Senior Living News Wire

Given that the 55+ housing market represents the “largest growing group of buyers” the National Association of Home Builders has ever seen in that age category, paired with the organization naming multigenerational housing as a top trend in 2012, it remains to be seen how this will be reflected in upcoming construction projects. 

Senior housing is changing, as demonstrated by consumers who want newer, different models of care—either in an age-specific community or in their own homes. And because products are shaped by what consumers want, builders are starting to pay attention to current market demand.

Rising number of multigenerational households

Multigenerational housing is an emerging niche market, at least in certain areas, says Steve Melman, Director of Economic Services at NAHB, adding that the trend is “something to be aware of.” 

As the saying goes, history repeats itself—and so do multigenerational living trends, apparently. By the end of the Great Depression, about 25% of the U.S. population lived in multigenerational households, but 20 years later that number dropped to 15%. By 1980, just 12% of the population lived in multigenerational households.

Right now, the nation is struggling to recover from what’s being called the Great Recession, and the trend is similar: In the past few years, recent figures show multigenerational households surging back up to about 17% of the population, according to Pew Research studies.

“Something’s clearly changing, and there are probably a couple of reasons: the recession is forcing people to move in with each other, or cultural shifts mean some groups are more comfortable having multiple generations living together, aside from economic reasons,” says Melman.

What might multigenerational development look like?

When building a home meant to house more than one generation, there needs to be a different design than for a traditional single-family home. 

One architect says he’s seeing some home developers taking large houses and simply splitting them up by putting in a separate entrance for the “primary” generation and the older parents, but he doesn’t think it’s the best method.

“This feels a little forced, just splitting off a little piece of a home instead of having something specifically built for what it was intended to be,” says Greg Irwin, partner at Orange County, Ca.-based Irwin Partners Architects. 

But he’s also seeing a rise in developers asking about how to incorporate senior accommodations, as multigenerational households increase and put more pressure on the need for intergenerational communities.

Being intentional about designing a home for multiple generations could mean dual master bedroom suites, says Melman, or “in-law” apartments with their own separate functionalities that may increasingly be used to house Grandma. The two master bedrooms could be used for the “primary” homeowner and for a returning college graduate or maybe an aging parent. Alternately, the primary homeowner could choose to have a caregiver (family or professional) move into the second bedroom.

Top trends for 2012

Irwin’s findings are consistent with the National Association of Home Builders’s (NAHB) list of the hottest design trends it expects new home designs will feature in 2012. Released each April, this year’s list pegs multigenerational living as a top trend, along with expanded amenities, reworked spaces, and more cost-effective, impactful designs (homes shaped like rectangles rather than multiple roof lines, etc.).

“Many families are all living under one roof due to increasing cultural diversity and the state of the economy during the past few years,” says NAHB. “New single-family home designs reflect this with “shadow” units that are built alongside a home, or separate living units that access the main floorplan through a door, or homes with at least two master suites—often with one located on the ground floor to be more accessible for elderly occupants.”

Where is the demand?

During a 2007 NAHB survey, a panel was asked if they thought demand for two master bedrooms would increase; 62% said yes. By December 2010, when NAHB again asked that question, expected demand had fallen pretty far down the list, “because at that point it was pretty hard to see the light at the end of the tunnel for the recession,” Melman says. 

“The trend might have been thwarted by the recession, but the demand is still there,” says Melman. What’s happening is that people are having a hard time qualifying for mortgages in general—let alone a larger home meant to house multiple generations. 

NAHB pegs the current 55+ housing market as the largest growing group of buyers the industry has ever seen for this age category, but Melman points to  another age range—a somewhat younger one—as the target audience.

“It’s the trade-up buyers—people who have a first home and are now trading up to a larger home,” he says. “They may be the ones who have elderly parents who might move in, instead of moving them into assisted living, which would be terribly expensive. Having them move in might be a better solution.”

