Graham and Mandi Willoughby, owners of Commonwealth House in Warwick, Rhode Island’s smallest assisted-living facility, tout personalized, small-scale care.
The facility is located within a remodeled ranch house in a residential neighborhood at 655 Commonwealth Ave., with space to care for up to 10 residents in eight rooms.
Graham said such small-scale facilities are common in California, Arizona, New Mexico and Colorado.
“In these states it is actually the preferred type of assisted living for families who cannot care for their senior loved ones on their own,” he said.
The couple moved to Rhode Island from California five years ago when Graham accepted a position in the Brown University Athletic Department. Mandi, an entrepreneur at heart, was familiar with small-scale assisted living, saw a need for it, and the couple began working on securing a license, purchasing and remodeling the home last year.
“Both Graham and I have elderly grandparents,” she said. Commonwealth House is the sort of place she’d prefer her grandmother takes advantage of when she’s ready, she said.
“This would be the perfect setup for her because she does not want to live in a big facility,” Mandi said.
Mandi noted Commonwealth House is not a nursing home. Residents need to be able to recognize a fire alarm and move outside the building on their own power in an emergency, she said. People with a dementia diagnosis or someone who needs help getting out of bed wouldn’t be a good fit for their facility.
They purchased the home in April 2016, and had the zoning approval, remodeling done and license acquired by October 2016. They’ve welcomed seven residents to the facility so far.
Graham said the setting provides a personal atmosphere you don’t find in larger facilities.
“You still get a feeling like you’re in a home because it was, at one point, someone’s home,” Graham said.
Kathleen Kelly, executive director at Rhode Island Assisted Living Association, says the homey feel of the facility is very compelling.
‘There’s no reason to believe that assisted-living options … won’t continue to expand.’
KATHLEEN KELLY, Rhode Island Assisted Living Association executive director
Rather than a private suite of rooms that residents have at larger facilities, Kelly said, residents at Commonwealth House have their own bedrooms.
The house is also much more intimate than a large facility would be, she said. You hear people coming in and out the front door, and talking in the other rooms. Meals are eaten around a large living room table, and the kitchen has been designed to feel like just an unusually large kitchen.
Also, it’s staffed around the clock. So, she said, if someone gets up in the middle of the night to use the bathroom, a staff member is able to make sure they get any help they need.
The facility is certainly unique in Rhode Island, she said. Of the 63 assisted-living facilities in Rhode Island, the next smallest after Commonwealth House is home to 18 residents.
According to Joseph Wendelken, spokesman at R.I. Department of Health, there is no difference in the regulations for assisted-living facilities based on size.
That’s been a challenge for California Advocates for Nursing Home Reform. In California a similar one-regulation for all sizes applies, but with many more small-scale facilities.
California has approximately 7,500 residential-care facilities for the elderly, said CANHR Executive Director Patricia McGinnis.
“About 80 percent of those are licensed for six or fewer beds. And most of these are for-profit,” she said.
While small-group homes can provide excellent care and provide a more “home-like” environment, the quality of care is really dependent on the staffing – the number of staff and the training and skills of staff – particularly if the needs of the residents are high, McGinnis said.
Tony Chicotel, a staff attorney at CANHR, favors a two-tier regulatory system.
In his version of a smaller-scale, assisted-living facility regulation, he said, there would be more frequent inspections, and a requirement for succession planning.
Often, he said, the family businesses set up to run the facilities are not set up to survive the original owner.
While Commonwealth House is currently Rhode Island’s only small-scale assisted-living facility, that might not be the case for much longer.
Kelly noted Rhode Island is subject to the same baby boomer population statistics the rest of the country is dealing with. There’s a growing population of people 85 and older. Before baby boomers, she said, there were only four types of cereal available at supermarkets. It’s no different with assisted living.
“So there’s no reason to believe that assisted-living options for older people won’t continue to expand,” Kelly said.
