Presentation to the · 2018-03-31 · STATE OF FLORIDA TRAVELER: EXAMPLE DEPARTMENT OF INSURANCE &...
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Presentation to the Governor’s Continuing Care Advisory Council September 29, 2015
Transcript of Presentation to the · 2018-03-31 · STATE OF FLORIDA TRAVELER: EXAMPLE DEPARTMENT OF INSURANCE &...
Presentation to the
Governor’s Continuing Care
Advisory Council
September 29, 2015
Reading of the Conflict of
Interest Statement
Chapter 112, Florida Statutes
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Duties of the Advisory Council
• Meet at least once a year
• Elect officers
• Hold other meetings as required
• Keep a record of its proceedings
• Act in an advisory capacity to the Office
• Recommend to the Office needed changes in statutes and rules
• Upon the request of the Office, assist with any corrective action,
rehabilitation or cessation of business plan of a provider
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STATE OF FLORIDA TRAVELER: EXAMPLE DEPARTMENT OF INSURANCE & TREASURER
VOUCHER FOR REIMBURSEMENT SOCIAL SECURITY NO. XXX-XX-XXXX NON-EMPLOYEE____ HEADQUARTERS: TALLAHASSEE
OF TRAVEL EXPENSES ORGANIZATION NO.: 43-82-23-10-000R1 RESIDENCE (CITY): THE CITY YOU RESIDE IN
Travel Performed Purpose or Reason Hour of Meals for Per Diem or Class Map Vicinity Other Expenses/Common Carrier Date From Point of Origin (Name of Conference) Departure and Class A & B Actual Lodging C Mileage Mileage Paid by Traveler
To Destination Hour of Return Travel Expense Meals Claimed Claimed Amount Type
09/17/2013 CITY TO TALLAHASSEE ANNUAL CONTINUING CARE TIME HOTEL AND RETURN ADVISORY COUNCIL MEETING DEPARTED
MILES AIRPORT PARKING
TIME AVIS CAR RENTAL
RETURNED
TOLLS
Statement of Benefits to the State or Attach Authorization Form (Conference or Convention): Column Column Column 0 MI. Column SUMMARY
Total Total Total 0.44 @MI. Total TOTAL ***PLEASE NOTE THAT THIS VOUCHER IS JUST AN EXAMPLE OF EXPENSES THAT
MAY OCCUR. ALL EXPENSES MAY NOT APPLY TO EVERY PERSON. PLEASE
REMEMBER TO SIGN THE VOUCHER AND ATTACH ALL ORIGINAL RECEIPTS. ***
TOTAL TOTAL
REMEMBER TO SIGN THE VOUCHER AND ATTACH ALL ORIGINAL RECEIPTS
LESS CLASS C MEALS (Employees Only)
NET AMOUNT DUE TOTALS REVOLVING FUND: MAIL CHECK TO: FOR ACCOUNTING USE ONLY: OBJECT AMOUNT CHECK NO.:
ORG: _________________________ CHECK DATE: EO: _________________
AGENCY VOUCHER NO.: NET AMOUNT DUE $
I hereby certify or affirm that the above expenses were actually incurred by me as necessary travel expenses in the performance of my official duties; attendance at a Pursuant to Section 112.031(3)(a), Florida Statutes, I hereby certify or affirm that to the best of my knowledge the above conference or convention was directly related to official duties of the agency; any meals or lodging included in a conference or convention registration travel was on official business of the State of Florida and was performed for the purpose(s) stated above. have been deducted from this travel claim; and that this claim is true and correct in every material matter and same conforms in every respect with the requirements of section 110.061, Florida Statutes.
TRAVELER'S SIGNATURE: X SUPERVISOR'S SIGNATURE:
TITLE: Council Member DATE PREPARED: X SUPERVISOR'S NAME:
SUPERVISOR'S TITLE: DATE:
TRAVEL PERFORMED BY COMMON CARRIER OR STATE VEHICLE
THIS SECTION REQUIRED TO BE COMPLETED ONLY WHEN COMMON CARRIER IS BILLED DIRECTLY TO THE STATE AGENCY.
