Senior Living News Wire

The Department of Health and Human Services recently drafted a plan to address the nation’s growing Alzheimer’s problem, but its framework fails to fully acknowledge the role of assisted living in caring for those with the disease, the Assisted Living Federation of America (ALFA) recently pointed out.

In response, ALFA is campaigning that assisted living’s role be mentioned and included more fully in the National Alzheimer’s Project Act’s goals and strategies. The HHS is accepting comments on its Draft Framework for the plan through Feb. 8, 2012, and the assisted living group has submitted a comment letter with some suggestions and recommendations.

Among the suggestions is adding licensed assisted living communities to the list of possible care settings to which individuals may be transferred after hospitals, along with including or mentioning assisted living in other areas of the framework.

“We were shocked that assisted living was not included as a setting [for] serving individuals with Alzheimer’s disease,” said Maribeth Bersani, senior vice president of public policy at ALFA. “We are a provider. We have companies that specialize in dementia-only care, and others who provide it with assisted living. We’re the leading consumer choice for the elderly, so it was just startling to us.”

A significant portion (42%) of assisted living residents have Alzheimer’s, according to the 2010 National Survey of Residential Care Facilities conducted by the Center for Disease Control’s National Center for Health Statistics, and ALFA says it expects this trend to continue as “many consumers prefer the state of the art programming that has been developed for memory impaired residents in assisted living.”

“The omission of assisted living is completely unacceptable,” ALFA said in a statement, urging others to also submit comment to correct the omission before the national plan is finalized.

“We hope to rectify that [omission], though,” Bersani told SHN, adding that the organization recognizes that this has been a draft, and not the final framework. “We have confidence that they will correct this.”

View ALFA’s comment letter here.

Written by Alyssa Gerace

Chelsea Senior Living, LLC, an assisted and independent living community operator with communities located in New Jersey, Pennsylvania, and New York, recently expanded its Northeastern presence with a New Jersey acquisition.

The operator acquired senior residence Van Dyk at Bald Eagle Commons for an undisclosed sum, and has since renamed the community the Chelsea at Bald Eagle.

“Van Dyk has successfully operated this wonderful facility for many years,” said Roger Bernier, president and chief operating officer of Chelsea Senior Living, in a statement. “We’re fortunate to be able to assume operations of such a well run community in this very scenic locale.”

Kevin Seidel is now the community’s executive director, after filling this role at the Chelsea residence in Montville.

Written by Alyssa Gerace

Assisted living laws in Florida could go from one side of the spectrum to the other in the wake of the Miami Herald’s series on elder abuse that occurred in many state facilities, with little or no ramifications.

Now, Florida lawmakers are looking to shift the state’s caretaker oversight from negligent to possibly the toughest in the nation, according to a Miami Herald article, recently passing committee bills 7176 and 7174.

With rampant abuse across the state, key lawmakers are calling for homes to be shut down when residents die from shoddy care, and caretakers banned from the industry, in the biggest changes in state law since the creation of ALFs a generation ago.

Unveiled this week by two Senate committees, the dual bills follow months of reports by The Miami Herald that showed frail elders were living in squalor and dangerous conditions while regulators failed to crack down on the worst abusers.

“[The state] wasn’t doing its job,” said Sen. Nan Rich, a Weston Democrat and vice chair of the Children, Families and Elder Affairs Committee. “They were not enforcing the regulations, and not closing down facilities that didn’t correct the violations and abuse.”

The proposal includes comprehensive legislation that seeks to improve oversight such as mandatory penalties in fatal neglect cases and a public ratings system derived from a facility’s regulatory history, the article reports.

Additionally, the regulatory reform bills take some power away from Florida’s Agency for Health Care Administration, which in the course of the investigation has faced scrutiny for failure to shut down or adequately penalize troubled facilities.

The full Miami Herald article lists several proposals from Rich’s Elder Affairs Committee and the state Senate’s Health Regulation Committee.

Written by Alyssa Gerace

Healthcare Transactions Group, Inc., based in Baltimore, Md., announced that it closed the sale of an Illinois long-term care facility portfolio on Dec. 30, 2011.

