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July 2007 issue
Telemedicine Works for Texas
Tech-
The Hurdle For Nursing Homes: Doctor Reimbursements
Texas Tech's Health Sciences Center has successfully
used telemedicine in correctional institutions. Debbie
Voyles, director of telemedicine, calls doctor
reimbursements the hurdle for using telemedicine in
nursing homes.
...
Overseas
Profits Can Support Mission-
Front Porch Set To Break Ground In Mexico In October
Generate and maintain enough financial resources through for-profit
activities to reinvest in the not-for-profit “mission” side of your
business. In October, Front Porch Development Company will break ground on
an active adult community in Mexico.
...
Q&A With
Paul Riepma
Paul Riepma, Senior VP at Pacific Retirement Services, talks about the new
trend in urban high-rise CCRCs.
...
Recent Refinancings
These five not-for-profit deals
that closed over the last few weeks provide a useful overview of
today’s senior care capital market.
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Read more about
Senior Living
Business.
Articles Archive
Steve's BLOG on Senior Care
Companies Mentioned in this issue:
July 2007
A
Autumn House p3
C
Carillon Senior Lifecare Community p4
D
Deerfield Capital Management p5
F
Front Porch p1
Front Porch Active Adult Communities p1
Front Porch Active Adult Communities LLC p1
Front Porch Development Company p1
H
Herbert J. Sims p3
Homecrest House, North and South p3
L
Lakeview Village p3
Lancaster Pollard p3
Lancaster Pollard Investment Advisory Group p5
LifeSphere p3
Luma p6
N
National Church Residences p3
P
Pacific Retirement Services p2
Posada del Sol p3
R
Redstone Village p3
S
St. Paul’s Senior Housing p3
Summerfield Plaza Apartments p3
T
Texas Tech Health Sciences Center p4
V
Village on the Isle p3
Z
Ziegler Capital Markets p3 |
Overseas Profits Can Support Mission-
Front Porch Set To Break Ground In Mexico In October
Email Editor
No one will argue with the fact that
retirement housing is a capital-intensive business. One way that
not-for-profit organizations can generate and maintain enough financial
resources to continue to reinvest in their campuses is to pursue
active-adult communities in overseas locations through a for-profit
subsidiary or entity.
Front Porch, California’s largest not-for-profit provider of senior living
communities, currently has 13 full-service retirement communities located
in California, Louisiana, and Florida that offer continuing or multiple
levels of on-site care. In 2006, the company created Front Porch
Development Company as a wholly owned subsidiary for the purpose of
providing real estate development services to the corporation and to Front
Porch Active Adult Communities LLC (AAC), another wholly owned sub-sidiary
created for the purpose of developing, owning, and operating
age-restricted (55 and up) active-adult communities. Both the development
company and AAC are for-profit entities.
Front Porch Development Company is embarking on an active-adult community
project in Mexico. Called Luma, the 400-unit property will be the first
American-developed, full-ownership, active-adult beachfront community in
Nuevo Vallarta. The Luma property is located within an American enclave
called Paradise Village, which is on the Bay of Banderas just north of the
popular resort town of Puerto Vallarta. The company will break ground in
October 2007, and the first 40 units will be completed by October 2008.
“In the United States, we cannot accept anybody under age 62 into our
senior housing communities without jeopardizing our tax-exempt status,”
says Bill Jennings, president of Front Porch Development Company. “There
are a few minor exceptions, but that’s a general rule. The age is 55 and
above for an active-adult community, but that is a taxable activity. In
any case, according to EEOC regulations, you can discriminate only at age
55 or 62.”
Those age limits don’t apply in Mexico, of course, and Front Porch has
actually dropped its age target down to age 50 for the Luma property.
“We’re targeting the boomer,” says Jennings, “because that’s the fastest
growing population segment in the United States.”
Why Mexico?
While estimates vary, it’s generally accepted that more than a million
full-time retired Americans and Canadians are already living in Mexico.
That number is expected to grow tremendously with the coming wave of baby
boomers — folks who were born in the United States or Canada, have lived
here all their lives, and are looking for second-home ownership or even a
primary retirement residence that is exotic and culturally interesting.
“When we first started looking at Mexico a few years ago,” explains
Jennings, “we tended to find little enclaves of North Americans throughout
Mexico that were very much integrated into the local communities. From
2002 through 2005, we noted both a tremendous explosion in second-home
ownership and the fact that people were seeking homes in exotic locations.
Mexico, in fact, has become fairly mainstream. We’re now seeing people
retiring to Panama, Nicaragua, and other Central American countries. Of
course, a lot of that has to do with people looking for good value in
beachfront property.”
The wave of people moving to Mexico really got started in the 1970s, as
retirees were looking for a place where they could live inexpensively on
social security. Mexico offered a very inexpensive lifestyle, but the more
interesting locations – the coastal cities, for example – have seen a
tremendous escalation in home values in the last six or seven years.
Nevertheless, beachfront property in and around Puerto Vallarta is still
considerably cheaper than, say, Florida or Hawaii. So now, the primary
target for second-home or retirement home ownership in Mexico is the
affluent market.
