2019 Summer 55+ News – www.BeachChatter.com

Remodels for Aging in Place

Every year the National Association of Home Builders (NAHB) conducts a broad survey of professionals involved in the housing industry. The results of that survey are published as the Remodelling Market Index (RMI). Among other data collected are details about the improvements made by seniors who plan to live in their current home as long as possible.

The ‘Aging-In-Place’ data includes how many professional remodelers do it, how many of their customers are receptive to it and what kinds of projects are completed. Using data from NAHB’s RMI survey for the 4th quarter of 2018, we look now at some of the specific types of Aging-in-Place projects undertaken last year.

It probably comes as little surprise to most readers that bathroom projects dominated the top spots. Over 80 percent of remodelers who answered the question reported installing grab bars, higher toilets and curb-less showers. The next-most-common project on the list, widening doorways, followed at a considerable distance (59 percent).

Much like the relationship between bathtubs and showers in general, walk-in bathtubs are not nearly as desired as curb-less showers. Only 12 percent of remodelers reported installing walk-in tubs in 2018, and only two of the 14 projects on the Aging-in-Place list were less desirable: lowering kitchen cabinets and lowering countertops.

When NAHB began asking Aging-in-Place remodeling questions in 2004, curb-less showers were about as common as wider doorways. But over the years the share of NAHB remodelers installing curb-less showers has grown, from 54 to 82 percent. Requests for curb-less showers are now nearly as common as higher toilets—even though installing higher toilets also reached an all-time high of 85 percent in 2018, up from 68 percent in 2004.

When the RMI questionnaire expanded in 2006, it started asking remodelers about reasons their customers undertake Aging-in-Place projects. Since that time “planning ahead for future needs” has consistently ranked as the most common motivation, cited by 75 percent of remodelers in 2006, and up to a record 86 percent in 2018.

“Acute age related disabilities” and “non-age disabilities” were also higher than ever in 2018, at 51 and 27 percent, respectively. This is only a 1 to 2 percentage point gain over their previous peaks, however.

Meanwhile, the share of remodelers citing “living with older parents” as a motivation has tended to drift downward over time, from over 50 percent in 2006 and 2007, to under 45 percent in 2016 and 2018.

For further results and more detail on the Aging-in-Place questions in NAHB’s RMI survey, the complete report may be found at http://eyeonhousing.org/wp-content/uploads/2019/05/RMI-2018-Q4.pdf.

New Horizons

For this issue we visit a couple who live in one of the original 55+ communities in the South Bay. The 600 homes in New Horizons were built in the early sixties. Most units have seen some remodelling, while a few have been extensively redone.

The basic units come in three configurations. The two story structures comprising the two most common, with single level ‘A’ units on the ground floor, and single level ‘B’ units upstairs. There are 237 each of the ‘A’ and ‘B’ units in that configuration.

Here an owner has installed a lift chair on the external stair of a two story building.

The two story buildings have downstairs units with essentially no stairs, and a nice patio, frequently enclosed in a wooden fence. The upstairs units have a large balcony off the living room.

New Horizon’s single story, ground level bungalows are highly sought after.

The third style is the highly sought-after bungalow with a total of 126 units. Each ground level building has three units, most in a staggered pattern to minimize shared walls.

Approximately 400 of the 600 units are identified as occupied by the owners. In many cases the official ownership record reflects the names of future heirs. Some units are occupied by seniors, but owned by investors, and we’ve found that often neighboring seniors will purchase available units for their own investment portfolio.

For this visit to New Horizons we’re talking to DeeDee and Arlo (names have been changed) who live in an upper story unit in one of the two story buildings.

Q1: How long have you lived here?
DD: “We bought here seven years ago. It was just what we were looking for. The owner had done a lot of upgrades, so we have dual pane windows & patio doors, and tile floors. A lot of things other units don’t have.“

Dining area with custom tile adjacent to kitchen.

Q2: Is it your first time living in a condominium?
DD: “We’ve both lived in an apartment before. This isn’t much different, except for involvement in the association. I was on a committee for a while, but it was too much. After I retire, I’ll get more involved … maybe.“

Wide and deep balconies offer immediately accessible outdoor space in addition to large units.

Q3: Have you made new friends here?
DD: “Lots of them! We’re friends with just about everyone in our building and the one facing us.”
AR: “It’s like a little Mayberry here. Everyone knows everyone and everything that’s going on. It’s really nice because the neighbors are very watchful. We know when there’s a stranger around, or a wild animal comes visiting.“

Q4: Have friends from your old neighborhood come to visit? What did they have to say about your new home?
DD: “We’ve had old friends come by regularly. There’ve been many family birthdays, and even super bowl parties! Everyone likes it. It’s much bigger than most condos.”

The New Horizons golf course has a gorgeous water trap!

