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WEALTH ADVISORY | OUTSOURCING | AUDIT, TAX, AND CONSULTINGInvestment advisory services are offered through CliftonLarsonAllen Wealth Advisors, LLC, an SEC-registered investment advisor
Sell to External Nursing Care ProviderClose Campus
Transition current residents to other nursing care settings as required by state and federal law and no longer provide services to County residents.
Campus upgrades to short term care units, common areas and technology support to be relevant to the needs and families in the County. Operational changes will be made to continue to balance cost reimbursement.
Engage a broker or independently market the SNF to a provider that will maintain the mission to focus on unmet nursing care needs of families in the County.
There are multiple options to consider to further PCHCC’s mission of serving the frail elderly population of Portage County, including:
Strategic Alternatives Overview• Key decisions are needed for clarity of strategic direction:
– Is the operation of a health care facility a priority of Portage County? and if so:
– Does the Committee support next steps to explore a collaboration model with Marathon County to achieve operational efficiencies and potential cost savings?
– Does the Committee support next steps to explore an investment to develop the infrastructure necessary to improve operational effectiveness?
– Does the Committee support development of a timeline of actions to reach a decision regarding the future strategic direction?
The “Status Quo” Scenario• A financial model was developed, based on current services
and expectations regarding revenue and expenses over a 10-year period
• Changing market forces and consumer demands were not incorporated into the status quo assumptions, such as effects of workforce challenges
• The model provides a high-level analysis regarding the effects of status quo operations on the GAAP basis financial statements.
• Building upon the “status quo”, a high-level financial impact of strategic initiatives to enhance the quality services is included in the following pages
Provide quality, individualized, cost effective, residential and rehabilitative services for elderly and adult clients with short and long-term care needs.
We promote resident choice and individualized care to improve quality of life. It has been found that active participation in the activities of daily living fosters longevity, happiness, contentment, self worth and dignity. Recognizing the obligation of a health care facility to help restore the resident to the best possible state of physical, mental, and emotional health, and to maintain his/her sense of spiritual and social well-being, we pledge our every effort.
Current Service Offerings• Short-term post acute care – Following hospitalization, the Portage County Health Care
Center (PCHCC) team provides medical and therapy services, bridging the transition between hospital and home. Services provided include:
– Complex medical management – Wound care – Post surgical orthopedic – IV therapy – Respiratory care – Diabetic management – Physical/ Occupational/ Speech therapies
• Long-term care – PCHCC cares for clients in need of a high degree of ongoing medical attention and/or supervision, while helping each individual achieve and maintain an optimal level of self care and independence
• Dementia Care Advanced Stages – PCHCC offers specialized care for residents with Alzheimer's disease or other related dementia, who may require a high level of medical management and physical care
• Hospice Services –Portage County Health Care Center works in partnership with Ministry Home Care Hospice and Aspirus Comfort Care & Hospice Services to provide this supportive end of life care
Portage County Health Care Center (PCHCC) has several competitive advantages which can be enhanced to better meet the needs of Portage County residents in the future. The programming provides much needed services to senior health care issues. The site location and beautiful outdoor setting is a unique asset that that can lift the spirits of residents and their families along with staff. Consistent key quality measures are meeting high standards of care as well.
As the senior healthcare landscape continues to change, repositioning of the community is needed to deliver services appropriately and competitively. Based on our review, the market can support a between 88 and 96 licensed beds related to the current services offered. PCHCC has 70 of the 130 licensed beds in the market areas, however continued ability to attract residents is likely to be dependent upon operational improvements and capital improvements, including:
• Renovation or replacement of the skilled nursing facility is crucial to PCHCC’s future success.• An investment in technologies allow the staff be more efficient and technology options that provide for
resident connection with family will provide for improved quality of life. • Continued focus on referral relationships and how PCHCC can provide value.• Exploration of collaboration with Marathon County in order to maintain service, while decreasing
overhead.
These renovations will allow PCHCC to maintain census and adjust the payor mix to create a more sustainable revenue stream.
• If the long-term vision of Portage County is to continue to provide skilled nursing services, a significant renovation or replacement of the current skilled nursing facility should be considered. PCHCC first opened at the current location in 1931 and was expanded in 1964 and 1994. Based upon tours of the building and discussion with the leadership team, the building has limitations in the provision of services, as compared to current expectations, including:
• Not designed for efficient staffing• Lack of air conditioning in many rooms• Insufficient lighting in resident rooms• Electricity in the resident rooms is not adequate to support clinical
equipment needs• Design does not incorporate accessibility and overall aesthetics in order
to remain competitive in the market area• A significant renovation of the space may provide for improved operational
efficiencies, but these are likely to be limited by the overall layout.
