Two facilities for elderly folks at opposite ends of the Hudson Valley are reflecting new approaches to solving the growing problems of housing senior citizens, a problem that will only grow more complex now with the aging of baby boomers, the oldest of whom are now nearing 65. But as traditional nursing homes are being reduced in size or are closing, can a smaller, family-oriented approach work as a business model?
In Kingston, two young entrepreneurs have just opened the new Mountain Valley Manor, a state-licensed adult care facility for up to 48 residents. Meanwhile, the Westchester Medical Center has announced plans to reduce further the number of patients at its Taylor Care Center, a skilled nursing home for the elderly and infirmed. The Taylor Center used to house some 321 patients but two years ago reduced its resident population to 181 and now seeks to reduce that to 90 residents.
But the two are not serving the same population, for the two facilities reflect the increasingly complex mix of elder-care options in society to care for seniors. There is now more of a demand for housing for relatively well senior citizens who need some help and less need for hospital type settings for very sick ones.
In 1946, 3.4 million babies were born in the U.S., a jump of 22% from the previous year, an upswing in births that continued until 1964; 1957 ”“ 50-year-olds last year ”“ is often cited as the peak. By 1964, 78 million baby boomers had joined the population and now make up 26 percent of the American population.
By 2030, when the first baby boomers reach 84, the number of Americans over 65 will have grown by 75 percent to 69 million. That means more than 20 percent of the population will be over 65, compared with only 13 percent today.
Where will they live? If Taber McNaughton, 32, and Salvatore DePoala 31, have their way, some will live in the sort of low-key, one-fee, full-service facility the partners have just opened in Kingston. After eight years of effort and $4.5 million, the 25,000-square-foot facility this spring opened for residents, a one-story facility with two wings, furnished and decorated in ways looking rather like an attractive hotel, but for the colorful and noisy parrot caged in the foyer.
When fully staffed, there will be 47 employees in various capacities at the center, which is licensed by the state Department of Health, but does not do nursing or medical care.
Residents are largely self-reliant, “with functional impairments caused by age, physical or cognitive disability,” in the arcane legalese of the state, which has three levels of regulated senior care. Adult care facility is the lowest rung on the continuum.
What are they banking on to make worthwhile their enormous investment in time and money? “I think it”™s the personal attention,” said DePoala, operations manager-owner, who said he lives “50 feet off the north wing” with his wife and two children. He said he frequently brings his toddlers to work, where they interact not only with the elderly residents, but the grandchildren of some of those residents when they visit.
“Here, you are always going to be dealing with one of the owners,” said McNaughton, the facility”™s administrator-owner. “It”™s a whole different ballgame. I see the business a helluva lot differently than someone who clocks their 40 and goes home.”
In keeping things simple and family oriented, the duo charges a flat fee of $3,380 per month for three meals daily, snacks, an attractively furnished living room and outdoor sitting areas and a large comfortable dining room. The cost for a full service nursing home is about $9,000 a month they said, but said most elderly don”™t need full nursing care.
The bedrooms are large and private with each room having its own toilet and wash area. The private rooms do not have showers, they said, because McNaughton, whose father operated a family nursing home in Oneonta, said the chance of a senior falling unattended in showers is too risky ignore. They don”™t charge an entry fee and say they don”™t charge various service fees, a practice they say does happen in the industry. “We have no hidden costs,” said DePoala, who said their costs are designed to serve the needs of middle-class Americans whose parents now need a supportive option for relatively active living. “We know our demographic,” Depoala said, saying they expect some residents will be from the Kingston and Ulster County areas, and others will be seniors whose children have second homes in the area.
They consciously try to welcome visiting family and friends of their residents, saying that such attention creates a healthy atmosphere around the facility that is sometimes lost in larger senior residences or nursing homes. Some corporate-owned senior facilities actually charge a family for the cost of sharing meals in the common dining room, a practice they abhor.
“When you start charging for simple things and itemizing the cost of a tuna fish sandwich to Grandpa”™s account, people think of the place differently. All that corporate stuff are things a family doesn”™t do and we won”™t do it, either,” said McNaughton. They said they will also concentrate on activities at the facility and on outings that most of their residents will be able to attend.
As Mountain Valley is gearing up to full utilization, the Westchester Medical Center board of directors decided on April 2 dramatically to scale back its Taylor Care Center. The skilled nursing facility, which has been located on the campus since 1936 cut back from 321 beds to 185 beds two years ago, part of a wave of cutbacks in nursing homes statewide in the wake of the Berger Commission recommendations to improve health care state wide.
“Keeping in mind that today there are a large number of vacant nursing home beds in the county, we will begin the processing of downsizing the number of our beds, while providing the same high level of care we have always made available to our patients and the community,” said Westchester Medical Center President and CEO Michael Israel in a statement.
The reductions will be gradual and no one will be forced to leave the facility, nor will the changes entail any layoffs of employees, he said. The hospital cites state department of health figures there are some 250 available nursing home beds within Westchester.
Taylor Center now has 165 residents. Most of them are long-term-care patients, and 20 are on ventilators. The hospital plans to ask the state Health Department for permission to convert five unused beds for ventilator use, which are in demand in the region. Hospital officials would like to develop a unit within the nursing home designed to care for patients who require both ventilators and dialysis machines. Other plans include a renovation of the building and certifying 70 medical surgical beds with private rooms for advanced orthopedics and neurosurgery. Such services could prove more economically viable to the medical center, which lost about $20 million last year.
