There is a criticism that the senior living industry is too “cookie cutter” despite demand for more diverse options. In response, some forward-thinking players—among them senior housing celebrity Dr. Bill Thomas—are experimenting with smaller format communities. But the board-and-care home model that is popular in California is another template, and providers in other parts of the country are seizing on that, too.
Rocky Mountain Assisted Living has three memory care and seven assisted living “homes” throughout the Denver metro area. The company’s primary goal is to provide many of the upsides found in a larger senior living community without some of the common disadvantages, according to Rocky Mountain Senior Living founder and CEO Dave Lewis.
“People that would get lost in the shuffle of a bigger 80- to 100-bed community will do really well in our setting,” Lewis told Senior Housing News. “That’s our niche.”
Rocky Mountain Assisted Living isn’t the only established small-home senior living provider in the country—far from it, in fact. Dallas-based Mustang Creek Estates, for example, specializes in building affordable comprised of six or seven individual homes that accommodate just 10-16 residents apiece.
Across the U.S., there are also many single-location “board and care homes” which function like a cross between a boarding house and a senior living community. In California alone, there are more than 8,100 licensed residential care facilities for the elderly, the majority of which are small board-and-care homes, according to the California Registry, a state licensed referral service. In fact, that’s where Lewis got the inspiration to found Rocky Mountain Assisted Living in 2010.
“My grandmother was in a board and care home in California with six beds or less,” he recalled. “I wanted to move into that segment, as well.”
Lewis also drew upon his background in home health care in founding the company. The small-home setting seemed like a good way to help bridge the gap between home-based care and assisted living or skilled nursing options.
“I think most seniors would stay at home if they had millions of dollars. Most seniors don’t,” Lewis said. “But they’ll have enough money to stay in the care home until they pass away.”
Benefits of building small
Rocky Mountain’s residences range in size between 10 and 16 beds and offer most of the core benefits of an average assisted living community, such as 24-hour care, help with daily tasks, meals and frequent outings. The smaller homes cost about $800,000 to develop, while the larger two-building campuses were roughly $4 million, Lewis said.
From the outside, the company’s communities look like typical Colorado ranch homes. But they were specifically designed to meet the needs of aging adults, with design features such as hardwood floors in the main common areas to reduce trips and falls, accessible entryways, private half-bathrooms and spacious floor plans.
While a typical senior living community might have dozens of workers, Rocky Mountain homes each employ a small team of staffers that perform a variety of duties, such as administering medication, cooking and cleaning.
The smaller, more homelike setting means residents can get to know their caregivers better, Lewis said. And oftentimes, it’s the personal care that translates into higher resident satisfaction and occupancy—which for Rocky Mountain generally runs between 90% and 95%.
“It’s just a numbers game. You can give better care when there’s less residents to care for,” he explained. “We have people who have moved from CCRCs into our homes because they’re not able to get the care they need in such a big setting. And they like the smaller environment better.”
Rocky Mountain’s residents pay a monthly flat rate of roughly $4,000-$5,000, which is comparable to other senior living providers—but that is an all-inclusive amount, meaning some residents who might need costlier a la carte services might actually save money in the long run.
“Most people [we see in our communities] have over 10 medications and typically need help with two or three activities of daily living (ADLs),” Lewis said. “To them, it’s a deal.”
No small feat
On the operational side, owning and operating a handful of small homes can be both a blessing and a curse.
“If we had one big building, we might have this huge mortgage payment…whereas here we’re spreading the risk over many properties,” Lewis said. “On the flip side, I think it can be more expensive when you are spread out, [because you are] paying for added oversight.”
Staff turnover is also sometimes a challenge, though that’s as much to do with the tight labor market in Denver as it is the small-home model. And then there’s the issue of scale.
“I’m not sure how you would scale this [small-home model]. The owner mentality of a small home goes a long way to keep it running really well,” Lewis said.
That doesn’t mean Rocky Mountain is done expanding its portfolio, however. The company is still looking for land development opportunities and potential acquisition targets in the Denver area.
Written by Tim Regan