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This case study describes the development of a 100 unit Assisted Living Facility (ALF) in Pinellas Park, Florida, one of the first private apartmentstyle assisted living facilities in Florida designed to serve a low and moderate income population, with a significant number of the project's residents funded through Medicaid.

This 100 unit ALF is successful because of Mia Senior Living Solutions extensive years of experience in the affordable assisted living arena, network of relationships, and ability to identify and involve key individuals who bring needed expertise to the project. As a result of this successful development, lower-income individuals who might otherwise be placed in nursing homes can receive the care they need in private apartments located in a quality residential setting.

We hope that telling this story will convince others interested in developing additional affordable assisted living projects to do so with Mia Senior Living Solutions as your development partner and operation manager.

Project Overview

This 100 unit ALF was developed in 2003 under a tax free bond with the purpose of expanding the supply of affordable assisted living in underserved communities. The vision of this program is to provide, within private apartments, assisted living services using 24-hour staff to seniors with modest incomes in affordable yet luxurious settings. The project was designated as a Robert Wood Johnson Coming Home Program.

Building Design

This 100 unit ALF is a one-story residential building configured in a honeycomb with the dining room overlooking landscaped courtyards. The facility includes a mix of studio, one-bedroom, and two-bedroom units. Each private apartment includes a kitchenette with a refrigerator and microwave; walk-in closet; and a bathroom with a large roll-in shower. In addition, each unit has individually controlled heating and air conditioning, cable television, telephone availability, and a personal emergency response system.

Service Availability

The following services are available at this 100 unit ALF:

• Supportive services – meals, housekeeping in resident units, laundry services, and arranging access to medical services

• Personal services – daily assistance with all activities of daily living including dressing, eating, bathing, grooming, toileting, transferring and ambulation or mobility; and medication management

• Building services – property repair and maintenance and building regulation adherence

• Business office services – expense and capital budgeting and management, accounts payables and receivables, vendor contracting and group purchasing

• Government service funding – assist with the securing of service funding, including Medicaid, for eligible residents, bill government for services provided, claim dispute and resolution

Fee Structure

The assisted living fees at this 100 unit ALF are based on a flat rate for a basic service package with additional services available on an a-la-carte basis. Service fees for eligible residents are reimbursed by either the local Medicaid agents/providers or the Veteran's Administration with the remaining residents paying privately. The strong relationships that the 100 unit ALF has developed through Mia Senior Living Solutions aging network have been critical to the success of the project. Mia Senior Living Solutions expertise in admission of residents that qualify for government funding has ensured facility profitability.

Resident Profile

The average age of the residents are 85 years of age and seventy percent of the residents have a mobility need. Of the current assisted living residents, 90% receive assistance with medications, 30% receive assistance with one or more Activity of Daily Living (ADL), and 70% receive assistance with three or more ADLs. A number of the 100 unit ALF's residents were successfully relocated from nursing homes.

Project Successes

When first contracted in 2008, Mia Senior Living Solutions conducted an audit of the operation and submitted a lengthy plan of correction within a week that was subsequently approved. Two of the largest problems at the facility were its occupancy rate of 80% and only 20% of the residents had government service funding, even though most of them were eligible for the funding. In addition, the facility had high expenses and a demoralized workforce.

Making Affordable Assisted Living a Reality

Most families who have had a parent or grandparent in a nursing home know that individuals usually prefer residential alternatives to institutions when unable to remain at home. Unfortunately, with rates averaging more than $100 per day, most assisted living facilities are not an affordable option for the majority of older Americans. Mia Senior Living Solutions was developed to fill this gap, creating models of assisted living that serve seniors with modest incomes.


Mia Senior Living Solutions has contributed to the development of more than 1,000 affordable assisted living units. Mia Senior Living Solutions has provided direct technical assistance to organizations and extensive resource development (including manuals and best practice guidelines). In addition, Mia Senior Living Solutions is working with states and federal agencies to implement or modify policies and programs essential to the creation of affordable assisted living facilities.