1. health and fitness

News | 3
Sacramento Business Journal | June 1, 2012 | sacramentobusinessjournal.com Senior living facilities survive by diversifying
Lull caused by real estate market isn’t
likely to last as age bracket grows
Recent headlines from SacramentoBusinessJournal.com
Sacramento adds 59 residents a day
KATHY ROBERTSON | STAFF WRITER
The senior care business has coped with
the ailing economy by diversifying its services and targeting growing areas such as
respite and dementia care.
That’s the tactic used by Hank Fisher
Properties, a Sacramento company that
develops and manages upscale senior
living communities, and by Carmichaelbased Eskaton, which banked on diversification and put new emphasis on supportive servic- Company helps
es for seniors who prefer to seniors downsize and orgastay in their own homes.
Like other segments of nize | Page 25
the real estate market, residential facilities for seniors have been
hampered by falling market values. Older residents have hesitated to sell their
homes in the down real estate market, and
adult children who sometimes pay the tab
have had to deal with financial woes of
their own.
“Volume has gone down because people
are concerned about making any kind of
move,” said Sally Michael, president of the
California Assisted Living Association.
One thing is certain: As the population
continues to age, growing numbers of seniors will need supportive housing and
health care services. The 60-plus population in the Sacramento region is projected to jump 142 percent from 2000 to 2040,
according to the Area 4 Agency on Aging.
Although seniors are putting off making
a move, the hiatus won’t last.
BEST WEB
of
the
Sacramento ranks No. 26 in the country
for population growth, according to a new
analysis. The region gained 59.32 residents
every day between July 1, 2010, and that
same date in 2011, according to an On
Numbers analysis of population estimates
from the U.S. Census Bureau.
The metro area grew by 21,652 people in that
time, going from 2,154,583 to 2,176,235.
­— Business Journal staff (Posted at 7:01 a.m. May 30)
High-Speed Rail Authority hires CEO
DENNIS McCOY | SACRAMENTO BUSINESS JOURNAL
Hank Fisher Properties CEO Nancy Fisher, standing, watches residents play cards at The Chateau
at River’s Edge — one of Fisher’s four full-service senior centers in the Sacramento area.
“People might wait longer, but when the
need for care gets to a certain point, people have to make change,” Michael said.
“Folks in our industry are much more optimistic than they were 18 months ago.”
GOING HIGH-END
Hank Fisher Properties oversees rental
communities in Northern California, including four full-service senior centers in
the Sacramento area.
The senior centers offer independent
and assisted living, short-term stays
to recover from illness or injury, and
Clean Technology
Melanie Turner
reporter
Follow her on Twitter @mturnersacbiz
memory care. The average occupancy
rate across Fisher’s senior business is
92 percent.
The number of memory care residents
has increased about 18 percent in the past
two years; short-term respite care has
grown about 15 percent over the same period. Simultaneously, annual revenue at
the company has grown 3 percent.
A good chunk of the local business is
assisted living, residential care for people
who can’t live alone but don’t need the
SENIORS | PAGE 25
The California High-Speed Rail Authority
has chosen a former director of the state’s
Department of Transportation to take the
wheel as CEO. Jeff Morales, who served as
director of Caltrans from 2000 to 2004,
replaces former CEO Roelof van Ark, who
resigned. Morales also was principal-incharge for the authority’s business plan.
—Melissa Wiese (Posted at 6:46 a.m. May 30)
Tip line created for labor complaints
A new public hotline for California workers
and employers to report complaints or
enforcement tips about the underground
economy has been set up by the state
Labor Enforcement Task Force. Businesses
operating underground often violate laws
designed to protect workers and California’s
economy. Skirting income taxes, not
carrying workers’ comp insurance and
paying employees less than what they are
owed are common practices. The hotline
number is 855-297-5322.
—Kathy Robertson (Posted at 6:22 a.m. May 29)
From the Front | 25
Sacramento Business Journal | June 1, 2012 | sacramentobusinessjournal.com Western Health Advantage financials
Net income (in millions)
$2.5
$2.0
$2.1
$1.8
$1.5
$1.6
$1.2
$1.4
$1.0
$0.5
0
’07
’08
’09
’10
’11
Revenue (in millions)
$400
$300
$375.8
$303.1
$271.6
$295.3
$305.3
’09
’10
’11
$200
$100
0
’07
’08
Membership (in thousands)
100
96.1
80
78.8
82.7
86.7
88.7
’08
’09
’10
’11
0.5%
0.5%
60
40
20
0
’07
Profit margin
1.0%
0.8%
0.6%
0.6%
0.4%
0.6%
0.4%
0.2%
0
’07
’08
’09
Source: Western Health Advantage
’10
’11
SBJ GRAPHIC
WHA | HMO receives high praise for its customer service
FROM PAGE 1
if we have an individual plan.”
