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Caring for Mom: Establishing Statutory Rights for Elder Care Facilities

Published online by Cambridge University Press:  01 January 2021

Abstract

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Type
Notes & Recent Case Developments
Copyright
Copyright © American Society of Law, Medicine and Ethics and Boston University 2020

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References

1 Construction Dangers Threaten Health and Safety of Children and Staff at P.S. 163, No Jewish Home Lifecare at Park West Village (Sept. 23, 2018), http://www.nojhlatpwv.com/blog/september-23rd-2018 [https://perma.cc/L2E5-8M8V].

2 Feltner, Kasey A., #Not in My Backyard, Granny: The Discoverability of a Public Official's Private Electronic Messaging Activity in Land Use Litigation, 5 Stetson J. of Advoc. & L. 50, 1 (2018)Google Scholar.

3 Long-term assistance in the context of this Note will include both skilled and custodial care. “Elder care facilities” may also be referred to as senior care facilities, nursing homes and other names.

4 Different Types of Elder Care Communities, Interim Healthcare, https://www.interimhealthcare.com/education-center/consumer-health-care-education/different-types-of-elder-care-communities [https://perma.cc/5XTN-7B6R]. Specific definitions of the different categories of elder care facilities, as well as their importance for a senior citizen's health and wellbeing, will be discussed when constructing the proposed statute.

6 Exclusionary zoning regimes have become a major hurdle to the development of elder care facilities, effectively pushing them to the outskirts of communities. See Kling, Michael, Zoned Out: Assisted Living Facilities and Zoning, 10 Elder L. J. 187, 215 (2002)Google Scholar.

7 2017 National Population Projections Tables, U.S. Census Bureau (2017), https://www.census.gov/data/tables/2017/demo/popproj/2017-summary-tables.html [https://perma.cc/N5NXLE47].

8 Id.

9 Older People Projected to Outnumber Children for First Time in U.S. History, U.S. Census Bureau (2018), https://www.census.gov/newsroom/press-releases/2018/cb18-41-population-projections.html [https://perma.cc/3JKC-CY48].

10 U.S. Census Bureau, Driving Population Growth: Projected Number of People Added to U.S. Population by Natural Increase and Net International Migration (2017), https://www.census.gov/content/dam/Census/library/visualizations/2018/comm/pop-projections-2.pdf [https://perma.cc/674A-6RVA].

11 Reenita Das, A Silver Tsunami Invades the Health of Nations, Forbes (Aug. 11, 2015), https://www.forbes.com/sites/reenitadas/2015/08/11/a-silver-tsunami-invades-the-health-of-nations/#20fde0193efd [https://perma.cc/9A8F-PL4Q].

13 Andrew Meola, Future Demand for Elderly Care Services Like Assisted Living & In-Home Care Are Rife for Digital Disruption, Bus. Insider (Jul. 8, 2019), https://www.businessinsider.com/senior-care-market-trends [https://perma.cc/K9JY-DQKX].

14 Anne-Marie Botek, Combatting the Epidemic of Loneliness in Seniors, AgingCare, https://www.agingcare.com/articles/loneliness-in-the-elderly-151549.htm [https://perma.cc/UN8T-B9KG].

15 LeRoy, Angie S. et al., Loneliness Predicts Self-Reported Cold Symptoms After a Viral Challenge, 36 Health Psychol. 512, 512 (2017)CrossRefGoogle ScholarPubMed.

16 Leland Kim, Loneliness Linked to Serious Health Problems and Death Among Elderly, UCSF (June 18, 2012), https://www.ucsf.edu/news/2012/06/98644/loneliness-linked-serious-health-problems-and-death-among-elderly [https://perma.cc/CBU6-VPWE].

18 Bartels, Stephan J. & Nasland, John A., The Underside of the Silver Tsunami: Older Adults and Mental Health Care, 368 New Eng. J. Med., 493, 493-96 (2013)CrossRefGoogle ScholarPubMed.

20 Trevor Tompson, et al., Long-Term Care: Perceptions, Experiences, and Attitudes among Americans 40 or Older, Associated Press-NORC Center (Apr. 2013), http://www.apnorc.org/projects/Pages/long-term-care-perceptions-experiences-and-attitudes-among-americans-40-or-older.aspx [https://perma.cc/3G98-6HNK].

