Bigger is not always better.

By Steve Moran

Several weeks ago I received this email:

Your recent article about small communities is the reason I’m reaching out to you. I operate a small community that I believe is pioneering a different approach to care, especially for the small communities. I’d love to talk to you about things you see in the market and to give you a look at our model as possible fodder for a future article.

There was actually more, to the email, but that was all I read, my bad . . .

I responded that I would be glad to talk, because I work really hard to be available to chat with people by phone about pretty much anything related to the senior living industry.  Giving credit to the quality of the people in the industry I would say that only once or twice a year do I feel like I wasted my time or was conned.

I also included in my email a time and date. He replied almost immediately with the address of his community which was maybe 10 minutes from me. Yep . . . he had already told me where it was . . .  in the rest of the email that I did not read.

I was not thrilled that I had ended up making a bigger commitment than I intended but thought . . . well I guess better go.

Not What I Expected

My GPS took me to a kind of mixed low/middle income neighborhood and what looked like a rather plainly built single family building. The only real clue was a small gravel parking lot out front. I did not have warm feelings about this. I walked to the front door, thinking there is going to be some middle aged first generation immigrant (I probably should not confess this in print), who barely speaks English and I am going to have to pretend to be impressed by something awful.

I rang the doorbell and a neat looking young man who could have passed for a Morman missionary minus the tie, invited me into this six bed assisted living community that blew me away. There was this wide open floor plan with a gorgeous residential kitchen that would have given my wife envy.

What Was Going On

Toly Molitvek watched how his father ran the family six bed elderly care home and wanted to do something similar but something very different. He found this modest single family home that he could remodel creating a classy six bed assisted living community that would attract private pay residents that were not well suited for traditional assisted living, which mostly meant they were looking for a way to have assisted living that still felt like home, but was as nice (or nicer) than the home they left.  

This place, “All Seasons” is just plain really cool. It is a home, it means that residents get the care they need in a place that feels more or less like home. Every room is private and has an attached private bathroom. They have two daytime staff who are, in effect, universal workers plus 2 night-time staff, giving them a three to one ratio. Residents can wake up when they are used to waking up. They also have a full-service person at night, which almost all but eliminates the 2 a.m. bathroom-visit falls we all dread. They eat family style at a large dining room table, but can eat at least breakfast any time they want, at the table, or in their room.

An Inadvertent Hospice Home

Their high quality care attracts high acuity residents. They come to escape the halls of the SNFs and get the care our social model so often fails to provide. We all know that acuity is going up, but these guys are actually meeting the care needs of those who used to have little options but to be institutionalized. Right now, his average length of stay is just six months and typically half of his residents are on hospice care. He charges $6,000 per month as an all-inclusive rate regardless of level of care, which means he is frequently less costly, all-in, than the higher end traditional senior living provider.

Puzzling About This

I am not sure, but when I look at my 85-year-old mom, who might one day be a candidate for assisted living, I find myself thinking she might very well find this to be a much more attractive “home-like” setting than traditional assisted living communities. It might even be, that I would like it better . . . though I am not quite sure about that, because I am a pretty social person.

We know a huge majority of elders (more than 90%) don’t want what we are selling and so I am thinking that if somehow, we could recreate this kind of living at scale, it might be a way to significantly expand our appeal.

I don’t know . . . do you have any thoughts?