The portfolio includes eight skilled nursing facilities and one assisted living facility, located mainly in the greater Chicagoland area and in Central Illinois, for a total of 1,540 beds. The sale also included a licensed renal dialysis center and 38 residential retirement apartments, with a total portfolio price ranging between $95 million and $100 million, plus undisclosed contingent considerations.

The seller is Morton Grove, Ill.-located Kensington Management Group, LLC and its affiliates, represented by Mark Davis, president of Healthcare Transactions Group. The buyer encompasses affiliates of Formation Capital, LLC, based in Alpharetta, Ga., who will lease the facilities to an affiliate of Nucare Management Corporation, based in Lincolnwood, Ill. Kensington Management Group had both owned and operated the facilities prior to the sale.

The facilities include Aspen Ridge Care Centre, in Decatur; Countryside Care Centre, in Aurora; Crestwood Care Centre, in Crestwood; Deerbrook Care Centre, in Joliet; Maple Crest Care Centre, in Belvidere; Maple Ridge Care Centre, in Lincoln; McKinley Court, in Decatur; Northwoods Care Centre, in Belvidere; and Sycamore Village, in Swansea. At the time of the transaction, the overall occupancy rate was 86%.

Written by Alyssa Gerace

When various types of buildings end up vacant and in disuse, sometimes the next logical step is to repurpose them for senior housing, especially as the nation’s senior demographic grows at a rapid pace.

Old hospitals, hotels, and schools are probably the three most common types of buildings that can be converted into an assisted living facility, because they’re typically already divided into individual units but also feature common spaces; rooms in hotels and hospitals often have the added advantage of already having private bathrooms.

However, embarking on these projects isn’t always a walk in the park, according to some companies with conversion experience.

One of the mistakes that people make is thinking that because they might be able to get a conversion property cheaply, it will be a cost-saving project, but this isn’t necessarily the case, says Mike Collins, president of Senior Care Realty, LLC.

It can actually be more affordable to build from scratch, he says, and it’s generally easier and more predictable to build from the ground-up, too.

In some circumstances, though, it does make sense, and when it comes to financing a project, there may not be too much of different compared to new construction. In some cases, conversions may even qualify for tax credits or historic preservation programs, Collins told SHN.

One big factor is the availability of land. If there’s a vacant building in an area that’s been heavily developed, he says, it could present an opportunity for conversion.

Other factors include the market.

“I’ve encountered many developers who perhaps are overly optimistic about how profitable a development can be,” Collins says. “If you look at it purely as a real estate deal and not a business opportunity, people can make mistakes.”

It’s important to understand the market and the business aspect before trying to take advantage of a real estate opportunity, he says.

The key indicator in deciding whether or not it’s worth converting a building is figuring out if the work can be done at a substantial discount to new construction.

Even if the building itself is being sold for a good value (think state-owned hospitals and schools that have fallen into disuse, or abandoned hotels), developers could face headwinds from a marketing standpoint, in that an old property may have “marketing baggage,” Collins says.

For example, an old hospital-turned-ALF maybe have a positive community perception, with residents having fond memories of their children being born there. On the other hand, a building that used to be a mental institution could be negatively viewed.

“There are always surprises when you’re dealing with historic buildings,” says Richard Westin, CEO of Agemark Corporation, based in Berkeley, Ca., naming “surprises” like asbestos or water damage that affects multiple floors.

The most common challenges when it comes down to physically converting an old building into an assisted living community include regulatory issues related to the physical plant, such as bathrooms that are not ADA-compliant; doorways that aren’t wide enough to comply with current regulations; utility costs that are much higher than they’d be in a new building; or the fire code not being up-to-date.

Ultimately, if a property can be acquired and remodeled at a price point that is at a discount to current construction costs, says Collins, then this sort of project makes sense.

Written by Alyssa Gerace

How much will an average assisted living cost? The answers vary widely depending on region, but the latest data from Northwestern Mutual indicates that assisted living residents face a single room average of $3,372.41 per month. For nursing home patients, the average is $246 per day.

The costs are mounting at a time when Americans are getting older, notes the cost of Long-Term Care study, but without much planning on the part of those who will seek the services.