The initiative is just one of several changes under way at the local health maintenance organization.
Western Health Advantage is exploring
expansion beyond its current six-county
footprint to be more attractive in the changing market.
The company is hiring staff to support
these changes and has
added office space on
Gateway Oaks Drive
Headquarters:
in Natomas to accomSacramento,
modate growth. The
established in 1997
HMO expects to add
nine employees over Employees: 111
the next year, upping Revenue: $376
its staff to 120. New million in 2011
hires will be in med- Website:
ical management, fi- westernhealth.com
nance, legal and sales.
“They are trying to
catch up with the new law in order to provide all services to all people in Sacramento,” said Dale Waters, Northern California
chairman at insurance brokerage Arthur
J. Gallagher & Co. “They’ll be extremely
competitive and, knowing their history in
group insurance, they’ll treat people fairly.”
Western Health Advantage, a nonprofit,
is owned by UC Davis Health System, Dignity Health and the NorthBay Healthcare
system in Fairfield. Members can use services offered by any of the three owners.
The HMO was established in 1997 to allow UC Davis to continue to treat Medi-Cal
recipients in Sacramento County after the
state managed care program was started.
The HMO expanded to the private sector
and has since dropped both Medi-Cal and
Western Health
Advantage
Medicare, the government health care programs for low-income residents and seniors, respectively.
Western Health Advantage still serves its
core function, however: to channel managed-care payments to the owner-providers and pay for quality care. The company
spends less than 7 percent on administration, with the rest going to medical care.
“We are content with our non-government sweet spot,” Maisel said. “Medicare
reimbursement continues to fall and California is near the bottom of the list in MediCal reimbursement.”
Current membership tops 92,000 residents in Sacramento, Placer, Yolo, Solano,
El Dorado and Colusa counties. The company is on a fiscal year that ends June 30;
revenue projections for 2012 show a profit
margin of 0.8 percent on revenue of $414
million.
UC Davis re-evaluates the venture every
year, said Ann Madden Rice, chief executive officer at the university medical center
in Sacramento. The plan has to work on
its own, as a vehicle for the providers that
own it — and for their employees, many
of whom are covered by Western Health
Advantage.
Expansion makes sense for the company
as it prepares for the new health exchange,
she said.
“The exchange wants affordable products, and to do that, we need the right geographic coverage,” Rice said.
It’s also important to employers who have
workers at multiple sites across the state,
others say.
Local brokers who sell Western Health
Advantage — and employers who buy it for
their workers — gush about the health plan,
which has a retention rate of 98 percent.
The reason: It vies with Kaiser
Permanente as the most affordable plan in
town and clients like its customer service.
River Oak Center for Children, which
provides insurance for about 100 employees in the area, switched to Western Health
Advantage about six years ago.
“We switched because Western Health
is local and their rates were so much more
affordable,” said Sherri Cerles, director of
human resources for the nonprofit provider of health and mental health services for
children at risk. The company also offers
Kaiser coverage. “We try to work with vendors that are local if we can, and some of
the features — like choice of specialists –
are so nice for employees.”
Dos Coyotes Border Cafe owner Bobby
Coyote switched his 17 management employees from Blue Shield to Western Health
Advantage two years ago to save money.
“It has a great network with plenty of
choices. Employees are thrilled,” he said.
Small and nimble, Western Health Advantage can adjust to changes in the market quicker than other insurers, said Sacramento insurance broker Joe Hart.
“It’s great they are pursing an individual plan, “Hart said. “WHA is easy to deal
with — and it’s easy to get a hold of people
to fix things.”
The only drawback, says Sacramento
broker David Fear Jr., is that WHA doesn’t
include Sutter Health.
“In the Sacramento Valley, with most
groups, I bring in WHA,” he said. “Kaiser
used to be far-and-away the best value” —
but now, Western Health Advantage is better, he said.
