In 1991, Sally Herriot and her husband, John, paid a $180,000 non-refundable entrance fee to Channing House, a Palo Alto CCRC that offers residents a continuum of care, from independent living to skilled nursing units. As is typical of CCRC contracts, the Herriot's admission agreement gave Channing House's administrators the right to determine the appropriate level of care for the couple and the authority to move either of them into an assisted living unit or a skilled nursing facility if and when it determined they needed more care.

Mr. Herriot died in 2005. Last year, Channing House notified Mrs. Herriot -- who uses a walker, needs help getting dressed and has problems with her eyes -- of their intention to move her from her spacious ninth-floor apartment with a covered balcony to a much smaller, hospital-like assisted-living unit where she would share a room but also be served by a trained nursing staff. Mrs. Herriot resisted, saying that with the help of the round-the-clock private aides she hires herself, she has everything she needs and does not require a higher level of care.

Mrs. Herriot's attorneys, Michael Allen and Susan Silverstein (who is with AARP), filed a lawsuit alleging that by forcing Mrs. Herriot to move, Channing House is violating anti-discrimination housing and disability laws. Channing House's executive director, Carl Braginsky, counters that decisions to move residents from one level of care to another are made only after careful consideration and consultation with medical staff. Paul Gordon, one of Channing House's attorneys, rejected as "insulting and misleading" Mrs. Herriot's attorneys' assertions that such decisions are motivated by the opportunity for financial gain, such as from the sale of Mrs. Herriot's now greatly-appreciated apartment.

The result of the case could have lasting repercussions on how America's burgeoning population of seniors is allowed to age. "If Sally Herriot can be forced to move, then it undermines the whole concept of aging in place," her attorney Michael Allen told the San Francisco Chronicle. "A favorable outcome in this case might ... help someone with dementia or other more severe disabilities in a similar setting."

Lawyers on both sides are scheduled to begin mediation in April, and considering that CCRCs are in the business of marketing peace of mind, Channing House may have additional incentives to avoid a trial. If a trial becomes necessary, Mrs. Herriot is prepared. "I'm a fighter," she says. "I'm sure they think I should shut up ... I'll put something in their way every time they move."

To read the San Francisco Chronicle account of the dispute, click here.

For more information on retirement living, assisted living facilities and continuing care retirement communities (CCRCs) click here.

Author K. Gabriel Heiser, an attorney specializing in elder care and estate planning, provides detailed and practical information on how Medicaid works and the strategies for qualifying for it. Very up-to-date, Medicaid Secrets includes the recent changes to Medicaid transfer rules made by the Deficit Reduction Act of 2005. Heiser takes a complicated subject and presents it in an easy to understand manner. Medicaid law varies from state to state, so the strategies won't work in all states, but the book gives readers a broad overview and many ideas to bring to their attorneys.

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