In 2015, national home care provider BrightStar Care launched a senior living business under a franchising model. Now, ground soon will be broken on the second BrightStar Senior Living location, and the company is refining its operations and brand identity under a clinical leader with a Brookdale pedigree.
The debut property for Gurnee, Illinois-based BrightStar Senior Living was a 34-resident assisted living and memory care building in Madison, Wisconsin. This was meant to be a “test case” to prove that the model could work on a larger scale, BrightStar founder and CEO Shelly Sun told Senior Housing News in July 2015.
The building passed the test, and BrightStar Senior Living is going into expansion mode. The site for the second location also will be in the Madison area, in the Village of Waunakee. The village has granted approval for the building, which is scheduled to be open in early 2018.
A few other locations also are under site review, Sun told Senior Housing News in a recent interview. The plan is to have another 10 in the works within the next two years, and then to hit a five to 10 community growth rate per year after that.
These future buildings likely will resemble the one in Madison. They will be modestly sized and will court residents who may have more complex needs than a standard AL provider would be eager or able to accommodate. It’s a part of the market that is underserved, says BrightStar’s Chief Clinical Quality Officer Sharon Maguire, who previously was vice president of clinical services for assisted living and dementia care at Brookdale Senior Living (NYSE: BKD), the largest senior living provider in the nation. She joined BrightStar about five years ago and has helped plan and execute the launch of the senior living offering.
Small Footprint, High Acuity
With 36 suites, the Waunakee building will be only slightly larger than the one now fully occupied in Madison.
By industry standards, that’s a small physical plant, points out Maguire. The idea is to create a homelike atmosphere rather than an opulent one.
“The furnishings are high-end but not chandeliers and waterfalls,” Maguire tells SHN.
But BrightStar is not budget assisted living. It currently is exclusively private pay, with residents paying rent and additional fees based on the level of care they are receiving—and that care can be substantial.
“You sometimes hear the term ‘assisted living light,’” says Maguire. “We’re not focused on that.”
Rather, the BrightStar model is to accommodate people even who have more extensive needs, such as for physical, behavioral, or cognitive assistance, or medication management. This has entailed receiving the highest level of licensure and investing significantly in labor, with a full-time director of health and wellness and a part-time registered nurse case manager, as well as a high caregiver-to-resident ratio.
“It was intentional, partially because of my background in the industry, understanding that there was this niche for individuals who didn’t want to have to choose the nursing home, who had the ability to pay and wanted premium person-centered services,” Maguire says. “Where do they go? We’ve had residents verbalize to us that they feel more welcome at BrightStar than at other places where frankly they may have been marginalized by their own peers.”
Home Care Synergy
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With higher labor costs related to providing more intensive care, BrightStar has one cost-control edge thanks to the well-established home care side of the business, which has 300 locations throughout the United States and Canada.
Take the ability to “borrow” caregivers, Maguire says.
If a caregiver at a BrightStar Senior Living location should call out at the last minute, it’s possible for a home care worker to pick up the shift. That’s a benefit for the home care employee who might be looking for more hours, and a benefit to the senior living community that has a wider pool of caregivers who have been trained to company standards.
There’s also shared marketing that can be done and a referral stream coming from the home care side.
“If the home care team evaluates a potential client and determines they may be better served by senior living, that referral is seamless,” Maguire says. “No one is forcing the consumer to pick one over the other, but we’re giving them a full continuum of care, almost. That’s something we … may even emphasize more.”
Common in home care, the franchise model is rare in senior housing. Quality control concerns are one reason why.
“I’m happy for [franchisees’] independnece, but brand standards, clinical standards, dining standards, life enrichment standards need to be maintained at a high level,” Maguire says. “How does one enforce that and support that?”
For one, by providing extensive operations manuals, training policies and procedures, and other materials and protocols. These include standard ways to do resident assessment and approach life enrichment, Maguire says.
BrightStar also will do audits once a quarter of franchisees for operations and clinical quality. These are intended to be consultative in nature, not just looking for problems but as an opportunity for continuing education, according to Maguire. Having a reportable events policy and utilizing platforms for financial performance also assist in ongoing monitoring.
Problems that increase or persist could lead to a default or termination of the franchise agreement.
Despite the risks, Maguire believes in the franchise model. And given industry concerns about a lack of quality operators, it may be a welcome addition to the mix as the age wave hits.
“I’ve talked to people about starting their own senior housing business, maybe opening just one community, and they have a lot of angst about how to create all this stuff. To get detailed, robust operations manuals and all those policies, training, tools and resources across all departments, that’s really hard to come by,” Maguire says. “That’s the beauty of the franchise model.”
Written by Tim Mullaney