Old-School Nursing Homes vs. Today’s Assisted Living Communities

While there are still some of the old-school nursing homes out there, there are a lot more new-school senior living communities that have populated the market, since the birth of the “senior industry” 30 years ago. 

The old-school nursing homes usually operate solely on revenue from Medicaid (the US government) and don’t have sufficient funds to make improvements, so they simply have not kept up with the changing market. Whereas, most of the new communities are private pay (by the residents) and do not accept Medicaid, so they operate more profitably, which allows them to make investments and improvements to serve their community and residents and remain competitive.

Over the past five years, there’s been an explosive growth of brand-new senior living communities developed by large established senior living owner/developer/operator companies as well as investors that have jumped into the senior housing industry. They’re all anticipating that the tsunami of Boomers turning 65 each year will want or need senior housing and care.


The properties just keep getting better and more impressive as the developers strive to meet consumer desires and to stay ahead of competitors, but it’s always important to research the owner/operator and interior designer. Consider everything when selecting senior living, not just price.

Established companies usually have their heart in it and are experienced. They know what works and what doesn’t. They know where they need to spend money and provide resources.

Investors’ priorities may be different, or they may be inexperienced and not have a handle on day-to-day operations, which can be disruptive for residents and their families, and cost them more which causes unanticipated rent increases. They’re also more apt to forgo hiring a professional senior living interior designer either because they don’t know any better or because they want to avoid the expense.

Senior living properties that have not been designed by a professional senior living interior designer put residents at risk with life-safety issues that are preventable.

Sadly, I come across this more than I should, and it makes me cringe. For example, recently I visited a brand-new large, senior living community with independent living, assisted living and memory care. I inquired, as I always do, as to who the developer and designer were. I was told that the developer was a local investor and their secretary did the design. Yikes! That is flat out scary and dangerous!

Assisted living and Memory Care are healthcare. Senior living, memory care and healthcare design are highly specialized and based on science and art. Design for seniors at every level of care requires that highly specialized design, which is a lot more than looking pretty. So, I will never recommend that community, despite that it looked nice. But only people that ask or are trained designers will know because it’s not visible to the untrained eye. The moral of the story is: Don’t judge a book solely by its cover, do your homework.  

Three Ways You Can Avoid Old-School Nursing Homes

  1. Be financially prepared to self-pay.
  2. Purchase a Long-Term Care insurance policy and make sure that it will cover home care as well as memory care, so that you’re fully protected.
  3. Hire a qualified Aging in Place design professional now and have your home and/or bathroom designed and remodeled for aging in place, so that it prevents falls and accidents and will enable you to stay in your home through active adult years and beyond, if you prefer. 55+ TLC also makes it beautiful and increases the home’s value, making it a wise investment.

I strongly recommended Long-Term Care insurance. Recent statistics indicate that 4 out of 5 people over 65 will need long-term care in their lifetime, and you’ll likely need it for 3 to 10 years. Most people aren’t financially prepared for that. LTC insurance can serve as a life preserver.

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