Health Care

Need Rises for New Senior Care Homes in Valley

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YOUNGSTOWN, Ohio – Those who assert the region’s nursing home and assisted living industry is overbuilt might want to think again.

Executives and specialists in the business say expansion is not only important for the survival of their industry, but critical to providing long-term quality care in the Mahoning Valley where the senior population is disproportionately large and not about to shrink anytime soon.

“Over the next 19 years, 10,000 people a day will turn 65 in the United States,” affirms Gary Weiss, executive director of Heritage Manor in Youngstown. “That’s more than 70 million people over the next 19 years.”

The most daunting challenge before providers of both skilled nursing and assisted living is how to prepare in the face of increasing and costly regulations, a growing aging population whose levels of acuity are higher, and a thinning labor pool, Weiss says. According to the U.S. Census Bureau, 18.8% of residents in Mahoning County are older than 65, above the state of Ohio average of 15.1%. The median age in the county is 43, higher than the national average of 38.

“We see a very strong need in this area for assisted living and memory care units,” observes Diane Reese, executive director at Briarfield, the operating division of EDM Management, which owns six assisted living and skilled nursing centers in the Mahoning Valley.

Anticipated demand convinced EDM to begin construction on a $12 million 89-unit assisted living center in Poland Township, Reese says. The new building – The Inn at Poland Way – will be built east of Clingan Road along U.S. Route 224. “It’s a state-of-the art design,” she says. “We should break ground in the next 30 days.”

There is also a need to accommodate more residents who require memory care and therapy, Reese continues. To address the needs of this population, The Inn will offer 25 units designed for the memory-impaired and those with advancing dementia and Alzheimer’s disease, she says.

Attention to residents in need of memory care inspired The Nugent Group to create a dementia care unit at its Nugent’s Continuing Care Retirement Community, a 105-bed skilled nursing center in Hermitage, Pa., says its marketing director, Sarah Boland.

The unit, added in 1997, is designed to compensate for a resident’s loss of memory through color-coded rooms and hallways, safe indoor walkways and an outdoor courtyard.

“It’s a 16-bed unit with 24-hour, around-the-clock nursing care,” she says.

Nugent’s continuing care houses both long-term and short-term residents, as does another operation, Clepper Manor, a 55-bed center in Sharon, Pa. “I would say it’s 50-50 between long-term and short-term stay residents,” Boland says. “We offer rehabilitation services in both homes.”

The Nugent Group also operates a home health service – NuChoice Home Health – a growing segment of the business since a major trend in the industry is allowing residents to stay in their homes as long as possible. “Usually, a patient would need home health care for a few hours a week. But, if they take a turn for the worse, we would send in a registered nurse, occupational therapist or a physical therapist. If they cannot remain in their home, then they can move into skilled facilities.”

Despite the trend to keep residents in their homes through home health services, there often comes a time when family members must decide whether and when to place a loved one in an assisted living or skilled nursing center.

Heritage Manor is a 72-bed skilled nursing home on the north side of Youngstown operated by the Youngstown Jewish Federation. The campus consists of a 24-unit assisted living center, Levy Gardens Assisted Living Residence. Moreover, “We also have an adult day care and expanding our Meals on Wheels program,” Weiss says.

Stays in skilled nursing centers are becoming shorter and shorter, he notes, while assisted living centers are assuming the role long-term nursing homes once played. “What’s happened is assisted living is turning into what was considered nursing home care,” he explains. “They’re not as regulated as nursing homes, but they will be in the future.”

Skilled nursing homes today are used mostly for short-term rehabilitation services, which are driving the need for this segment of the industry to expand, says Brian Kolenich, executive director of Park Vista Retirement Community in Youngstown.

Park Vista is in the midst of expanding its short-term rehabilitation wing from 24 private apartments to 45 private rooms. “We’re finding that there’s a lot more need in short-term rehab,” he says.

Demand for short-term rehabilitation is on the rise because hospitals are discharging patients sooner. Often, if the patient requires further treatment he’s discharged to a skilled nursing center instead of remaining in a hospital bed.

Other aspects of the industry are changing as well, most of which are driven by the demands of the aging population, Kolenich says. In June, Park Vista broke ground for an addition to accommodate the new Gelhaar Center, which will house programs for the campus’ Lifelong Learning Institute. The new center will host academic lectures on political science, arts and culture, religion and spirituality, and wellness and rehabilitation.

Meanwhile, Kolenich says, Park Vista continues to build its wellness training and aquatics programs. “On the assisted living side, you’re seeing more of a focus on wellness and promoting a healthier lifestyle,” he says.

Larger apartments, flexible menus and dining hours, and more options for financial assistance will likely drive the future of the industry, says Jason Cicchillo, administrator at Copeland Oaks Assisted Living and Crandall Medical Center in Sebring.

However, assisted living communities are experiencing an influx of residents with more health complications than 20 years ago, Cicchillo says. “They’re coming in with higher acuity levels,” he says, which will force the industry to re-examine the model of care these facilities provide.

That means a push for expanded Medicaid and Medicare coverage to support those residents who require assisted living but lack the ability to pay. Programs such as the state of Ohio’s Medicaid Waiver program help pay room and board for certain eligible residents, but such funding is inadequate to cover what is expected to be a sizeable population of aging baby boomers who will enter assisted living.

It’s this generation that is also forcing a dramatic change in the entire industry, Cicchillo adds. “We’re really focusing on long-term, person-centered care,” he says. “They have a choice what time they get up in the morning – as they should – what time they should eat and their dining options. It’s really centered around the resident.”

Over the next three years, Cicchillo reports, the assisted living industry anticipates a 2% increase in referrals and placements. However, growth in this sector will likely outpace the pool of available long-term health care workers, he says.

“The industry is estimating that over the next 10 years, we’ll be down about 2.5 million health care workers related to long-term care,” he says.

Pictured: rendering of The Inn at Poland Way designed by Strollo Architects. EDM Management expects to break ground in September for the $12 million assisted living center

Published by The Business Journal, Youngstown, Ohio.