The 55+ buyers, he says, are going to be empty-nesters and many will be looking for a smaller footprint. Young families, on the other hand, generally can’t afford to buy large first homes. Trade-up buyers, in their mid-30s and 40s, he says, “could use that larger home for a variety of reasons, whether its for their growing family, or aging parents.” 

Overall, the market for new construction is slowly, steadily improving—especially for older demographics.

“Consumers are starting to see the resale market show some improvement, which allows them to start thinking about moving into 55+ housing,” said NAHB Chief Economist David Crowe. 

Written by Alyssa Gerace

Given that the 55+ housing market represents the “largest growing group of buyers” the National Association of Home Builders has ever seen in that age category, paired with the organization naming multigenerational housing as a top trend in 2012, it remains to be seen how this will be reflected in upcoming construction projects. 

Senior housing is changing, as demonstrated by consumers who want newer, different models of care—either in an age-specific community or in their own homes. And because products are shaped by what consumers want, builders are starting to pay attention to current market demand.

Rising number of multigenerational households

Multigenerational housing is an emerging niche market, at least in certain areas, says Steve Melman, Director of Economic Services at NAHB, adding that the trend is “something to be aware of.” 

As the saying goes, history repeats itself—and so do multigenerational living trends, apparently. By the end of the Great Depression, about 25% of the U.S. population lived in multigenerational households, but 20 years later that number dropped to 15%. By 1980, just 12% of the population lived in multigenerational households.

Right now, the nation is struggling to recover from what’s being called the Great Recession, and the trend is similar: In the past few years, recent figures show multigenerational households surging back up to about 17% of the population, according to Pew Research studies.

“Something’s clearly changing, and there are probably a couple of reasons: the recession is forcing people to move in with each other, or cultural shifts mean some groups are more comfortable having multiple generations living together, aside from economic reasons,” says Melman.

What might multigenerational development look like?

When building a home meant to house more than one generation, there needs to be a different design than for a traditional single-family home. 

One architect says he’s seeing some home developers taking large houses and simply splitting them up by putting in a separate entrance for the “primary” generation and the older parents, but he doesn’t think it’s the best method.

“This feels a little forced, just splitting off a little piece of a home instead of having something specifically built for what it was intended to be,” says Greg Irwin, partner at Orange County, Ca.-based Irwin Partners Architects. 

But he’s also seeing a rise in developers asking about how to incorporate senior accommodations, as multigenerational households increase and put more pressure on the need for intergenerational communities.

Being intentional about designing a home for multiple generations could mean dual master bedroom suites, says Melman, or “in-law” apartments with their own separate functionalities that may increasingly be used to house Grandma. The two master bedrooms could be used for the “primary” homeowner and for a returning college graduate or maybe an aging parent. Alternately, the primary homeowner could choose to have a caregiver (family or professional) move into the second bedroom.

Top trends for 2012

Irwin’s findings are consistent with the National Association of Home Builders’s (NAHB) list of the hottest design trends it expects new home designs will feature in 2012. Released each April, this year’s list pegs multigenerational living as a top trend, along with expanded amenities, reworked spaces, and more cost-effective, impactful designs (homes shaped like rectangles rather than multiple roof lines, etc.).

“Many families are all living under one roof due to increasing cultural diversity and the state of the economy during the past few years,” says NAHB. “New single-family home designs reflect this with “shadow” units that are built alongside a home, or separate living units that access the main floorplan through a door, or homes with at least two master suites—often with one located on the ground floor to be more accessible for elderly occupants.”

Where is the demand?

During a 2007 NAHB survey, a panel was asked if they thought demand for two master bedrooms would increase; 62% said yes. By December 2010, when NAHB again asked that question, expected demand had fallen pretty far down the list, “because at that point it was pretty hard to see the light at the end of the tunnel for the recession,” Melman says. 

“The trend might have been thwarted by the recession, but the demand is still there,” says Melman. What’s happening is that people are having a hard time qualifying for mortgages in general—let alone a larger home meant to house multiple generations. 

NAHB pegs the current 55+ housing market as the largest growing group of buyers the industry has ever seen for this age category, but Melman points to  another age range—a somewhat younger one—as the target audience.