Q5: Obviously there are things you like and some you don’t care for. What is your favorite part of living here?
DD: “I play Bunko every second Tuesday. It’s fun and I’ve met a lot of new people–mostly ladies–that way.”
AR: “I love the green. Everywhere you look there’s grass, trees, planters, and things growing. The golf course is especially nice with the lake and fountains.“
DD: “We’re not at the beach, but being upstairs we get a nice cross-breeze. We wanted to be upstairs because of the extra light coming in and the upstairs units all have attic storage.“

Custom built barbeque for al fresco dining on the grounds.

Q6: 55+ communities vary considerably in the amenities provided. What does the association provide that you like most?
AR: “We haven’t even tried everything. There’s a gym with showers, a wood shop with all kinds of tools, and a pottery shop with a kiln. There’s a pool and hot tub here, bocce ball, and a bigger pool over by the recreation center. The rec center has ping pong, pool tables, card rooms, a meeting room with a stage and audio/visual equipment. There’s even a library.“
DD: “The association cares for the owners. One of our neighbors needed a lift chair to get upstairs to the second level. The HOA was totally cooperative.”

The grounds are among the most opulent in the South Bay.

Q7: How about the things you like least. What would those be?
AR: “There are all the usual things about living with other people–the gossip, pettiness, and perpetual complainers.”
DD: “The garages are shared, and you can’t really store anything in them.”
AR: “Guests and delivery people have a hard time finding addresses. I usually have to go out to guide them in because there’s a combination of block numbers, building numbers, street addresses and unit numbers.“

Q8: What are your plans for the future?
AR: “For right now, we’re staying right here. We’ve talked about moving to Temecula, but haven’t looked into it.”
DD: “We could swap to an inexpensive house there, but we really like being close to the beach and near family and friends.“

When Is Assisted Living “In-Home Health Care?”

Last year the Centers for Medicare & Medicaid Services (CMS) expanded how it defines many of the “primarily health-related” benefits that insurers are allowed to include in their Medicare Advantage (MA) policies. Air conditioners for people with asthma, healthy groceries, rides to medical appointments and home-delivered meals are among the new benefits now being considered for coverage by insurers. More importantly, insurers are now allowed to cover non-skilled in-home care starting this year.

Assisted living providers often provide this type of care, such as helping residents with bathing and dressing. Thus, the CMS change opened up the possibility that insurance dollars could start flowing to senior housing and care companies. Analysts already envision major MA insurers buying into senior housing companies to maximize profits.

Technically, the Assisted Living facility is your home,
so “home health care” benefits should apply.

Only a handful of insurance companies are offering any new benefits in 2019. Among them, Long Beach, California-based SCAN, announced its “Returning to Home” and “Home Advantage” offerings in mid-November. SCAN was able to quickly add new supplemental home care benefits because it has covered similar services in the past

To provide these benefits, SCAN already has contracts in place with home care agencies. According to SCAN executives, it’s possible SCAN would contract directly with an independent living or assisted living company if it has caregivers on staff, and residents signed up for these new plan offerings.

It’s possible a retiree will have health care
provided by a medical organization
owned by the insurer. Would that be
considered a conflict of interest?

Both SCAN and Anthem, another major player in the MA arena, have indicated they are open to contracting with senior living providers or otherwise forging partnerships with them. We can expect a variety of differing relationships between insurers and providers as best practices are devised.

As insurance companies create their benefits packages and consider potential senior living moves, some senior living providers are looking at ways to add MA policies to the 55+ living packages they offer.

Sunrise Senior Living has a newly established plan called Sunrise Advantage which is currently offered in four states (California is not included). The Sunrise plan replaces the insurance company that normally comes in between the health provider and Medicare. Physician referrals to Sunrise are up 300% since Sunrise Advantage launched, per Sunrise executives.

Should we allow the health industry,
providers or insurers, to engage in monopoly?

Senior living providers like Sunrise, who create their own plans can tap into the new supplemental benefits as well as more well-established options. The changes promise to add bottom-line value for the senior living business, while enhancing residents’ outcomes and reducing some of their expenses.

Many Medicare Advantage plans already offer some health benefits not covered by traditional Medicare, such as eyeglasses, hearing aids, dental care and gym memberships. The new rules, developed with industry input, expands that significantly to items and services not directly considered medical treatment.

CMS said the insurers will be permitted to provide care and devices that prevent or treat illness or injuries, compensate for physical impairments, address the psychological effects of illness or injuries, or reduce emergency medical care.

The changes were adopted late in 2018, so many insurers are still designing their modifications, and many changes will come in 2020. Some health insurance experts said additional benefits could include modifications in beneficiaries’ homes, such as installing grab bars in the bathroom, or aides to help with daily activities, including dressing, eating and other personal care needs.

Even though a physician’s order or prescription is not necessary, the new benefits must be “medically appropriate” and recommended by a licensed health care provider, according to the new rules.