KATHY ROBERTSON covers health care, labor/
workplace issues, law, immigration, medical
technology and biotechnology.
[email protected] | 916-558-7869
SENIORS | Hank Fisher communities’ high-end amenities include chefs, daily cocktail hour
FROM PAGE 3
complex medical care a nursing home
offers.
There are affordable units, but the company’s local target is seniors who want an
active social calendar in a Ritz Carltonlike setting.
“Assisted living
always is a combination of care and
hospitality, which
is a very strong Headquarters:
component of the Sacramento, established
market,” Michael 1979
said. “Adult children want their Employees: 250
parents in a com- Revenue: WND
fortable setting.” Website:
With prices that hankfisherproperties.com
range from $2,820
to $7,020 monthly, assisted living at Hank Fisher is not
cheap — and it generally is not covered
by insurance.
Perks help sell the place.
“Our places are all about social interaction,” said Nancy Fisher, who became
president and CEO following the death
of her husband, Hank, in 2006.
Fisher, an active community volunteer
with a marketing degree and background
in fashion, oversees design and builds
buzz by holding parties at local centers
with names like The Chateau at River’s
Edge.
Amenities range from daily cocktails to
Wii bowling, lectures, trips to Reno and
walks along the American River. Meals
are prepared by professional chefs.
Hank Fisher
Properties
Professional organizer helps seniors deal with downsizing
KATHY ROBERTSON | STAFF WRITER
When moving Mom or Dad into senior
housing seems like an overwhelming
task, it may be time to call for help.
Lee Mahla, owner of Get Orderlee
and RightSize Your Move, is one of a
handful of professional organizers in
the Sacramento region who help seniors
downsize to the stuff that really matters
— and make the difficult transition to
another place.
It’s a little-known but growing business
as the population ages. The National
Association of Senior Move Managers,
established in Arlington, Va., a decade
ago, has almost 600 members nationwide.
A professional organizer and certified
relocation and transition specialist,
Mahla got into the business five years ago
Corporate chef Priya De Silva, who
graduated from the Greystone Culinary Institute of American in Napa, has
worked for Hank Fischer Properties for
12 years. She took the job after a stint at
Buca di Beppo in Roseville, looking for
a more hands-on approach to cooking.
She uses fresh produce, some of it grown
on the premises, and fresh herbs to enhance taste.
“I like to cook. I like people to enjoy
what I do — and I like the feedback,” De
Silva said.
when a real estate agent asked for help.
The client was an elderly widower who
was moving from a 40-year home into
much smaller digs. He was not happy
about it.
“What has you most stressed out about
this?” Mahla asked the client after a walk
around his longtime home.
“I’m not sure I can get my TV hooked
up in the new place,” he said.
Mahla made calls. The hookup could be
done on moving day, she told him.
“He just sighed,” Mahla said.
“Transitions are always emotional. Part
of it is to zero in on the one thing that
has the client stressed. Everybody has
something different.”
Clients, faced with choices, may pick the
piano over the sofa or a roll-top desk over
the dining room table.
‘CHANGE AND ADAPT’
Diversity has helped nonprofit Eskaton weather a downturn in business in
recent years.
“It’s been more challenging, for sure,”
said CEO Todd Murch. “The message
is: Be willing to change and adapt the
model.”
Eskaton enhanced independent and assisted living services — and beefed up service coordination to prepare for changes
under federal health care reform.
The big push, however, was toward
“They need to be part of the decision,”
Mahla said. “I take clients on an
emotional journey of what makes a home
feel like home.”
Familiar with local senior housing
communities like Hank Fisher Properties,
Mahla knows the constraints of
particular units.
Her services range from an in-home
assessment and development of a moving
plan to customized space planning for
the new place, downsizing and disposal,
packing and unpacking. Mahla typically
charges $75-$85 an hour. Most senior
moves take 10 to 15 hours. Movers are
separate.
For more information, go to getorderlee.
com or nasmm.org.
[email protected] | 916-558-7869
support services for people who want to
age in their own homes. The goal is to create an affinity for Eskaton that translates
to residential housing later on.
“It’s tough, but there’s never been more
opportunity,” Murch said.
“There’s certainly a lot more seniors
around.”
KATHY ROBERTSON covers health care, labor/
workplace issues, law, immigration, medical
technology and biotechnology.
[email protected] | 916-558-7869