While some other senior living providers are pausing growth plans during Covid-19, one small nonprofit in a state with a fast-growing population of older adults believes the best course of action is to extend its reach.
Kalispell, Montana-based Immanuel Lutheran broke ground last month on an expansion to its campus — a collection of four two-bedroom cottages for seniors age 55 and older. It is launching a property management and development company to form partnerships and manage communities throughout western Montana, and it is developing a home health care segment to provide services for seniors who are not ready, or unable, to transition to senior housing, CEO Jason Cronk told Senior Housing News.
Immanuel Lutheran Communities’ Buffalo Hill campus offers independent living, assisted living, memory care, skilled nursing and short-term rehabilitative care services.
Cronk, who is Montana’s advocate for nonprofit industry group LeadingAge, also assumed a greater role speaking on behalf of the state’s seniors. Earlier this month, he penned an op-ed encouraging empathy and personal responsibility to protect Immanuel Lutheran’s residents from the coronavirus, and to wear masks and practice social distancing when out in public. Montana reported 185 new coronavirus cases on September 15, and tallied 9,847 Covid-19 cases and 141 deaths to date.
Cronk felt compelled to speak out. Montana’s senior population increased 40% between 2007 and 2017, as more retirees move to the state to take advantage of a low cost of living, favorable tax rates and lower health care costs. One in five Montanans is age 65 or older, Cronk told SHN.
Additionally, the 65-plus demographic is expected to account for 21% of Montana’s total population by 2040, according to data from the Congressional Budget Office (CBO).
“The more we can be safe in our community with sheer numbers, the fewer chances I’m going to deal with a positive case,” he said.
Achieving greater scale and diversification could also keep Immanuel Lutheran competitive in a market attracting greater attention from senior living providers and developers. For instance, Chicago-based developer and operator CA sees the Montana city of Bozeman as the type of market that could become more appealing in the coming years, as the pandemic may create a flight from denser urban markets toward smaller cities that offer a high quality of life.
Managing cash while pursuing growth
As is the case with many senior living providers, the pandemic has affected Immanuel Lutheran’s operations and bottom line. Census is down significantly in its skilled nursing segment and Cronk hopes that state public health officials will allow the provider to open a portion of its nursing wing in the coming weeks. The company has received payroll protection and provider relief funds via the CARES Act stimulus; 60% of Immanuel Lutheran’s nursing revenue is generated from Medicaid billing.
Assisted living occupancy has dropped from the high 90% range to the high 80s over the months, while memory care has remained full because it is a needs-based level of care. Immanuel Lutheran is accepting move-ins, with testing and a 14-day quarantine period, and independent living has held steady throughout.
“We’re looking long-term to manage cash for the next year, assuming there’s no new [relief] money coming in,” Cronk said. “Hopefully if this continues, there’s new money provided to organizations like ours.”
Immanuel Lutheran has been able to stay on top of the virus in part through its participation in Novare, a collection of 17 single-site and small-system CCRC providers, totaling over 7,200 combined units. The providers in the network share best practices with each other, and adjust their coronavirus responses as a result. Immanuel Lutheran was one of the original providers to launch the network.
“[Novare] provided the bench strength to help us navigate these waters much more confidently,” he said.
Expanding its service lines will help mitigate the revenue strains from Immanuel Lutheran’s assisted living and skilled nursing segments. The provider is in discussions with multiple landlords across western Montana to manage or develop senior housing properties across the western half of the state.
Meanwhile, it is only beginning to lay the groundwork for Immanuel at Home. Immanuel Lutheran conducted focus groups to get feedback on what customers want to see in the program, but does not have a concrete launch window. But Cronk points to Immanuel Lutheran’s waiting list – which currently holds 75 people – as proof of the demand.
“I don’t think we can grow fast enough in our market to meet the demand,” he said.