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Assisted Living Sector Expands

By Robert Hadley

Sunrise of Louisville is a 91,000-s.f. assisted/independent senior living facility built in east Jefferson County.

Masonic Homes of Kentucky’s groundbreaking last month on The Meadow, a 230,000-s.f., 122-unit apartment-style complex on its 82-acre Louisville campus is part of a move by the region’s significant aging-care sector to fill an expanding need.

Waves of aging baby boomers are driving expansion of the aging-care industry both nationally and in especially in Louisville as the largest demographic group in U.S. history enters retirement. The number of men and women over age 60 in the commonwealth, according to a 2011 report from the Kentucky State Data Center, is in the midst of rising from 829,000 in 2010 to nearly 1.1 million by 2020.

In Louisville an even more dramatic increase is projected, with the report forecasting a 35 percent jump from 177,514 in 2010 to almost 240,000 by 2020 in the Louisville Metro area.

The rising elderly population is boosting demand for assisted living facilities, which often bridge the gap between full-on nursing homes and hospitals. These types of homes offer more independence, but with nursing care available when residents need it.

Overall construction figures are
not readily available, but the state was issuing $100 million in tax-free municipal bonds this month for Masonic Homes. Its amenities-rich The Meadows, 84 percent pre-sold at groundbreaking, will cost $44 million, and Masonic Homes early next year plans to begin construction of Grove Pointe, a $14 million 48-unit assisted living community also on its 82-acre campus along Frankfort Avenue.

Healthcare, including senior facilities, plays a significant role in the Louisville Metro economy. Eight of the city’s top 20 employers are healthcare related, employing approximately 85,000 workers with an annual payroll of $3.5 billion, according to Alison Brotzge-Elder, spokesperson for Greater Louisville Inc.

Louisville considers its aging-care sector the world’s largest, with $50 billion in annual revenues.

Assisted living firms like Atria Senior Living, Elmcroft Senior Living, ResCare, Signature HealthCARE, Trilogy Health Services and others play a large role in making healthcare a vital contributor to the Metro’s economy.

“The growth of this sector is occurring in the areas of pharmaceutical development, health technology and life sciences, making Louisville a center for innovation, thereby strengthening our economy,” Brotze-Elder said.

The state’s largest city is home to a number of assisted living communities. Here’s a roundup of some of the more prominent ones:

Headquartered in Louisville, Atria Senior Living operates 180 communities across 28 states, including three in Louisville. Its facilities are monthly rented, private-pay apartments with options for active seniors or those requiring help with daily living activities or Alzheimer’s disease.

Signature HealthCARE LLC operates 143 facilities in 11 states, including 46 in Kentucky, 10 of which are in Louisville. It reports a range of services suited for short- and long-term stays, targeted toward urban and rural markets. These facilities are often paid for through Medicaid and Medicare, as many of their locations have earned five-star ratings from both insurers.

Trilogy Health Services LLC operates multiple communities in Kentucky, Indiana, Michigan and Ohio, its 102nd facility opening recently in Kendallville, Ind. In Louisville, their website lists six facilities, including the Franciscan Health Center and Glen Ridge Health Campus. These locations offer combinations of skilled nursing and temporary rehabilitative care, as well as assisted living.

Elmcroft Senior Living has 83 facilities in 18 states, servicing 6,000 senior adults. It operates Elmcroft of Mount Washington, a facility about 30 miles south of Louisville that offers assisted living and dementia care.

ResCare, a home-care provider, is the nation’s largest supplier of services to people with disabilities.

Boomers launch ‘tsunami’ of demand

Retirement wasn’t always as messy and complicated as it is today. A generation ago, the average life expectancy saw senior citizens living until around 70, nearly a decade less than currently.

That extra decade means people are living longer with chronic illnesses that occur late in life. Heart disease, dementia, strokes and diabetes formerly struck adults, but scientific advances are lengthening life. The downside, though, is the debilitating complications that accompany such ailments.

Alzheimer’s disease or other forms of dementia are particularly devastating in terms of care requirements, and the effects are deeper than simple forgetfulness.

“Most people think of dementia as a cognitive problem, rather than a physical problem,” said Jennifer L. FitzPatrick, MSW, author of “Cruising Through Caregiving: Reducing The Stress of Caring For Your Loved One.” “But ultimately one of the reasons assisted living becomes so important is that this person can’t get to the bathroom anymore or can’t feed themselves.”

Although diabetes and heart disease may bring less-debilitating complications, those with these conditions can still require various types of assistance. Diabetics may be unable to walk due to amputations. Heart medications can make users dizzy and unable to drive or take showers.

“There are so many seniors out there now who need some type of assistance,” said Julie Hess, executive director of ACM Care, a St. Louis nonprofit that matches families to affordable care alternatives for senior adults. “Assisted living facilities are taking care of people who are a little more dependent than they would have been 10 years ago.”

These communities have emerged to bridge the gap between less intensive in-home care and nursing homes providing 24/7 skilled nursing. Some offer “memory units” designed to treat dementia, while others supply physical therapy for only a few weeks. The stay can be temporary for some, but other patients make the facilities their permanent homes.

According to a recent report by the Small Business Development Center Network, around 1 million people live in an assisted living facility.

The SBDC report pinpoints the cost for a typical assisted living community at $3,000 to $4,500 per month. Extra care can raise the bar closer to $6,000 a month. Either way, it’s a lot of money for the middle-income retiree to afford. These people fall into a gray area where financing options are limited.

“If you are destitute, then the state will help pay for the care,” Hess said. “The problem is 80 percent of the people who are in between, who don’t qualify for the help and can’t afford it on their own and don’t have long-term care insurance.”

The issues surrounding the cost of care as more people require it in the next decade is likely to become a political debate, with no clear answers for those who can’t afford care on their own but exceed the Medicaid threshold.

“If they don’t get help in their homes, they’ll end up with the state paying for a nursing home,” Hess said. But “studies have shown it’s typically less expensive to keep someone at home than to have them go into a nursing home.”

Robert Hadley is a correspondent for The Lane Report. He can be reached at [email protected].