• Investment in technology upgrades, both operationally and clinically, appears to be a barrier to efficiency and quality improvements
• Replacement of the current electronic medical record (EMR) which requires significant manual / duplicate entry
• Remote monitoring systems to provide for staffing efficiencies in the existing building
• Development of additional service offerings will provide value to existing residents, including the potential to expand such service offerings to those outside of PCHCC. There are numerous senior services not currently offered at PCHCC that residents need to travel off-site to receive, including:
• Mental care support• Locked dementia units• Dialysis• Home care• Transportation Services
• Hospital referrals are vital to maintaining a strong Medicare census. While most Wisconsin markets have experienced increased discharges to home, PCHCC has experienced stable rehabilitation census. This should be monitored, as residents begin to utilize hospital care differently. PCHCC can use this information to capitalize on their ability to manage complex cases and increase their revenues and rehabilitation resident percentage.
• PCHCC should continued to develop relationships with area hospitals, focusing on areas where post-acute care can improve outcomes.
• PHCC should also consider collaboration with other area senior living providers. Organizations such as North Central Health Care in Marathon County have realized cost savings by sharing of key resources, technology platforms, and processes.
BackgroundPortage County Health Care Center first opened at the current location in 1931 as the Portage County Home. PCHCC was expanded in 1964, and 1994. The PCHCC currently operates with a 70 bed capacity. PCHCC has a 5 Star overall CMS Rating.
The building was seen as the most significant barrier by the majority of the leadership team, including: • Building is not setup for efficiency, given how care is provided• Lack of air conditioning• Insufficient lighting in resident rooms• Electricity in the resident rooms is not adequate to support equipment needs
In general, demand for aging services, including skilled nursing care, is influenced by five main factors (referred to herein as “demand influencers”):• Managed Care, relationships and preferred provider agreements often supersede resident choice• Environmental factors such as population growth, acute care usage and caregiver availability• Lifestyle and consumer choice, such as the substitution of housing and service alternatives for
institutional skilled nursing care• State and public policy, such as home and community-based service funding• Income and wealth, particularly poverty rates and availability of retirement income
Recommendations• Despite a limited number of skilled nursing beds (130) in the Market Area relative to the
senior population, CLA estimates the bed need will decline by 2025• Replacement of the current electronic medical record (EMR) which requires significant manual
/ duplicate entry• The Market Area is significantly impacted by skilled nursing options nearby, yet outside of, the
Market Area in Marshfield, Wausau, Weston and Wisconsin Rapids
• The number of beds per thousand in the Market Area is much lower than Wisconsin and the U.S. in 2020
• As projected in 2025, the Market Area remains significantly lower than Wisconsin and the U.S.• The ratio decreases for seniors age 65+ and 85+ in the Market Area from 2020 to 2025 given
the projected increase in the senior population during that time period
• The baseline demand in the Market Area in 2020 is estimated at 96 beds, which represents an average occupancy of 74.2 percent
• Assumptions for changes in population, length of stay, hospital utilization and other environmental impacts are estimated to result in a decrease in demand for nursing beds in the Market Area in 2025 to 88 beds (a decline of 8.3%)
Background• There is estimated population and household growth in the Market Area from 2010 to 2020.
Growth is projected to continue from 2020 to 2025 in all three senior age cohorts• Incomes in the Market Area are similar to the State of Wisconsin overall.
• Seniors in the 65-to-74 age cohort are estimated to have a slightly higher incomes in the Market Area than in the State of Wisconsin overall
• For the 75-to-84 and 85+ cohorts, estimated incomes are slightly higher in the State of Wisconsin than in the Market Area
• Nearly 73% of seniors in the Market Area owned their homes in 2010 and could use money from the sale of their home towards senior housing
• There are 234 RCAC assisted living beds in the Market Area with an overall occupancy of 91.5 percent
• There are 233 CBRF assisted living beds in the Market Area, which reported a 95.7 percent occupancy (Point Manor Assisted Living was the only community to report an occupancy below 90 percent, which may indicate pent up demand for CBRF assisted living)
• The majority of the existing CBRF assisted living beds in the Market Area offer small units, including shared studios, private studios, but no one-bedroom or two-bedroom units
Recommendations• CLA recommends PCHCC consider development of RCAC assisted living, and/or CBRF assisted
living and memory care assisted living• Despite limited 75+ population projections in the Market Area, there is estimated future
demand for both RCAC and CBRF assisted living units• The strongest estimated demand is for RCAC assisted living with monthly rents starting at
$2,500 per month and for CBRF assisted living with monthly rents starting at $4,500 per month
• Many of the shared units in both CBRF assisted living and memory care assisted living in the Market Area were occupied by residents utilizing Medicaid Waiver funding
• PCHCC may have advantages if it chooses to expand, pairing its reputation for quality care and staff continuity, with a new building
BackgroundExpanded amenities meet the evolving needs and expectations of seniors and their families. As a new generation of seniors enters the marketplace, new demands surface. Drawing in this next generation will be challenging as many seniors want to stay in the comfort of their homes longer and are nervous to give up the “outside experience”. Expanding amenities available could increase the marketability of PCHCC’s and draw in that next generation or younger senior.