21 “Unpaid caregiving” refers to support given to senior citizens by other members of their family. See Tom Daschle & Tommy Thompson, Who Will Care for America's Aging Population?, Wash. Post (Nov. 21, 2013), https://www.washingtonpost.com/opinions/who-will-care-for-americas-aging-population/2013/11/21/2609df64-4657-11e3-a196-3544a03c2351_story.html [https://perma.cc/BAE8-5T88].

22 Id.

23 National Academies of Sciences, Engineering and Medicine, Families Caring for an Aging America (Richard Schultz & Jill Eden, eds., 2016).

24 Id.

25 Botek, supra note 14.

26 Id.

27 The Benefits of Living in a Nursing Home, Senior Path, https://seniorpath.com/the-benefits-of-living-in-a-nursing-home/ [https://perma.cc/MUZ2-ME73].

28 Beth Burnham Mace, Five Key Takeaways from NIC's Third Quarter 2018 Seniors Housing Data Release, National Investment Center for Seniors Housing & Care, https://blog.nic.org/blog/five-keytakeaways-from-nics-third-quarter-2018-seniors-housing-data-release [https://perma.cc/YV7A-CQMV].

29 Id.

30 U.S. Census Bureau, supra note 7.

31 Older People Projected to Outnumber Children for First Time in U.S. History, U.S. Census Bureau (2018), https://www.census.gov/newsroom/press-releases/2018/cb18-41-population-projections.html [https://perma.cc/RN28-BX9V].

32 Donna Mitchell, Occupancy Rates for Assisted Living to Plateau in 2017 Before a Spike, Natl Real Est. Inv. (Jun. 27, 2016), https://www.nreionline.com/seniors-housing/occupancy-rates-assisted-living-plateau-2017-spike [https://perma.cc/YBC6-6K2T].

33 Selected Long-Term Care Statistics, Family Caregiver Alliance (Jan. 31, 2015), https://www.caregiver.org/selected-long-term-care-statistics [https://perma.cc/78XU-BDUX].

34 Id.

35 Mary Blumberg, Metro Atlanta's Senior Housing Shortage, Atlanta Regl Commn (April 2017), http://atlantaregional.org/wp-content/uploads/arc-policybriefing-aginghousing-final-1.pdf [https://perma.cc/4KR8-3BUU].

36 Health Affairs Study: More Than Half of Middle-Income Seniors Will Lack Financial Resources for Seniors Housing and Care by 2029, National Investment Center for Seniors Housing & Care (Apr. 24, 2019), https://www.nic.org/news-press/health-affairs-study-more-than-half-of-middle-income-seniors-will-lack-financial-resources-for-seniors-housing-and-care-by-2029 [https://perma.cc/J6ML-V3ZZ].

37 Blumberg, supra note 35.

38 Id.

40 See Mass. Gen. Laws ch. 185, §§ 1, 3A (2019).

41 A Practical Guide to Understanding Zoning Laws, Property Metrics, https://www.propertymetrics.com/blog/2017/01/06/zoning-laws [https://perma.cc/E4UE-UTVZ].

42 Mass. Gen. Laws ch. 40A, §1A; see generally Young v. Am. Mini Theatres, Inc., 427 U.S. 50, 74 (1976) (quoting Village of Euclid, Ohio v. Ambler Realty Co., 272 U.S. 365, 387-88 (1926)). It must be noted that the “health, safety, and general welfare” portion of the law reflects the Supreme Court's justification for the legality of zoning ordinances in general. Village of Euclid, 272 U.S. at 383.

43 See Mass. Gen. Laws ch. 40A, § 5.

44 An as of right development “complies with all applicable zoning regulations and does not require any discretionary action” by local planning board and zoning board of appeals. Glossary of Planning Terms, NYC Dept. of Planning, https://www1.nyc.gov/site/planning/zoning/glossary.page [https://perma.cc/7QB2-VT55].

