The face of senior living and assisted care facilities is changing. From Continuing Care Retirement Communities (CCRCs) and stand-alone memory care and rehabilitation facilities, to entrance-fee models and rental options and hybrids of all of the above, continuum care is departing from a sullen and depressing nursing home stigma. There is no better place to witness the evolution of senior care, than in Arizona — where continuum care is a booming business.
“There’s always going to be a need for assisted living and assisted care,” explains Chris Harrison, Southwest office leader for The Weitz Company. “But if you look at the heat map, most of the concentrated builds reside on the smile: California, Arizona, Texas, Southeast Florida and up the coast.”
Coinciding with the metamorphosis of the type of care and housing being offered, is a comparably evolved demographic of seniors seeking more than simply warm weather and an attractive landing pad.
“The oncoming senior population is looking for more of an urban/mixed-use feel when seeking senior retirement and living options,” Harrison says. “They like restaurants, retail, activities and continuing education, with access to nearby colleges and universities.”
According to Harrison and GPE Commercial Advisors Executive Vice President Julie Johnson, these factors will increase in importance in the next decade and beyond, as the Baby Boomers transition into senior living.
Although the Baby Boomers may be years from making the physical move into a Continuing Care Retirement Community (the typical age of entry is 82), they’re impacting senior housing now.
“They are the decision makers for their parents who are now in — or are going into — senior care,” says Johnson. “The qualities Baby Boomers are looking for in senior care for their parents are also what they ultimately want for themselves.”
Johnson goes on to explain that Baby boomers have high standards, the expectation for amenities and affordability.
So how do the expectations for more amenities and lower-living costs translate into an existing senior-care market?
“The rental model is definitely growing,” Johnson says, “rather than the entrance-fee CCRC.”
According to Johnson, this is partly due to the Millennial mindset transcending into the senior-living population by passing along the desire for a lock and leave lifestyle. But there’s more to the story.
“The recession affected a lot of nest eggs,” Johnson says, “When it was over and people were finally able to sell their homes, that’s when they were finally able to enter memory- and-assisted-living care.”
Also trending: an increase of stand-alone memory care and rehabilitation facilities.
“With more awareness of Alzheimer’s and dementia, 30 percent of senior living facilities (whether stand alone or CCRC) offer memory care,” Johnson says. “Unfortunately, the statistics are growing exponentially.
“If you look at the Affordable Care Act and the improvement of long-term outcome,” says C. Mark Hansen, president and CEO of Santé, a healthcare real estate development company, “continuity of care will become more and more important.”
As a result of this, Hansen feels that continuum of care will keep moving toward an all-encompassing transitional-hybrid model of independent living that progresses to offering multiple levels of assisted care.
“We have high-acuity assisted living, custodial nursing and amenities,” Hansen says of in-progress Santé at Westgate. “Occupants will have their own apartment, but once they make the decision for assistance, they won’t have to move.”
Preventing displacement is a key component in the facelift of senior care.
“People moving into assisted living can be very traumatic and to have to do it more than once is even more difficult,” Hansen says.
Sun Health’s Executive Vice President Joe La Rue agrees.
“We offer an insurance model with continuum care included,” La Rue says, “so that no matter what happens health wise or financially, we’ll take care of you for life. We understand that to move someone is devastating — that’s something we can’t do.”
Sun Health has also created a product that allows seniors to stay in their home, extending a bundle of services much like what you’d receive in a CCRC, but with the added benefit of allowing an entrance fee in exchange for space on one of their campuses.
“People who really get the aging process are going to want to protect the downside risk,” La Rue says.
Senior care developers, operators and future tenants alike are also becoming more transparent in their expectation of needs — No. 1 being that they wouldn’t touch a nursing-home type of environment with a 10-foot cane.
“Nobody wants to move into Grandma’s nursing home,” La Rue say. “Even the term ‘assisted living’ makes my skin crawl.”
This evolution in mindset will most likely spur the advent of more hybrid senior care developments, such as Sun Health’s The Colonnade, recipient NAHB Silver Award for The Best of 55+ Housing.
“The Colonnade consists of a 40-acre campus with casitas that resemble single-family homes,” La Rue explains. “We also have a section that we refer to as villas that are independent living units, as well as a new clubhouse with a pool, spa and yoga services and a meditation garden.”
“Incoming senior tenants tend to feel younger than their parents did at the same stage of life,” Johnson says. “They expect to live longer and will require more flexibility and choices — in amenities, floor plans and more.”
Freedom of choice and varied options is becoming increasingly more important.
“Many communities won’t let you make changes to the environment,” La Rue says. “We want to keep as much control and decision-making as possible with the individuals.”
As senior care continues to move forward, one thing is clear: there won’t be a shortage of options.
“The biggest trend I’m seeing is overbuilding,” Hansen says. “We track every new facility being built in Maricopa County. We’re in Gilbert and there are 20 senior living facilities alone. My prediction is that there will be an oversupply in the short term — the next three to four years. Once you get past that and Baby Boomers come online, that will solve that problem, but that’s still quite a few years away.”