Recommendations• Expanding on-site amenities has minimal potential for additional revenue, yet it can enhance
residents’ experiences at PCHCC by providing the “outside experience” that many seniors feel they are giving up when moving in a senior community
• Amenities can enhance the marketability of PCHCC, as well as improve the quality of life of the residents, by giving residents additional gathering spaces to allow them to socialize and create a sense of community
• Consideration should be given to the cost benefit relationship of adding each of the additional on-site amenities, along with the potential to share space (for example, a game room could easily convert to a movie theater when not in use, or to a lunch café’)
BackgroundDevelopment of additional service offerings will provide value to existing residents, including the potential to expand such service offerings to those outside of PCHCC. The ability to limit resident transfers will also improve their quality of life and reduce complications in getting to another site for such services. There are numerous senior services not currently offered at PCHCC that residents need to travel off-site to receive. Additionally, there are services that would draw in new residents and community members. Available options discussed with the management team include:• Mental care support• Hospice care• Locked dementia units• Dialysis• Home care• Transportation Services
Recommendations• The primary benefit of expanding service offerings is that it can be accomplished with limited
additional up front capital and additional debt• Risk can be further reduced by partnering or contracting with an external organization• Residents will benefit by having these services on site to enhance the worry-free lifestyle• Onsite services also limit the need to transport residents elsewhere to receive services• Consideration should be given to space and accessibility requirements for being able to
contract out these services• There are multiple factors that need to be taken into consideration with offering dorm style
housing for nursing students at local tech schools• This opportunity should be taken into consideration with other initiatives currently
being explored, such as building a new AL building and renovating the current space• This option could be a good fit for the existing AL space if that decision is being
considered • Constructing new space specifically for dorm style housing would not likely produce a
positive cost benefit relationship• Contracting with transportation services companies, such as Lyft, should be considered to
provide consistency in transportation needs of residents
BackgroundThe availability of a qualified workforce has reached crisis levels. The senior living industry continues to experience challenges in attracting and retaining clinical, dining, housekeeping and other resident support resources. Furthermore, the number of Wisconsin residents living in long-term and residential care facilities has grown 18% since 2003. To mitigate this risk, the following opportunities can be explored:
• Develop relationships/programs with technical schools
• Collaboration with external entities (hospital or senior living) for training
• Re-assess employee benefits available to workforce
Scope of WorkCompleted a Market Assessment for RCAC assisted living, CBRF assisted living, memory care assisted living, and skilled nursing for Portage County Health Care Center in Stevens Point, Wisconsin.
• Defined Market Area – The market area (“Market Area”) uses ZIP Code boundaries and is based on admission data provided by management, geographic barriers, transportation patterns, discussion with Portage County Health Care Center (“PCHCC” or “The Community”) and our knowledge of the draw areas for senior housing.
• Demographic Analysis – Examined 65+ senior demographics from U.S. Census Bureau data for 2000 and 2010, as well as estimates for 2020 and projections through 2025. (Note that all 2020 and 2025 demographic data is estimated/projected by Environics Analytics, a nationally recognized demographic data services company).
• Competitive Inventory – Inventoried RCAC assisted living (“RCAC AL”), CBRF assisted living (“CBRF AL”), memory care assisted living (“MC”), and skilled nursing facilities (“SNF”) in the Market Area.
• Pending – Inventoried pending senior living projects in the Market Area.
• Demand Analysis – Estimated demand for RCAC assisted living, CBRF assisted living, memory care assisted living, and skilled nursing facility units in the Market Area to 2025.
AL/MC Licensure in WisconsinIn Wisconsin, there are three licensed categories of senior housing that can be considered assisted living (memory care is a subset of this category and is usually a secured area within an assisted living building or a separate component that offers specialized programming and more intensive supervision than standard assisted living developments). Each of these is described as follows:
• Residential Care Apartment Complex (“RCAC”) are places where five or more adults reside. Apartments must have a lockable entrance and exit; kitchen, including a stove (or microwave oven); an individual bathroom, sleeping and living area. This living option also provides to persons who reside in the place, not more than 28 hours per week of supportive services, personal assistance, nursing services, or emergency assistance.
• Community Based Residential Facilities (“CBRF”) are places where five or more adults reside. Services provided include room and board, supervision, support services, and may include up to three hours of nursing care per week. According to the Wisconsin Department of Health and Family Services, “CBRFs can admit people of advanced age, persons with dementia, developmental disabilities, mental health problems, physical disabilities, traumatic brain injury, AIDS, alcohol and other drug abuse, correctional client, pregnant women needing counseling and/or the terminally ill.”
