Texas Assisted Living Facility Adds Skilled Nursing Beds With A Medicaid Focus

August 2, 2018, Maggie Flynn, Skilled Nursing News - Simpson Place Assisted Living expanded its facility in Dallas, adding 50 skilled nursing beds and celebrating with a ribbon cutting last month.  It’s a move that could seem curious given declining skilled occupancy and Texas’ low Medicaid reimbursement rates.

Simpson Place operator StoneGate Senior Living “kind of bucks the trend” in terms of occupancy, according to Brandon Tappan, the StoneGate divisional vice president of operations over Texas and Colorado.

Adding skilled nursing beds to Simpson Place — now Simpson Place Assisted Living & Skilled Nursing — was a direct response to the needs of the assisted living residents there, Tappan told Skilled Nursing News.

The facility is a collaboration with the Dallas Housing Authority (DHA), where StoneGate and and the DHA work together to provide affordable assisted living for low-income and moderate income people.  Medicaid is accepted as a payer at the facility, as well as vouchers from people enrolled in the DHA’s affordable housing program.

Simpson Place had a five-story assisted living facility with 120 apartments, while the building’s sixth floor was built and finished but empty.  StoneGate converted that sixth floor to skilled nursing at a cost of roughly $500,000, Tappan said.  Because the building was already in place, construction on the skilled units started around the beginning of this year and was completed in about six months.

Currently 75 of the 120 assisted living apartments are filled.

“Demand has been great, but a lot of our patients have needed skilled nursing and have had to go off to a lot of skilled nursing centers in the area,” Tappan explained.  “And so with this property, we thought we could take our sixth floor [for skilled nursing].”

At the time of the interview, Simpson was waiting for the building’s health inspection for Medicare and Medicaid licenses in Texas; the facility has already passed its life safety code inspection, the first step of the two-part process in the state for certification.

In the meantime, the facility can take a few private-pay patients for skilled nursing, of which it had two at the time SNN spoke with Tappan.

The DHA partnership doesn’t come into play for the skilled nursing beds, but they’re intended primarily for the assisted living residents at Simpson who need long-term Medicaid beds in the skilled setting. 

Though rehab-to-home isn’t a major focus, the facility is “right in the shadow of Baylor University Medical Center,” Tappan noted.  As a result, six rooms have been set aside and left completely private for transitional care; the rest of the skilled beds will be semi-private, he explained.

“We may find that demand for transition care is stronger than we thought,” he noted.  “The first intent really, again, is just to provide a good Medicaid product for long-term care.  There’s a lot of folks who come from the hospital who may be younger and may not even be Medicare yet, only Medicaid.  And those folks are sometimes hard to place.”