Health care versus hospitality. The two concepts are pitted against each other in a long-standing debate in senior living. But new development projects suggest how health care and hospitality can co-exist and add value to each other.
These projects involve amenity-rich senior living communities in close proximity to major health care providers. The organizations behind these senior living projects are not just counting on the location of nearby hospitals to make health care accessible, but are forging partnerships with these neighbors.
The trend is driven in part by the Affordable Care Act (ACA). While the ACA passed six years ago, it has taken time for the massive U.S. health care system to begin implementing many of the new programs and models created under the law. A number of these programs are intended to create more coordination between hospitals, physicians, post-acute providers, and other parts of the health care system; providers are being incentivized to work together more closely to manage the health of their patient populations, keeping people in lower-cost settings such their homes for longer periods of time.
With these different providers striving to work together more closely, it makes sense that they might also seek to be located near each other. Senior living providers have been involved in some co-location projects that already are up and running.
One example is the “Medical Mile” project in Voorhees, New Jersey, near Philadelphia. Toledo, Ohio-based real estate investment trust Welltower Inc. (NYSE: HCN) brought three of its partners together, and now there is a Brandywine Senior Living community there, right down the road from Virtua Voorhees Hospital and a Genesis PowerBack Rehabilitation center. Seniors can live in the hospitality-centric Brandywine community but are just minutes away from the medical care available at the other buildings.
“Voorhees offers a template for the future of connected health care development at the community level,” Welltower states on its website. “Connected health systems are the key to improving quality of care and addressing patient needs, and are only possible with innovative partners, ideas and resources.”
Other developers also believe in this model, including a high-profile new entrant to senior living development, and a well-known innovator who has been in senior care for more than two decades. They are pursuing projects, coincidentally, in the same area—making Kansas City a hotspot for this type of development.
A Natural Fit
Steve Shields is no stranger to challenging the status quo in senior living. In conjunction with the Action Pact organization and a few other pioneers, he developed the household model of senior care in the late 1990s. In this model—now widely adopted—the traditional, institutional model of long-term care is replaced by a home that emphasizes the autonomy of residents.
Now CEO and President of Manhattan, Kansas-based Action Pact, Shields is at the forefront of a development that he believes also could be an example of innovative change.
In his work with Action Pact and, earlier, as CEO and President of Meadowlark Hills—a continuing care retirement community (CCRC) also in Manhattan, Kansas—Shields saw benefits in breaking down silos within the senior care model that had segregated different resident populations. He wanted to take that further.
“If we take the framework that we used to dissolve those silos and now go the next step and connect that with the physicians and acute-care system and outpatient systems and create a seamless, integrated system for people of all ages, there could be something really dramatic that would come out of that to decrease health care costs and increase person-centered care,” he tells Senior Housing News.
Health care reform was beginning to incentivize providers elsewhere on the continuum to also look for opportunities to create more integrated systems. Liberty Hospital in Liberty, Missouri—just northeast of Kansas City—was one of these providers.
“It was kind of a natural fit, like we discovered each other,” Shields says of Action Pact and Liberty Hospital.
The result is Norterre, the development project that broke ground in May 2016. Phase 1 of the project is estimated to cost $66 million, with the development partners having invested $14 million and the balance coming from a regional bank. This initial stage involves constructing a number of buildings on a 17-acre parcel of land adjacent to the hospital, which already includes a physician and medical arts building.
The new construction will include an assisted living residence with 60 units divided into three “households,” as well memory care and skilled nursing households of 20 units each, along with 40 short-term rehabilitation suites. Action Pact Management will be the operator and will charge on a rental—not entrance-fee—basis. Construction on Phase 1 is expected to be completed by early summer of 2017.
But the plan for Norterre goes far beyond simply building senior living next to a hospital.
“What we’re building really is a town within the town of Liberty,” Shields says. “The heart of this small town is going to be a city park, it is going to be a place that everything is built around.”
That park, also part of Phase 1, is envisioned to have a recreation area, water features, outdoor art, and entertainment spaces. It is meant to host farmers’ markets, performances, and other events that will draw the Liberty community at large.