• Adult Family Homes (“AFH”) are for persons seeking a small congregate setting. They house up to four persons. Care guidelines are similar to CBRF’s except that they can provide up to seven hours of nursing care per week. Because of the very small size of these facilities, they were not included as comparable for the purposes of this study.
Portage County Health Care Center first opened at the current location in 1931 as the Portage County Home. PCHCC was expanded in 1964, and 1994.
The Community has an easily accessible location along Whiting Avenue and Water Street. Water Street is a major thoroughfare providing direct access to downtown Stevens Point.
PCHCC currently operates with a 70 bed capacity. Services include short term care, long term care, physical therapy, and occupational therapy. PCHCC has a 5 Star overall CMS Rating.
the Market Area are estimated to total 5,708, an increase of 1,372 households or 31.6% from 2010.
• An overall increase of 716 households or 12.5% is projected for 2020 to 2025.
• Senior households 75+ are projected to increase by 114 households from 2020 to 2025, or 23 households per year.
• Senior household trends closely parallel population trends: The 65-74 represents the strongest projected growth at 19.0% from 2020 to 2025, or 602households.
• Overall population of the Market Area (in all age groups) was 51,930 in 2010. By 2025, the population is projected to increase to 53,910 people, an increase of 1,980 or 3.8%.
• The proportion of seniors age 75+ in the Market Area is projected to increase from 6.9% in 2020 to 7.3%in 2025. This reflects a greater projected growth among seniors age 75+ compared to the overall population growth projected over the same time period.
• A higher proportion of seniors can indicate a greater need for care in a formalized setting.
Proportion of Seniors in the Market Area Compared to Overall Population
• Senior household incomes impact choice of housing.
• 2020 projected median household incomes are estimated to be slightly higher in the Market Area as compared to Wisconsin for the 65-to-74 age cohort and slightly lower in the 75-to-84 and 85+ age cohorts.
Tenure - 2010Among all Market Area senior households, 72.6% owned their housing in 2010. This ownership rate is lower than the homeownership rate in Wisconsin overall, 74.9%.
Home ownership declines with age. In the Market Area, 81.1% of seniors 65-74 owned their housing in 2010, compared to 73.1% of seniors age 75-84 and 49.9% of seniors age 85-and-over.
According to Environics Analytics, the estimated median home value of owner occupied housing in the Market Area for 2020 is $173,284. This compares to an estimated median value of $199,321 for Wisconsin.
The table is a summary of RCAC AL units in the Market Area. The total number of units is used later in the report for estimating demand in the Market Area.
Competitive Summary – RCAC AL
Competitive RCAC Assisted Living Units No. of Beds Occupancy
Brookdale Stevens Point 75 97.3%River View Lodge (Point Manor) 51 76.5%The Lodge at Whispering Pines 68 100.0%Willow Brooke Point 40 85.0%
Total 234 91.5%
Source: Personal visits, phone interviews, and/or other research conducted in December 2019.
• Activity of daily living (“ADL”) needs were applied to the age/income qualified base for RCAC, 5.7% for ages 65-74 (1-2 ADL needs), 22.2% for ages 75-84 (1-2 ADL needs) and 31.8% for ages 85+ (1-2 ADL needs).
• RCAC monthly service fees were tested at $2,500 and $3,500 per month with 80% of annual income allotted to pay for assisted living services.
• For homeowners who are able to draw on the equity of their home, an annual income of $25,000, $30,000 and $35,000 was used, respectively, for the different rent levels.
• Gross market penetration of 45% was used, based on the number of RCAC units in the Market Area.
• 20% allowance for residents outside the Market Area, based on admission data provided by PCHCC.
The following table shows the demand for RCAC assisted living in 2020, 2022, and 2025 in the Market Area.
The estimated demand shown in the tables in net of existing units and those under construction; that is, demand for new development. Demand at the higher rent level is included in demand at the lower rent level.
2020 2022 2025RCAC ASSISTED LIVING SENIOR HOUSING:Rents starting at…$2,500/Month in 2020 dollars 50 53 56 $3,500/Month in 2020 dollars 5 6 7
• ADL needs were applied to the age/income qualified base for CBRF, 5.2% for ages 65-74 (3+ ADL needs), 8.7% for ages 75-84 (3+ ADL needs) and 17.6% for ages 85+ (3+ ADL needs).
• CBRF monthly service fees were tested at $4,000, and $5,000 for assisted living and $5,500 per month for memory care assisted living. Each service fee was tested with 80% of annual income allotted for assisted living and 90% to memory care assisted living.
• For homeowners who are able to draw on the equity of their home, an annual income of $25,000, $30,000 and $35,000 was used, respectively, for the different monthly service fee levels.
