Housing allows aging in place
While getting into the family nursing home business Doug Cyr prefers to avoid, the 28-year-old has embraced the role of managing another family venture that’s filling a need for senior citizens housing.
Cyr recently purchased the Leisure Gardens and Leisure Village retirement apartments in Presque Isle from his grandfather, Albert Cyr, who turns 86 in October and has owned the Caribou and Presque Isle rehabilitation and nursing centers since the 1970s.
“The demand is increasing,” Doug Cyr said of the interest in the 137-apartment community. “We will be growing one way or another.”
Albert Cyr and more recently his children, have run the two nursing care facilities for decades, after he left the potato farming business in Hamlin. But Phil Cyr, one of Albert’s six children and the administrator of the Caribou center, said the future is uncertain.
“Family operations like ours are a dying breed,” Phil Cyr said.
The nursing centers are turning a small profit – $40,000 on $10 million of revenue – but the government’s payments and the scope and complexity of regulations have put the independent nursing homes on an unsustainable financial path, he said. They’ve considered selling the businesses before but have never gone through with it.
“I meet the families of my residents at the grocery store and I need to be able to look them in the eye and feel that they are happy with mom’s service.”
Phil Cyr’s own mom has dementia and is a long-term resident of the Leisure Gardens with her husband, Albert Cyr, who also maintains a small home down the street.
Phil, 61, said that “while the federal government’s payment (Medicare) for short-term rehab and skilled care has been acceptable, the state payment (Medicaid/MaineCare) has not covered the cost of services for long-term care.”
Over the past decade in particular, Cyr said, “nursing homes saw very small annual increases, which didn’t keep pace with inflation. Around 2012, we were getting paid based on what we spent based on 2007. The core of the problem is neither level of government has planned for the increasing demand (more elderly) and are trying to make up for their lack of planning by paying service providers less per person.”
On average nursing homes cost more than $8,000 per patient per month. “One of the reasons it costs so much is because of the government requirements,” Cyr said. “We have lots of very highly paid nurses who push paper every day to please the government.”
While there continues to be a need for skilled nursing and rehabilitation care, the model of Leisure Gardens remains a bright opportunity that Doug Cyr is excited about — a largely free market business that can help seniors age in place.
Albert Cyr opened the independent and assisted living apartments in 1986 and quickly filled them up, offering a new housing option at the same time that the use of nursing homes among some elderly was being re-evaluated by the government.
“The state of Maine decided in 1994 that they were too dependent on nursing homes for senior care and changed the definition of who they would pay for,” Phil Cyr said. “They essentially told the healthier half to move out, go back to your home and get home care or go to a boarding home.”
Leisure Gardens offered apartments, drawing people still driving in their late 70s or early 80s, as well as some of the “healthier half” of former nursing home residents – to whom Cyr also offered home health care services through the Visiting Nurses of Aroostook, which allowed the residents to use their Medicare home health benefits.
“There was a period of time when Leisure Garden tenants were receiving five hours of care per day from home care nursing staff, which was about equal to what they were receiving at the nursing home. The cost for this care at Leisure Gardens, including rent, meals, etc. was one-third less than what it was costing the government at the nursing home,” Phil Cyr said.
“That clearly showed how regulations add to costs.”
Albert Cyr described the business as “I have an apartment complex with a home care agency that never leaves the building,” Phil Cyr said. “The state didn’t like that he was doing assisted living, for which they didn’t have a license, and thereby the state couldn’t control it as they like to do.”
Eventually the State developed an assisted living facility license and pressured Leisure Gardens to get licensed — which Albert Cyr did not want, fearing it would drive up costs.
Leisure Gardens eventually stopped offering the home health services in the 1990s, and today offers personal care services, while residents can also bring in home health and nursing services from any community agency.
“This is their home,” Doug Cyr said. “Any service that can come to your house can also come here.”
The apartment complex takes private payments, with some residents receiving assistance
through Elder Independence of Maine, and rent starts at $700 per month for a 300-square-foot
studio, including a kitchen and bathroom, all utilities and cable television.
“You can move in here completely healthy and have no services and as your health declines, you can hire assistance in house or hire home care nurses,” Phil Cyr said.
The Leisure Gardens model allows seniors to age in place and also incentivizes them to stay independent as they get older through its pay-as-you-go personal services.
“If you have to request assistance to put your shirt on, and you know that every time you call for help it’s going to cost you $5, you’re going to put your own shirt on longer than if you didn’t have to pay,” Phil said. “Your wallet encourages your continued independence.”