“It’s the trade-up buyers—people who have a first home and are now trading up to a larger home,” he says. “They may be the ones who have elderly parents who might move in, instead of moving them into assisted living, which would be terribly expensive. Having them move in might be a better solution.”

The 55+ buyers, he says, are going to be empty-nesters and many will be looking for a smaller footprint. Young families, on the other hand, generally can’t afford to buy large first homes. Trade-up buyers, in their mid-30s and 40s, he says, “could use that larger home for a variety of reasons, whether its for their growing family, or aging parents.” 

Overall, the market for new construction is slowly, steadily improving—especially for older demographics.

“Consumers are starting to see the resale market show some improvement, which allows them to start thinking about moving into 55+ housing,” said NAHB Chief Economist David Crowe. 

Written by Alyssa Gerace

It’s not uncommon for people to negotiate prices for flea market finds, cars, or even houses, but one area where most people don’t think to bargain is retirement residences—and they should, reports the Wall Street Journal.

Especially at continuing care retirement communities (CCRCs)—most of which charge entrance fees—incoming residents could save a bundle, like a Pennsylvania woman who was able to shave 35% off her upfront costs of moving into one such community.

Dickering can pay off. “Active adult” developments often charge steep monthly fees for amenities, and CCRCs generally require a hefty deposit, along with monthly fees for care ranging from independent living to round-the-clock nursing.

The average entrance fee for a CCRC unit is $259,000, according to the National Investment Center for the Seniors Housing and Care Industry, a research and data group in Annapolis, Md.

But the real-estate downturn, which made it tougher for older adults to unload their houses, in turn wiped out waiting lists at many popular retirement communities, giving retirees who are ready to move in more leverage, experts say.

Such communities need to stay full to fund their general operations, build reserves and help finance refunds. The community where Mrs. Nerenberg plans to move, for example, refunds 90% of the entry deposit after the resident dies. And monthly fees paid by residents in independent-living units generally help support the higher costs of those who have moved to assisted-living or skilled-nursing arrangements.

Haggling prices for retirement homes is a trend that’s still “in its early stages,” but some financial planners are helping their clients evaluate their retirement living options and costs. 

Read the full Wall Street Journal article. 

Written by Alyssa Gerace 

Pharmaceutical company Omnicare, Inc. (NYSE:OCR), the nation’s largest pharmacy for long-term care facilities, must pay the U.S. government $50 million in a settlement over complaints it dispensed painkillers to nursing homes and other senior care facilities across the country without proper prescriptions or authorization.

The Covington, Ky.-based company’s settlement with the Department of Justice is the second-largest civil settlement in history of the Controlled Substances Act, and follows a Drug Enforcement Administration investigation of “alleged errors and deficiencies” in how certain Omnicare pharmacies distributed controlled substances.

“While DEA regulations specifically address retail and hospital pharmacy operations, long-term pharmacies have historically operated in a less defined middle ground, dispensing controlled substances on instructions from long-term care facility staff after the staff’s consultation with the ordering authorized prescriber,” said Omnicare in a statement about the settlement. “This civil settlement makes it clear that DEA interprets its regulations to require the ordering authorized prescriber to either sign an order containing all of the elements of a valid prescription prior to dispensing, or in limited emergency circumstances for Schedule II controlled substances to speak directly with the pharmacy prior to dispensing.”

Omnicare’s CEO, John Figueroa, said the pharmaceutical company “understands and accepts” the DEA’s efforts to make sure appropriate procedures are followed when distributing drugs. “While requiring authorized prescribers to communicate directly with the pharmacy can potentially cause delay, we have committed ourselves to shortening the time in which nursing home residents receive required medication,” he said. 

As part of the settlement, Omnicare has agreed to make the payment within the next few days in exchange for being able to continue dispensing medication.

The company has developed an electronic prescribing application for controlled substances for the institutional market which is expected to improve patients’ quality of care while adhering to DEA regulatory interpretations; it also transmits electronic prescription orders for other non-controlled drugs.

