As Montana's elderly population grows, so does demand for skilled-care nursing homes

May 13--Care facilities for the elderly, staffed with skilled medical technicians and trained nurses, will be in increasing demand in Montana as more and more Baby Boomers enter their golden years.

That rapid growth will create a market for skilled-care nursing homes, and as some companies move to get out of the business -- it's risky and expensive -- others are coming in to fill the void, like Chicago-based Legacy Healthcare, which sees an opportunity in Billings.

On Feb. 1, Legacy bought Billings Health and Rehabilitation and Valley Health Care from the Goodman Group, which is headquartered outside Minneapolis, and renamed the facilities -- Billings Health and Rehab is now Avantara and Valley Health Care is Bella Terra.

Goodman sold the two facilities as it looks to keep its focus on senior living and retirement communities, which is the majority of its business.

"Legacy is moving in the opposite direction," said Ben Tyrrell, regional director for Legacy.

Tyrell managed the Avantara facility for seven years when it was still Billings Health and Rehab.

The skilled-care nursing facilities business, which is different from senior living and retirement communities, is complicated and oftentimes risky.

It has a health care component that plugs into the complex world of Medicare, Medicaid and insurance requirements and compliance. And it leans heavily on medically trained and certified staff, which is expensive to maintain.

"We're such a highly regulated industry," said Jorel Underdahl, Montana Veterans' Home administrator. "I think only the craziest of us are still here."

Montana is home to two state-owned veterans homes; both are skilled-care facilities. One, in Columbia Falls, is run by Underdahl, and the other, in Glendive, is run by a private management group. These companies are successful if they're dedicated to the work and learn to navigate the regulatory side of the business, Underdahl said.

It's something Legacy believes it has figured out.

"They've been very successful in the Chicago market," Tyrrell said.

Legacy owns 24 facilities in Illinois and two years ago began expanding westward. The company has spent years improving on the model it's developed, and it now owns a skilled-care nursing home in Colorado and two in Utah.

The company's strategy has been to invest in the properties it purchases, in the people it employees and in the community in which it resides. That combination of investment has helped the company grow, Tyrrell said. And as Legacy expands its business model west, he believes it'll continue to be successful.

And the company is eager to continue moving west.

"The Billings market is very attractive," Tyrrell said.

In the past decade, Montana's population of adults older than 65 has grown by almost 40 percent. Nearly 20 percent of Montanans -- 1 in 5 -- is older than 65. In 2010, it was 15 percent, or 1 in 6.

However, the most significant growth is among those older than 80, said Barb Smith, Senior and Long Term Care Division administrator for the state's Department of Health and Human Services. With advancements in medicine and improvements to home care for seniors, Boomers simply are living longer, she said.

Even with the population boom, growth right now in the skilled-care nursing home market is manageable.

"We have an adequate supply of beds," Smith said.

As the state's elderly population has grown, the market for skilled-care nursing homes has remained relatively flat, she said. That's due in large part to advances in health care and growth in home-helpers businesses -- companies that place workers in the home to assist with care-giving.

"If you ask most people they'd rather stay at home," she said.

But that will become increasingly difficult as the Boomer population continues to grow. The market will open wide, and the state anticipates the companies that specialize in elder care will struggle to stay fully staffed, given that those jobs require specialized training and specific skills, Smith said.

Montana's unemployment rate is relatively low at 4 percent -- not an especially large pool to draw from, she said.

"Who's going to deliver the care?" she said.

It's a problem that is never far from Tyrrell's mind. It helps that Billings is a medical hub, home to two regional hospitals and dozens of businesses that support the medical industry, which draws qualified workers to the area.

The rub is that everyone is competing for the same help.

"We're all trying to hire nurses," he said.

One way to use that as an advantage is to specialize, Tyrrell said. Legacy recently purchased a skilled-care facility in Southern Utah, where residents with certain respiratory issues were still traveling nearly four hours to Salt Lake City for treatment.

After doing research, Legacy brought a respiratory therapy program to the care home there, which eliminated the need to send the residents to Salt Lake. That improved the quality of life for those residents and, as the only one with the program, Legacy didn't have to compete with other facilities to find qualified respiratory specialists.

Tyrrell believes Legacy will look at doing the same in Billings to make Avantara and Bella Terra more efficient and more attractive.

It's a smart approach, he said. He's spent his entire career in health care management, and he's seen firsthand how some companies thrive in the marketplace and others sink.

It's easy to get overwhelmed and slip into "survival mode," he said. Companies that exist only in survival mode can't grow strategically or operate efficiently, he said; all efforts are focused on simply keeping afloat.

The smart companies invest in their facilities, their people and the surrounding communities, Tyrrell said.

He's excited about future growth and eager to see Legacy become part of the community.

"They're a different company," he said.

___

(c)2018 the Billings Gazette (Billings, Mont.)

Visit the Billings Gazette (Billings, Mont.) at www.billingsgazette.com

Distributed by Tribune Content Agency, LLC.