By Steve Moran

A couple of weeks ago we published an article titled  “Sunrise and Others Sued Over Ala Carte Care Pricing – Do They Have a Point?” I followed the reader comments to the New York Times article that inspired my article and I came away with one overwhelming conclusion — we think we are in the lifestyle-for-older-adults business. Consumers think we are in the business of providing care for frail declining older people.

Some of the Comments

The facilities are frequently understaffed, the menu of food choices pitched to you nonexistent, and the caretakers are not properly trained, nor emotionally or mentally up for the task.

When we questioned if there was enough staff to care for the 50 people who lived there, we were told that NYS only required 2 staff to be in the building at any one time, because it was assisted living, not a nursing home.

Good luck trying to find the nurse on duty for the whole facility. We filled in the gaps for what she needed as much as we could, while still working full time. Was the cost justified? No, not even close.

We paid several hundred a month so my relative could have two showers (with shampoos) every week, but observing her it was very clear this happened randomly if at all and was often missed. My relative was also left in dirty clothing! (though this facility did provide decent laundry service).

In a building with 24 residents on two floors, there were two (2) aides at any given time — to assist all those residents, most over 87 and in wheelchairs or walkers! Give showers to all twice a week! Help with dressing and, oh, serve all meals, including setting tables and bussing afterward.

There were a few people who commented saying they and their family members had a great assisted living experience, but even those were focused on care.

Are Ae Deluding Ourselves?

We devote massive amounts of effort telling our story as a lifestyle story and I get it. We spend a lot of money and devote a lot of energy creating amazing spaces for our residents. We have this narrative of changing people’s lives and giving them the best last chapters of their lives.

But I find myself wondering:

  • What if our message were, “We know you only have a few months to live and we want that time to be great.”
  • “We are completely devoted to providing amazing care.”
  • “Your loved one’s security is paramount.”
  • “There is no question that what we are offering is really expensive, but the hard truth is that average resident lives in a community less than two years and should you be spending your money to create an amazing experience for those last two years?”


Hospitals make no bones about selling care. They don’t apologize for being expensive. They don’t hide the fact that a lot of people die in hospitals. Their message each and every time is great care with great compassion.

Maybe we need to rethink this whole thing.