1. We totally agree with this article. We have worked in this industry for many years. And we all know that if the average age is 35 years and the models that they're based on doesn't work. We have been working on the new Culture Change model and have a concept that will drive new business but also give the residents a place that they can really call home.

  2. This article raises excellent questions. We have upgraded existing properties and have replaced properties, as both model can work depending on the circumstances and conditions. One issue is whether the market and payers are willing to accept the increased costs of the new construction. As Medicaid has been the primary payer of services, most states will not recognize the increased costs beyond a certain level. Our recent experience indicates that a new construction project requires a daily rate of at least $40.00.