Utica care center could use open-concept Green House model


Community members are discussing options for a new senior care center in Utica.

About 50 people attended a presentation Dec. 12 to learn about one option –a Green House model – and the logistics of building and operating such a facility.

Ten students from a business plan class at Concordia University in Seward researched what it would take to open a care center in Utica. They presented their findings, which included potential locations, a three-year operational cost analysis and a look at who the center would serve.

“Utica’s in a strong position from a countywide standpoint. We’re the ninth-fastest-growing county in the state,” said Jonathan Jank, president and CEO of the Seward County Chamber and Development Partnership. “We want to make sure we’re doing something that’s in the best interest of the community moving forward.”

The former Utica Community Care Center was built in 1967 through a community development project. It was a 41-bed, skilled nursing facility that followed the traditional nursing home model.

The center closed just a month after it and Crestview Care Center in Milford, along with centers in Blue Hill and Columbus, were bought by Azira Health in September 2019. The closures displaced 95 residents in Seward County and, collectively, 205 residents and 240 employees across the state.

The Utica Care Center has been sitting empty ever since.

Cold weather and high winds thwarted the Utica Volunteer Fire Department’s plan for a practice burn inside the building this past weekend. The drill likely won’t be rescheduled.

“The building is officially past its useful life, so for the health and safety of the community, it needs to come down,” Jank said.

The three acres the building occupies will be turned into housing, but the need for skilled senior care continues.

Why build in Utica?

The CU students behind the research said Utica is an ideal location for a new care center because of its population and proximity to other villages.

A new center would serve the 1,856 people in Utica, Beaver Crossing, Gresham, Waco, Cordova and Thayer not only with skilled nursing and assisted living services but also with jobs.

According to their presentation, data from the 2021 Utica Citizen Survey show that people who grew up in Utica want to stay in the community, so they need jobs and a place to go when they age out of their own homes.

The Green House Project:

The students suggested using a Green House Project model for the new center. The Green House Project is a nonprofit organization that operates care centers across the United States.

The model has gained traction over the past 20 years as a way to return control over daily living activities and decision-making to residents.

The model houses 10 to 12 residents in a cottage, each with their own bedroom and bathroom. Kitchen and living spaces are shared to create a sense of social connectedness and allow for better relationship building, which in turn improves the quality of life.

The cottages are staffed with a highly trained nursing aide who does everything from cooking meals to washing clothes to assisting with personal care.

Jesse McConnell, an architect with Peters and Associates, has worked with Green House models in the past. He said it’s a way for residents to participate in their own care.

“Each kitchen has a CNA to do the cooking, but if the residents want to come in and it’s safe to do, they allow them to do that,” McConnell said. “Each cottage is its own entity. They might meet monthly to decide what they want for food…but they still have a monitored diet to some extent. Each facility evolves into what the schedule of the residents is, and over time, it evolves into the cottage schedule.”

So, if a resident wants to sleep later or eat a late lunch, for example, they have the freedom to do so.

“It gives that ownership back to that resident. They’re participating in their daily caregiving and not being told what they’re going to do. We want these to be more like home,” McConnell said.

Green House Project staff are coached in a way that empowers them to build relationships with residents, thereby reducing the amount of turnover in both residents and staff.

Jobs and finances:

In Utica, the idea is to build three separate cottages of about 7,000 square feet each. They would offer a combination of assisted living and skilled nursing services.

The students suggested locating the cottages near the existing baseball fields and village shop or east of the village pump facility.

Jank said they could easily fit in existing residential areas as long as they comply with zoning regulations.

CU student Austin Jablonski said the center would open employment opportunities in the area with 27 jobs to fill.

For comparison, the former Utica Community Care Center had a nearly one-to-one ratio of residents to employees with about 40 staff.

“With Centennial High, there would be a lot of part-time job opportunities, as well as volunteering and CNA training,” Jablonski said. “With Concordia University, the same plus some community outreach. Concordia offers a Master of Healthcare Administration, so it would be an internship opportunity for a lot of students.”

The students looked at other facilities of similar size and scope to put together a three-year financial plan based on 36 residents.

“It will operate at a loss in year one because of depreciation, but by year three it will approach the break-even point,” CU student Jack Nelson said.

They anticipate a 79% occupancy rate in the first year, with that rate increasing to 89% in year two and reaching 100% in year three.

It would cost around $8 million to build the three cottages, according to their research.

“That’s with 80% debt financing at an 8% rate, with 20% investment equity,” said Todd Johnson, accounting professor at CU. “When you’re spending in that upper $7-8 million range…it takes until about that third year until it will create positive cash flows.”

The center could be run as a for-profit business or as a nonprofit with the ability to receive charitable donations or charitable investments. In that case, people could pay up front to reserve a spot for a loved one when the time comes.

Steve Palandri, a local resident interested in working on the project, said the idea came from a visit to The SunPorch, a Green House home in Smith Center, Kansas.

“That town is much like Utica. They’re farming and ag-based. They have a high work ethic,” Palandri said. “They are partnering also with a university nearby plus a high school. They’re doing a lot of good things for the community, providing a gateway for students who are interested in the medical field. There’s dignity and respect for those who live there and those who choose to work there.”

Palandri said the Green House model improves the quality of life for residents and staff because of the level of freedom and lower costs associated with operating such a facility compared to a traditional nursing home.

Staff are trained to be able to assist with everything instead of having separate staff to do laundry, clean, prepare meals and provide personal care services.

He said the federal government pays about 80% for covered chronic care through Medicare and Medicaid. Facilities are supposed to be reimbursed for all of those costs, but they often aren’t, and when they are, the payments don’t come on time.

That’s what happened with the former Utica Community Care Center, he said. When most residents were on Medicaid, the facility was not reimbursed at 100%, and there was little source of other income, so it became harder and harder for them to keep their doors open.

Palandri said with the Green House model, the cottages could incorporate commercial space, too, where a storefront could be built in tandem with the care facility to add more benefit for the community.

“For example, it could bring at least a part-time pharmacy to town, because there’s going to be an increased need for pharmaceutical services,” he said. “This is only one possibility. We don’t know which direction the community would like to go unless we get your feedback.”

Those in attendance at the presentation asked questions about how the center would be funded, who would operate it, direct access to the highway for emergency medical situations and whether Utica is large enough to draw the number of employees needed for a care center.

“We are in the Lincoln MSA (Metropolitan Statistical Area), so our ability to attract workers is a lot higher than in other rural communities,” Jank said.

Paper surveys were distributed at the presentation for attendees to give their feedback on the needs of the community and what they would like to see in a new care center.

“This is not a definitive solution that when the students present this, this is what it’s going to be,” Jank said. “It’s the start of a larger conversation. We will need engagement from all ages and stages of life to make this successful.”