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Program allows participants to buy access to long-term care long before it's needed

New Hampshire Union Leader

May 30. 2017 2:50AM
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Silver Linings is a continuing Union Leader/Sunday News report focusing on the issues of New Hampshire's aging population and seeking out solutions.

Union Leader reporter Gretchen Grosky would like to hear from readers about issues related to aging. She can be reached at or (603) 206-7739.

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Pat Francis is 74, wants to live a long life, and hopes when the time comes she will die in her own bed.

But Francis is betting the odds she may end up in a nursing home. She joined a one-of-a-kind program in New Hampshire called At Home By Hunt, a nonprofit organization that promises to coordinate all her future care at home.

If the time comes for a nursing home, At Home By Hunt guarantees Francis a private room with bath — and it will all be paid for.

Francis paid $46,000 to join last year and continues to pay a monthly fee of $515. She said it took her a year to decide whether it was worth paying so much for services she has yet to use or may never need.

“Every day you get up in the morning and you feel fine and then you start waking up and there is an ache here or an ache there,” she said. “You starting thinking, ‘What’s coming next?’”

She decided At Home By Hunt was a way to ensure she gets the future care she wants at today’s nursing home prices.

“You insure your health. You insure your car. You insure your home. You insure your life,” Francis said. “Why wouldn’t you insure your future?”

At Home By Hunt is one of 32 such continuing care at home (CCAH) programs in the country and the only one in New Hampshire. The goal of the program is to keep seniors healthy and at home for as long as possible. These programs bank on keeping their members out of expensive facilities by taking only physically and financially fit members who pay for their care in advance.

At Home By Hunt is a nonprofit that has been around since 2011 and is sponsored by Silverstone Living in Nashua. Should At Home By Hunt ever suffer financial difficulties, Silverstone would be on the hook for members’ care, said Mary Rhodes, At Home By Hunt’s executive director.

Francis is banking on it.

“The cost is a major factor. You’re putting a lot of money up front,” Francis said. “But you’ve got to be thinking about what it will cost you down the road.”

Cost of care

At Home By Hunt only takes healthy people age 62 or older who can afford the service. Contracts show the one-time fee can range from about $40,000 to $122,000 depending on a person’s age and the type of plan they choose.

All members agree to pay a monthly $515 fee, which is up from $500 last year, said John Parolin, marketing director. There is a discounted rate for couples who are accepted.

Rhodes compares the price of At Home to the average cost of annual nursing home care, which stands at about $110,000 nationally.

At Home members “may be receiving 12,000 dollars’ worth of services a month, but they are receiving it for $515,” Rhodes said. “This is the wave of the future.”

At Home By Hunt is not covered by Medicare or Medicaid, but does work with some long-term care insurance providers.

Parolin said up to 100 percent of the membership fee and up to 71 percent of the monthly fee may be tax deductible, depending on a person’s tax situation. He said it’s like buying health care at today’s rates, no matter when you use it in the future.

“You don’t buy home insurance because you think your home will burn down,” he said. “You do that because you’re a planner. It’s a way to mitigate the exposure.”

How it works

Each potential client and his or her home is evaluated physically before being accepted, Rhodes said. Parolin said members pride themselves on their health, mentioning an 89-year-old member who is still an avid skier.

Once signed up, a member is assigned a care coordinator for when there is a need, Rhodes said. Whether it’s a 24-hour companion, a visiting nurse, or some light housekeeping, the At Home care coordinator ensures it happens and the organization pays for it.

Should the need become too much, At Home pays for care at an assisted living facility or a nursing home.

Rhodes said the staff works hard to keep members healthy, offering exercise classes, opportunities to socialize and other programs at The Huntington in south Nashua, which, along with the Hunt Community in downtown Nashua, is also part of Silverstone Living.

Francis joined a water aerobics class, is taking Tai Chi, and will go over to The Huntington for a Saturday night movie or dinner.

“Their goal is to keep you well and out of their place,” Francis said.

The membership does continue without interruption for members who move elsewhere in New Hampshire, Rhodes said. At Home is working on a reciprocal agreement with a similar program on Florida’s Gulf Coast so snowbirds could get continuous coverage in either state.

Should a person’s money run out, Rhodes said, the client will be taken care of. “We make a promise to them that we will be there when they need us,” she said.

The viability

At Home currently has 63 members and only three are receiving services, Rhodes said. LeadingAge, a national association of CCAH communities, reports only 2 percent of all members across the country are in nursing homes.

That’s proof of success, said Steve Maag, director of residential communities for LeadingAge.

He said these types of communities began in the early 1990s, but didn’t take hold until the recession 10 years ago. It was then that those in elder care started looking at home-based programs instead of building expensive facilities, Maag said.

Maag said the majority of these programs — like At Home By Hunt — are linked to residential communities, which helps mitigate the risk of a CCAH finding itself in financial difficulty.

In New Hampshire, At Home By Hunt is regulated by the state Division of Insurance, which requires the nonprofit to keep a certain amount of money on hand and to provide all members with financial statements.

“It can be scary to think of paying so much money up front, especially to an organization that might not have any real physical assets beyond the fees that (it takes) in,” Maag said. “It’s not for everybody.”

Promise of quality care

At Home By Hunt sends out mailers to area seniors, inviting them to free lunches hosted around the state to learn about the program.

“We’re not trying to sell people. We’re trying to educate people,” Parolin said. “We want to help with their decisions.”

Rhodes said At Home By Hunt’s mission is quality care, not money. She points to the fact that At Home is not accepting new members in the Lake Sunapee area because of the state’s shortage of health care workers.

“We are not going to take on new members that we cannot ensure quality care for,” she said. “We make them a promise and we stick by it.”

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