• Incidence of dementia was applied to the age/income qualified base of residents living alone for memory care 3.2% for ages 65-74, 17.6% for ages 75-84 and 32.8% for ages 85+.
• Gross market penetration of 60% was used for CBRF assisted living, and 30% was used for memory care assisted living. Both percentages are based upon the number of existing beds and the CBRF specific ADL need percentages included in the qualified population pool.
• 30% allowance for residents outside the Market Area, based on admission data provided by PCHCC.
2020 2022 2025CBRF ASSISTED LIVING SENIOR HOUSING:Rents starting at…$3,500/Month in 2020 dollars 2 6 12 $4,500/Month in 2020 dollars 37 39 43
CBRF MEMORY CARE SENIOR HOUSING:Rents starting at…$5,500/Month in 2020 dollars 31 33 35
Source: CliftonLarsonAllen LLP
Estimated Demand
51
The following table shows there is no demand for assisted living and memory care units in 2020, 2022 and 2025 in the Market Area.
The estimated demand shown in the tables in net of existing units and those under construction; that is, demand for new development. Demand at the higher rent level is included in demand at the lower rent level. Demand for assisted living and memory care assisted living overlaps.
CLA contacted staff at planning departments in the Market Area to determine if any new senior housing was being proposed in the Market Area. At the time of research, the following project was identified within the Market Area:
• Stevens Point Commercial is a mixed-use development currently under construction at 1443 North Water Street in Stevens Point (54481). The development will house 88 affordable senior independent living units along with retail and office space. The project is planned to be complete in the fall of 2020. Since the project is affordable and only offering independent living, it was not included in demand estimates.
Number of Number of Percentage Percentage Percentage Percentage PercentageLocation Referrals to
Client SNFMedicare
DischargesDischarged
HomeDischarged to
SNFDischarged
to HHADischarged to
HospiceOther
Ascension St Michaels Stevens Point 127 1,268 55.3% 17.7% 13.0% 3.1% 10.9%
Source: Definitive Healthcare
Top Hospital Referring to PCHCC
Notes: Annual Medicare Data is from the Medicare Standard Analytical Files (SAF). Data shown is from the 2018 calendar year.
The following table summarizes the number of Medicare discharges and the percentage discharged by location for the top hospital discharging to PCHCC, based upon 2018 Medicare cost report data.
• Ascension St. Michaels referred 127 residents to PCHCC in 2018.• Approximately 18% of Medicare discharges in the Market Area were to SNF locations. • While other hospitals outside the Market Area referred residents to PCHCC, the total was significantly
Demand for nursing beds has been declining overall nationally as more seniors with less acute medicalneeds are accessing other forms of care. One way to assess the potential for nursing beds is to comparethe beds-per-thousand ratios for the population age 65-and-over and age 85-and-over in the MarketArea with ratios in the State of Wisconsin and the United States. The ratios are as follows:
• The number of beds per thousand in the Market Area is much lower than Wisconsin and the U.S. in 2020. Asprojected in 2025, the MarketArea remains significantly lower than Wisconsin and the U.S.
• The ratio decreases for seniors age 65+ and 85+ in the Market Area from 2020 to 2025 given the projected increase in the senior population during that time period.
Age 65 + Age 85 +SNF Beds Age 65 + Age 85 + Beds/1,000 Beds/1,000
Market Area 130 (2) 8,807 1,157 14.8 112.4
Wisconsin 29,278 (3) 1,025,861 128,994 28.5 227.0
United States 1,677,474 (3) 54,964,989 6,584,557 30.5 254.8
Age 65 + Age 85 +SNF Beds Age 65 + Age 85 + Beds/1,000 Beds/1,000
Market Area 130 (4) 10,138 1,187 12.8 109.5
Wisconsin 29,278 (4) 1,173,776 133,110 24.9 220.0
United States 1,677,474 (4) 63,790,899 6,994,842 26.3 239.8
Source: CLA, Environics Analytics, LTC Stats: Nursing Facility Operational Characteristics ReportNotes to Table:(1) Population data from Environics Analytics.(2) The number of nursing facility beds in the PMA is from page 20.(3) Total nursing home beds are based upon data from the American Health Care Association "LTC Stats: Nursing Facility Operational Characteristics Report”, October 2019, and represents total beds. (4) For 2025, the number of beds is assumed to equal the number of beds in 2020.
In general, demand for aging services, including skilled nursing care, is influenced by five main factors (referred to herein as “demand influencers”):
• Managed Care / ACO / Medicare Advantage Part C referral sources, relationships and preferred provider agreements that often supersede resident choice;
• Environmental factors such as population growth, acute care usage and caregiver availability;
• Lifestyle and consumer choice, such as the substitution of housing and service alternatives for institutional skilled nursing care;
• State and public policy, such as home and community-based service funding; and
• Income and wealth, particularly poverty rates and availability of retirement income.
