 2019. The Washington Health Care Association and LeadingAge Washington partnered with city safety forces to decrease the number of 911 calls for lift assistance for long-term care facilities. The organizations educated first responders on the training and staffing requirements of assisted living communities compared with skilled nursing facilities, and provided education to community and facility staff members.