Written by Alyssa Gerace 

As assisted living regulations evolve and tighten, Medicare and Medicaid reimbursements fluctuate, and healthcare reform begins to take effect, many states are facing their own challenges as they continue to develop, operate, and implement new rules and programs. Here is a collection of long-term care related stories from across the nation that are worth reading.

From the Sun Sentinel (Florida)—Assisted Living Evictions Have Few Rules in Florida

“Assisted living facilities often market themselves as “just like home,” cozy places where people will live just like they did in their houses or condos. But many don’t realize their new lifestyle has the equivalent of a month-to-month lease,” reports the Sun Sentinel. “Under Florida regulations, assisted living operators need give residents little more than a 45-day written notice in order to evict them. The discharge rules are among the least restrictive in the nation, according to the National Senior Citizens Law Center.” Read more…

From Enterprise News (Massachusetts)—Battle Looming at Statehouse Over Nursing Home ‘Bed  Holds’

“Senior advocates are calling on state lawmakers to preserve a program that allows nursing home residents to keep their rooms after brief absences, such as hospitalizations,” reports Enterprise News. “Bed holds were the center of a funding battle last year, when Patrick vetoed $6 million for the program from a supplemental budget. Defying the governor, lawmakers put the money back into a final version of the budget and Patrick ultimately signed it in the fall. Without the bed hold program, the [nursing] home receives nothing, giving some little choice but to fill a bed with another patient in order to keep funding operations, said [W. Scott Plumb, senior vice president of the Massachusetts Senior Care Association].” Read more…

From the Health Care Council of Illinois—Nursing Home Supporters Rally in Chicago to Fight Medicaid Cuts

Pending cuts to Illinois’ Medicaid system would costs thousands of jobs and threaten care at nursing homes across the state, according to nursing home administrators, health care leaders and elected officials who rallied at the Thompson Center in Chicago on Monday in an event organized by the Health Care Council of Illinois (HCCI), which represents more than 500 nursing homes and rehabilitation facilities across the state of Illinois. “Legislators are considering Governor Quinn’s proposal to slash Medicaid spending by $2.7 billion. The proposed cuts to nursing homes could drastically jeopardize the quality of care for the more than 50,000 people residing in Illinois nursing homes who pay with Medicaid,” says HCCI. “These cuts put nursing homes at risk for closing, especially some Chicago nursing homes where Medicaid recipients make up more than 90 percent of the resident population.” Find out more…

From Mainline Media News—Pa. Gets First Look at Voter IDs for Nursing Home Residents

“Pennsylvania Secretary of State Carole Aichele came to Rosemont Presbyterian Village Friday to tout the state’s efforts to get approved identification for residents of retirement and nursing centers for voting in November. Aichele appeared with Radnor State Rep. William Adolph to answer questions about the new law. At the meeting Aichele unveiled a new identification paper, provided by the care facility, which is acceptable for voting,” reports Mainline Media News. “Aichele said that the identifications would be provided by the health-care facilities. The ID will include the name of the facility, the picture, the person’s name and an expiration date. The nursing home then needs to send the Department of State a copy of names on the IDs.” Read more…

Assisted Living Today Ranks Top 20 Massachusetts Assisted Living Facilities

The list of senior care facilities—which was compiled by the research staff at Assisted Living Today—features 20 of Massachusetts’ finest assisted living facilities that were evaluated on a range of factors, including operational excellence, quality of the residences, range of amenities and access to 24-hour care, among others. View the list.