Area Referring Hospitals Area Long Stay Short Stay TotalMedicaid Other Total Medicare MC Adv Total
Baseline Demand 2020 31 32 62 21 13 34 96 34 25 58Impact of Changes in Population (CAGR) 1 1 2 3 2 5 7 1 4 5
Market Area Total - Population Adjusted 2024 31 33 64 25 15 39 103 35 28 63 2025 Impact of Environmental Variables-9% Changes in Hospital Utilization Rates (3) (3) (6) (2) (1) (4) (10) (3) (3) (6)
-10% Changes in Length of Stay 0 0 0 (2) (1) (4) (4) 0 (3) (3)
0% Other Environmental Impacts 0 0 0 (2) 0 (2) (2) 0 (0) (0) Estimated Environmental Impacts (3) (3) (6) (7) (3) (9) (15) (3) (5) (8) Total Demand 2025 28 30 58 18 12 30 88 31 23 55 % Change vs. 2020 -6.9% -6.9% -6.9% -17.3% -4.7% -12.6% -8.9% -6.9% -6.2% -6.6%CAGR -1.4% -1.4% -1.4% -3.7% -1.0% -2.7% -1.9% -1.4% -1.3% -1.4%Note: the sum for each category may not equal the total, due to rounding estimates.
Market Area
PCHCCLong StayLong Stay Days Short Stay Days
59
SNF Demand Analysis - EstimatesThe following table shows demand for short stay and long stay beds in the Market Area.
• The baseline demand in the Market Area in 2020 is estimated at 96 beds, which is made up of 62 long stay and 34 short stay beds. This represents an average occupancy of 74.2 percent.
• Assumptions for changes in population, length of stay, hospital utilization and other environmental impacts are estimated to result in a decrease in demand for nursing beds in the Market Area in 2025 to 88 beds (a decline of 8.3%).
• There is estimated population and household growth in the Market Area from 2010 to 2020. Growth is projected to continue from 2020 to 2025 in all three senior age cohorts. The majority of the senior population growth is projected in the 65-to-74 age cohort.
• Incomes in the Market Area are similar to the State of Wisconsin overall. Seniors in the 65-to-74 age cohort are estimated to have a slightly higher incomes in the Market Area than in the State of Wisconsin overall. For the 75-to-84 and 85+ cohorts, estimated incomes are slightly higher in the State of Wisconsin than in the Market Area.
• Homeownership rates and estimated median home values are lower in the Market Area compared to the State overall. However, nearly 73% of seniors in the Market Area owned their homes in 2010. This indicates a majority of seniors who could use money from the sale of their home towards senior housing.
• There are four RCAC assisted living providers in the Market Area with an overall occupancy of 91.5 percent. River View Lodge had the lowest occupancy, at 76.5 percent. River View Lodge staff indicated the recent ownership change and subsequent staff changes may have driven down the occupancy.
• Among RCAC assisted living communities, Brookdale Stevens Point and The Lodge at Whispering Pines had the highest occupancies. These two communities are the only ones offering one-bedroom and two-bedroom units. Brookdale Stevens Point had the greatest range in pricing, from $2,700 to $5,100 and staff noted there is typically high demand for all unit types. They said occupancy is consistently very high.
• There are 233 CBRF assisted living beds in the Market Area, which reported a 95.7 percent occupancy. This is above the stabilized occupancy of 93.0 percent. Point Manor Assisted Living was the only community to report an occupancy below 90 percent. This could indicate pent up demand for CBRF assisted living. Point Manor Assisted Living (part of the same campus as River View Lodge) could also be experiencing a drop in occupancy after recent staff and ownership changes. Staff that met with CLA was new to the community.
• The majority of the existing CBRF assisted living beds in the Market Area are offering small units, including shared studios and private studios. None offer one-bedroom or two-bedroom units.
• Memory care assisted living also had a very strong overall occupancy in the Market Area, at 98.8 percent. There is not a large existing supply of memory care assisted living beds in the Market Area. Some of the CBRF assisted living communities in the Market Area did not offer memory care specific programming or a secured community, but did have residents in assisted living with dementia. This could indicate some pent up demand for memory care assisted living.
• Copperleaf Senior Living’s three adjacent buildings (North Crest, North Haven, and North Ridge) offer both assisted living and memory care assisted living together, all licensed for CBRF. Staff estimated half to be residents in need of dementia care and said the buildings typically go through cycles as a resident group ages in place. The buildings are well designed with a more modern décor than the majority of the other CBRFs in the Market Area. Staff said the three buildings are typically very full.
