Three 6-bed houses within ten minutes, or one 16-bed with a full time administrator
Four homes in and I have hit the thing everyone warns about. My second house is my best performer and my third is dragging because the manager there is stretched. Adding a fifth 6-bed means adding a fifth manager, and good managers are the constraint, not houses.
So the two paths in front of me.
Path one, cluster. Buy two more single family homes inside a ten minute radius, run a shared float pool across all of them, one regional person over the managers. Houses stay residential in character, licensing stays in the small-home category in my state, and I can sell any single house to a retail buyer if I want out. Per-house overhead stays ugly, though. Every home needs its own kitchen, its own laundry, its own overnight coverage for six people.
Path two, step up. One purpose-built or converted 16-bed with a licensed administrator, commercial kitchen, real staffing ratios. Overnight coverage spread over sixteen instead of six. Rate per bed can go up because I can actually offer more. The catch is that the license category is different in most states, and whether a 16-bed falls under the small residential rules or full assisted living rules is a state-by-state question I would confirm with the licensing agency and a healthcare attorney before I sign anything.
I keep flipping. Where does the real economy of scale live in this business?
Where does scale actually come from in assisted living?
28 votes