Assisted Living Pro Forma - PDF by sxl13928

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									Garfield County Coming Home
        Assisted Living
•History                  •Locations
•Population Trends        •Financial Pro-Forma
•Project Phases           •Funding Sources (back-of-
                          the envelope projection)
•Community Support
                          •Pros & Cons
•Feasibility Study
                          •Coming Home Commitment
•Competitive Analysis
•Comparative Analysis
•Regulatory Environment
Garfield County Coming Home
        Assisted Living
                 HISTORY

 Discussion began in 1984
 Renewed interest by GCICC 2000

 Grant funding from WHF for community study

 General wide spread support for a project
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        Assisted Living
        POPULATION IN GARFIELD COUNTY
  400
  350
  300
  250
  200                                   2000
  150                                   2010
  100                                   2020
   50
    0
         45   55   60   65   75 85+
         to   to   to   to   to
         54   59   64   74   84
 Garfield County Coming Home
         Assisted Living
                             PROJECT PHASES
          Phase I                                Phase II
   Preliminary Market                           Full Market
        Feasibility                             Feasibility
        • Education                          • More Education
  • Demographic Analysis                   • Community Survey
   • Competitor Analysis                   • Composite Analysis
  • Project Mission, Goals               • Alternate Site Selection
     • Project Sponsor                     • Financial Projection

          Phase III                                 Phase IV
          Financial                               Full Project
         Feasibility                             Development
      • More Education                   • Analysis of funding Options
       • Sizing of Units                          • Site Search
       • Function Plan                     • Financial Package Prep
  • Financing Assumptions                           • Funding
• True Operating Pro-forma                  • Architectural Designs
   • Development Budget                         • Permit Process
Garfield County Coming Home
        Assisted Living
                Community Support


                          unlikely
                            5%




                              Likely
                               95%




  80 Years and Older Likely to Use Local Facility
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        Assisted Living
              Feasibility Study


      “15 units could reach full occupancy
    within eight to twelve months of opening”

     “A 15-bed facility would have to attract
    15.1 percent of the eligible households in
        2001 and 14.4 percent by 2006”
Garfield County Coming Home
        Assisted Living
                    Feasibility Study
       Table 5 - Market Penetration Requirements by
              Facility Size for 2001 and 2006
            (Assuming 100 percent 65 and over
                  from Garfield County)

 Facility Size      2001            2006
 10 Units           17.7%           16.8%
 15 Units           26.5%           25.2%
 20 Units           35.3%           33.6%
Garfield County Coming Home
        Assisted Living
             Competitive Analysis

                  Tonasket                $65
    Good Samaritan Village                             $135
                   Odessa                  $74
   Clarkston Shelter & Care
     Clarkston Care Center          $50
         Brookside Landing               $60
        Wedgwood Terrace                   $72
     Guardian Angel Homes                   $73
   Seasons Residential Care              $58
           Juniper Medows                $61
             Booker Annex                 $65

                              $0   $50          $100   $150
Odessa   Comparative Analysis
12 Units all Studios
Universal Caregiver Approach
9,000SF Total
Concept Centers Around
Kitchen
Open Spaces
50% Medicaid
Located on Hospital Property
Garfield County Coming Home
        Assisted Living
            Regulatory Environment
 • 1987 State begins push toward community
 based care settings
 • 1989 Medicaid Personal Care Program
 Legislated
 • 1992 Assisted Living offered as an option to
 Medicaid clients
 • 1993 Community Options Initiative – designed
 to strengthen in-home care alternatives
 • 1995 Legislature authorizes AASA to “limit
 unnecessary nursing home utilization by
 systematic diversion and voluntary relocation of
 clients into community based settings”
Garfield County Coming Home
        Assisted Living
             Regulatory Environment