• Many of the shared units in both CBRF assisted living and memory care assisted living in the Market Area were occupied by residents utilizing Medicaid Waiver funding. None of the Medicaid Waiver beds in the Market Area were included in the competitive supply for the purposes of estimating demand.
• There is estimated demand for RCAC assisted living, CBRF assisted living, and memory care assisted living. The strongest estimated demand is for RCAC assisted living with monthly rents starting at $2,500 per month and for CBRF assisted living with monthly rents starting at $4,500 per month.
• Despite a limited number of skilled nursing beds (130) in the Market Area relative to the senior population, CLA estimates the bed need will decline by 2025. The Market Area is significantly impacted by skilled nursing options nearby, yet outside of, the Market Area in Marshfield, Wausau, Weston and Wisconsin Rapids.
• CLA recommends PCHCC consider development of RCAC assisted living, and/or CBRF assisted living and memory care assisted living. Despite limited 75+ population projections in the Market Area, there is estimated future demand for both RCAC and CBRF assisted living units. PCHCC may have advantages if it chooses to expand, pairing its reputation for quality care and staff continuity, with a new building.
• The objective of this engagement was to collect and analyze as much data on the market as outlined in the Process Outline. CLA assumes no responsibility for matters legal in character. Certain information and statistics contained in this report, which are the basis for conclusions contained in the report, have been provided by other independent sources. While we believe this information is reliable, it has not been independently verified by us and we assume no responsibility for its accuracy. The conclusions in the report are based on our best judgments as market research consultants. CLA disclaims any express or implied warranty of assurance or representation that the projections or conclusions will be realized as stated. The result of the proposed project may be achieved, but may also vary due to changing market conditions, changes in facts that were the basis of the conclusions in the report or other unforeseen circumstances.
• Note that this Market Assessment should in no way be used to finance a project. Once a final housing concept has been defined, a full market Feasibility Study should be conducted prior to making a decision to proceed with a project. This document is for the internal-use-only of Portage County Health Care Center and should not be distributed to third parties.
Pines Willow Brooke PointStreet Address 5625 Sandpiper Drive 1800B Sherman Avenue 3450 Bridlewood Drive 1801 Lilac LaneCity/State/ZIP Code Stevens Point, WI 54482 Stevens Point, WI 53073 Plover, WI 54467 Stevens Point, WI 54481Owner/Sponsor Brookdale Senior Living North Shore Healthcare Privately Owned Willow Brooke LivingNumber of Beds
RCAC AL studio-shared 0 0 0 0RCAC AL studio-private * 51 34 40RCAC AL one-bedroom * 0 34 0RCAC AL two-bedroom * 0 0 0
Total RCAC AL Beds 75 51 68 40RCAC AL Square Footage:
RCAC AL studio-shared N/A N/A N/A N/ARCAC AL studio-private 300 * 481 400RCAC AL one-bedroom 600 N/A 630 N/ARCAC AL two-bedroom 1,000 N/A N/A N/A
RCAC AL Monthly Service Fees:RCAC AL studio-shared N/A N/A N/A N/ARCAC AL studio-private $2,700 $2,420 $3,800 $3,000RCAC AL one-bedroom $3,700 N/A $4,800 N/ARCAC AL two-bedroom $5,100 N/A N/A N/A
Occupancy Rate-RCAC AL 97.3% 76.5% 100.0% 85.0%Included in Monthly Service Fee:Meals 3 meals/day 3 meals/day 3 meals/day 3 meals/dayHousekeeping Weekly Weekly Weekly WeeklyLinen service Weekly Weekly Weekly WeeklyLaundry service Weekly Weekly Weekly WeeklyPersonal Care A la carte A la carte (1) A la carte A la carte
64
RCAC AL Competitor Detail
Source: Personal visits, phone interviews, and/or other research conducted in December 2019.Notes to Table:* = Unable to obtain information from the facility.N/A = Not applicable to this facility.River View Lodge(1) Care can go as high as $2,090 per month.