“What’s interesting is that most people realize they will need care, and yet by their own admission they’re not sure how they plan for it,” said Steve Sperka, Northwestern Mutual vice president of long-term care.

The costs depend greatly on location and care-type, but are consistently high, the report states, with the most expensive region seeing monthly costs for assisted living of more than $6,600 (Bethesda, Maryland) and the least expensive at $1,200 per month (Milwaukee). For nursing care, the average annual cost for a private room is roughly $90,000.

“The data is sobering, and doesn’t even include the added expenses of medical equipment, transportation, drugs and other hidden costs,” Sperka said. “Relative to other financial commitments in retirement, long-term care costs are disproportionately high and people need to think ahead to lessen the financial and emotional impact.”

The study also tracks hourly rates of pay for home health care, finding the national rate for Home Health Aides is $20.65 per hour.

View the study highlights.

Written by Elizabeth Ecker

Belmont Village Senior Living Breaks Ground in Dallas, Texas

Belmont Village Senior Living broke ground in January for Belmont Village Turtle Creek, scheduled to open in Summer 2013. The senior living community will feature 201 independent and assisted living as well as Alzheimer’s care.

Lend Lease Begins Construction on The Terraces at Bonita Springs, A SantaFe Senior Living Community

Lend Lease has been selected by SantaFe Senior Living, a SantaFe HealthCare company, to provide construction management services for The Terraces at Bonita Springs, a retirement community in Bonita Springs, Fla., with Greystone Communities as SantaFe’s development consultant. Construction for the 144 one-, two-, and three-bedroom apartment homes, 48 assisted living, 40 skilled nursing, and 18 memory support residences began on Nov. 4, 2011.

Construction Underway at Senior Living Complex in Fridley, Minnesota

Construction is underway for the Landmark of Fridley senior living project in Fridley, Minn. What was formerly a neighborhood restaurant has been torn down, and the project developer broke ground in late September for a 70-unit independent and assisted living and memory care community.

Wartburg Breaks Ground on Affordable Senior Housing

On Jan. 11, 2012, a groundbreaking ceremony was held for the Friedrichs Residence, which will be a 4-story building with 61 affordable senior apartments in Mt. Vernon, N.Y. Bank of America Merrill Lynch Community Development, Enterprise Community Investment, Inc., and  the New York State Housing Finance Agency all contributed to the financing of this project, along with a a $1 million bequest from the late Juanita E. and Arthur M. Friedrichs, for whom the project has been named.

Inland Group Launches Construction for Lafayette Senior Housing Development

Affinity at Lafayette, a senior housing project in Lafayette, Co., broke ground in recent weeks, led by Spokane, Wash.-based Inland Group. The senior independent living apartment community will feature 12 studios, 60 one-bedroom and 48 two-bedroom units, contained in one building.

Of more than 38,000 assisted living communities across the nation, Caring.com sought to find the best facilities based on popular consumer vote. The site designated 119 communities “Caring Stars” of 2012 in recognition of service excellence, with the results announced this week.

Across 24 states, the communities received the designation based on a yearlong compilation of consumer ratings and reviews. The results were tallied in December 2011.

California holds the greatest number of Caring Star designees, numbering 23 facilities. Arizona has the second largest number of any state, boasting 21 facilities on the list.

“Our research shows that word-of-mouth recommendations from others outweigh all other factors for caregivers choosing an assisted living community for a loved one,” said Andy Cohen, co-founder and CEO of Caring.com. These first-hand testimonials are consistently cited as more important than anything else, including price and location, which are second and third in impact respectively.”

View the list.

Written by Elizabeth Ecker

The Assisted Living Federation of America this week announced it has partnered with the first-ever senior living association in India. ALFA will work with the new Indian group to develop its senior living program to benefit the country’s consumers, the organization said.

“The Indian senior living sector is still in its infancy and is expected to grow at a rapid pace in the coming years,” said ALFA Director Steven Vick, co-founder and CEO of Signature Senior Living. “Senior living providers in India can learn a tremendous amount from the fits and starts we had when senior living was in its infancy in the U.S.”

The announcement comes following the first-time Retirement Living World India conference, held in December in New Delhi. There, industry leaders announced the formation of the Indian senior living group coined Association Senior Living India (ASLI).

