More Providers See CCRC-At-Home Models As The Right Offering For Middle-Class Consumers

Ten years ago, Lisa Hoffman — the executive director of Pathstones by Phoebe — asked a room of 400 senior living executives and employees a question. She’s still shocked by the answers today.

“How many of you,” Hoffman asked, “would move into your community?”

Ten people raised their hands.


“That was very revealing to me,” Hoffman said during a panel at LeadingAge’s annual conference this month. “People in the industry were essentially saying they would not want to move into their community. That was one of the early indicators to me that we have a very high percentage of people wanting to stay at home for as long as possible.”

The Pennsylvania-based Pathstones by Phoebe is a home-based continuing care retirement community, otherwise known as a CCRC.

CCRCs — sometimes known as life plan communities — are long-term care living situations that allow seniors to age in the same place during their advanced years through an all-encompassing approach.


These models — especially in a post-pandemic world — offer seniors flexibility in the way they age in place.

“It’s not like a brick and mortar, it’s much more fluid,” Hoffman said. “And we’ve been able to evolve over the years and kind of pick and choose what we want to offer and what we don’t offer. We’re able to be flexible in that way, which offers our members flexibility as well.”

One of the new evolutions that Hoffman hopes is coming to the at-home space is a model that lives below the CCRC model but above the Program of All-Inclusive Care for the Elderly (PACE) model.

Middle-market consumers have become the focal point of many aging service providers in recent years. In order to serve that market, Hoffman thinks there needs to be innovation around how to serve those who are falling through the cracks.

“A lot of the programs these days require significant investment up front,” she said. “Going to something in the middle has been the goal, and what we’ve been able to do at least is offer a variety of contracts that do require less up front and maybe a lower monthly fee, but it’s a tough one. It really is.”

For other providers, an at-home program offers the chance at the middle market. That’s the case for LifeSpire of Virginia.

The Richmond-based LifeSpire of Virginia is a senior living provider that manages four CCRCs with over 1,300 residents throughout the Old Dominion state.

In 2019, LifeSpire launched Lakewood at Home, a continuing care at-home membership program.

Having an at-home program does a number of things for the business. Perhaps none more important, however, than diversifying its revenue streams.

“Our strategy is that our at-home program is our middle market,” Jonathan Cook, president and CEO of LifeSpire of Virginia, said. “It allows us to offer a much more reasonable entry-free barrier, a lower monthly service fee and it allows people to stay in their home. If we have another 2008 where people can’t sell their houses and move in, we’re going to turn the switch and say, ‘Come into our at-home program.’”

It’s also a bridge and lifeline of sorts to people in the community at a local level, Cook said.

“It’s really an extension and in alignment with our mission statement,” he said. “It lets us offer something to the church secretary or that social worker who could never afford to live in a senior living or retirement community. It gives them that peace of mind.”

The next step for CCRCs — and at-home programs in general — is about spreading the word.

Pushing these programs beyond the obscurity they may be in now will be a team effort moving forward.

“It’s been just over the last few years that we’ve really been able to coalesce all of the at-home programs,” Kendal at Home CEO Lynne Giacobbe said. “As an industry, we have to really check the data and be able to share our outcomes because these programs are helping people stay and age successfully in their homes. When people start to understand what these outcomes are, that’s really going to make a difference.”

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