Brookdale Stevens Point Care Partners Maple Ridge of Plover North Crest North Haven North RidgeStreet Address 5625 Sandpiper Drive 3349 Whiting Avenue 2831 Maple Drive 2225 Eagle Summit 2301 Eagle Summit 2201 Eagle SummitCity/State/ZIP Code Stevens Point, WI 54481 Stevens Point, WI 54481 Plover, WI 54467 Stevens Point, WI 54482 Stevens Point, WI 54482 Stevens Point, WI 54482Owner/Sponsor Brookdale Senior Living Care Properties LLC Tanglewood Senior Living Copperleaf Care Copperleaf Care Copperleaf Care
Number of BedsCBRF AL studio-shared 0 8 0 4 4 0CBRF AL studio-private 0 24 18 23 18 24CBRF AL one-bedroom 0 0 0 0 0 0CBRF AL two-bedroom 0 0 0 0 0 0
Occupancy Rate-CBRF AL N/A 96.9% 94.4% 96.4% 100.0% 95.8%Occupancy Rate-MC 100.0% N/A 100.0% 96.4% 100.0% 95.8%Included in Monthly Service Fee:Meals 3 meals/day 3 meals/day 3 meals/day 3 meals/day 3 meals/day 3 meals/dayHousekeeping Weekly Weekly Weekly Weekly Weekly WeeklyLinen service Weekly Weekly Weekly Weekly Weekly WeeklyLaundry service-CBRF AL N/A Weekly Weekly Weekly Weekly WeeklyLaundry service-MC Weekly N/A Weekly Weekly Weekly WeeklyPersonal Care-CBRF AL N/A All inclusive A la carte Levels of care (2) Levels of care (1) Levels of care (1)
Personal Care-MC A la carte N/A A la carte Levels of care (3) Levels of care (2) Levels of care (2)
Whiting Whispering Pines Willow Brooke PointStreet Address 1800B Sherman Avenue 100 N Green Avenue 1902 Post Road 3380 Bridlewood Drive 1800 Bluebell LaneCity/State/ZIP Code Stevens Point, WI 53073 Stevens Point, WI 54481 Stevens Point, WI 54481 Plover, WI 54467 Stevens Point, WI 54481Owner/Sponsor
North Shore Healthcare Sylvan CrossingsWisconsin Illinois Senior
Housing Privately OwnedWillow Brooke Senior
LivingNumber of Beds
CBRF AL studio-shared * 4 8 0 0CBRF AL studio-private * 15 20 40 30CBRF AL one-bedroom 0 0 0 0 0CBRF AL two-bedroom 0 0 0 0 0
AL/MC Monthly Service Fees:CBRF AL studio-shared Waiver Waiver $2,570 N/A N/ACBRF AL studio-private $3,920 $3,800 $3,750-$4,500 $4,000 $3,450 CBRF AL one-bedroom N/A N/A N/A N/A N/ACBRF AL two-bedroom N/A N/A N/A N/A N/AMC studio-shared N/A N/A N/A N/A N/AMC studio-private N/A N/A N/A N/A $3,450 MC one-bedroom N/A N/A N/A N/A N/A
Occupancy Rate-CBRF AL 89.7% 94.7% 92.9% 100.0% 96.7%Occupancy Rate-MC N/A N/A N/A N/A 100.0%Included in Monthly Service Fee:Meals 3 meals/day 3 meals/day 3 meals/day 3 meals/day 3 meals/dayHousekeeping Weekly Weekly Daily Weekly WeeklyLinen service Weekly Weekly Weekly Weekly WeeklyLaundry service-CBRF AL Weekly Weekly Weekly Weekly WeeklyLaundry service-MC N/A N/A N/A N/A WeeklyPersonal Care-CBRF AL Levels of care (1) Levels of care (1) Levels of care (1) Levels of care (1) Based on assessmentPersonal Care-MC N/A N/A N/A N/A Based on assessment
North Crest(1) There are 27 secured beds that can be used for assisted living or memory care. (2) There are three levels of care, the first of which is required and included in the rents shown. Additional levels are priced at $1,000 and $2,000 per month.(3) There are three levels of care, the first two of which are required for memory care and included in the rents shown. The additional level is $2,000 per month.North Haven(1) There are 22 secured beds that can be used for assisted living or memory care. (2) There are three levels of care, the first of which is required and included in the rents shown. Additional levels are priced at $1,000 and $2,000 per month.(3) There are three levels of care, the first two of which are required for memory care and included in the rents shown. The additional level is $2,000 per month.North Ridge(1) There are 24 secured beds that can be used for assisted living or memory care. (2) There are three levels of care, the first of which is required and included in the rents shown. Additional levels are priced at $1,000 and $2,000 per month.(3) There are three levels of care, the first two of which are required for memory care and included in the rents shown. The additional level is $2,000 per month.Point Manor Assisted Living(1) There are four levels of care, none of which are required or included in the rents shown. Levels of care are priced at: $340, $830, $1,320, and $2,000 per month.Sylvan Crossings of Stevens Point(1) There are levels of care ranging up to $2,797 per month. The average level of care is $819 per resident.Wellington Place at Whiting
Whispering Pines(1) There are four levels of care, none of which are required or included in the rents shown. Levels of care are priced at: $500, $1,000, $1,500 and $2,000 per month.
(1) There are seven levels of care, none of which are required or included in the rents shown. Levels of care are priced at: $275, $390, $500, $728, $950, $1,100, and $1,250 per month.
MC = Memory Care
Source: Personal visits, phone interviews, and/or other research conducted in December 2019.Notes to Table:* = Unable to obtain information from the facility.N/A = Not applicable to this facility.