45 King, Paul E., Exclusionary Zoning and Open Housing: A Brief Judicial History, 68 Geographical Rev. 459, 460 (1978)CrossRefGoogle Scholar.

46 Village of Euclid, 272 U.S. at 389-90.

47 Hall, Eliza, Divide and Sprawl, Decline and Fall: A Comparative Critique of Euclidean Zoning, 68 U. Pitt. L. Rev. 915, 918 (2007)Google Scholar; Wickersham, Jay, Jane Jacob's Critique of Zoning: From Euclid to Portland and Beyond, 28 B.C. Envtl. Aff. L. Rev. 547, 548 (2001)Google Scholar.

48 Rachel Watsky, The Problems with Euclidean Zoning, B.U. Dome (July 19, 2018), http://sites.bu.edu/dome/2018/07/19/the-problems-with-euclidean-zoning [https://perma.cc/3G7F-DQT2]

49 One example of inflexibility would be how strict density restrictions create zones dedicated for the wealthy due to the effective impossibility of building affordable housing. See Richard Florida & Citylab, The Segregation That Zoning Inflicts on Cities, Atlantic (Jan. 5, 2016), https://www.theatlantic.com/business/archive/2016/01/zoning-land-use-segregation/422595 [https://perma.cc/Y9Z2-JH2N].

50 Acker, Frederick W., Performance Zoning, 67 Notre Dame L. Rev. 363, 370 (1991)Google Scholar.

51 Types of Zoning Codes, Re:Code LA (Jan. 21, 2014), https://recode.la/updates/news/types-zoning-codes [https://perma.cc/H4P8-FN4W]; Ottensmann, John R., Planning Through the Exchange of Rights Under Performance Zoning, Economic Affairs 40, 4041 (2005)CrossRefGoogle Scholar.

52 Another example performance zoning can be seen in Laconia, NH, where the local zoning board was proposing to not subject developments downtown to usual zoning restrictions if they help driving quality and innovative economic development. See Rick Green, #LaconiaCityBoxscore — March 30: City to Hold Zoning Hearings, Laconia Daily Sun (Mar. 29, 2019), https://www.laconiadailysun.com/news/local/laconiacityboxscore-march-city-to-hold-zoning-hearings/article_1ac91ab8-5257-11e9-a6a7-df5f917de92e.html [https://perma.cc/4VVZ-UNDZ].

53 Costonis, John J., The Chicago Plan, Incentive Zoning and the Preservation of Urban Landmarks, 85 Harv. L. Rev. 574, 581 (1972)CrossRefGoogle Scholar.

54 Id.

55 Talen, Emily, Zoning for and Against Sprawl: The Case for Form-Based Codes, 18 J. Urb. Design 175, 176 (2013)Google Scholar; Types of Zoning Codes, supra note 51, at 5, 6.

56 Types of Zoning Codes, supra note 51, at 5, 6.

57 Id.

58 Talen, supra note 55, at 188-89.

59 Types of Zoning Codes, supra note 51, at 5, 6.

60 Form Based Code vs Traditional Code, City of Marshall, http://www.cityofmarshall.com/system/res/881/original/Form-Based_Code.pdf [https://perma.cc/J8Q7-BP35]; Form-Based Codes Defined, Form-Based Code Institute, https://formbasedcodes.org/definition [https://perma.cc/XU5D-Z6GM]; Types of Zoning Codes, supra note 51, at 5, 6.

61 Form-Based Code Institute, supra note 60.

62 Id.

63 Talen, supra note 55, at 176.

64 For the purposes of this paper, only regulations during the building process with be taken into account.

65 The following links are examples of zoning maps and land use tables from Nashville and New York City. Note that even in zones which are in close proximity to each other, they may be vastly different in what types of developments are permissible. See City of Nashville, Zoning District Land Use Table (Apr. 20, 2018), https://www.nashville.gov/Portals/0/SiteContent/Codes/docs/public_docs/LandUseTable.pdf [https://perma.cc/6R2F-3YNG]; ZoLa: New York City's Zoning and Land Use Map, City of N.Y., https://zola.planning.nyc.gov/about?layer-groups=%5B%22building-footprints%22%2C%22commercial-overlays%22%2C%22subway%22%2C%22tax-lots%22%2C%22zoning-districts%22%5D#9.42/40.7515/-73.8218 [https://perma.cc/B4UQ-94MJ].

