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Models for Affordable Assisted Living

NCB Development Corporation. Mission: To address the problems that poverty creates in America.Loaned or invested more than $1 billion for economic and community development. Resulting in, among many other things, over 1,000 units of affordable assisted living.. Coming Home Program. A Robert Wood Johnson Foundation funded initiative, providing on-going technical assistance for Affordable Assisted Living in 9 states.With these 9 states well on their way, NCB Development Corporation would like 197

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Models for Affordable Assisted Living

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    1. Models for Affordable Assisted Living AAHSA Spring Conference April 10, 2002 www.ncbdc.org

    3. Coming Home Program A Robert Wood Johnson Foundation funded initiative, providing on-going technical assistance for Affordable Assisted Living in 9 states. With these 9 states well on their way, NCB Development Corporation would like to work with other states to promote affordable assisted living.

    4. NCBDC/ AAHSA Affordable Assisted Living Award To recognize & disseminate operating examples of affordable assisted living projects that provide excellence in services, environment and support.

    5. NCBDC/ AAHSA Affordable Assisted Living Award Must be an operating project. Call for proposals will appear @ www.ncbdc.org in May, Submissions due late summer, Awards announced at AAHSA fall conference in Baltimore.

    6. Three Successful Projects Rock Cove, Skamania Co., Washington. Rural project with a public housing authority. McDonald Residence, Portland, Oregon. Inner city project with deep subsidy. John Whitaker Place, Penacook, NH. Rural project in partnership with aging agency using layered smaller subsidies.

    7. Site Photo Rock Cove

    8. Rock Cove Assisted Living 30 units, 8 one bedroom (506 sq. ft) & 22 studio (308 sq. ft.) Total sq ft: 18,390 Single story frame building on Columbia River cove that separates Oregon & Washington In rural, economically depressed part of Washington State.

    10. Rock Cove Income 15 units serve incomes at or below 80% of the Area Median Income. 10 of the 15 are M.A. eligible, so they are < 50% of AMI The other 15 are market rate. Current average income is: $22,600 Area median income, Stevenson, WA is $29,800.

    11. Approach to Rock Cove

    12. Rock Cove Demographics: 22 women & 8 men (73% / 27%) Age range: 55 - 100, average of 82

    13. Rock Cove Acuity Average resident needs assistance with 5 ADLs 75% receive medication management assistance 50% have significant cognitive impairment

    14. Rock Cove Services: Home like setting supporting maximum independence and respecting privacy. 3 homemade meals per day in dining room w/ fireplace and beautiful view Nursing, Housekeeping, recreation, transportation, behavior management, ADL Assistance, home health & hospice

    15. Rock Cove Dining Room

    16. Rock Cove Rates (studio) Private Pay Medicaid Level I: $1,770 $54 Level II: 2,005 $60 Level III: 2,240 $66

    17. Rock Cove Real Estate Development, Costs: Land (lease): $102K Buildings: 1,620K Soft Costs: 267K Developer (deferred): 200K Financing & other 116K Total: $2,305K Total per unit: $77K

    18. Rock Cove Real Estate Development, Sources: Wash. Comunty Reinvstmt (30 yr): $ 1,495 Local gov’t trust fund (1% 50 yrs): 500 Deferred Developer’s fee: 225 Land leased by county, nominal fee: 85 Total: $2,305

    19. Rock Cove Operating Expenses (monthly) Payroll / Employee: $30,517 Administrative 3,950 Dietary 5,335 Utilities 3,412 Property, Contracts, Misc. 14,090 Total $57,304 Per unit per month: $1,910

    20. Rock Cove Operating Income (Monthly) Private pay income: $30,700 Medicaid (services) Income: Residents 9,357 State 20,877 Total: $60,934

    21. Rock Cove What makes this special? Revitalized site in a rural, economically depressed area. Beautiful views of the water, great design Capacity to serve very low income (< 50% of AMI)

    22. Rock Cove

    23. Street View Macdonald Residence

    24. Macdonald Residence 54 Units- all studio, 271 – 425 sq. ft. 4-story design accommodates common dining, living and recreational space on ground floor and an enclosed courtyard Residential units are on floors 2 – 4 with kitchenettes and private baths. Serves downtown urban core of Portland, OR

    26. Macdonald Residence Income All 50 units serve incomes at or below 50% of the Area Median Income- Medicaid waiver eligible. Area Median Income, Multnomah Co. OR: $40,000

