The business of aging
Private sector steps in as hospital gears back
By JIM GORDON
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.
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