66 Within any given zoning scheme, “as of right” may include, but is not limited to compliance to the following types of regulations: 1) the type of structure allowed in an area; 2) the dimensional limits of the structure; 3) any setback, driveway and other spacing requirements; 4) whether special structures or features would have to be added onto the building based on type of use; or 5) whether there are limitations on building/renovation due to landmark status. NYC Dept. of Planning, supra note 44.

67 Depending on the municipality, special permits may also be called conditional use permits.

68 Processes vary from state to state. An example of the special permit process can be seen in Mass. Gen. Laws ch. 40A, § 9 (2019).

69 Id.

70 An example of a zoning board meeting can be seen by looking up videos and transcripts of cities and town which releases such information. See e.g., Boston City TV, Zoning Board of Appeal Hearings 09-25-18, YouTube (Sept. 5, 2018), https://www.youtube.com/watch?v=LeIgv0-yIhg [https://perma.cc/9RDVT3RA].

71 Under Massachusetts General Laws Chapter 40A Section 9, the required time limits for a public hearing and said action may be extended by written agreement between the petitioner and the special permit granting authority. A copy of such agreement shall be filed in the office of the city or town clerk. See Mass. Gen. Laws ch. 40A, § 9.

72 The total time of the special permit process varies by jurisdiction, but the estimate given by Massachusetts statute is not an outlier as other states have a similarly lengthy process. It must also be noted that certain localities, such as Manhattan, has its own unique process. See, e.g., N.Y. Gen. City § 27b.

73 Mass. Gen. Laws ch. 40A, § 9.

75 See, e.g., Krafchuk v. Planning Bd. of Ipswich, 903 N.E.2d 576, 529 (Mass. 2009) (granting local zoning board broad power over zoning requirements and waivers).

76 Administrative Discretion in Zoning, 82 Harv. L. Rev. 668, 668-69 (1969)CrossRefGoogle Scholar.

77 It must be noted that variances are generally only given to get around dimensional regulations. While it is legally possible for a developer to get a variance for type of use, it is frowned upon and not often given by municipalities. For interested parties to use their land in a way prohibited by the zoning code, they would have to use the political process and convince the town to change the local zoning by-laws. This regime makes sense as use variances are counter-intuitive to the policy behind zoning and redundant. (For example, if the town was going to waive a zoning law's ban on building a gas station in the community because it is seen as beneficial, they might as well change to zoning code to allow it because the purpose of zoning codes is to allow a municipality to control and guide the direction of its growth.)

78 Mass. Gen. Laws. ch. 40A, § 10 (2019).

79 Id.

80 Id.

81 City of Weymouth, supra note 74; What Is the Difference Between a Special Permit and a Variance, City of Yarmouth, http://yarmouth.ma.us/FAQ.aspx?QID=107 [https://perma.cc/XFJ9-P24Z].

82 Joseph P. Schweiterman & Dana M. Caspall, The Politics of Place: A History of Zoning in Chicago (Lake Claremont Press 1st ed. 2006); Stanislaw J. Makielski, The Politics of Zoning: the New York Experience (Columbia University Press 1st ed. 1966).

83 Manchester Township Zoning Board of Adjustment, Minutes of Meeting 2-3 (Aug. 25, 2011), http://www.manchestertwp.com/adjustments/Minutes/AUGUST%202011%20-%20ZBA%20MINUTES.pdf [https://perma.cc/C7B5-3RY3] (identifying that the town's zoning ordinances and policies for nursing home originated in 1960s).

84 Control is effectively lost because if zoning is so lenient to the point of granting a blank check to developers, then zoning no longer serves as a tool to control development through the power to refuse and permit plans.

85 Zoning ordinances are subject to takings challenges, which are ruled based on standards set by Lucas, the balancing test set in Pennsylvania Central Transportation v. New York City, and applicable state cases. See Lucas v. S.C. Coastal Council, 505 U.S. 1003 (1992); Pa. Cent. Transp. Co. v. New York City, 438 U.S. 104 (1978); Pa. Coal Co. v. Mahon, 260 U.S. 393 (1922).

