PHILADELPHIA REFLECTIONS
Musings of a Philadelphia Physician who has served the community for six decades

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Old Age, Re-designed
A grumpy analysis of future trends from a member of the Grumpy Generation.

Another Proposal for Residents of Retirement Villages to Consider

There's a law against throwing old folks out of a nursing home or retirement community, just because they exhausted their assets and can't pay for further care. Responding to this demand, it is now customary to demand an up-front deposit. The deposit has many possible uses, but among them is re-allign the interests of clients with those of the organization. The indigent resident will always have this asset available at death, to meet unpaid bills. Depending on prevailing interest rates, the front-end deposit will pay for six to twelve years of residence.That's not absolutely guaranteed to solve the problem, because everybody involved has also acquired an incentive to encumber this asset for other purposes. When the building of CCRC's finally meets or exceeds the demand for them, ways will probably have appeared to use the asset to promote marketing. For the present, however, everybody has this assured estate. When that is exhausted, almost all residents will still have an incentive to squirrel away some savings for a rainy day. By this they probably have inflation in mind, and no one will deny the wisdom of inflation protection of some sort.

{CCRC}
CCRC

Meanwhile, consider a CCRC named Kearsley. Dr. Kearsley was a Tory in Philadelphia during the Revolutionary War; the rebels didn't treat him very well. However, in time he was pivotal in the creation of a home for indigents, associated with Christ Church and originally located on nearby Third Street. In time, the town grew and Kearsley was forced to look for more space, which turned out to be the farm of the Roberts family, located on City Line Avenue. To shorten the story, Kearsley eventually became a CCRC surrounded by the Bala Country Club golf course, mostly filled with indigent Episcopalian gentlewomen fallen on hard times. Its management was brisk and active, seeking charitable and government funds to make it possible to live there without personal assets. The chairman of the board set a challenge for Kearsley: I want this place to be every bit as good as the CCRC I am planning to enter, myself.

Well, times change and sometimes it becomes quite a hustle to find the money to keep that promise. The center of Philadelphia has moved away from Christ Church, so the pool of charitable parishioners has dwindled. Nevertheless, here is a retirement village with an almost certain perpetual need for assistance, and a track record of management expertise in the fine points of government assistance programs. Without meaning to give offense to the development officers of every other retirement village in the nation, it seems likely that a think-tank which concentrated on this issue, located on the campus of a working model with a two-hundred year track record, would enhance the efforts of every other CCRC trying to achieve the same objectives. For them to affiliate in some manner with other CCRC's with many residents who have the same interests but more surplus funds, would seem to be fairly natural.

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