Little did they know or care at the time, but the procreatively inspired World War II generation shaped one of the fastest-growing industries in Westchester when they gave birth to their baby-boomer offspring. Those boomers are now oldsters, retiring from the workforce, dealing with health issues and adjusting accordingly where and how they live. That has made eldercare, which encompasses everything from home-health and companion care to nursing homes and hospice services, a burgeoning sector in the county’s economy — and it’s likely to grow even more in the future.
Driving that growth, of course, is the aging of our population. Since 1960, the number of Westchester residents aged 65 and older has grown at nearly twice the rate of the rest of the population. The 2010 census showed that group representing almost 15 percent of the county’s total population, a number projected to rise to nearly 19 percent by 2040. Those same projections, by the way, show population declines for 5-to-14- and 25-to-64-year-olds.
Like any growing market, eldercare is attracting a wealth of new businesses eager to tap into it. And the growth has spurred change among institutions that have served in eldercare for decades. “We have diversified from our original mission, to include many levels of care,” explains Rita Mabli, president and CEO of United Hebrew of New Rochelle. “People are simply living longer, and they have more health issues. Coincident with that, they need more care.”
United Hebrew today cares for more than 800 people every day, including residents, home-based clientele, assisted-living and nursing-facility patients, as well as short-term rehab patients.
Independent seniors can live in two fully occupied apartment houses at United Hebrew, both of which have a two- to three-year waiting list. “We also just opened the only free-standing memory-care pavilion for assisted living in Westchester,” Mabli reports. “Our original memory-care unit kept incurring a waiting list, so we built Willow Gardens.”
Persons reaching age 65 now have an average life expectancy of an additional 19.2 years, according to the US Department of Health and Human Services, and most of them have at least one chronic condition. That’s one big reason healthcare has grown to become Westchester’s largest employer.
Those chronic conditions also challenge eldercare providers, says Matt Anderson, president and CEO of The Osborn in Rye, who points to “the increasing level of illness, often multiple conditions, which so many [elderly] are dealing with.” The Osborn, which is home to 435 residents on its lush 56-acre campus, serves an additional 500 clients through short-term and outpatient rehab and provides 12,000 hours of home care each week.
“The increasing number of seniors, and with that, the increasing number of people with Alzheimer’s and other forms of dementia,” he adds, will challenge institutions well into the future. (According to the Alzheimer’s Association, the number of Americans living with the affliction is expected to triple by 2050.) “At The Osborn, we have a dedicated care wing, the H.O.P.E. Center, as well as services available for people at varying stages of dementia.”
Along the spectrum of eldercare are multiple business opportunities. Home care is an increasingly growing part of the business, since it has a relatively low cost of entry for new operators, is fairly scalable, and fits well into Medicare’s long-term goal of treating more seniors at home. That’s one big reason it’s the fastest-growing franchise opportunity in the country, as reported by the Wall Street Journal.
Local entrepreneur Vincent McMahon opened a First Light Home Care franchise in Mount Kisco in 2012. His 80 to 100 aides provide help with the activities of daily living that often become more difficult as a person ages. “Most of our clients are in their 80s and older,” he explains.
The NYS Department of Health has 319 listings for agencies licensed to provide home-care services in Westchester, 86 of which are located in the county. Competition is a big hurdle, but according to McMahon “the bigger hurdle is finding quality aides and caregivers.”
Another growth segment in the industry is luxury assisted-living. There are currently more than 30 licensed assisted-living communities in the county, with many more on the way. One of the newest is The Ambassador in Scarsdale, a $45 million development with 95 apartments for assisted living, plus 22 for memory care. It reached full occupancy less than one year after opening in 2015, according to general manager Jean Dunphy.
At The Ambassador, a studio apartment with base services starts at $7,000 per month; rates run up to $15,000 for full services, like bathing, dressing, medication management, and escorting to activities. The Alzheimer’s program (at $10,000 per month) has a wait list.
Steven Krieger, partner at The Engel Burman Group, which owns and manages The Bristal Assisted Living communities, which includes locations in Armonk and White Plains, points to home values as an underlying economic reason the luxury assisted-living segment is growing so rapidly in Westchester. “With median home values rising, most people [who sold homes in which they had built a lot of equity] could afford to move to an assisted-living community like ours,” he explains.
Aging Westchester = Growing Eldercare Market |
Krieger also notes: “People are generally coming to live at The Bristal at an older age. Right now, the average age of a new resident is 87 years old. To put that into perspective, the average age was 82 when we opened our first community in 2000.”
The segment of the industry that’s floundering is the nursing-home business. The county has 45 of them, but they’re being squeezed by Medicare, Medicaid, and private insurance companies to shorten patient stays and convert to a managed-care model of payment, resulting in several sales and mergers, as well as conversions from nonprofit to for-profit operations. St. John’s Riverside Hospital in Yonkers, the Hebrew Hospital Home in Valhalla, and Fieldhome in Cortlandt Manor have all been impacted by these changes.
“The for-profits are buying up the nonprofits in our industry like crazy,” confirms United Hebrew’s Mabli.
The Wartburg in Mount Vernon represents the other end of the success spectrum. The full-service continuing-care orga-nization celebrated its 150th anniversary this year and opened a new outpatient rehabilitation clinic in its $31 million, 75,000 sq ft rehab and adult day-services center. The 34-acre campus also includes market-rate and affordable senior housing, post-acute nursing care, memory care, and home-care services.
CEO David Gentner says the organization’s eyes are firmly fixed on the future. “As we look ahead, we will provide services to populations who live as independently as possible for as long as possible.”
He also expects to make a significant announcement about a new facility to be built on the Wartburg campus early next year that will appeal to the middle market. “When we look ahead to the future of independent housing, we’re going to focus on the middle-income boomer. It’s easy to see the appeal of very high-end retirement communities for the five-percenters who can afford it, but we’re looking more to the moderate middle market.”
Other Westchester eldercare developers have busy drawing boards, too. Purchase College has announced plans to build a 385-unit senior community on its campus in partnership with Life Care Services and Senior Care Development LLC. Artis Senior Living has proposed a 72-bed memory-care facility in Hastings-on-Hudson, while Capital Seniors Housing is negotiating to build a 101-unit senior-housing facility on the former site of Frank’s Nursery & Crafts in Greenburgh. A 16-acre property that once housed Good Counsel High School and Academy in White Plains has been purchased by George Comfort & Sons, who are planning to turn it into a mix of family, senior, and dorm-style housing.
But not every development is welcomed with open arms. A group of residents this year filed a challenge in state court to a Maryland developer’s plan to build 160 units of senior housing on the site of a former rock quarry in West Harrison. Brightview Senior Living, the developer, operates 35 similar facilities, including one in Tarrytown.
Eldercare in Westchester is a thriving industry driven by favorable demographics and economics. The service-heavy industry is not all dollars and cents, though, according to The Ambassador’s Jean Dunphy. “If the hands that provide the care are not kind, and the administration doesn’t see it as a service business, then all you have is a hotel with services.”
Freelancer writer Dave Donelson is a frequent contributor to 914INC.