Developing Affordable Assisted Living in Iowa

1. Developing Affordable Assisted Living in Iowa Analyzing the Market May 2005

2. How does affordable assisted living differ? • It was created to serve low-income people from the start • Service plans are flexible and based on the tenant’s individual needs • Rent, board and services are separate so that tenants can access multiple funding sources • Partners willing to commit enormous amounts of time and energy overcoming obstacles and finding solutions to make the program available to even the lowest income people

3. Thinking about affordable assisted living? • Complete market study to determine the need for affordable assisted living in your market area • Use County-specific Census Data • Affordable assisted living programs should be targeted to Medicaid waiver-eligible individuals

4. Who is our potential customer? • The majority of assisted living tenants are widows, age 82 and older, with assistance needed for two or greater activities of daily living • Very few people age 55 to 75 move into assisted living; however, this age group may be a predictor of future market demand

5. Who is our potential customer? • When predicting demand, a reliable measure is that 2-3% of those age 65 and older will choose to live in assisted living • A reliable measure of those age 75 and older is 4-6% will choose to live in assisted living • Nationally less than 10% of seniors live in a nursing facility, and many of your potential customers will have a similar level of personal care needs to residents who reside in a nursing facility

6. Who is your potential customer? • The Census data addresses income, but not assets • When predicting who will move into an affordable assisted living, look at customers at 50% or less of area median income (these are the most likely to qualify for Medicaid waiver from an income perspective)

7. Who is your potential customer? • Renters vs. homeowners are more likely to move to an assisted living property • Information on disability (sensory, physical, mental, self-care, or ability to go outside home) is a predictor of potential customers

8. Purpose of a Market Analysis • Assess the short term (>5 years) demand for assisted living within a given market • Provide an overview of the community in which the ALP will be located • Provide preliminary guidance for marketing the program once it is operational

9. Five Key Components of a Market Study for Assisted Living • Identification of the geographical, social and cultural boundaries of the market area • Enumeration of the households within the market area who need and can afford the proposed program • Examination of current and proposed programs, within the market area, that will compete with the proposed program

10. Five Key Components of a Market Study for Assisted Living • Estimate, based on market area and potential households, the penetration rates needed to fill the program or the estimated number of units marketable within the market area • Qualitatively assess the marketability of the program given the current social, cultural and economic conditions of the market area

11. Importance of accurate market analysis • Inaccurate estimate of market weakens validity of analysis • Invalid estimates might well result in a program that struggles to reach full occupancy • Recent evidence may indicate a decline in disability rates; existing census data may not reflect changing attributes of population (1990 census)

12. Conclusion • Market study findings must be used with great care • The market study is an important tool but is not the only tool in the decision-making process

13. More important than the market study are . . . • Reputation and experience of the owner and management • Pricing • Range of services available • Amenities included in building • Site and building esthetics

14. Getting Started • Use the planning process to create awareness and establish a base for future support • Invite community leaders to have a role in the planning process • Hold community meetings to educate on the assisted living concept and build consensus

15. Getting Started • Explain the difference between what is proposed and what currently exists in community (nursing facility, assisted living, independent senior housing) • Understand the BIG PICTURE: Incorporate into a general discussion on planning for housing and health related needs of the elderly

16. Eight Questions about Elder Care in Your Community • Preventive Care: Are we providing our elders with the opportunities they deserve to remain strong, healthy and independent? • Focus on Function: Do we know how well our elders are doing, not just what diseases they have? Has analysis been completed on the ability of elders to do ADLs and IADLs?

17. Eight Questions about Elder Care in Your Community • Long Term Care: What are the long-term care resources in my community and how well are we supporting families caring for frail elders in the home? • Geriatric Assessment: Do we have a mechanism in place to provide a comprehensive assessment of elders, in the clinic or in the community? This is a key to rational and cost-effective allocation of long-term care services.

18. Eight Questions about Elder Care in Your Community • Care at the End of Life: Are we providing compassionate and competent care to those who medicine cannot cure? • Knowledge Base: Does our staff have the knowledge base needed to provide high quality care to elders?

19. Eight Questions about Elder Care in Your Community • Focus on Quality of Care: Are we looking at elder-specific outcomes in our program improvement efforts? • Resources: Do we know where to look or who to call if we have any questions about elder care; either clinical questions of questions about program development?

20. Getting Started • Establish a preliminary plan • Select site. Do feasibility study. • Establish preliminary budgets (Development Cost Proforma)

21. Sources of Information • www.ncbdc.org; “Request for Proposal for Affordable Assisted Living Market Study” • “Market Analysis in Assisted Living” presentation by Michael R. DeShane, PhD; Concepts in Community Living, October 2002