86 For the purposes of this Note, the standard for standing in Massachusetts is used. Although standards for standard is specific circumstances may differ among states, the general concept of standing does not vary significantly. Standerwick v. Zoning Bd. of Appeals of Andover, 849 N.E.2d 197, 203 (Mass. 2006); The Pendulum Swings in Massachusetts Standing Law in Zoning Appeals: The “Good Old Days”, Phillips & Angley (Apr. 6, 2015), https://www.phillips-angley.com/blog/2015/04/the-pendulum-swings-in-massachusetts-standing-law-in-zoning-appeals-the-good-old-days.shtml [https://perma.cc/ET7R-54UP].

87 If a plaintiff is determined to have standing, the developer defendant would most likely settle or stop the project because the hardship requirement for variances is strict and subject to scrutiny. Simple variations in dimensions are highly unlikely to pass the hardship standard. In the case of special permits, developers may still win on the merits because courts generally give deference to a board's special permit decisions. See Humble Oil & Refining Co. v. Bd. of Appeals of Amherst, 276 N.E.2d 718 (Mass. 1971). Nevertheless, any resulting litigation is still time consuming.

88 Wheaton, William C., Real Estate “Cycles:” Some Fundamentals, 27 Real Est. Econ. 209, 209-10 (1999)CrossRefGoogle Scholar.

89 Cornell Univ. SC Johnson Sch. of Bus., Phases of the Real Estate Cycle (2017).

90 Id.

91 The timeline established by this Note is fully theoretical and created through an analysis of demographic changes and the real estate cycle.

92 U.S. Const. art. VI, cl. 2.

93 This is similar to the reasons behind the need for a uniform choice of law in general, which is the assurance of predictable outcomes. See Kramer, Larry, On the Need for a Uniform Choice of Law Code, 89 Mich. L. Rev. 2134, 2137 (1991)CrossRefGoogle Scholar.

94 42 U.S.C. § 2000cc (2018); Mass. Gen. Law ch. 40A, § 3 (2019).

95 Mass. Gen. Law ch. 40A, § 3.

96 Bible Speaks v. Bd. of Appeals of Lenox, 391 N.E.2d. 279, 283 n.10 (Mass. App. Ct. 1979).

97 Id.

98 Id.

99 Mass. Gen. Laws ch. 40, § 25 (1950) (repealed 1954).

100 Bible Speaks, 391 N.E.2d at 284 n.11.

101 It must be noted that the Dover Amendment does not include specific language allowing for reasonable dimensional limits. See Martin v. Corp. of Presiding Bishop of Church of Jesus Christ of Latter-Day Saints, 747 N.E.2d 131, 136 (Mass. 2001).

102 Mass. Gen. Law ch. 40A §3 (2017).

103 U.S. Dept of Justice, Place to Worship Initiative (Nov. 7, 2018), https://www.justice.gov/crt/religious-land-use-and-institutionalized-persons-act [https://perma.cc/VN7ELB7C].

104 See Emp't. Div., Dept. of Human Res. of Or. v. Smith, 494 U.S. 872 at 882-84 (1990); John R. Hermann,

Employment Division, Department of Human Resources of Oregon v. Smith, Middle Tennessee State University, https://www.mtsu.edu/first-amendment/article/364/employment-division-department-of-human-resources-of-oregon-v-smith [https://perma.cc/AP7F-R92C].

105 See H.R. 1308, 103d Cong. (1993) (enacted).

106 Tuttle, Robert W., How Firm a Foundation? Protecting Religious Land Uses After Boerne Governing Two Cities: Civil Law and Religious Institutions: A Symposium - Regulating Sacred Space: Religious Institutions and Land Use Controls, 68 Geo. Wash. Law Rev. 861, 862 (2000)Google Scholar.

107 S. Rep. No. 103-111, at 8 (1993).

108 See City of Boerne v. Flores, 521 U.S. 507, 532 (1997).

109 Gaubatz, Derek L., RLUIPA at Four: Evaluating the Success and Constitutionality of RLUIPA's Prisoner Provisions, 28 Harv. J.L. & Pub. Poly 501, 510 (2005)Google Scholar.

