More Seniors Need Higher Levels of Care

YOUNGSTOWN, Ohio – The market for in-home care for seniors is growing in the Mahoning Valley.

Michael Senchak, co-owner and president of FirstLight Home Care of the Valley in Austintown, says his business and clientele has grown each year. In-home care is becoming a popular option, he says, because individuals prefer to stay at home.

“[In-home care] is a growing sector of health care. We celebrated our 10-year anniversary in June,” Senchak says. “On average, in any given month, we are between 180 to 200 clients [or] families that we serve.”

FirstLight Home Care’s purpose is to help seniors stay independent as they age, he says. Some individuals may need help with certain activities of daily living such as bathing, meal preparation or transportation but do not want to be removed from their homes and routines.

FirstLight assesses the level of care an individual needs and then tailors treatment suitable for seniors and families.

“That care could be anywhere from a one-hour visit once a month for light housekeeping to being serviced 24/7,” Senchak says. “All of our employees are either a [state tested nurse aide] or a licensed home health aide.”

FirstLight used to have employees who were strictly companions but noticed over the years that an additional level of care is often needed and added that service.

“FirstLight partners with Expand Health and Home, which is a skilled agency,” Senchak says. “[Expand Health and Home] sends in nurses, physical therapists, occupational therapists or speech therapists … after a patient is discharged from the
hospital or [if specialized care is needed].”

This partnership is beneficial to the clients because it builds on the level of care that is provided. Skilled agencies do not see patients every day like nurse’s aides or home health aides do and the FirstLight employees can’t provide the specialized care.

Senchak says the partnership is imperative as the senior population grows.

The biggest hurdle for Senchak is the worker shortage. Like many other health care fields, he says he is noticing a shortage but has implemented measures to retain and recruit more employees with increased wages and benefits.

FirstLight Home Care has grown over the years. But the workforce shortage has slowed that process. Senchak says he’s lucky to have the dedicated employees he has now but needs more to continue increasing and providing services to more families.


Paisley House Assisted Living in Youngstown is a nonprofit senior care center that provides a safe, structured and social environment for seniors who aren’t fully independent. Jill Cox, the executive director of Paisley House and a registered nurse, says assisted living promotes healthful living.

“We do follow a medical model because we’re going to make sure [our residents] are OK and that they’ll be OK. Assisted living does extend someone’s lifespan. I’ve had people move in here and live for eight to 10 years, where if they were living at home I don’t know if they would’ve lived that long,” Cox says.

Health and safety are the top priorities but the familylike environment turns Paisley House into a new home, she says.

“It has a homey feel because it is a house. [Our residents] feel that way with our employees. They’ll say ‘We’re just one big happy family here,’” Cox says.

“[Paisley House] is smaller so it does get a little more personable. We know all our families by name, and they also get really involved.”

Unlike Senchak and FirstLight, staffing isn’t a hurdle for Cox and Paisley House. Paisley House has retained the same number of staff over the years.

Instead, Cox’s biggest hurdle is vacancies.

Paisley House Assisted Living started in 1909 and because it is in an old house that has been slightly renovated, there are some design limitations for individuals seeking assisted living.

“Our patients are maybe a little higher functioning because we don’t use [personal mobility] lifts and due to the fire code we can’t take wheelchair dependent individuals … a newer facility may not have that problem,” Cox says. “[Another thing] is that we have private bedrooms but shared bathrooms.”

With in-home care becoming a popular option, Cox says some people are choosing to stay home longer to maintain independence and comfort but it’s a matter of what is safest.

Cox says these factors make it harder for her to fill vacancies but Paisley House makes up for it in experience.

Paisley House was voted No. 1 in family satisfaction in the state in the 2021 survey of the family members of residents. The results of the latest satisfaction survey of residents have not been announced yet but she believes Paisley House will finish in the top three.

Price is another factor in the senior care center’s favor. Paisley House costs $2,300 a month, which is one of the lowest assisted living rates in the region, according to Cox.

“With our residents and families happy, I have to assume [our vacancies] are due to the sorority-like living. That’s my biggest hurdle. The thing is, once [residents] come here and get used to it – it doesn’t even bother them,” Cox says.

Cox has also noticed an increased level of care needed by Paisley residents and has made accommodations by having more clinical workers available and nurses during the day.

But sometimes, people seek assisted living beyond what is manageable.

“You should be seeking out assisted living when mom is OK to get in the car and see the facilities. Not when mom is in the hospital and can’t go back home. It needs to be looked at sooner and sometimes people who want to come here are beyond what is safe for them,” she says.


When individuals are beyond the level of care that assisted living can provide, skilled nursing centers are another option.

Nursing homes can provide more extensive and clinical care than most options. However, there is a stigma surrounding nursing homes that makes it difficult to get seniors the care they need when they need it.

Joe Cilone is president of Inspira Health Group, which has four skilled nursing facilities and two assisted living facilities across northeastern Ohio. He says people don’t want to enter skilled nursing centers until they have to but Inspira has been combating that stigma.

“Caprice [skilled nursing facility located in North Lima] is a 5-star facility and that speaks volumes for itself,” Cilone says. “A lot of it is word of mouth. We get more referrals because people have been with us in the past and they liked the care.”

For Cilone, the biggest challenge is the skilled workforce shortage.

Inspira’s three southernmost facilities still struggle with getting proper staffing and that has led to it using more agency employees — which is costly and can impact care.

“We’ve gone through ups and downs in my career – this is my 27th year – and this [workforce shortage] has been the most challenging to get through,” Cilone says. “We try to avoid [agencies] as much as possible but sometimes it’s your only option. You also must look at who you can and can’t admit because of the level of care.”

With the increase of in-home care and private settings, Inspira has changed its facilities to have more private bedrooms. It also permits spouses and siblings to room together. Because some seniors prefer socializing with a roommate, that’s also an option.

Another focus of Inspira is having space for high-acuity patients.

“We do a lot of ventilator and dialysis care that we can provide for our residents,” Cilone says.

Residents have said they wish they got involved with Inspira sooner, according to Cilone.

“Once we get people in [residential assisted living], they end up really enjoying it and they wish they would’ve come sooner. They make friends there and enjoy the socialization and hospitality,” Cilone says.

“We try to do the same thing with our [skilled nursing facilities] but obviously the level of care is much higher.”

The state has taken steps to address the needs of the senior care centers, Cilone says, including earmarking more funding. It was long overdue. More must be done.

“[The budgeted relief] will keep some of the industry alive but with rising costs and slow reimbursement rates, it’s going to be hard — especially places that maybe only have one or two facilities,” he says.

Pictured at top: Jill Cox, executive director of Paisley House Assisted Living, and Wendy Swick, administrative assistant and marketing specialist, stand outside of Paisley House in front of their new pavilion at the senior care center.