Bill Mulleneaux lived a life full of accomplishments, from decades of service as a highway patrol officer in the Department of Public Safety, to his time as a council member on the Thatcher Town Council, to many other positions of service to the community.
“He dedicated his life to this community down here,” said Scott Mulleneaux, Bill’s son, “I’m very proud of him.”
As Bill grew older, he developed Alzheimer’s disease and started to need more help doing everyday things. Scott said he and his family tried as best they could to take care of those everyday needs. Eventually, they needed some help too, more specifically, they needed a room in an assisted living facility for Bill.
“He needed more care than my family could give. We looked everywhere, and we didn’t want to take him all the way to Tucson,” Scott said, “I couldn’t get my dad into any facility down here. There’s a desperate need down here.”
According to the last census, 14% of Graham County’s residents, or approximately 5,437 people, are over the age of 65. In Greenlee County, 13.7% of the county’s population, or approximately 1,301 people, are also over the age of 65. Between the two counties, there’s only one nursing home, Haven Health Safford and one assisted living facility, BeeHive Homes of the Gila Valley, in Thatcher.
“That does seem strange to me,” said Miranda Lang, the compliance surveyor for residential licensing at the Arizona Department of Health, when presented with those statistics, “you would think that there was more need in the area and a need for more facilities in the area.”
According to a searchable database from the Arizona Department of Health Services of both residential facilities, including assisted living facilities, and long-term care facilities, which includes nursing homes, counties with similar smaller populations like La Paz and Santa Cruz counties don’t have a single assisted living facility, or a nursing home. Nearby Gila County though has 18 residential facilities and four nursing homes.
Dr. Fred Fox, the medical director of the Greenlee County Health Department, who lives in Silver City, New Mexico, but has been working in Greenlee County since 2004, said he couldn’t recall there ever being either a nursing home or assisted living facility in Greenlee County. In his home in Grant County, New Mexico though, with a population of 26,998, 28.6% of which are 65 or older, Dr. Fox said there’s one nursing home, two assisted living facilities and one state run longer term care facility.
“It’s hard for small rural counties to support nursing care facilities,” Dr. Fox said.
Shi Martin, the Long Term Care Regional Ombudsman Coordinator for the Southeastern Arizona Governments Organization’s Area Agency on Aging put the situation a little bit more bluntly, “There’s not enough to meet the needs,” Martin said, especially for people who can’t pay out of pocket for care, “those that need it usually have to leave Graham or Greenlee counties.”
Scott and his family briefly considered going to Tucson, but he said that even facilities in Tucson were full, so they tried to get Bill into BeeHive in Thatcher, but the facility didn’t have any room available, so Bill was placed on a waitlist behind nine other people looking for a space in the facility.
BeeHive has 15 rooms available for 15 residents. Because of demand, BeeHive often has a waiting list to get into the facility. In early June, that wait list was 17 people long, with people waiting from six months to a year to get to the top of that list.
Scott said he and his family got on that waitlist in either February or March of last year, but by July, Bill still hadn’t gotten a room, and they were getting desperate.
Fawn Kilpatrick, manager of BeeHive Homes of the Gila Valley, said that a six month to a year long wait on the waitlist is common.
“I don’t like those phone calls, they make me feel really bad. Some people move on, or pass away,” before they get to the top of the waitlist Kilpatrick said.
At Haven Health Safford, the only nursing home in both Graham and Greenlee counties, the facility has the capacity to serve 106 people, Haven’s Executive Director, J.D. Sitchler said, with around 50 rooms for patients, some of which are private rooms, others which house two people.
“We are able to handle the patient load now,” Sitchler said, adding that he thinks a lot of senior citizens are now getting cared for at home, either from hired caregivers, or family members themselves, especially since the COVID-19 pandemic hit the county last year.
“What happens in rural counties is families take care of the elderly, or families have to take their family members outside of the county,” said Dr. Fox.
That’s exactly what Bill and his family decided to do, hire private caregivers to take care of Bill at home.
“It’s a whole other world with the elderly here. It’s not a glamorous world, so I don’t think people talk about it much,” said Valerie Hernandez, one of the private caregivers that cared for Bill, “It’s kind of uncomfortable for people to talk about.”
Hernandez, who is a licensed caregiver, a patient care tech, and is now finishing training to become a medical assistant, has had her own troubles with senior care facilities in the area. Hernandez cared for her own grandfather, at home, for about a year.
Hernandez said her family considered taking her grandfather to an outside facility in Graham County, but his insurance and social security wouldn’t cover the costs, so Hernandez moved in with her mom and her grandfather, and became his caretaker.
BeeHive does not accept Arizona Long Term Care System, Arizona’s Medicaid health insurance for seniors, meaning the charge for people’s rooms, which run from $4,000 a month to $4,800 a month based on a sliding scale of the amount of care needed for each resident, comes out of people’s pockets.
At Haven Health, people’s insurance will usually cover the first 20 days of care, after which a co-pay usually starts, Sitchler said. Sometimes people will pay $200 to $240 a day before their insurance coverage starts. Once people’s ALTCS kick in, the ALTCS reimburses them for the money they paid out of pocket. Sometimes though, people’s insurance won’t cover their stay, Sitchler said, in which case people have to look for other care options.
Hernandez said she was glad to care for her grandfather, but it’s difficult to be a caregiver and a family member of the person you’re caring for, but sometimes it’s what families are forced to do because of finances, or other responsibilities.
“Before that, I was blind to it as well. When I actually worked with the elderly, I saw that it was a need,” Hernandez said, “We’ve all kind of had a blanket over us. I don’t know why. Maybe it’s ignored.”
Rather than just a matter of the economics of running a nursing home or an assisted living home or facility, Dr. Fox said the lack of senior care facilities in significant parts of the country is also a matter of a lack of political will.
For that to change, Dr. Fox said people need to raise their concerns about the lack of senior care facilities in their towns and counties to their local, state and federal political representatives to pressure them to direct funding to support, and build, senior care facilities.
“In order for something to be done, it’s going to need political will, and the only way that’s going to happen is if people communicate their needs about it,” Dr. Fox said.
In April of last year, Hernandez’ grandfather passed away. In December, Bill Mulleneaux passed away.
Now, Hernandez and Mulleneaux are working together to start their own assisted living home in Safford called Essential Patient Care, with Hernandez as the manager, and Mulleneaux as the assistant manager.
Hernandez and Mulleneaux are projecting it will be completed in July, and be able to house 16 people in two neighboring houses in Copper Canyon.
Before that though, they’re hoping to start a temporary assisted living home in a rented home in Central.
They hope the home will be ready by next month, pending their application to run an assisted living home with the Arizona Department of Health Services.
“There’s a need in the community, and we can’t wait until December,” Hernandez said.
Four people already signed up to move into the home in Central, which Mulleneaux described as a large house with four large rooms that can fit two people per room, or one person in a private room. Mulleneaux said they can house four more people in the temporary facility, and that he and Hernandez were working with BeeHive so that BeeHive can refer people on their waiting list to them.
Hernandez said that their assisted living home would not take ALTCS or other Medicaid insurance initially, although she said they wouldn’t rule out trying to work with ALTCS patients in the future. Instead, Hernandez projected that rooms at Essential Patient Care would run from $3,500 to $5,000 a month, based on a sliding scale of patient needs.
“It’s just a little bit more personalized,” Mulleneaux said about the homes, but “the need is greater than what we have unfortunately.”
“I want the homes to be like homes away from home,” Hernandez said, “A lot of elderly people think that they’re a burden at that age. When they’re around others of their age group, they do a little better. That’s my vision. For people to feel like it’s comfortable and their home.”
