“Dramatic Need” for New Construction, Concepts to Transform Short-Term Senior Care

In a previous article, Senior Housing News looked into the concept of senior living residences incorporating hospitality features to attract a younger resident in pursuit of lifestyle rather than care. While not every boomer is looking for (or can afford) a hotel-like stay on a long-term basis, this idea might be more attractive for shorter-term, rehabilitative senior communities with high Medicare census.

When the hotel industry began to offer a more hospitality-based, service-enriched experience to its guests, consumers were excited by the novelty of the offering as something they weren’t used to getting at home.

While some architects are trying to incorporate the same kinds of concepts into senior living communities for permanent residents, this idea might be more effective on a short-term basis.


That’s where resort-style short-term and rehabilitation facilities could come into play.

Capital and development company Mainstreet used to focus on acquisitions of existing skilled nursing and assisted living properties. But with the average age of nursing homes at 37 years old, and assisted living “not much better,” according to Zeke Turner, the CEO/founder of the health care real estate investment company, a new focus emerged for new development.

“We basically found that we can buy those [existing facilities], or we can attempt to completely redesign the very essence of a nursing or assisted living facility,” Turner told SHN.


In 2011 alone, Mainstreet undertook six projects for $100 million worth of development, and new projects make up about 90% of its business, according to Turner.

“We believe the changing consumer preference as well as the desire to move people to more efficient forms of care is going to create significant demand for new products,” he says, adding that the demographic wave of boomers and the current stock of properties “becoming functionally obsolete” is creating a “dramatic need” for new construction in the industry.

What his company seeks to do, he says, is disconnect from the institutional look and feel of nursing homes and rehab facilities, and design buildings around an “entirely different concept.”

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“We chose to take hotel designs and add medical components to them to change the nature of the way these buildings felt and looked,” he says.

Rather than have someone who’s transitioning from the hospital to home endure a dreary stay at a post-acute or rehab facility, Mainstreet wants to be in the business of creating unique destinations within in their residences.

This is evident from the outside in, according to Turner, who says the exterior of Mainstreet-developed buildings aren’t just the brick and vinyl that might be seen on older properties. “We design for a hospitality-based look and feel. Our properties could be hotels; they could be nice residential buildings; they fit very well into the overall community,” he says.

On the interior, Turner says his company looks to build a social concept very intentionally around a “whole host of amenities.” Buildings offer provide multiple dining options, including restaurants with on-site chefs, cafes or coffee shops, and bistros; they also feature salons, theaters, community rooms, and a therapy space that is often three to four times larger than others in older buildings, set up in a gym format.

“We want our residents to have something to do. No matter the age, after a couple days in your room, you’re itching to get out and go do something else,” he says.

In today’s senior housing and care properties, people spend about 80% to 90% of their time in their rooms, according to Turner. “We’re trying to invert that,” he says.

Because of a primarily rehabilitative-care model, this resort-themed style of senior living can in fact be affordable.

“The vast majority of our focus is on short-term rehab and therapy, and we’re utilizing Medicare; that’s as available to someone who’s inner city, as well as in the suburbs,” Turner says, adding that it does no good to build a beautiful high end property that only one to two percent of people can afford. Mainstreet’s residences range anywhere from suburban properties that can be considered “high-end locations” to rural and heavily urban areas, encompassing a wide range of financial capabilities, he says.

The hospitality-based “destination” concept doesn’t just apply to short-term care, though, and developers should consider boomers’ attitudes toward retirement when planning projects.

“The approach of being more hospitality-oriented inverts the standard method of recruiting people to your property,” Turner says. “In the past, larger campuses tried to get people to downsize their life, to sell their homes and move into independent living and be cared for for the rest of their life. There has been intense research of boomers, and they’re not intending to downsize at all—but they still have needs. We focus heavily on need-driven services.”

Written by Alyssa Gerace

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