WASILLA — The Matanuska-Susitna Borough, with one of the fastest growing senior populations in Alaska, has no skilled-nursing facilities for rehabilitation and other medically supervised services for seniors who are released from the hospital.
That may be about to change.
Two companies want to build major new skilled-nursing facilities in Mat-Su. And they're suddenly going head to head in a state licensing process to get the chance.
The process, called the Certificate of Need, is the way the Alaska Department of Health and Social Services avoids duplication of medical services and limits the state's Medicaid exposure.
It's possible only one skilled-nursing facility will emerge, officials say. Or the process could result in approval of parts of each application.
"It's not an across-the-board kind of rule," said Alexandria Hicks, coordinator of the state's Certificate of Need program. "The demand is key, and since there are no assisted skilled-nursing facilities in the Mat-Su, that is significant."
Faraway care
Seniors here face the prospect of care in Anchorage, the Kenai Peninsula or more distant facilities in Valdez or Cordova if they don't have family or friends to help.
A skilled-nursing facility is long overdue for Mat-Su, senior advocates say.
"It's not a need. It's a necessity," said Joan Tower, a 75-year-old former EMT who broke her hip and wrist last fall and quickly realized the closest skilled-nursing facility to her Palmer home was an hour away.
Tower said she's lucky: A son with medical experience cared for her at home. She got support from the Palmer senior center and friends and a Medicaid-funded caregiver who came to the house 20 hours a week.
A friend from the senior center just had heart surgery, Tower said. Now she's in Anchorage at St. Elias Specialty Hospital, she said, "for who knows how long, because there's no place here."
Same category, different care
The two skilled-nursing facilities proposed for Mat-Su involved skilled nursing — patient care under a physician's supervision, registered nurses on staff — but each would provide slightly different services.
A Utah company called Maple Springs Senior Living is behind the $36.1 million centers in Palmer and Wasilla scheduled for completion in 2018, according to an application filed with the state. Maple Springs would provide a spectrum of care including rehabilitation and assisted living but also hospice and "memory care" for residents with dementia.
An Idaho company called Spring Creek wants to build a skilled-nursing facility near Mat-Su Regional Medical Center — the borough's only hospital — called Mat-Su Colony. The 104-bed, $20.7 million facility would focus on post-hospital, transitional care and long-term care, according to an application with the state. The facility is scheduled for completion in late 2017.
Both have to establish a community "need" for the services they'll provide under the final review for state approval by DHSS Commissioner Valerie Davidson.
A decision is expected within 4 1/2 months.
The addition of two facilities would increase the state's Medicaid payouts, said Rachel Greenberg, executive director of the nonprofit Mat-Su Senior Services in Palmer. Most facilities cost $10,000 to $12,000 a month for patients.
"It will be interesting in that the budget is going to play a significant role in whether the Certificate of Need goes through, even though the need is there," Greenberg said.
The state currently has a $4 billion shortfall in revenues.
Top senior state
Alaska has the fastest growing senior population in the nation, with a 36 percent increase in people 65 and older between 2010 and 2015, according to Alaska demographer Eddie Hunsinger. Nonetheless, seniors still make up a smaller share of Alaskans than any other state, just roughly 10 percent, statistics show.
Aging baby boomers are the main reason for Alaska's senior tsunami, as it's sometimes called, as is the tendency for people to move less as they age than in years past.
But Mat-Su doesn't have the highest rate of senior population growth or total percentage of seniors, according to Hunsiger's analysis. Skagway and the Aleutians West Census Area had higher rates, though Mat-Su was among the highest. About 10 percent of the 100,000 people in Mat-Su were over 65 — the same as Anchorage and statewide percentages, Hunsinger found. Wrangell and Haines were much higher, with 19 percent in 2015, while the Kenai Peninsula Borough was at 15 percent and Southeast at 13 percent.
Moving ahead regardless
That two skilled-nursing providers were simultaneously going through the Certificate of Need process wasn't originally part of the plan, according to Marc Dunn, Maple Springs' president and chief executive.
Maple Springs learned of the Mat-Su Colony proposal when it applied for the state review, Dunn said. Then the company learned it had to file a final application by June 21 to be considered at the same time as the Mat-Su Colony proposal.
Douglas Clegg, chief executive of Mat-Su Colony, didn't return messages. But Clegg said at a recent Mat-Su Assembly meeting that his company plans to proceed with part of the project regardless of the state's determination.
"We will not know for 135 days if Health and Social Services will issue a Certificate of Need for this project," Clegg told the Assembly earlier this month. "But that will not stop us from constructing this facility."
Maple Springs' Dunn said his company plans to proceed with assisted-living and "memory care" regardless of the outcome of the state's decision.
Dunn said he was shocked to learn the Valley had no skilled-nursing senior facilities at all, he said.
"When we started the company five years ago, we figured Alaska was a place we wanted to get at the end of our careers," Dunn said. "Through casual conversation, we came to realize Alaskan communities need these services now. And so we shifted a lot of our development plans from the Lower 48."