New Type of Senior Community: The Cottages

This article came from

The Cottages is an Idaho based senior living provider that believes small is beautiful.  A few weeks ago I had a chance to visit with Mark Maxfield, President and COO of The Cottages, about their counterintuitive approach to developing and managing senior living communities.

Here is what he had to say.

The Cottages

The Cottages is based in Eagle, Idaho. Their primary model is to develop and operate in small markets that can be as small as 8,000 people.

Their typical scenario is to purchase a parcel of land that is large enough to build two 16-unit buildings.  They build one  building and, when that building is full, they add a second building that will serve as their dedicated memory care building.  Each building operates more or less autonomously, using a universal worker staffing model, though I prefer the way Mark put it, “everybody does everything.”

Their monthly service fee ranges from $2,800 to $3,800 with an average of around $3,400.  Their target is private pay residents but they do allow rollovers to Medicaid when private resources are exhausted.  They only operate in waiver states.

They have 17 communities operating or under development.  In addition they have identified 20 markets for future development.

How and Why It Works

My big question for Mark was this: “How do you make any money?” Here is why it makes sense:

  • Their target market is small communities where land, entitlement and development costs are low.
  • Fill-up marketing costs are low.  In many markets the communities they build are the only thing (or the best thing) in town.  There are no long fill-up costs.  There is no need for a marketing director for each individual location.
  • Once they are built and operating they become a high barrier to entry for other providers because of limited demand.
  • Each of their buildings hold a uniquely high appeal for residents in rural America.  These communities look and feel a lot more like the home the resident moved from than a big institution.  This means it becomes a lot easier to get residents engaged in community life.  It is common (but not required) for residents to help in the kitchen and lead out in activities.
  • The Cottages tend to group their communities in clusters of 2 to 3 so that they can provide easy supervision and assistance with one or two regional resources.
  • They centralize all financial, marketing and quality assurance activities, freeing the local staff to do local things.
Five hearing tech announcements that could benefit older adultsPosted: 12 Sep 2016 07:20 AM PDTHearing technology advances -- the hearing aid industry considers changing. It’s a positive when you see disruption of industries that have too tight a lock on the consumer, whether it is in categories of health insurancetelecom carriers or hearing aids.  You spend time with people everywhere you go – those with significant hearing loss but no hearing aids; they have hearing aids, but hate to wear them.  According to a recent NY Times article, two-thirds of adults over 70, but only 15-30% of those wear them – and at $5000 a pair, no wonder. In recent years, personal sound amplification products(PSAPs) that are not classified as hearing aids and thus do not require the audiologist role, though the FDA may change that. Just asking, if the device is called a 'Wearable,' does Silicon Valley find it more worthy of funding?  But anyway. In July, Consumer Reports published an explanatory guide that should be required reading for organizations that serve older adults. It would seem to be the wild west of innovation.  Here is a sampling of five recent product announcements:ReSound. The firm "introduced a new model to the award-winning ReSound LiNX2™ family: the world's only mini behind-the-ear (BTE) model to feature Made for iPhone. In addition, the mini BTE also features telecoil capabilities. ReSound LiNX2 is the world’s first internet-connected hearing aid, connecting to the internet to locate misplaced hearing aids. This new model enhances the award-winning ReSound Smart Hearing portfolio, giving users even more choices to meet individual preferences and hearing loss needs." Learn more at Resound.Oticon. 

"Technological limitations of current hearing aids have led to the use of tunnel directionality: Speech coming from the front is clear, whereas the rest of the sound environment is suppressed. This results in a limited, narrowed and artificial listening experience. With new, groundbreaking technology, Oticon Opn™ is fast and precise enough to analyse and follow the soundscape and differentiate between sounds. Even in complex listening environments, this allows Oticon Opn™ to constantly open up and balance individual sounds to deliver a rich and meaningful soundscape, empowering the brain to choose on which sounds to focus." Learn more at Oticon.

Silicon Valley based startup that "offers an entry-level rechargeable hearing aid (FDA class I medical device) that it sells directly to consumers. Eargo is a near-invisible in-the-canal device offering four volume settings. Developed by a French ENT, it features patented silicone “flexi-fibers” that enable the device to sit comfortably deep in the ear canal while letting air and natural sound flow freely to the eardrum. At $1,980 per pair, the Eargo hearing aids are more expensive than many of the new off-the shelf “hearables” (classified as personal sound amplification products, or PSAPs, by the FDA), but less expensive than the higher end hearing aids fitted by audiologists." Learn more at

 "Cochlear Limited (ASX: COH), the global leader in implantable hearing solutions, announces today it has received U.S. Food and Drug Administration (FDA) approval for its newest innovative hearing loss solution, Kanso. The Kanso Sound Processor provides a distinct new way for cochlear implant users to hear. Unlike most hearing aids and current cochlear implant sound processors that are worn on the ear, Kanso is a small, off-the-ear hearing device  that provides a more discreet hearing solution and delivers the same hearing experience as a behind-the-ear sound processor." Learn more at Cochlear.

 "iHear® Medical announced today the launch of the world’s first online hearing solutions platform. The company begins taking orders today for its flagship invisible iHEARHD® hearing aid, and the iHearTest™, which recently received landmark FDA approval as the first and only home hearing screener. Delivery of iHear products starts July 15, 2016. The company also plans to launch the iHEARMAX™, a mini behind-the-ear hearing device, on August 15, 2016. iHear’s products are currently being offered in the U.S., with plans to introduce them in China and other markets in 2017." Learn more at iHearMedical.