    27. Macdonald Residence Demographics 22 women & 31 men (40% / 60%) Age range: 27 - 83, average of 55 Expect a younger population Minimum age is 18

    28. Macdonald Residence

    29. Macdonald Residence Acuity 75% need assistance with ADLS All need nutrition management Almost all need medication management 40% or more have a mental health diagnosis

    30. Macdonald Residence Services Meals, housekeeping, laundry, ADLs, nursing, medication Van Macdonald Center Groups Spiritual & emotional support from volunteer students from four nearby nursing schools

    31. Macdonald Residence Rates Rent: $447 Services: 1,413 Total: $1,860 Increases at rate of 3% annually State has 5 levels, negotiated a single rate, all at Level 4, regardless of acuity.

    32. Macdonald Residence

    33. Macdonald Residence Real Estate Development, Costs: Land 0 Construction $3,882K Developmt & Finance 908K Start-up 165K Reserves: 192K Total: $5,147K Cost per unit: $95K

    34. Macdonald Residence Real Estate Development, Sources: Loan: $1,138 FHLBank AHP Grant: 200 PDC Loan 200 Private Fund Raising 873 LIHTC Equity 2,736 Total $5,147

    35. Site Photo Macdonald Residence

    36. Macdonald Residence Operating Expenses (monthly) Payroll / Employee $54,179 Administrative 6,803 Dietary 7,755 Utilities 5,254 Property, Contracts & Misc. 14,562 Total: $88,553 Total per unit per month: $1,640

    37. Macdonald Residence Operating Income (monthly) Rental Income (Tenants): $21,873 Services Income: Tenants 6,812 State 63,176 Miscellaneous: 2,405 Total $94,266

    38. Macdonald Residence What makes this special? Serves a very low income population in the inner city with no additional operating subsidies beyond SSI and Medicaid. High quality building in a high cost area

    39. Macdonald Residence

    40. John Whitaker Place 50 Units Central core includes living room, dining room, community room, library and elevator Residential units are in wings

    47. John Whitaker Place Income 50 units, 11 Medicaid Waiver & 39 limited to 175% of Area Median Income Current income range is $6,360 to $64,531. Area Median Income, Concord, NH: $59,090.

    48. John Whitaker Place Demographics 40 women & 11 men (78% / 22%) Age range: 58 – 96, average of 81

    49. John Whitaker Place Acuity 90% receive assistance with ADLs, most of these need medication management. For remainder, spouse needs assistance. 2 are totally visually impaired, 2 on dialysis, majority ambulate with walkers and canes.

    51. John Whitaker Place Services Meals Housekeeping, nursing, recreation, transportation, ADL assistance Medication Management

    52. John Whitaker Place Rates Low Income: Rent: $505 Services: $1500 Moderate Income: (Bundled; as of ’01) Studio: $2048 1 Bed Room: $2573 2 Bed Room: $2888

    53. Site Photos

    54. John Whitaker Place Real Estate Development, Costs: Land & Buildings: $4,353K Soft Costs: 580K Developer: 530K Reserves: 595K Total: $6,058K Total per unit cost: $121K

    55. John Whitaker Place Real Estate Development, Sources: Tax exempt bond (7%, 30 yr.) $5,060K HOME Loan (30 yr., deferred) 650K Developer Loans 348K Total $6,058K

    57. John Whitaker Place Operating Expenses (monthly) Admin. (mgmt, van, office): $46.5K Dietary : 16K Utilities: 8K Transportation & Recreation: 6.5K Services 25.6K Housekeeping 10.8K Total (includes $1.25K reserve): $113.3K Total per unit per month: $2,260K

    58. John Whitaker Place Operating Income (monthly) Rental Income: Low Income (@ $505) $5,550 Moderate (bundled w/ svcs) 95,480 Services Income: (Medicaid) 16,500 Misc. (Includes 6% vacancy) 667 Total $118,197

    60. John Whitaker Place What makes this Special: Managed to pull off the real estate development without Low Income Housing Tax Credits or other deep subsidy. Use of microchip; technology Devoted staff; Contract with VNA for Services

    63. Per Unit Development Cost Rock Cove: $77,000 Macdonald House: 95,000 Whitaker Place: 121,000

    64. Per Unit Per Month Operating Expenses Rock Cove: $1,910 Macdonald House: 1,640 Whitaker Place: 2,260

    65. Questions ?

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