“ALFA, working closely with ASLI, can contribute to their success by sharing with our partners in India what we’ve learned over the past 20 years,” Vick said.

Written by Elizabeth Ecker

Nevada is tightening its regulations for what can be considered “assisted living” in the state, reports the Las Vegas Review-Journal.

The Nevada Department of Health Care Quality and Compliance issued regulations last June that requires retirement communities to follow “strict regulations and meet certain standards” in order to be allowed to use the term “assisted living” to describe themselves, the Review-Journal says.

While the regulations went into effect last year, retirement communities had until January to either make their facilities conform to the new standards, or else drop the “assisted living” label from their listings.

In order to be qualified as assisted living, facilities must offer services including intramuscular, subcutaneous, and intradermal injections by licensed staff; care of indwelling catheters; oxygen monitoring; wound care; assistance with colostomy; and ileostomy care, says the article. The regulation also requires that a medical professional, such as a registered nurse (or higher), be on staff to manage residents’ care.

Across the nation, various states are seeing regulations develop or tighten for assisted living. In recent months, Pennsylvania has worked to define the middle ground between personal care homes and nursing homes, with facilities billing themselves as “assisted living” needing to follow certain regulations. Florida assisted living facilities are also enduring close scrutiny in regards to enforcing existing regulations and implementing new ones.

View the full Las Vegas Review-Journal article here.

Written by Alyssa Gerace

Bunker Hill Community College’s Division of Professional Studies recently introduced a program designed to meet the needs of the growing field of Assisted Living, titled “Management of Assisted Living and Institutional Facilities.”

The program is contained within the Associate in Science Degree: Hotel Restaurant program, which is earned after completing a total of 65 credits.

The Assisted Living and Institutional Facilities Option will be a combination of the specialized skills needed to manage an Assisted Living Facility and the guest-centered focus of BHCC’s Hotel/Restaurant Management program. The first courses will be available in Spring 2012, with the semester beginning January 23rd.

Assisted Living Facilities are one of the fastest growing areas of both the health care and hospitality industries, with well-known entities such as Marriott and Hyatt entering the marketplace with divisions devoted to the management of Continuing Care Communities.

BHCC is located in Massachusetts and enrolls approximately 13,000 students on two campuses and four satellite locations.

Written by Alyssa Gerace

The Ensign Group, Inc. (NASDAQ:ENSG) announced on Jan. 4 that is has acquired a Phoenix, Ariz.-located assisted living facility, effective Dec. 30, 2011 with the transfer of operations effective on Jan. 1, 2012.

Rose Court Senior Living is a 93-unit facility that had an occupancy rate of approximately 50% at the time of acquisition. Bridgestone Living, Inc., Ensign’s seniors housing subsidiary, expects the property to be operationally accretive to earnings in 2012.

“This opportunistic acquisition further solidifies Ensign’s operating synergies in the Phoenix market,” said Christopher Christensen, Ensign’s President and Chief Executive Officer.  He also noted that the facility was purchased from a lender that foreclosed on the property last summer.

The purchase was made in cash and brings Ensign’s portfolio to 102 healthcare facilities, 77 of which are Ensign-owned; three hospice companies; and four home health business, located in 10 states. Additionally, Ensign affiliates hold purchase options on five of their 25 leased facilities.

Written by Alyssa Gerace

MedHoldings, Inc., a healthcare real estate and investment company with holdings in Florida, Georgia, and Puerto Rico, recently announced the opening of Puerto Rico’s first combined assisted living and memory care community.

Located in San Juan, Puerto Rico, the 85-bed The Residence Senior Living offers both assisted living and memory care services and features suites with kitchenettes and full private bathrooms. The community is managed by Insignia Senior Living.

“We are excited to provide safe and joyful environments for seniors now in Puerto Rico,” said Milton L. Cruz, Esq., president of MedHoldings, in a statement. “This new state-of-the-art community has all the comforts and amenities seniors deserve.”

With the opening of The Residence, the number of senior communities owned by MedHoldings and affiliates totals 16.