From News and Sentinel—Ohio Program Helps Seniors Age at Home

“While nursing and rehabilitation facilities may be the right option for some people, programs like the Housing Assistance Grant Program through the Area Agency on Aging 8 aim to help seniors “age in place,” since remaining in one’s home can be beneficial to seniors—and the state’s coffers,” reports the News and Sentinel. “A year in an Ohio nursing home costs an average of $60,000 for someone covered by state Medicaid funds, according to figures from the Area Agency on Aging 8. Even people who start out spending their own money could wind up being supported by public dollars once their assets are depleted. Meanwhile, the annual care plan for [one Ohio resident] who is covered by the Medicaid-funded PASSPORT program, costs $8,497.” Read more…

From the Missourian—Veterans’ Nursing Home Funding Bill Sent to Missouri Governor

“Missouri lawmakers have sent the governor a measure providing a dedicated funding source to veterans’ nursing homes,” reports the Missourian. “The bill given final approval Thursday by the House would earmark most of the state’s fees from casinos to a trust fund for the Missouri Veterans Commission. The intent is to provide a permanent, predictable funding stream for the state’s seven nursing homes that serve more than 1,300 military veterans.” Read more…

Third time wasn’t a charm for Covington Investments, LLC, who has sent three rejected proposals to acquire Brentwood, Tenn.-based skilled nursing operator Advocat Inc. (NASDAQ:AVCA)—the latest for $8.50 a share (approximately $51 million). 

“In letters on February 27, March 22, and April 12, 2012, we made what we believe to be very compelling proposals to acquire Advocat in a transaction that would provide substantial value to your shareholders,” wrote John McMullan, the president Covington Investments, in a letter to Advocat’s board of directors, dated May 11. “We were surprised and disappointed that Advocat’s Board of Directors has shown no interest in a discussion to explore our acquisition proposal.” 

Covington believes Advocat’s shareholders “would want and expect” its board to “explore” the possibility of the transaction, and after the lack of response, the investment company has decided to make its proposal public “in order to inform Advocat’s shareholders of the significant value they could receive in a transaction with Covington.” 

The proposal values the skilled nursing facility operator at $8.50 per share, for an approximate $51 million (or $44 million, excluding the 12% of shares Covington’s affiliates already own).

The price increased from the $7.50 per share offered in the Feb. 27 letter, after Advocat’s board indicated the price “was not sufficient to discuss a combination,” said McMullan in the letter. 

Now that they’ve upped the price, Covington says their offer “represents an extraordinary value” to the operator’s shareholders, as the price represents a 96% premium above May 10′s closing price of $4.34, a 71% premium above the average closing share price in the past 30 days, and a 55% premium above the average closing share price in the last 90 days. 

And, McMullan points out, the last time Advocat’s shares closed above $8.50 was in November 2009.

“We do not understand how the Board’s unwillingness to even discuss our Proposal in favor of an uncertain and questionable standalone strategy can serve the best interests of Advocat’s shareholders,” said McMullan in the letter. “In light of Advocat’s financial performance, as evidenced most recently in its first quarter earnings release on May 9, 2012, we are even more puzzled by the Board’s refusal to entertain our Proposal.”

Advocat reported a $1.54 million net loss attributable to shareholders in the first quarter ended March 31, 2011, attributed to Medicare reimbursement cuts and rising costs of facility staffing, marketing, and support areas resulting from “strategic initiatives,” according to Kelly Gill, the company’s CEO.

“We remain focused on the implementation of our growth strategy, which centers on enhancing our high acuity patient care services, modernizing our facilities, and prudently expanding our facility portfolio,” said Gill in the first quarter earnings report. “We are seeing benefits from these efforts in terms of improved skilled census, our capabilities to market to and care for higher acuity patients and, as a result of the implementation of electronic medical records, the ability to better document the high quality services we have always provided.” 

Following Covington’s public acquisition proposal announcement, Advocat shares surged over 70% on the NASDAQ to $7.39.

Advocat did not respond to SHN’s request for comment as of press time. 

Click here to view McMullan’s letter to Advocat shareholders.

Written by Alyssa Gerace 

Long-term care pharmacy provider Omnicare has agreed to pay the government $50 million to settle charges that it illegally dispensed controlled medications to long-term care residents.

Cholesterol lowering medications known as statins might help prevent new-onset atrial fibrillation in elderly adults with hypertension, a new study reports.

Most people with dementia don’t die in nursing homes after all. In fact, they are more likely to spend their final days at home, a new study finds.