Staff at Bronx adult day care center speak of insurance challenges during COVID-19

Seniors at of Open Arms Circle Social Adult Day Center, which is struggling to take care of its clients.
Photos courtesy of Open Arms Circle Social Adult Day Center

When the coronavirus started to ramp up in the country, many health insurance companies refused to cover services provided by adult day care centers.

Since then, the staff at these centers have had to make adjustments, including communicating with patients via telecare and going door to door to provide other services. Without insurance coverage, many of the expenses are coming out of center owners’ pockets, not patients. The patients have never been charged an extra fee.

Boris Feldman, owner of Open Arms Circle Social Adult Day Center at 860 E 161st St., and its program director Jennifer Kelman, explained that most insurance companies are only paying 20 to 50 percent of the agreed-upon, contractual rate for daily services.

According to Feldman, one insurance company pulled a contact after eight years, exercising their no-cause clause, but ultimately denying the patients the care they are entitled to.

“We don’t need to be open,” Feldman stressed. “We need to be compensated so we can provide the services.”

The center primarily deals with physically and mentally disabled adults in the Latino and African American population. With 130 clients and 50 to 60 at the facility on a regular basis, they explained that helping patients has not been easy during the pandemic.

When COVID-19 arrived, adult day care centers in the city closed and staff at Open Arms began checking in on people virtually, delivering masks, gloves, food, newspapers and arts and crafts kits.

Feldman and Kelman said the center had lost clients to the coronavirus and many constantly asked when the facility is reopening.

“They are depressed,” Feldman said. “Some of them don’t even want to get out of bed. They just want to socialize, come back and be around people. They want to continue receiving care and hot meals from us.”

Feldman and Kelman claimed the insurance companies have not been abiding by the Department of Health guidelines regarding COVID-19.

The staff at Open Arms was reduced from 12 to three people and insurance companies were only providing coverage for 35 clients according to Kelman who noted that it’s a battle just to get that money.

“We are their only lifeline,” Feldman said. “We were angry in the beginning. I can’t even say we are upset. We have to be there to provide services to the clients. It’s about survival.”

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