Written by Alyssa Gerace

A 57-unit assisted living facility located in Walnut Creek, Calif., approximately 32 miles east of San Francisco, recently sold for $11.3 million, or $198,246 per unit.

The sale was brokered by Rob Reis, a senior associate in Marcus & Millichap Real Estate Investment Services’ San Francisco office. He represented both the buyer, a national owner/operator, and the seller, a local developer.

“Tiffany Court has an outstanding reputation in the community,” Reis said in a statement. “The property was developed, owned, and operated by the seller.”

The facility opened in November 1996 and within three-and-a-half months was fully leased, according to Reis.

At the time of sale, Tiffany Court was 95% occupied.

Written by Alyssa Gerace

Supportive living facilities (SLFs), Illinois’ affordable assisted living program, is in danger of needing life support since the state hasn’t paid out regular Medicaid reimbursements since July 2011, according to several local operators.

Like many other states across the nation, Illinois is facing a budget crisis that is deeply impacting SLFs as they struggle to remain operating despite inadequate funds.

For most facilities, the number of residents whose care is funded through Medicaid far outnumbers the “private pay” residents, and it’s these facilities that are being hit the hardest.

“Places will have to shut down if payments don’t come soon,” says Nancy Kapp, president of the Renaissance Company, which owns and operates the 107-unit St. Luke Renaissance at Greenview Place in Chicago. “You can’t go on like this.”

Some state providers have gotten word that they’re supposed to receive a payment before Christmas, a promise that many are depending on with payments currently more than 150 days behind.

While Kapp says her facility is not in imminent danger of shutting down in the next month or so, she says it could face closure in the next couple of months if it still hasn’t received payment.

Across the state, about 16 facilities have been able to get on an expedited payment program, says Bob Schleicher, managing member of St. Francis Woods LLC, which operates a 92-bed SLF in Peoria, Ill. In order to be eligible, their Medicaid population must be at 80% or more, and their asset-to-liability ratio at 1.1, he says, and while only 16 were in the program the last time he checked, there are a “whole lot more facilities that are on the periphery of those numbers.”

Unfortunately for St. Luke Renaissance at Greenview Place, even though its resident mix is more than 80% Medicaid, its capital reserves barred it from eligibility for the expedited payment program, says Kapp, and according to Schleicher, the state is trying to change the requirements of the program that would further disqualify other facilities by changing the asset-to-liability ration to 1.5.

On a day-to-day basis, many of the state’s 133 operating facilities are struggling to continue business as usual.

“They’re having a hard time finding money to pay vendors and staff; they’re using lines of credit or reserves, but that’s rapidly coming to an end,” say Wayne Smallwood, executive director of the Affordable Assisted Living Coalition.

The lack of reimbursement could cause some to go out of business, and the facilities that operate only one or two units are most at risk, he says. About half of the facilities are smaller operations with one or two buildings, while the other half are generally owned by those who operate five or more facilities.

“The small ones feel the impact quicker,” says Schleicher. “We don’t have as large of reserves, or as large of a capital bank.”

And even the big ones are feeling a pinch. “You can only move money within your large organization so much before you’re handicapped,” he says.

“It all hinges on what the governor and the assembly do to solve the state budget problem,” Smallwood says, adding that Illinois has the “highest per capita deficit.”

The situation isn’t looking good, and Schleicher and fellow managing agent for St. Francis Woods LLC Nancy Lee-McQuillan say there isn’t a clearcut solution.

“Without the state doing what they agreed to do, which is pay us on a monthly basis, we can’t operate a facility,” says Lee-McQuillan.

“We can’t seem to get an answer of how this can get fixed,” Schleicher added.

A recent state Medicaid study conducted by Eljay, LLC on behalf of the American Health Care Association (AHCA) predicts that the shortfall in Medicaid funding for seniors’ long term care needs will reach $6.3 billion in 2011.

“Limited state resources, sagging state economies and continued rebalancing efforts are reflected in that at least 60% of states that have either reduced Medicaid rates or provided no Medicaid rate increases for FY 2012,” said Joseph Lubarsky, president of Eljay, LLC and author of the report, in a statement.

The Illinois Department of Healthcare and Family Services did not provide a comment on the situation as of press time.

Written by Alyssa Gerace