An Abundance of Care
Can Generous Preventive Services in Senior Living Save Money?
Tuesday, April 18, 2006; Page HE01
Ernestine Brown, 89, sits in a chair in a sunny hallway at Greenspring Retirement Community in Springfield, lifting a five-pound dumbbell to her chest. Fitness specialist Bill Verneer is conducting a simple assessment, counting how many arm curls Brown can do in half a minute.
"This is the longest 30 seconds," she jokes as the weight appears to grow heavier.
  Keeping fit in their retirement community's gym are Greenspring residents Frank Chabot, foreground, Joann Laurents, center, and Bob Laurents. (John Mcdonnell - The Washington Post) Health Special Reports |
Verneer next asks Brown to see how many times she can stand up from a seated position in 30 seconds, without using her arms to help her rise. "That's the one I'll fail," she says.
"There is no failing," he assures her. "We'll use the results to help make a plan for you."
Verneer and Brown review her scores. She has done well on the arm curls, scoring in the 75th percentile of older people nationwide. But as she predicted, she didn't do so well on the sit-to-stand exercise. "You're in the range where you don't want to lose any functional ability," Verneer tells her. "We'll work on endurance."
While Brown tackles that goal, the people behind Greenspring are working to show that delivering abundant, comprehensive and coordinated care in a busy, upscale setting can be medically, socially and financially successful. Although their overall model is not yet proven to improve health, many elements of what they offer residents -- regular walking and other exercise, social support and easy access to medical services -- have been shown to benefit older people. Whether everyone would be happy in such a large setting, though, remains a question.
Greenspring is among 17 Erickson retirement communities in 10 states. Each is a continuing care retirement community (CCRC), offering a range of housing and health care options, from independent apartments to assisted living and nursing home care. Nationally, 600,000 people live in 2,240 licensed CCRCs, according to the American Association of Homes and Services for the Aging. Residents pay a hefty entrance fee and monthly service charges in exchange for lifelong care.
Greenspring has room for about 2,000 people, most of them in apartments; about 100 occupy assisted-living rooms, and another 180 can be accommodated in a nursing home setting.
The entry payment ranges from $99,000 for a studio to $503,000 for a two-bedroom, two-bath apartment; monthly fees of $1,312 to $2,238 cover rent, one meal a day, utilities and cable TV.
The Washington area, where many seniors can draw on ample equity from the sale of their homes, is prime turf for CCRCs. In addition to Greenspring, the region has more than 20, including another Erickson project, Riderwood in Silver Spring.
Betting on Complete Care
What sets the Erickson properties apart is their cornucopia of medical and wellness services. Greenspring -- where 85 percent of the residents use the medical center rather than off-campus physicians -- has five full-time geriatricians on staff, as well as regular office hours for nine consulting specialists. A podiatrist, audiologist, optometrist, dentist and mental health nurse are onsite, as is an X-ray lab.
"We do education about diet and nutrition, we discuss exercise, and we review and perform a falls-risk questionnaire," said Matt Narrett, chief medical officer for the Erickson communities.
