How Sonida, Bella Groves, Abe’s Garden Are Growing and Evolving in Memory Care

Memory care demand is expected to grow in the years ahead – but operators must evolve for the future if they hope to see it.

To help attract new residents in the months and years ahead, operators are both focusing on the real estate and the knowledge of treating cognitive decline. That is resulting in companies both developing new communities as well as new ways to reach people who may never move into a memory care community despite needing the services.

As they grow, operators are encountering challenges in staffing that could limit their ability to serve more older adults. At the same time, the nature of memory care adds a challenge for operators in the form of keeping residents well for longer.

But the prize ahead is well worth it for companies in the space, according to Sonida Senior Living (NYSE: SNDA) CEO Brandon Ribar.

“If you do those things correctly, as this industry expands, the sky’s the limit from a demand perspective,” Ribar said during a BRAIN panel in Chicago earlier this month.

‘Greatest growth’ seen in memory care, demand incoming

Memory care operators are spending the coming years preparing for a high level of demand for those services.

Sonida Senior Living “the greatest growth” in memory care programming within its portfolio of 72 senior living communities. The operator recently reported nearly 86% average occupancy in its first quarter earnings call earlier this month.

“Looking at any of the percentages, it would tell you that [memory care] is the most rapidly growing area of focus and the age range is much more broad in terms of the individuals you can provide services for,” Ribar said during the panel. “Developing the right programming is really the opportunity and the challenge is training and making sure you’re retaining staff because it’s a specialized offering.”

As Ribar looks out across the memory care landscape, he said he believes that there’s a large percentage of operators that don’t have the right kinds of services and programs for the upcoming generation of older adults in memory care.

“Until we get the programming consistent across the board, it will be beneficial for people to stay home,” Ribar said.“We’ve got to keep getting better at that.”

That phenomenon is partly why San Antonio, Texas-based Bella Groves is expanding its services beyond the four walls at its 32-unit community, according to CEO James Lee. Bella Groves has spent the last three years growing a membership model to extend beyond the community and reach those with cognitive issues sooner.

Photo by Merz Photography for WTWH Media Photo by Merz Photography for WTWH Media

“Something we don’t talk about enough, but the biggest challenge that I’m interested in, is how to help people… five to ten years before they enter our communities,” Lee said during the panel.

In meeting demand for memory care, Lee said he envisions Bella Groves and its unique business model to “create pockets of dementia friendliness all over San Antonio,” to provide dementia training to outside organizations.

Lee referenced eight to 10 locations in the San Antonio area that residents receive services from where they “are starting to feel like they belong in those places.”

“We’re not trying to solve the real estate problem with dementia care, we’re trying to solve in reverse the isolation problem that comes with it,” Lee said.

Abe’s Garden Chief Operating Officer Chris Coelho said “great programming” and engagement were the keys to meeting future demand. That’s led to Abe’s Garden adding additional memory care beds on its campus, while also attempting to reach residents outside the community.

“We’re looking at how to meet people in their homes, and bringing what we do inside the building out to them,” Coelho said during the panel.

That could lead to operators considering options like adult day programming to home health services focused on dementia care, Coelho added.

Staffing remains a key challenge in memory care

Memory care is simply a staffing-intensive kind of senior living given the care that those residents need. That makes recruiting and retaining workers – already an ever-present challenge in senior living – an even greater priority for memory care providers.

Through its Magnolia Trails memory care program, Ribar said Sonida is able to pair trained staff with a memory care director at the community level to improve services given to residents within memory care units. Sonida pays for certain certifications for staff and creates a clear career pathway for staff, which can improve retention, Ribar added.

“It’s a way to help people build a career that’s going to be rewarding and be differentiated from other caregivers that don’t have that skill set, so I think appealing to people’s care and interest and love for the offering, but also build their capabilities so that they can earn a greater wage as the world continues to evolve,” Ribar said.

Training for Abe’s Garden memory care staff helps staff “address unmet needs” of residents within the community with monthly training, with the organization also adding career pathways for high school students interested in senior living careers.

Lee said the company was able to build out its business plan around a higher-than-average memory care staffing model, instead of staffing to a bottom line figure. The company employs a staffing model of one staffer for every four residents.

All staff at Bella Groves undertake a 13-week memory care training with a future aim of having the physical community serve as a “learning center” for caregivers in San Antonio.

“It’s a hypothesis we’re testing in real time,” Lee said. “Thinking further ahead about our business goal is to try to help family caregivers.”

Affordability remains elusive in memory care

It’s no secret that memory care prices, regardless of market, are unattainable for the majority of older adults. Meeting affordable senior living is now more pressing than ever considering demographic changes afoot.

Rather than build new units, Abe Garden now wants to expand its adult day program options to meet residents in their homes at a more affordable price point for care.

Ribar added he felt that the “equation gets really challenging around affordability,” but could be improved by operators relying more closely on technology to support operations and being “incrementally support” memory care with reimbursement.

But reimbursement rates still leave a gap between reimbursement and meeting the bottom line need. “I think you’ve got to figure out how to meet the needs of residents with hours that are more efficient and effectively driven on resident need,” Ribar said.

Moving forward, Lee said operators’ most valuable resource lies in knowledge and training of the detailed needs of memory care residents, with the need to meet residents with the resources they have if unable to meet steep asking rents for a memory care unit.

Community engagement would also remain important in the years to come to make businesses and the public more “dementia friendly.”