Problem & Solution
Problem Worth Solving
There is a lack of full-time assisted living facilities available that offer skilled and respectful care to residents. In addition, there are not enough medically skilled short-term care facilities for patients in CT.
Bright House aims to be that home for 14 lucky full-time assisted living residents, offering medically-skilled care in a respectful, self-sustaining community, and offering skilled nursing care for short-term residents. On our beautiful, newly remodeled 6 acre property (the former Wayfield Bed and Breakfast) in the small college town of Middletown, CT, Bright House brings together decades of experience and innovative, alternative visions of the potential in our elderly family members’ latest years.
Market Size & Segments
We are basing our Market Analysis on data from Middlesex and Hartford counties, affluent portions of which, such as Glastonbury, are within a short drive of our facility.
Base Numbers for private residents:
The current total population of residents 65 and older, according to the 2000 U.S. Census, is 155,071 in Middlesex County, and 857,183 for the same group in nearby Hartford County. (The percentage of elderly in both counties is slightly higher than the 12.4% of the overall Connecticut population.) Our projections reduce that number by 70% to account for those healthy enough to care for themselves, or with family members able to care for them, leaving us with a total potential market of 303,676. We then reduce that number again by half to get the total potential customers living within a 35 minute drive of Middletown (these are small counties, and we are situated at their juncture), leaving us with 151,838. Of these, we estimate roughly 8.5% will have the means ($150,000 or more family income) to pay for full-time private care at our facility (based on the 2000 census data about Connecticut income).
This leaves us with roughly 12,906 nearby upper-income residents of Hartford and Middlesex County who are 65 or older, and in need of medical or other daily assistance in their living situation. To project into the future, we again looked to the 2000 Census. The Census’ Projected Population of Connecticut is as follows:
While the overall population of Connecticut is projected to decline over the next five years, before rising again, we know that the proportion of the overall population age 75 and older (our target market age) is slowly rising. We therefore include a modest projected increase in potential customers of 1% over the next five years.
Medicare residents and short stays:
A study published recently in the journal Health Affairs by Morrissey, Sloan, and Valvona found that the proportion of Medicare patients transferred to post-hospital care has doubled since the Prospective Payment System (PPS) was introduced. Rather than staying in the hospital until recuperated, the current system preferentially delegates recovery care to private non-hospital facilities, leaving room in hospitals for urgent or crisis care. We base our projections for Medicare residents on the same figures listed above, but looking at the percentage of elderly with family incomes between $30,000 and $75,000 dollars,* rather than just the highest bracket, we get 40% of the population, or 60,735. We apply the same conservative 1% growth rate, below.
This income range was chosen because it correlates with the kind of higher education levels that most families choosing non-hospital model skilled nursing care report. Although residents with lower incomes may have a need for our service, they are traditionally less likely to seek out alternative care.
Although we have broken our target population into two groups based on income, our marketing strategies rely on another level of breakdown—marketing to potential residents, and marketing to the families of potential residents, who may or may not have similar needs.
Target Market Segment Strategy
The overall populations we wish to serve are older people (65 and older), in need of daily assistance, who value community and the contributions of their peers. Since Bright House will become their home, we especially are seeking residents willing to make this house a home, and learn from and teach each other.
We also recognize that we must meet the somewhat different needs of our residents’ families, who will help them make the decision to live with us, or recuperate here, and who will almost certainly be contributing to the monthly payments necessary to provide for their care.
Alternatives and Usage Patterns
Families choose one elder care facility over another for a variety of reasons. The most common issues involved in their decision are distance from their home(s), affordability, quality of staff and facilities, and particular medical specialties necessary for their family member. Families will usually choose the highest level of care affordable within 45 minutes to one hour of their homes, in order to make visiting their family member easier.
The following three organizations are representative of the types described above:
Fox Hill Center, Rockville
- For-profit, part of a chain
- 3.37 nursing staff hours/resident day
- 150 beds (not 150 rooms)
- 11 deficiencies in Medicare inspection
Fox Hill Center is typical of the hospital-model nursing home. It is large (150 beds), for-profit, and has a fairly low rate of nursing hours per resident day. Its size makes it able to care for many patients, but often at the expense of individual attention.
Sister Anne Virginie Grimes Health Center, New Haven
- Nonprofit, religious based, located in a hospital
- 4.16 nh/rd
- 125 beds
- 3 deficiencies
The Grimes Health Center, like many religious care centers, is nonprofit, and has a slightly higher rate of nursing hours per resident day than the for-profit centers, despite its large size. Quality of care, however, is noticeably higher (3 deficiencies in inspection, compared to 11 at Fox Hill).
Leeway, Inc., New Haven
- 5.04 nh/rd
- 40 beds
- 4 deficiencies
Leeway is a typical specialized private (not in a hospital) nonprofit care facility. It is much smaller than the other two described, has the highest rate of nursing care per resident day, and high quality marks in inspection. Its small size and nonprofit status allow it to focus on providing individual attention. Leeway is Connecticut’s first and only skilled nursing home dedicated solely to the treatment of people living with AIDS.
Although the hospital model of care practiced in most nursing homes provides good results for Medicaid and Medicare billing purposes—that is, easily quantifiable lists of procedures and medicines administered, test results, and billable nursing hours—it does not provide good quality of life for residents (or "patients," as they are referred to in the hospital model).
At Bright House, we see a different way of assisting our elderly members through a new stage in their lives. Acknowledging that where they live is their home, and belongs to them, not to the medical staff, we have established a facility that not only meets their medical and physical needs, but one that also nourishes their social connections, individual dignity, and personal preferences. Each resident has a private room with bath, opening onto a central shared common area containing the kitchen, living room, and dining room, where all meals are shared communally at our 15 foot farm-style dining table.
Far more devastating than physical illness to our elders, is lack of purpose. Studies have shown over and over that seniors who are engaged in activities they find meaningful are far more likely to retain mental acuity, physical health, and emotional well-being. Although the hospital model tries to provide such stimulation, its "activities" are usually organized by staff, with little or no input from "patients," and become just one more set of required tasks for all involved. At Bright House, we have already begun working with prospective residents to identify areas of interest and methods of community involvement that will appeal to them.
Keys to Success
Keys to Success
We have identified four keys to success for Bright House:
- We offer more resident-oriented, small-scale, home-model care than our competitors;
- Our innovative use of Elder Assistants lowers the cost of providing this care considerably;
- Our fair wages and team structure lower dissatisfaction, and thus turnover rates among our staff;
- Our on-site Skilled Nursing Facility ensures continuity of care when our residents need more intensive assistance.