Hearthstone latest of several assisted living facilities to open in Bloomington

March 20--There's a new kid on the assisted living block, and it's part of an increasingly crowded neighborhood.

The Hearthstone Health Campus, at 3043 N. Lintel Drive, northwest of Bloomington, is a $10 million, 55,000-square-foot facility that offers both assisted living and long-term skilled nursing care -- plus short-term rehab, outpatient therapy and respite care. It's owned and operated by Trilogy Health Services, which was founded in 1997 and now has 50 campuses in Indiana, plus 31 more in Kentucky, Ohio and Michigan.

Hearthstone's long-term skilled nursing care building, called its health center, will open as soon as it's inspected and approved by state officials, probably by the end of this month. The health center can serve 78 residents who either need nursing home care or transitional care.

Its assisted living facility opened Feb. 25. It can hold 26 residents, and 19 of the suites have already been reserved. "By the end of the month, we expect to be filled up and have a waiting list," said Tammy Walker, Hearthstone's community services representative.

The Hearthstone Health Campus, off North Curry Pike near West Ind. 46, joins a list of other facilities that offer assisted living, including Bell Trace, Sterling House and Monroe House. Autumn Hills offers specialized assisted living memory care for Alzheimer's patients; Bell Trace offers independent living, assisted living, outpatient rehab and long-term skilled nursing care; Meadowood Retirement Community has independent living, outpatient rehab and long-term skilled nursing care.

Phil Stafford, director of the Center on Aging and Community at the Indiana Institute on Disability and Community, said he's not surprised that Bloomington has become an assisted living mecca.

"Bloomington has a high number of successful professionals and IU faculty in middle life who are bringing their parents here -- often from out-of-state -- to live in assisted living facilities," he said. "I would suspect these parents make up a good portion of the assisted living market in Bloomington."

Assisted living care is not for weak wallets. At the new Hearthstone Health Campus, for example, the rate for an assisted living suite ranges from $95 to $135 a day -- depending on the size of the suite -- plus $400 to $650 a month depending on what level of assistance the resident needs. The Hearthstone Health Campus, as is the case with every other assisted living facility in Monroe County, does not accept Medicaid.

"Both in Bloomington and across the country, those with less means can't afford assisted living," Stafford said. "Indiana does have a Medicaid rate for licensed assisted living facilities, but not many of them take Medicaid because of the low reimbursements."

Kerry Conway, director of the Area 10 Agency on Aging, said the assisted living facilities in Monroe County are "absolutely wonderful," and absolutely beyond the means of most low-income people.

"The people who can afford to go to Bell Trace or Hearthstone either have long-term care insurance, which is very expensive, or they have sufficient savings and pensions to afford those kinds of places," she said.

Conway said that she does not blame assisted living facilities in Monroe County for not accepting Medicaid.

"The Medicaid reimbursement rate is so low that they can't even break even on it," she said. "If you take Medicaid patients, you have to do some cost-shifting to the private pay people to make it work financially. But that is really hard to do that."

Stafford said assisted living facilities began proliferating nationally about 15 years ago. "The industry saw there was a market niche for people who could no longer manage being home alone and needed a lot of nonmedical support," he said.

But Stafford said industry experts were surprised to find that the average age was higher and the degree of frailty greater among those entering assisted living facilities than what they'd anticipated.

"They underestimated how long people would wait before choosing assisted living," he said. "The industry has adjusted somewhat since then, and some of them have added long-term skilled nursing care units."

Suzanne Mann, marketing director for Bell Trace's senior living wing, said the explosion of assisted living facilities occurred in Bloomington between the fall of 1998 and the spring of 1999 -- when Sterling House, Monroe House and Bell Trace's assisted living wing all opened. Autumn Hills opened in December of 2011.

"All our 42 assisted living studio apartments are full -- and our units, combined with the units at Monroe House, Sterling House and Autumn Hills -- are at 80 percent capacity," Mann said.

Stafford admits wondering at times whether Bloomington has reached the assisted living saturation point.

"But before new assisted living organizations come into town, they do pretty extensive market research," he said. "So I guess there is evidence showing the need still exists. So far, none of the assisted living facilities have gone out of business."

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