While there will continue to be a fair amount of consolidation in the industry there will also be new emerging players providing the industry and consumers a healthy mix of large and small providers.

Yesterday I published an article titled “The New World of Assisted Living –  I Am Not So Sure.” it was based on an article on the Forbes website by Howard Glickman that reflected his future casting on assisted living. While I think it is a very good read, I expressed reservations about several of his beliefs. 

Today I want to offer my views of what assisted living will look like in the future:

  • Consolidation –  While there will continue to be a fair amount of consolidation in the industry, there will also be new emerging players providing the industry and consumers a healthy mix of large and small providers. Even today we see senior living companies like Merrill Gardens and Bonaventure selling parts of their portofolios, freeing up resources to develop their next generation senior living.
  • Fragmentation – All indications are that while encountering some expected choppy sailing, Brookdale is well on its way toward successfully integrating Emeritus into its family. I don’t think this will be a universal result of consolidation. I believe we will see some of these mergers implode with lots buyers with ready cash standing by to pick up the pieces.
  • Medical Model Assisted Living – The amount of healthcare allowed in assisted living communities varies greatly from state to state. Ultimately though allowing extensive nursing services in assisted living communities serves government well. It also mostly serves residents well. Some would argue the quality of care in medical model assisted living is not as good as in a skilled nursing facility. There does not seem to be much hard evidence that this is true. In fact, in many cases, a medical model resident actually receives more one-on-one care in AL than they would in a skilled nursing facility. This is largely the case because in skilled nursing regulatory compliance chews up so much staff time.
  • Creative HousingSocial Model Assisted Living – There will also continue to be a need for assisted living that operates on more of a social model, though if trends continue, the demand for this style of assisted living will continue to diminish. This is unfortunate and has largely been brought on (though unintentionally) by the senior living operators.
  • New Models: Assisted Living – I think we are going to see a wider variety of senior living options. We are already seeing some of this. LGBT-specific communities, and university-based communities. Of course, in some sense, it is really an old model used by churches, retired military officers and teachers.  

    We are seeing a major resurgence in small home-like communities (not memory care) that are home to 12-25 residents operating more or less autonomously even if clustered on a single campus. I could see a Hard Rock Café does senior living, or communities of book or movie lovers.

    I can also envision senior living communities that will better serve the moderate income seniors where part of the care will be in the form of sweat equity by either seniors or their families.

  • New Models: Independent Living –  I expect to see a resurgence of independent living with services that will better appeal to younger seniors. I also would anticipate seeing more independent living as a method to better control costs.
  • New Models: Non-Traditional – I think we will see some really crazy, creative cool operating models that I can only begin to imagine: Golden Girls co-housing; multigenerational house sharing that allows young families to purchase homes in return for caring for non–related elders. There is someone in Canada right now who has created a co-housing, almost-assisted-living model that looks like a condo or co-op where the resident or their family purchase an ownership share that can be resold when the elder no longer needs it.
  • New Model: Steve’s Crazy New Idea – This one will need to wait for an article of its own.

The senior living industry is vast and growing. There are a bunch of new players looking at how to serve seniors in all sort of new and novel ways, both in senior communities and at home. It is an exciting time and I would never ever suggest that assisted living as we are doing it today is in serious trouble or is even facing huge challenges.