A new continuing care retirement community (CCRC) is currently under construction in the City of Hope located in a growing area of southern Florida. This is a growing area of the state with a population within 30 miles of the new community of 1.25 million people. Because of the low taxes and mild climate, it has become a very popular retirement destination. Currently, about 32 % of the population is over age 60 and the number of retirees seems to be increasing monthly. The average household income in this area is $102,000 which is much higher than the national average. This community was started by a very generous donation of $ 5 million from the estate of Mrs. Logan who had retired to this area of Florida and spent her last year of life in a nursing home. Because her mother had a bad experience, her son wanted to use some of the proceeds from her estate to open a CCRC where residents could stay in familiar surroundings and age in place.
With the donation, an operator was found with experience in the development and operation of long term care facilities within the continuum. The developer has just hired you as the new Executive Director of this community. You were selected because of your 15 years of experience in this industry and your master’s degree in health care administration from UMUC. You also met the requirements because you are a licensed nursing home administrator in the state of Florida.
This new community is going to be operated as a for-profit corporation under the guidance of a 10 member board of trustees. The project is scheduled to have a luxury apartment complex with 150 one bedroom apartments for seniors who are able to live independently. These apartments will cost about $ 1000 a month in rent and provide excellent security with a concierge around the clock and will also have a van with a driver to transport the residents for shopping and entertainment. Because of the growth of the senior population, it is anticipated that these units will be fully occupied within six months of opening. Residents will use their personal income to pay for these apartments and they can leave without penalty after their lease of one year is complete.
There will be a second building on this campus which will house 50 Assisted Living Apartments for residents who require significant assistance with their Activities of Daily Living. The Assisted Living Area will have apartments without kitchens that open to a central living area and community dining room. Nursing staff will be onsite 24 hours a day and licensed nurses will monitor and oversee the administration of medications for these patients. Residents will pay $2000 a month each to utilize these services. On the other side of the building connected by a central atrium, a 50 bed nursing home will be located. This nursing home is projected to charge $9,000 per month. The owner has projected that 50 % of these costs will be covered by Medicare Reimbursement and 50% will be covered by private pay. Based on your experience, you are certain that the facility should plan for a payer mix as follows: 50% Medicare or other insurance, 20% private pay and 30% Medicaid. Because of the demographic in the area, you are comfortable with market projections that indicate that both the Assisted Living Facility and the Nursing Home should be at 90 % capacity at the end of the first year of operation. Based on market projections, the other nursing facilities are at capacity and the largest provider just had some very negative press due to significant life safety violations cited when residents had to be evacuated because their air conditioning system failed and could not be repaired timely.
As the new Executive Director, the Board Chairman asks that you prepare a budget for the first year of operation and provide a projection on when the CCRC will achieve profitability.
Case Study Questions:
1. Prepare a budget for the first year of operation assuming that the CCRC will be fully open as of January 1st. Please make assumptions where you do not specific facts as you will be evaluated based on the logic and realism of your assumptions. Please make sure to consider staffing costs, revenue and overhead expenses.
2. Identify within your operating budget what key positions that you would need to hire for this new venture.
3. A part of your presentation to the Board, provide feedback to them regarding whether you believe that profitability can be achieved within one year and your rationale.
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