Ticket Number or Name of Common Carrier or DATE State Vehicle Number From To Amount State Agency owning vehicle
DI4-500 (REV. 09/93)
Travel Voucher
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Review & Approval of Minutes of
the Governor’s Continuing Care
Advisory Council Meeting (September 29, 2014)
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Actions Requiring an
Acquisition Filing
• Section 628.4615 (13)(a), Florida Statutes
o “Acquisition” includes any form of change in control
whereby any person or affiliated person acquires or
attempts to acquire, directly or indirectly, 10 percent
or more of the ownership interest or assets of a
CCRC or of a controlling company.
• Examples include but are not limited to:
o Purchase of interest in a provider or parent company
o Purchase of a facility’s asset(s)
o Mergers
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Findings Required for Approval of
an Acquisition Application
• Upon completion of the acquisition, the CCRC will be able
to satisfy the requirements for the issuance of a license.
• The financial condition of the acquiring person or persons
will not jeopardize the financial stability of the CCRC or
prejudice the interests of its residents or the public.
• Any plan or proposal made by the acquirer is fair and free
of prejudice to the residents or to the public.
• The competence, experience, and integrity of those
persons who will control the CCRC indicate that the
acquisition is in the best interest of the residents and in the
public interest.
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Approval findings (cont.)
• The background information provided indicates that it is in the best interest
of all involved to allow those who have applied to exercise control.
• The partners, owners, managers and other persons performing similar
duties to be employed after the acquisition have sufficient CCRC
experience and ability to assure reasonable promise of successful
operation.
• The management including officers and directors of the CCRC after the
acquisition will be competent and trustworthy, and will possess sufficient
experience so as to make the proposed operation of the CCRC not
hazardous to the public.
• The acquisition is not likely to be hazardous or prejudicial to the residents or
the public.
• The acquisition will not substantially lessen competition or create a
monopoly.
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Application Components
• Information on the acquirer
o Industry experience
o Financial statements
• Disclosure of whether the acquirer intends to
make any changes to the organizational
structure or operations of the CCRC
o Pro forma financial statements
o Actuarial analysis or feasibility study
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Application Components (cont.)
• Information on owners, officers, directors and
managers
o Biographical affidavits
o Fingerprint cards
o Investigative reports
• Financing documents
• Proof of reserve funding
• Updated escrow agreements, residency contracts, and
other forms
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Application Requirements
• An acquirer is required to file a Letter of
Notification within 5 days of the agreement to
acquire or within 5 days after the acquisition of
the ownership interest;
• The acquisition application is required to be filed
within 30 days after the acquisition has occurred;
and
• The Office has approved the acquisition.
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Application Requirements (cont.)
• During the pendency of the proceeding or review period by the office any person or affiliated person complying with the filing requirements of this section may proceed and take all steps necessary to conclude the acquisition so long as the acquisition becoming final is conditioned upon obtaining office approval.
• As a practical matter, pre-approval is considered
necessary. A transaction may be required to be
unwound if the provisions of the acquisition statute
are not followed.
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Administrative Supervision
Statute Overview Chapter 624, Part VI, Florida Statutes
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Administrative Supervision
• A CCRC can consent to Administrative Supervision or be
ordered into Administrative Supervision by the Office.
• If Administrative Supervision is ordered by the Office, a
CCRC is entitled to an administrative hearing, which will
stay the action.
• Successful Administrative Supervision requires the
agreement and cooperation of the management of the
CCRC.
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Administrative Supervision (cont.)
• The management of the CCRC stays in place during Administrative Supervision.
• A deputy supervisor is appointed to oversee the management of the CCRC, but, unlike a receiver appointed pursuant to Chapter 631, Florida Statutes, the deputy supervisor does not manage the CCRC.
• The deputy supervisor approves or disapproves actions proposed by the management.
• While under administrative supervision, the CCRC may contest actions taken or proposed to be taken by the supervisor, and the CCRC is entitled to administrative hearings on those actions.
