Could Senior Living Communities “Without Walls” be the Model of the Future?

Whether it’s the economy or merely the fact that a large majority of people desire to stay in their own homes, aging in place is something that senior living communities must figure out how to incorporate into their business model going forward.

A recent MetLife Mature Market Institute survey shows 83% of retiring boomers have no plans to move from their current residence, while market researchers have noticed a higher average age of those entering retirement communities.

Rather than fear the trend, providers can capitalize on it by offering services to individuals in the surrounding area for a “community without walls” model that could even result in individuals eventually transferring into a provider’s network of senior living communities. And companies like Intel-GE Care Innovations are creating products to transform how and where senior care is delivered.


Preparing for the Future of Senior Care

Rather than sit back and wait for older seniors to enter their communities, not-for-profit Evangelical Homes of Michigan, which operates seven senior care communities in its home state, has embarked on a different route: Help care for seniors who are still living in their own homes.

EHM has been around for more than 130 years, and for most of that time, it offered mainly nursing home-type services. But in 1999, when forward-thinking company president Denise Rabidoux took over, EHM began to transform its business line.


“We started to look at the needs and desires of older adults and what was going on around us in the field, and asking what older adults would want in the future,” says Rabidoux.

More than 90% of older adults never enter traditional nursing homes or retirement communities, she says, and a huge majority stay in their homes for life—echoing the findings of the MetLife survey.

And if these trends meant EHM could only capture about 5% of its target market, Rabidoux told SHN, the company started thinking about what it could do in the future if it started to provide what the senior population needed and wanted.

Expanding Services to for a Larger Target Market

EHM took action and began acquiring home care and home healthcare agencies, along with opening a geriatric care management service line. The company also utilizes Intel-GE Care Innovations’ Connect program, which allows them the ability to virtually engage with residents living both inside and outside of their communities.

The thought is to keep clients living independently in their apartments or homes as they start to age, whether they’re in one of EHM’s communities, or in an individual residence.

Within the past couple of years, EHM began to offer a program called LifeChoice, described by Rabidoux as a “retirement community without walls” that allows seniors to receive the same services they would in a retirement community, but in their own home. Participants pay an entrance fee at the beginning, the amount of which varies depending on age and can range from about $30,000 to $40,000. They also pay a monthly membership fee which totals about $5,000 a year.

Getting in-home care is an option that’s been around for a while, says Steve Hopkins, the vice president of Wellness and Home-based Solutions at EHM, but his company has striven to be ahead of the curve.

“Part of our voyage has been preparing the company for the future, and that’s where LifeChoices and solutions for older adults that aren’t just care oriented can be thought of as forward-thinking,” he says.

Only healthy residents who can live independently can join the program, and the a la carte services that are available to LifeChoices participants are the same as those offered on EHM campuses.

The Michigan-based not-for-profit is one of less than a dozen organizations across the country offering a continuing care at home program that has tried the model and been successful, according to Rabidoux. Hopkins says it took about a year to build the program, and EHM is now about a year and a half into selling it.

“We’re hitting our stride,” he says, adding that his company is taking on three to four new members each month.

Is it Cost-Effective for Senior Living Providers?

While it may be beneficial and cost-saving for a consumer to participate in this type of program, the big question is whether it’s cost-effective and worthwhile for an operator to provide services in someone’s home, rather than moving them into a community.

Most of the time, it is cost-effective, Hopkins says. “The whole game change is when you’re in the business of trying to help people stay healthy,” he adds, rather than being in the business of taking care of people after they become sick. Another perk, he says, is that they don’t have to adhere to rules that activate payor systems.

But EHM is a not-for-profit organization—turning a profit on this model of business isn’t exactly a main goal, especially as it serves a large low-income population and provides a significant amount of charitable care.

Additionally, because the program is still relatively new, EHM (among other providers that have implemented this type of program) haven’t yet reached the point where their CCRC-without-walls “residents” need skilled nursing. Offering services that for now are mostly centered around prevention/well-being, socialization, transportation, and home maintenance doesn’t give a full indication of how much it will cost to provide skilled nursing to an individual in their own home.

Around the Industry: What are Other Providers Doing?

There are numerous examples throughout the industry of senior living providers expanding their services for a broader clientele base. To name a few: East Coast Erickson Living has its own geriatric care management system; West Coast Emeritus Senior Living has said it’s looking into providing home health services, and already offers complimentary in-home nursing visits/consultations to area residents around its communities.

The Ensign Group has also diversified its product offerings by buying up several home health and hospice agencies, and Innovative Senior Care by Brookdale Senior Living features home health services through its Care3 Wellness program.

Written by Alyssa Gerace

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