 • State is very motivated to move clients to less
 restrictive and less costly environments
     • Requesting proposals to limit nursing home
     beds -or- offer to buy out beds to close
     facilities
     • New flexibility in wavers
     • A “lets talk” attitude
 • Regulations are always susceptible to change
Garfield County Coming Home
        Assisted Living
            Regulatory Environment

 • Standards
     • Structural Requirements
         • 220sf Private Room
         • Private Bathroom
         • Kitchenette
     • Maintain Health Records
         • Develop Plan of Care
     • WAC Requirements – Standards of Care
     • Licenced as Boarding Home
     • Regulated by DSHS
Garfield County Coming Home
        Assisted Living
               Locations

 •   Blue Mountain Estates Property
 •   Nazarene Church Lot
 •   Catholic School Property
 •   Pee Wee (Kiwanis) Park
 •   Clinic Site
 •   Port District Property
 •   Herres Seed Company Property
 •   Hospital Property
 •   Adjacent Farm Land
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        Assisted Living
       Revenue
  Assisted Living
  Other
          Bac
               k of
  Operating Revenue
                    the
       Expense          E   nve
  Wages & Benefits
                                lo   pe
  Supplies
                                        Pro
  Utilities
  Purchased Services                        je   ctio
  Repairs & Maint                                    ns
  Staff Education
  Other

  Total Expenses

  Operating Gain or (L

  Financing Expense
  Depreciation
  Interest
Garfield County Coming Home
Assisted Living
                                                 Assisted Living Facilities
                           Odessa    Wilbur    Tonsasket Goldendale Pend Orelle Brewster   Dayton    Average
                             12       10          30         39         42         20        15        23
         Revenue

Assisted Living            299,929   253,005    659,190    774,315     356,976   237,345   165,105    392,266
Other                                    212                 7,593       2,352     3,367                3,381

Operating Revenue          299,929   253,217    659,190    781,908     359,328   240,712   165,105    394,198 100.00%

          Expense
Wages & Benefits           143,380   181,052    201,750    323,014     296,724   195,555    84,999    203,782   51.70%
Supplies                    31,358    24,611     17,561     77,857      38,052     1,637       492     27,367    6.94%
Utilities                   13,064    12,174      3,204     48,143      21,564    15,801        15     16,281    4.13%
Purchased Services           1,607     5,276      4,920     22,198      25,272    21,787       780     11,691    2.97%
Repairs & Maint                                              3,776                 4,447                4,112
Staff Education                810                           2,445                   834                1,363
Other                                               995     16,386      26,676     1,806     2,868      9,746   2.47%

Total Expenses             190,219   223,113    228,430    493,818     408,288   241,867    89,154    267,841   67.95%

Operating Gain or (Loss)   109,710    30,104    430,760    288,089     -48,960    -1,155    75,951    126,357   32.05%

Financing Expense           26,973                          79,303                                     53,138   13.48%
Depreciation                                               174,865                                    174,865   44.36%
Interest                                                   115,671     189,456                        152,563
Garfield County Coming Home
Assisted Living
                     Per Unit Averages
                                                    Assisted Living Facilities
                           Odessa    Wilbur       Tonsasket Goldendale Pend Orelle Brewster   Dayton       Average
                             12       10             30         39         42         20        15               23
         Revenue

Assisted Living             24,994    21,084         54,933     64,526     29,748    19,779    13,759        32,689
Other                            0        18              0        633        196       281         0           282

Operating Revenue           24,994    21,101         54,933     65,159     29,944    20,059    13,759        32,850 100.00%

          Expense
Wages & Benefits            11,948    15,088         16,813     26,918     24,727    16,296     7,083        16,982   51.70%
Supplies                     2,613     2,051          1,463      6,488      3,171       136        41         2,281    6.94%
Utilities                    1,089     1,015            267      4,012      1,797     1,317         1         1,357    4.13%
Purchased Services             134       440            410      1,850      2,106     1,816        65           974    2.97%
Repairs & Maint                  0         0              0        315          0       371         0           343
Staff Education                 68         0              0        204          0        70         0           114
Other                            0         0             83      1,366      2,223       151       239           812   2.47%