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Florida CCRCs
2014
• 71 licensed CCRCs
• No PCOAs
• 7 Monthly Reporters
• 56 Quarterly Reporters
• 13 Accredited Providers
• 5 CCRCs in Run-Off
2015
• 71 licensed CCRCs
• 1 PCOA
• 8 Monthly Reporters
• 58 Quarterly Reporters
• 9 Accredited Providers
• 4 CCRCs in Run-Off
21 Source: Life & Health Financial Oversight
Leon Alachua Clay Duval Westminster Oaks Oak Hammock Park of the Palms* Cypress Village
Penny Ret. Comm. Fleet Landing
Pinellas Freedom Square Masonic Homes of Florida Mease Manor Regency Oaks St. Mark Village Westminster Palms Westminster Shores Westminster Suncoast Hillsborough Canterbury Towers Freedom Plaza John Knox Village of Tampa Bay University Village Polk Florida Presbyterian Homes Estates at Carpenter’s Manatee Freedom Village Westminster Comm. Of Bradenton Providers Not Owning Facilities Independent Order of Foresters- Forester Haven *
Lake Freedom Pointe at the Villages Lake Port Square Lakeview Terrace Seminole Village on the Green
Sarasota Bay Village of Sarasota Fountains at Lake Pointe Woods* Glenridge at Palmer Ranch Lakehouse West Plymouth Harbor Village on the Isle Waterside Retirement Estates * Charlotte South Port Square Lee Cypress Cove Gulf Coast Village Shell Point Village Terraces at Bonita Springs
Collier Arlington at Naples Glenview at Pelican Bay Moorings Park Vi at Bentley Village * = Facilities in Runoff
St. Johns Glenmoor Vicar’s Landing Westminster Woods on J. Creek Volusia Alliance Community for Retirement FL Lutheran Retirement Center John Knox Village Central FL Orange Mayflower Retirement Center Orlando Lutheran Towers Westminster Towers Winter Park Towers Brevard Buena Vida Estates Indian River Indian River Estates Martin Sandhill Cove Palm Beach Abbey Delray Abbey Delray South Devonshire at PGA National Edgewater Pointe Estates Harbour’s Edge La Posada Sinai Resident of Boca Raton St. Andrews Estates Vi at Lakeside Village The Waterford Broward Casa Sant’Angelo (PCOA) Covenant Village of Florida John Knox Village of Florida
Escambia Azalea Trace
CCRC Facility Location
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Miami-Dade East Ridge at Cutler Bay Vi at Aventura
Source: Life & Health Financial Oversight
Facility Size by Unit Count
1 - 300 Units 18 Facilities
27%
301 – 600 Units 39 Facilities
58%
601 – 900 Units 8 Facilities
12%
More than 900 Units 2 Facilities
3%
23 Source: Life & Health Financial Oversight
Total Occupancy
2011 2012 2013 2014
24,199 24,129 24,776 25,490
28,158 28,212 29,084 30,511
CCRC Residents
All Occupants
24 Source: Life & Health Financial Oversight
CCRC Units
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
2011 2012 2013 2014
2,111
2,407
2,635 2,737
3,430 3,503 3,538
3,117
CCRC Units Sold
CCRC Units Vacant
25 Source: Life & Health Financial Oversight
CCRC Units (cont.)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2013 2014
19,218 19,637
2936 3054
4927 5407
2077 2407
Rental Units
Skilled Nursing Beds
Assisted Living Units
Independent Living Units
26 Source: Life & Health Financial Oversight
Median Occupancy All Units
83.0%
84.0%
85.0%
86.0%
87.0%
88.0%
89.0%
90.0%
2013 2014
86.1%
88.0%
85.7% 85.7%
87.9%
89.3%
85.2%
87.9%
Independent Living
Assisted Living
Skilled Nursing
All Units*
*CCRC Residents only, excludes Rentals
27 Source: Life & Health Financial Oversight
Florida CCRC Industry Data
(200,000,000)
0
200,000,000
400,000,000
600,000,000
800,000,000
1,000,000,000
1,200,000,000
1,400,000,000
1,600,000,000
Total Revenue* Total Expenses**
Total Net Income
2013
2014
Income
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*Total Revenue is the total amount of revenue reported in the 2013 and 2014 annual reports. **Total Expenses is the total amount of expenses reported in the 2013 and 2014 annual reports. These definitions are consistent with prior presentations to the Governor’s CCAC.
