Post #205: Some data on assisted living

Posted on March 22, 2019

Edited 3/22/2019 to soften my conclusions about Sunrise and 100 beds.  Edited late 3/22/2019 to explain what all those eight-bed assisted living facilities are.

On this page, I assemble, map, and tabulate some fairly hard-to-find data on a) location of all licensed assisted living facilities in Fairfax County, and b) the base monthly rates charged by most of them (2017 data).

Surprisingly, the table of monthly rates goes a long way toward explaining Sunrise’s behavior at the last Planning Commission meeting.  When questioned about five floors in their building, they were prepared.  They whipped out several other sets of building plans, all of which had more-or-less the same number of beds as their original plan.  And now I see that the Sunrise buildings in Fairfax (or, at least, for which I could find monthly price data) mostly cluster tightly between 100 and 120 beds.  It looks like they build these for a standard operating model.  So, one way or the other, I would guess, they’re going to get their 100 beds.

I just heard that we are slated for yet a third new circa-100-bed assisted living facility in the Vienna area, although this one is outside the Town boundary.  The newest proposed assisted living facility will be next to the Church of the Good Shepherd on Hunter Mill, about 2 miles (as the crow flies) from the proposed new Sunrise assisted living facility (Church and Center) and proposed new Kensington assisted living facility (to replace the BB&T bank on Maple Avenue West).

Unlike my previous count of (e.g.) local 7-11s, it’s not straightforward to get a map of all assisted living facilities and related facilities in this area.  This is due in part to the numerous types of eldercare available, and then due to the plain lack of easily accessible data.

In the end, I relied on Commonwealth of Virginia licensure data.  Assisted living facilities are licensed by the Commonwealth.  You can search for every licensed assisted-living provider in the area at this link.  Using the Commonwealth’s data, I came up with this “live” map of local assisted living facility location and bed size.  Click the map, then zoom in to locate facilities, and click the pin to see detailed data.

This first map shows all facilities, including a large number of facilities with just eight beds (which must reflect some quirk in the licensure rules.)  The next map excludes the numerous eight-bed facilities.

You get a clearer view if I remove the numerous eight-bed licensed facilities.  This removes few beds but greatly simplifies the map.  With some caveats, this is a better map of the real assisted living opportunities in Fairfax County.

The only conclusion I come up with is that these are fairly evenly distributed throughout the county.  And that there is currently a bit of a “bald spot” between Vienna and Reston.  (And secondarily, people who talk about having no “local” assisted living beds are taking a narrow view of local.)

An aside on all those eight-bed facilities. Those are not due to a quirk of the licensure laws.  Those represent a different model for assisted living.  These smaller, more house-like assisted living facilities are “group home” assisted living facilities.  These are more common in other parts of the Metro area, but not so much in Northern Virginia.  Here’s a Washingtonian article explaining what they are.  So, although they do not much matter in Fairfax, in terms of overall bed capacity, they are a legitimate assisted living option.  For the most part, they appear to be in residential areas. 

Another interesting aspect of the Commonwealth of Virginia’s data is that if you are willing to pay them a bit of money, they’ll show you some limited information on what the monthly base rate charges are at some facilities.  This is part of their effort to encourage price “transparency” in health care. And I am putting this next table here, in part, because I have found it hard to get comparative price data on assisted living rates.  (But that is due, in some part, to the fact that the rate depends on a person’s health, with higher charges for those requiring more assistance.)  The Commonwealth’s own data is, in fact, the only systematic price data I have found.

The table below shows the rates charged to individuals who needed fairly little help.  How little, exactly, is a business decision on the part of the provider.  Typically, this is measured by the amount of help required to perform the  activities of daily living.  As a resident gets frailer and needs more help, the rates increase accordingly.  And these fees would be for standard assisted living, not for memory (Alzheimer’s) care.  This table does not list all facilities.  It only lists facilities for which the Commonwealth supplied some price data.

CAVEAT:  The Commonwealth gathers this information, and distributes it, but there’s no way to tell how good it is.  I’d be willing to bet that it is NOT a mandatory reporting item for licensure.  Which means, it may not have been audited for accuracy.  And it was just plain missing for maybe a quarter of providers or more.  That said, this seemed ballpark with my experience with one provider in this area, as long as you factor in a significant increase in fees, above these levels, as a resident requires more daily help.

The one item most relevant to MAC is that tight cluster of Sunrise facilities between 100 and 120 beds.  That’s highlighted in yellow in the table.  They pretty clearly try to build to a very specific operating model.  So when the dust has settled, I would be surprised if Sunrise ended up with fewer than 100 beds in Vienna.   (It might be of some interest to see how they ended up with fewer in the two locations outside the highlighted cluster.)

I think this, more than anything else, explains the aggressive pursuit of five floors for the building, and explains why Sunrise came “loaded for bear” when that was questioned — they already had several other building plans, all of which preserved their total room count, or very nearly.

The other point is that, ignoring the escalation of fees with declining functional status, Sunrise is not the high-cost player in this marketplace.  Their base fees are more or less at the (bed-weighted) mean for this market.