110 Rashid, Qasim, The Right to Enforce: Why RLUIPA's Land Use Provisions is a Constitutional Federal Enforcement Power, 16 Rich. J. L. & Pub. Int. 267, 268 (2013)Google Scholar.

111 Cutter v. Wilkinson, 544 U.S. 709, 719-20 (2005).

112 See Charles v. Verhagen, 348 F.3d. 601, 606-08 (7th Cir. 2003).

113 Freedom Baptist Church of Del. Cty. v. Twp. of Middleton, 204 F.Supp.2d 857 (E.D. Pa. 2002).

115 Id.

116 Policy Guide: HUD Section 202: Supportive Housing for the Elderly, Democracy Collaborative, https://community-wealth.org/strategies/policy-guide/hud_section-202.html [https://perma.cc/GJU2-4VTW]

117 Id.

118 12 U.S.C. § 1701q (2018).

119 This paper will not delve into whether services provided by independent living facilities should fall under the jurisdiction of HUD, CMS or some other government entity.

120 What is Assisted Living?, Nat'l Center for Assisted Living, https://www.ahcancal.org/ncal/about/assistedliving/Pages/What-is-Assisted-Living.aspx

121 Id.

122 Id.

123 Lisa Newcomb, Assisted Living Residence, Empire State Association of Assisted Living, https://aging.ny.gov/livableny/resourcemanual/housing/iii1s.pdf [https://perma.cc/4VL2-PJR8]

124 Id.

125 See N.Y. Pub. Health Law § 4651 (2004). New York Statute also includes a list of exemptions, which will not be discussed in this Note.

126 Mass. Gen. Laws ch. 19D, § 1 (2019).

127 Fla. Stat. § 429.02 (2018).

129 See 42 U.S.C. § 1395i-3 (2018). To have a fully functional definition, it is likely that the entirety of the statute covering skilled nursing facilities will have to be imported. For the purpose of readability, the statute will not be quoted, and it is suggested that the reader peruse the statute for details.

130 Jessica C. Barnett & Edward R. Berchick, Health Insurance Coverage in the United States: 2016, U.S. Census Bureau (Sep. 12, 2017), https://www.census.gov/library/publications/2017/demo/p60-260.html [https://perma.cc/G8W7-NB8H].

131 Ctrs. for Medicare and Medicaid Servs., Nursing Home Data Compendium 2015 Edition (2015).

132 Id.

133 How Continuing Care Retirement Communities Work, AARP (last updated Oct. 24, 2019) https://www.aarp.org/caregiving/basics/info-2017/continuing-care-retirement-communities.html [https://perma.cc/YH7Y-T3YH].

134 Id.

135 Continuing Care Retirement Communites (CCRC), A Place for Mom (last updated July 2018), https://www.aplaceformom.com/planning-and-advice/articles/continuing-care-retirement-communities [https://perma.cc/NB2W-D7FY].

136 Aging in Place - What Does Aging in Place Really Mean?, SeniorLiving.org, https://www.seniorliving.org/aging-in-place [https://perma.cc/MGK3-BLFS].

137 Fla. Stat. § 429.02 (2019).

138 Exec. of Elder Affairs, Continuing Care Retirement Communities, Mass.Gov, https://www.mass.gov/service-details/continuing-care-retirement-communities [https://perma.cc/XQ3S-7CVN].

139 42 U.S.C. § 2000cc (2018).

140 Mass. Gen. Laws ch. 40A, § 3 (2019).

141 42 USC § 2000cc; Mass. Gen. Laws ch. 40A, § 3.

142 Loo, Ernst J.T., State Land Use Statutes: A Comparative Analysis, 45 Fordham L. Rev. 1154, 1154 n.4 (1977)Google Scholar.

143 Note that even with the list of activities presented by the Dover Amendment, the concept of reasonableness is still a nebulous concept that often shows up in litigation. See, e.g., Martin v. Corp. of the Presiding Bishop of the Church of Jesus Christ of Latter-Day Saints, 747 N.E.2d 131, 137-139 (Mass. 2001).