If the park is the heart of Norterre, its “uniter” will be a 50,000-square-foot Healthy Living Center, says Shields.
Healthy Living Centers were developed by Healthy Living Centers of America, which has joined the project as a minority partner. Part therapy setting, part local gym or community center, Healthy Living Centers are places that bring together those who have been referred by a health care professional for rehabilitation or other treatment, people who are taking part in corporate wellness initiatives, and individuals who use it essentially as a gym.
Norterre is planning to create a patient navigation system so that not only are these buildings close together, care truly is more coordinated.
For a resident in Norterre’s senior living community, this might mean that if they need a procedure, they will have a physician-directed navigation team already in place to help coordinate the surgery, post-acute rehab, and return to home. Everything from primary care to acute care to therapy, even a weight loss clinic, will be available for the care navigation team to direct a person to, as needed.
“Instead of it being a discharge process, it’s a navigation process,” Shields says. “We think we will be able to dramatically improve outcomes and reduce costs.”
Of course, even if this model of more integrated health care and senior living makes sense, no one wants to feel like they live on a hospital campus. So, in addition to the park, there are plans to construct multifamily apartments, homes, and retail. But even before these Phase 2 additions, Norterre should bring together people of all ages, Shields believes.
“People of all ages, through the Healthy Living Center, will be naturally integrated,” he says. “So someone in the assisted living could come down to a restaurant and be seated next to a family of four. Everything will be multi-generational. I think that’s going to be a game changer.”
A New Venture
Drive about 50 minutes southwest of Norterre, to the opposite side of Kansas City, and you will reach the first senior living project undertaken by Chicago-based CA Ventures.
A well-established developer in student housing, multifamily, and hospitality, CA Ventures is making a name for itself in senior housing now, working with recognizable names in operations and finance. Its first senior living project is to be operated by Chicago-based Pathway Senior Living.
This project, Travanse Living at Olathe, hosted its grand opening celebration on Aug. 23, showing off the $22 million renovations to the building on the campus of the Olathe Medical Center.
Among the renovations was the creation of The Rehab Place at Travanse Living at Olathe, where rehabilitation services will be provided by the Olathe Health System. CA Ventures views this as a unique benefit for residents who may have outpatient rehab needs, and The Rehab Place also is open to the general public.
Physical, occupational, and speech therapy services will be offered, as well as specialty services such as lymphedema therapy and programs aimed at helping those with Parkinson’s disease.
But the ties to the Olathe Health System and an on-site doctor’s suite, as well as the proximity to the Olathe Medical Center and other medical office buildings, does not mean that the senior living community has skimped on the hospitality offerings. Indeed, the building may have even more of a hospitality bent than it did before the renovation, when it was a Holiday Inn.
A spa, movie theater/chapel, fitness center and therapy gym, recreation room with teaching kitchen, and several lounges are among the amenities. Dining options include a casual bistro and the all-day Claiborne Dining Room. The grounds include an enclosed courtyard, a gazebo, and raised gardens.
Its 75 assisted living units are outfitted with granite countertops, stainless steel appliances, and stone finishes in the bathrooms. It also has 57 studio units for memory care.
Not every CA Ventures community will be on the same campus or directly adjacent to a health care center, but proximity to health care is one of the elements that the team looks at when evaluating a potential site, says John Dempsey, CEO of CA Senior Living, the senior housing division of CA Ventures.
Furthermore, he firmly believes in the co-location model.
“Wouldn’t it be nice if a resident were able to sit downstairs in the assisted living community, and then walk or have the shuttle take them across the street to the medical office building?” he tells SHN. “Or the doctor walks over and does the checkups in the community.”
In fact, Dempsey sees such appeal in this model that he could envision CA Ventures getting into medical office development itself. And his vision doesn’t stop there, but extends to something even more large-scale—in fact, something that sounds similar to what Norterre is undertaking not too far away from Olathe.
“If we buy a parcel of land for senior living, why wouldn’t we do medical office?” Dempsey says. “I would think we would do medical, a little retail, and create a community, a lifestyle center. A place where people feel like they’re really at home.”
Written by Tim Mullaney