“Our conclusion,” says Jennings, “was that Mexico offered a really strong
opportunity for a specific facility or community geared to the North
American retiree market. And if we could offer American-style services and
amenities and an exotic lifestyle for a less expensive price than a
comparable setting at home, then we felt that was a good combination. Luma
is not what you’d call inexpensive, but it is a beachfront community. And
because wages are so much less in Mexico, we can put together a high-level
concierge service package and still have very affordable rates. In Florida
or Hawaii, a similar package would probably be double the cost.”
Initial offering prices for Luma, for example, range from $446,000 for a
one-bedroom unit to $779,000 for a three-bedroom home and $1,775,000 for a
penthouse. The concept combines home ownership with a host of personal
lifestyle amenities and services that include concierge, chef, and
housekeeping services and access to amenities available at Paradise
Village, such as the spa, restaurants, shops, conference center, and its
18-hole championship golf course.
Partnering with a local developer
To facilitate the development in Mexico, Front Porch has partnered with
local developer Grupo Krone. Obviously, Mexican business practices and
customs are different from those in the United States. As an American
development company, Front Porch felt it prudent to have a Mexican partner
to help navigate through the local business environment. Grupo Krone is
also a very strong equity contributor to the project and helped bring
capital into the project.
“I would recommend that any company expanding internationally seek out a
similar partnership,” says Jennings. “We’re trying to bring the best of
what we do here in America down there, but not everything works the same
way. By having a local partner, we’re able to ‘tropicalize’ our project.”
It’s not simply having the language skills, because Front Porch does have
Spanish-speaking people on its staff. Rather, it’s a matter of knowing how
to conduct business locally. “Our business practices are more pragmatic,”
Jennings adds. “In Mexico, they’re based more on relationships. You need
doors opened and calls placed to the right person. Grupo Krone helps to
facilitate that.”
Addressing health care
While a tremendous number of people are moving to Mexico — whether
full-time or part-time — who don’t appear too concerned about health care,
Front Porch wants to make sure it has covered that piece and is addressing
the availability of health care services in a couple of ways.
“First,” explains Jennings, “we spent a fair amount of time sourcing
reputable health care in and around the project. Fortunately, an AmeriMed
hospital is located nearby in Puerto Vallarta.” Founded by the chief of
staff at one of the largest hospitals in Phoenix to provide health care
services to people on cruises, AmeriMed continues to have contracts with
most large cruise lines and also operates hospitals in many of the large
ports where the ships call. It has also expanded to provide American-style
medicine to the vast number of Americans living in Mexico. The AmeriMed
hospital is about 10 minutes away from Luma’s location.
“Then,” he continues, “we’re planning on providing the onsite services of
a physician, as well as nurses, for limited hours — probably three days a
week at the onset and later, perhaps, expanded beyond that. The doctor
will mainly help integrate the health and wellness program in our
community, as well as serve as an advocate for any resident who needs to
access the local health system.” The doctor and nurses will speak the
language, interpret the health situation, and make sure there are no
misunderstandings or questions about available health care.
The cost of this health and wellness advocacy program will be part of
Luma’s monthly fees, but any medical procedure done in Mexico, while less
costly than back home, would be an out-of-pocket cost for the resident.
Those would most likely be emergencies, because anything elective or that
could be delayed would more than likely be done back in the United States
or Canada. “We’ll certainly encourage all of our residents to maintain
their U.S. or Canadian health programs, whether that’s Medicare or a
private insurance plan, just for that eventuality,” Jennings says.
A number of insurance companies are beginning to look at overseas
coverage, recognizing the opportunity to provide health care across the
border, according to Jennings. The issue to the insurer becomes one of
ensuring quality. “While I think they’re coming, we haven’t seen those
policies yet,” he says. “We do know, though, that Medicare has
commissioned a study to look at covering care beyond U.S. borders due to
the significant number of Americans retiring abroad.”
Supporting the mission
For its Luma project, Front Porch will pay taxes in Mexico and also in the
United States. “We’ve looked at this pretty closely,” says Jennings, “and
certainly wouldn’t do anything that would jeopardize the tax-exempt status
of our parent company and our existing not-for-profit retirement
communities.” Front Porch clearly separates the for-profit and
not-for-profit parts of the company.
“If we’re successful,,” he adds, “our active-adult community projects will
create financial surpluses that we can reinvest in the not-for-profit side
of the business to support our affordable housing and our market-rate
retirement communities.”
Front Porch just began accepting reservations and is already experiencing
very strong interest. With only 400 units in total and 40 units opening in
the first phase, 1,200 people are already on an “interested” list.
Some of the active adults who move to Mexico also may want to remain there
if or when they need to move to an assisted living environment. “We’ll
have to see how that market evolves,” he says. “In any case, we definitely
want to be at the forefront as opportunities become reasonable. This is
our first venture outside the country. We want to see how the market
ultimately receives it. Then, we’ll consider doing more – there and
elsewhere.”
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