Senior Living Communities - Where does Mom's rent go ?

Retirement communities seem like a great idea on the surface: like a cruise ship for seniors. Social opportunities, wellness opportunities, fine dining, special holiday functions, maintainence services, housekeeping; some have nurse stations, and some have full time LVN's represent a picture of complete care just waiting to put it's arms around your aging parent.
You and your parent tour a facility. The people are so nice. The place looks like a fine hotel. Everyone is so happy to see you. It must be heaven. Oops, trying to avoid that! But as the last stop on route, except of course for some of you, not a bad place to hang your silk scarf, and support hose.
"That beautiful apartment is how much?" $5,000 dollars a month..."and up!!!!????" You swallow. Subtle, but hard. Your parent imagines friends,fun, privilege, bridge players, and chocolate. So where does your rent go? I will give you a hint: it is not dining services, or housekeeping, or maintenance, or capital improvements of health care, or activities. In many upscale senior living communities, you may be surprised to discover that over 40-50% of the operational dollars go to marketing and not to services that directly benefit your parent. The reason is simple, senior residents move into these communities when they have an average of 5 years left to live. Sad, but factual. So inherent in all "retirement communities" is alot of resident turnover, even when residents are content within their community. Just imagine the numbers, when the residents are not content.
When a resident dies, an apartment becomes empty, and corporate revenues shrink. Some corporations have silent partners (investors), who do not appreciate declines in occupancy levels. Less occupants, less profits. So a tremendous amount of your rent dollars are spent attracting a continual stream of new residents. 40-50% of the yearly budget at the property level is spent on marketing, and the recruitment of future residents. There is even greater turnover, of course, when the services are so-so. I was given $2.40 per person per meal, based on two meals per day in one such upscale retirement community in La Jolla California, as recently as 2007. Marketing first, nutrition? Somewhere much farther down the list.
The caretaking mission represented by these corporations is really not their mission. Profit, not people, again is the mission. The mission of most of these communities is NOT to keep your parents content with cruise ship five star services, no matter what they say to you, during your "free" marketing tour and lunch. The corporate mission is to keep the building full, create large revenues, make tremendous profits,purchase more properties, turn them in to more goldmines. Oh, the hours spent in departmental leadership meetings, working on the shape of the spin.
Until late 2007, I functioned as the Dietary Director for one such "for-profit" corporation. This Carlsbad company, proudly announced, at the 2006 dietary conference for all dietary directors, that they made a NET profit of $11 million dollars with their 23 properties nationwide. More shocking is the fact that some of their properties went much of the year below full occupancy. You can just imagine the profit at full occupancy. Alot of profit for a company that on my campus, outside of dining services, had alot of resident turnover, unhappiness with other services, and four executive director turnovers in two years! It is only about occupancy folks. The rest is marketing.
I am not alone in my understanding of just how senior living communities operate. But, people on the inside of the industry, do not speak up because: they are care-givers, and need these jobs. Some, like me, become disillusioned care-givers, and leave the industry. Find the honest broker on your marketing tour, and call them later for a personal chat. They will tell you. Most workers, and local property leadership in these companies are disillusioned too. Or they have darker motives for staying in silence.
There are many things I discovered in my tenures, that have turned me off to retirement communities as a viable future option for aging adults. I have not even touched on the average direct care-giver to resident ratios of 1 to 20 :at the very best. This ratio is at the very root of the problem. Try caring for twenty parents with two hundred challenges daily per parent, and you will get the picture. The cloth just does not stretch to cover the need.
Higher corporate costs drive operational changes that should concern adult children seeking quality residential solutions to caring for their aging parents. I do not believe that all upscale retirement communities really fulfill their care giving promises: and today there are alot of other alternatives you should also consider.For this much rent ( and more), similar services, are offered for this inclusive price: you should, and do expect five star level housekeeping, fine dining complete with special holiday programming; wellness programs that focus on fall prevention, strength training, and balance education for your parent; maintainence (toilets do have their problems, so do air conditioners/heaters, elevators). If you are still considering an upscale independent living community of 100 to 500 occupants, consider this: every year, you can expect a cost of living increase of 5-9 % in these communities: whether you like it or not. And trust me, the corporation can always defend the reasons for the increase. You will have only the choice to pay or move.
Are indepenedent living communities really full of independent living seniors? Retirement communities ususally bill themselves as housing for independent living residents: those with minimal mobility and functionality issues. But in the last twelve years, I have seen less truly independent residents, and more highly dependent, borderline assisted living or early dementia type residents move in. The corporation is motivated simply by the drive to keep the place full. This creates a great demand on service personnel, often untrained. If your parent is very independent, it can be depressing. Your high functioning parent may be seated in the dining room, at dinner, with someone with incontinence issues. Or worse. So before you sign that rental agreement, remember what I have shared with you : current and future residents are hunted constantly by full time marketing people to keep the building full. We had 140 residents, and two full time marketers: they were each required to make 50 phone call contacts each day to "prospects". Be comfortable but observant, when taking a marketing tour of a community: observe the care giving ratio; study the interaction of the residents with each other, and with department heads, peak into administrative offices, talk with the maintainence director and the dietary director about the challenges of their positions. Call them later to ask about what they didn't say. Find out about the property's budget: anyway you can. Look at the food served; tour the kitchen, look in those walk-ins. Fresh, homemade preparations or commercial preparations? Sit down at lunch with a random group, and not of the marketer's choosing. Always try to take an 'unplanned' tour, to get the most honest insight.
In conclusion, you may get more services, of a better quality, in smaller board and cares, than you will in large retirement communities. Retirement communities do have a huge socialization advantage: alot more prospective playmates for your parents. But they are not for everybody. Make sure to take an industry savvy professional along with you while you are touring, and examining what you really ARE getting for your rent.