In looking at the senior housing industry as a whole and assisted living more specifically, I see four realities:

In looking at the senior housing industry as a whole and assisted living more specifically, I see four realities:

1.  As much as the industry would like it to be different, seniors are putting great effort and resources into growing old at home.  This means when they finally make the move to assisted living, they are older than would be ideal, from the perspective of the assisted living operators.  The net effect is that assisted living stays are shorter and residents require more attention, which makes the financial proposition for the community less attractive. 2.  Seniors who move into assisted living present with more medications and more complex medical needs.  They also require higher levels of support with activities of daily living. 3.  When a senior moves to a higher level of care it does great damage to their emotional well-being, their physical well-being and their families’ well-being.  Studies have shown that the fewer moves a senior makes the better off they will be in every respect. 4.  While there are some great skilled nursing facilities, it is never a “lifestyle choice”.  The public perception is that if you have to go into a skilled nursing facility you are close to the end of your life.  It is often perceived as going to a place to die. While at ALFA in Dallas a several weeks ago I attended two breakout sessions where the presenters described a number of Assisted Living communities that are in effect, operating medical model assisted living communities.  One of the presenters was Tiffany Tomasso, one of the founders and partners of Kensington Senior Living, LLC and a partner in Fountain Square Development. Prior to founding Kensington Senior Living, Tiffany was the Chief Operating Officer for Sunrise Senior Living.  She is a former Past Chairman of ALFA and currently serves on the Springpoint Senior Living BOARD OF TRUSTEES.


Tiffany and her team took their long term care and assisted living experience and asked this question: Given what we know about seniors and the assisted living market place today, how can we create a model of care that will better serve the needs of today’s seniors in the current senior marketplace? While the Kensington Model is a work in progress here is what it looks like today:

1. They have a strong clinical framework –The average age of their seniors is 84 with a myriad of health care needs.  The anchor point at Kensington is an RN with a critical care background.  She leads the nursing team and effectively functions as a case manager for the residents.  The team includes multiple LPNs on each shift who are responsible for both medication administration and other nursing interventions. Kensington also has agreements with a Board Certified Gerontologist, an Internist, a Cardiologist and a NeuroPsychiatrist.  Each of these professionals make regular visits to the community to see patients in the on-site physician office. Each community also has a well-equipped therapy center where physical therapy, occupational therapy and speech therapy are offered 5 days per week.  The Kensington communities also have a preferred partnership program with the local VNA and Hospice.

2. Best Medical Outcome – Because the community, while providing a great environment, is medically focused, their goal is to determine what resources are needed to give each resident the best possible medical outcome which results in the highest possible quality of life.  This means that whenever possible services will be brought to the resident.  This includes rehabilitation therapy, laboratory and mobile x-ray services.

3. The Kensington is positioned as “The Option” for physically frail seniors who want to age with dignity.  This includes minimizing the likelihood of needed to move into a skilled nursing facility.  This represents a major shift in thinking or at least a major shift in how the community is marketed. While most residents, who move into an assisted living community, make that decision based on need rather than lifestyle, most assisted living communities present themselves as a lifestyle choice. That said, Kensington communities are rich in amenities including all day dining, an active social program and 7 day a week transportation to medical and personal appointments.

4. One Time Choice –  Making the decision to move from home to a senior housing community is a gut wrenching process for the resident and their family.  The Kensington concept is that moving into a Kensington community will mean the resident and their family will have to wrestle with this decision only that one time.  This means that in a very real sense, Kensington moves into a case management role.  It also means great peace of mind for the family.

5. A Single Move –  As important as a one-time choice is a single move.  Studies show that multiple moves are particularly hard on seniors and can do great damage to the physical and emotional well-being.  It can result in a shortened life expectancy.   The Kensington Model says, that in almost every case, a move into a Kensington community will be the last move the resident ever has to make.

6. Memory Care –  The Kensington offers two neighborhoods for memory care: one for seniors in the early to mid-stage, and one for those residents with late stage.  Almost 50% of the resident total resident capacity is for memory care and both neighborhoods filled in the first 11 months.

7. Marketing and Sales –  One third of the move-ins have come from professional referrals (physicians, case managers), and fifty percent of the residents have come from another care setting.

Lessons Learned

1. Families really like the idea that the resident will never need to move again.  In the first 10 months of operation, only four residents have moved to a higher level of care.  Of those four, two needed psychiatric intervention that the community is not equipped to provide and two residents went to an inpatient hospice.

2.The early to mid-stage memory care neighborhood has been filled with residents at the mid stage of memory loss, while those with early cognitive impairment are functioning very well in assisted living.  In fact, almost half the residents in AL have mild cognitive impairment (MCI).

3.Having two physician groups has been better than having just one group.  Groups provide coverage than solo physicians.  These lessons have resulted in better coverage and more choices for the residents and their families.  Adding specialists to the physician roster has added convenience for the families.

4.About 15% of the residents had Long-Term Care Insurance which helps to make the economics work.

5.In future designs they will create more common areas and more wandering areas for the memory care program.  They will also have lighter furniture and less furniture in the memory care community. Steve Moran ++++++++++++++ Don’t miss a single issue of Senior Housing Forum, subscribe today. It is free! We do not sell or share your contact information. The posts are practical and never too long. Go to the main page of Senior Housing Forum and on the top you will see a place to enter your email to subscribe. You will receive notification when a new article is posted. You can unsubscribe at any time.

Finally: If you know anyone who is looking at emergency call systems I would appreciate the opportunity to talk with them about Vigil Health Solutions.