Total Expenses              15,852    18,593         19,036     41,152     34,024    20,156     7,430        22,320   67.95%

Operating Gain or (Loss)     9,143     2,509         35,897     24,007     -4,080       -96     6,329        10,530   32.05%

Financing Expense            2,248            0           0      6,609          0         0            0      4,428   13.48%
Depreciation                     0            0           0     14,572          0         0            0     14,572   44.36%
Interest                         0            0           0      9,639     15,788         0            0     12,714
Garfield County Coming Home
Assisted Living             Monthly Pro-forma Income Statement

                            Mix    Rate
 Number of Units                              12       12       12       12
 Census                                      85%      90%      95%      98%
 Private Pay                 50%   $67.00    $342     $362     $382     $394
 Medicaid COPES              50%   $61.17    $312     $330     $349     $360

 Average Daily Revenue                       $654     $692     $731     $754

          Revenue
 Assisted Living                            19,610   20,764   21,917   22,609
 Other

 Operating Revenue                          19,610   20,764   21,917   22,609   100.00%
                                                                                          Available for Debt
           Expense
                                                                                           Service
 Wages & Benefits                           10,137   10,734   11,330   11,688   51.70%
 Supplies                                    1,361    1,441    1,522    1,570    6.94%
 Utilities                                     810      858      905      934    4.13%
 Purchased Services                            582      616      650      671    2.97%
 Repairs & Maint                               196      208      219      226    1.00%
 Staff Education                               196      208      219      226    1.00%
 Other                                         485      513      542      559    2.47%

 Total Expenses                             13,767   14,577   15,387   15,873   67.95%

 Operating Gain or (Loss)                    5,843    6,186    6,530    6,736   32.05%

 Financing Expense                                                              13.48%
 Depreciation                                                                   44.36%
 Interest
Garfield County Coming Home
Assisted Living
 Funding Sources

 •   Traditional Loans
 •   FHA/HUD Mortgage Insurance (sec 242)
 •   USDA Community Facilities Program
 •   State Health Facilities Finance Authority
 •   Private Foundations
 •   Grants
 •   State Office Of Rural Health
 •   Federal HRSA (Health Resources and Services Admin.)
 •   Tax Credit Financing
 •   Local Health Foundation Fundraising Efforts
Garfield County Coming Home
        Assisted Living
      Pros
      • Community Support
      • Community Need
      • Sustain Healthcare
      • Support Economy
      • Gov. Incentives
      • Successful Examples
                              Cons
                              • Up front Commitment
                              • Very Tight Margins
                              • Questions of Governance
                              • Financial Stability of
                              District
                              • Unknowns
Garfield County Coming Home
        Assisted Living
         Coming Home Commitment

    18 to 24 months to get a project open


                               w ithin the
                                   ye ar
              10 or m or e         16%
                 ye ar s             1 - 2 ye ar s
                  37%                     9%

                                       2 -5 ye ar s
                                           17%
                      5 - 10 ye ar s
                           21%




    When Assisted Living Services Would be Needed
Garfield County Coming Home
        Assisted Living
            Coming Home Commitment




                    NOT m et
                      18%
                  other
                   5%
                                 in-hom e
                 nursing
                                 (various)
                  hom e
                                    58%
                   19%




   How Current Assisted Living Needs are Being Met
Garfield County Coming Home
        Assisted Living
           Coming Home Commitment
  Borrower : Non profit organization that meets the
  requirements of the program
  Amount: Max $100,000
  Terms:
     • 6% up to 24 Months
     • Borrower matches 25%
     • At least $10,000 in cash
     • Loan is due when project funds or 24 month
     from closing date
     • Loan converts to a grant if the project is not
     funded
Garfield County Coming Home
        Assisted Living
Garfield County Coming Home
        Assisted Living

								
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