Small Town Seniors

Limited Care Options

By Cutright Elizabeth on Jun 24, 2016 in News

With over 20% of older Americans living outside major cities, rural senior living providers face unique challenges and untapped opportunity

In small towns across the country, senior citizens face a trio of challenges as they transition into retirement: lower than average incomes, few housing options, and a shortage of services. As aging baby boomers put even greater strain on senior living services, rural communities throughout the United States will have to act quickly to meet demand.

Small, Expensive and Rare

According to a 2014 survey by the Housing Assistance Council (HAC) entitled Housing and Aging Rural America: Rural Seniors and Their Homes, nearly one-quarter of US seniors live in rural communities. Unfortunately, for older adults residing outside of the nations’ urban centers, senior housing options are slim to nonexistent. Additionally, the standard of care available doesn’t always compare to what’s offered in suburban and urban areas. Even in situations where facilities exist, most are too expensive because incomes are usually much lower outside larger municipalities.

“Much of the affordable-housing stock in rural housing areas is old and in need of repair, says Sheila Crowley, president of the National Low-Income Housing Coalition. “Many of the people who live there don’t have the resources that they need in order to keep the houses in good repair,”

“A rapidly aging population will significantly impact nearly all aspects of the nation’s social, economic, and housing systems,” note the authors of HAC’s report. “With the scope and magnitude of the looming demographic shift of seniors, rural communities will need to develop a range of housing options available to seniors such as more rental housing, rehabilitation and repair programs, housing with services, and assisted living.”

Filling the Void

Where HAC highlights the challenges of rural development, Jane Adler sees opportunity. Writing for Seniors Housing Business, Adler writes, “While the big markets get the lion’s share of attention, some senior living contrarians are finding success in small places.”

“Often overlooked by large companies, small and rural markets lack a variety of basic services for seniors, which can create opportunities for owners and operators willing to take the risk.”

The risks Adler alludes to are not insignificant. Investors planning to build a rural facility face lack of resources and little government support. In a recent article in the Atlantic, David Dangler, the director of Rural Initiatives at NeighborWorks America, explains the situation facing many senior living providers contemplating a rural project.

“Developers can’t count on any kind of municipal infrastructure to help them,” says Dangler. “When it comes to building, things that are often taken for granted in more urban areas, like water, sewers, and even access to quality roads, aren’t guaranteed, which can make building a quality house much more challenging.”

Additionally, there’s often little in the way of funding for new or restored properties. “There’s a handful of programs that serve people in rural communities,” says Crowley says in that same Atlantic article.

“They tend to be much smaller in scale in terms of the amount of money than the HUD programs. They also tend to be lost in the bureaucracy.”

Community Connections

HAC’s report also reveals that home ownership among seniors in rural areas is significant. Older adults often choose to buy rather than rent because there are few rental opportunities available and property values are usually more affordable outside the city limits. Because they own their own home, rural seniors are also much more adamant about aging in place. This means rural operators should focus on community connections when appeal to prospects.

“Location, size and design of product are key to success in small markets,” writes Adler. “Operators [should] emphasize the importance of becoming part of the broader community.”

Adler also points out that local residents may need extra coaching and outreach when a facility first opens in their midst.

“A challenging is education the community about the concept of senior living,” she explains. “Local residents may not have had the experience with the product.”

The Tech Advantage

Because rural areas often lack a pre-established senior living market, providers interested in developing a care facility have one major asset on their side: technology. As Adler explains, “small and rural market operators are on the cutting edge of experiments in new healthcare delivery models.”

“Small towns often have fewer medical resources, creating an opportunity for senior living providers to step in and fill the gap.”

Because resources like hospitals and pharmacies can be several miles away, perhaps even located in neighboring townships, centralized medical records and a streamlined software platform like Yardi Senior Living® provide rural senior living facilities with the ability to provide immediate and responsive care to residents.

“The cost of new technology may be an obstacle,” admits Adler, but the senior living operators she interviewed agree the payback is worth it by reducing time spent on paperwork and connecting operations with sales, marketing, and inventory control.

As Adler explains, the use of Electronic Health records and point-of-care systems to track medications and services, allows rural facilities to provide “the same capabilities as operators of big markets.”

Meeting Demand

It’s an undisputed fact that the senior living industry faces a sea of change over the next few years as the baby boomer generation heads towards retirement. While many cities and wealthy suburban enclaves have sufficient resources to meet this increased demand, rural communities are lagging far behind.

“The senior population is growing at an unprecedented rate, and rural regions account for a significant portion of this population,” the HAC report concludes.

“The availability of decent and affordable housing is essential to the health and the well-being of older Americans. The issues, concerns, and trends in this report highlight the importance of providing options and assistance for rural seniors. The impacts of these issues play a considerable role in their quality of life and cannot be overemphasized.”

Or as Jim King, the president of Fahe, a nonprofit housing organization that serves Appalachia, tells the Atlantic, “The stakes are very high in rural places if we don’t figure some stuff out. People and places shouldn’t be disposable.”