Source: Life & Health Financial Oversight
Florida CCRC Industry Data (cont.)
0
200,000,000
400,000,000
600,000,000
800,000,000
1,000,000,000
1,200,000,000
1,400,000,000
1,600,000,000
1,800,000,000
Total Operating Revenue*
Total Operating Expenses**
Net Operating Income
2013
2014
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*Total Operating Revenue is calculated as all revenues and gross entrance fees received less earned entrance fees and refunds paid. **Total Operating Expenses is calculated as all expenses less facility interest, depreciation, and amortization expenses. This information comes from the 2013 and 2014 annual reports. The definitions provided are consistent with prior presentations to the Governor’s CCAC.
Source: Life & Health Financial Oversight
Median CCRC Data
2013
• Median Revenue o $19,150,000
• Median Expenses o $19,200,000
• Median Net Income o $85,000
• Median Net Operating Income o $4,889,754
• Median Revenue Growth o Monthly Fees 3.50%
o Health Care Revenue 1.18%
o Other Income 2.69%
2014
• Median Revenue o $18,890,000
• Median Expenses o $18,800,000
• Median Net Income o $ (67,000)
• Median Net Operating Income o $4,401,488
• Median Revenue Growth o Monthly Fees 4.00%
o Health Care Revenue 4.06%
o Other Income 20.55%
30 Source: Life & Health Financial Oversight
Facilities Reporting Positive Income
2013
• Positive Net Income
o 53.6%
• Positive Net Operating
Income
o 94.2%
2014
• Positive Net Income
o 49.3%
• Positive Net Operating
Income
o 100%
31 Source: Life & Health Financial Oversight
CCRC Complaints Received by the
Department of Financial Services,
Division of Consumer Services
July 1, 2014 - June 30, 2015
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Complaint Resolution
1. Reserves Issue - 1/29/2015
Resident concerned with community’s monetary
reserves.
Status: Closed
Resolution: Resolved
2. Property Conditions Issue - 4/1/2015
Request for mediation by provider with resident.
Status: Assigned
Resolution: N/A
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Refund Data Calls
Data Calls for refund information are sent to all
licensed providers on a semi-annual basis.
Data Call “As of Dates”
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2013 2014 2015
August 31, 2014 June 30, 2015
December 31, 2013 December 31, 2014
Source: Life & Health Financial Oversight
June 2015 Data Call Results
• 72 Providers responded
• 1 Provider did not respond
• 42 Providers had outstanding refunds
• 289 total outstanding refunds
• 101 Refunds due from next entrance fee
• Reason for contract cancellation
o Withdrawal of Resident – 89
o Passing of Resident – 200
• $40,319,119 of outstanding refunds
• 6 Providers have refunds outstanding that are over 360 days
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Source: Life & Health Financial Oversight
June 2015 Data Call Results
No Outstanding 42%
1 - 5 Outstanding
Refunds 40%
16 – 20 Outstanding
Refunds 4%
11 – 15 Outstanding
Refunds 4%
6 – 10 Outstanding Refunds
4% 21 – 25
Outstanding Refunds
6%
37 Source: Life & Health Financial Oversight
Advice to the Office on matters
pertaining to the operation and
regulation of continuing care
facilities
Presented by
Governor’s Continuing Care Advisory Council
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Review and Discussion
regarding a “Guarantee Fund”
for CCRC Refunds
Presented by Walter Hood
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Confidentiality of potential
Board members who are
involved in the PCOA process
Presented by Rich Scanlon
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Presentation of the
CCRC Default Study provided
by Ziegler
Presented by Rich Scanlon
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