Senior living

A message to incoming retirees: Come for the golf, stay for the area's array of senior living options.

South Carolina's ranks continue to swell with aging residents who want to spend their hard-earned "recreational" retirement years lounging on the area's beaches, eating at local restaurants and enjoying the area's thriving cultural scene.

But after those golden years pass, some will have to move from what now serves as a retirement residence into a real retirement home, whether classified as assisted living, a skilled-care nursing home or a dementia-level facility.

That need for medical supervision likely will place a greater burden on South Carolina's existing retirement-age housing options.

When the time comes, will the state's senior living facilities be able to handle them all?

"We have never had (such a large age group) come through the pipeline in such a short span of time," said Pat Mason, whose Columbia research and publication firm, the Center for Carolina Living, shows that Palmetto State-bound retirees are healthier, better educated and wealthier.

Roughly one in four of the nation's 74 million baby boomers plan to move upon retirement — and probably to a place that won't require them to pack a snow shovel and ice scraper.

The exact number of retirees who move each year to the Charleston area each year is hard to figure, especially since the recession has slowed silver-haired in-migration, Mason said. It gets more complicated when you factor in employed workers in their 50s who come with plans to work for a spell before eventually retiring in the area.

Here to stay

Generally, about 130,000 people move to South Carolina each year, and Mason's firm estimates that roughly half of those are older than 50.

While some of these newcomers eventually may move back to their previous homes in other cities to be closer to family members, Randy Lee of the Columbia-based S.C. Health Care Association predicts that many will stay. And that could lure more extended family members to the area.

"By that time, the kids don't want to shovel snow either," said Lee, who represents 160 of the state's roughly 185 nursing homes.

State officials track the immediate need for senior living options.

The S.C. Department of Health and Environmental Control, which regulates some senior living facilities, projects a need for roughly an additional 1,100 nursing home beds by next year for this region. Charleston County has the greatest need with 456 beds, according to the agency's plan, while Berkeley and Dorchester counties are projected to need a combined total of 661 beds.

Lynn Bailey, a Columbia-based health consultant, said those figures don't account for the latest trends in senior health care. For example, Bailey said that more residents, especially those on tight budgets, are likely to rely on daily nurse visits in their homes.

With that type of home-based health care on the rise, the conventional nursing home could become what Lee described as "the facility of last resort."

Statewide, experts generally agreed that private industry will step up to address the demand for senior care residences. But accommodating that demand likely will be a tall order given the enormous expense and risk.

Bill Trawick, chief executive officer of the 450-resident Bishop Gadsden retirement community on James Island, says he routinely fields calls from real estate developers who claim to have the perfect tract of land for a similar facility.

If it were only that easy, he said.

Changing expectations

Senior living complexes are highly regulated and expensive to develop. Trawick estimates it would cost $125 million to build Bishop Gadsden from scratch now. That per-resident figure of $280,000 becomes even harder to justify in tough economic times when "there's just not a lot of access to capital," he said.

Bailey said Medicaid funds also are tough to secure, but they often are necessary to have before breaking ground.

State lawmakers allocate money for Medicaid beds, which are distributed throughout the state's nursing homes. That money pays for residents who can't afford skilled-nursing home care on their own.

While incoming retirees often have retirement accounts that enable them to pay for nursing home care without Medicaid, many developers still prefer to build with Medicaid-allocated beds to minimize their risk, Bailey said.

"You're going to have someone who comes in at 70 and is still hanging out at 93, and by that time, they will have run out of resources," she said.

Some senior-care community operators have found it's more economical to expand an existing facility than to build from the ground up. That's what Bishop Gadsden has done over the years. Founded in 1850 through the Episcopal Diocese of South Carolina, the community started with assisted-living units and branched out to offer nursing home-level care, apartments and a memory-care unit.

"We wouldn't have built out here if we didn't have the opportunity to expand," Trawick said.

Bishop Gadsden said it is constantly renovating to accommodate shifting needs and changing tastes. The younger wave of retirees often come to the Camp Road complex with a clear concept of how they'd like to live out their final years, Trawick said.

"Unless the economy really changes people's expectations in the long term, people will continue to expect larger amenities and accommodations," he said.

Likewise, across the country, many nursing home owners, especially those courting retirees with private money, are changing their offerings to make them more like a home and less like an institution.

"We are having to change how we do things, which is good news for you," Lee of the S.C. Health Care Association said a recent luncheon for a local building industry trade group. "People don't want concrete buildings with concrete floors."

Reach Katy Stech at 937-5549 or kstech@postandcourier.com.