Showing posts with label Geriatrics. Show all posts
Showing posts with label Geriatrics. Show all posts

Sunday, August 20, 2017

And The Best State To Grow Old In Is...

Elder-care company Caring.com recently conducted a study to determine the best US states to grow old in. And the winner is…


Utah.


That"s right: In addition to being one of the top 5 fiscally responsible states in the Union, the home of Mormonism is also the most friendly state for elderly Americans to grow old and retire in. Earlier this year, the Mercatus Center at George Mason University compiled a comprehensive study, based on a number of objective financial metrics, ranking the 50 US states according to their overall fiscal condition. Utah came in third behind Alaska and Florida.



But Utah handily bested both those states on a ranking based on 13 categories including quality, cost, and availability of health care for seniors, as well as factors that speak to the state’s overall quality of life.


Here’s a breakdown of the data, courtesy of Bloomberg:


Best states:
Utah/$2,950
Iowa/$3,518
South Carolina/$3,000
Washington/$4,500
Nebraska/$3,510


Worst states:
Wyoming/$3,995
North Dakota/$3,340
New York/$4,136
Indiana/$3,528
West Virginia/$3,263


New York, one of the worst states for retirees, was singled out because of the extreme disparity between health-care cost and quality, as Bloomberg explains…





“New York, No. 33 in the well-being ranking, was singled out by Caring.com for its extremes. The very high cost of the state’s health care doesn’t produce results close to commensurate with that spending, according to the report. While New York ranked 46th in cost (the lower the rank, the higher the cost), its life/health care quality rank was 34 (the lower the rank, the worse the quality). Massachusetts had a similar pattern; it ranked 49th in cost and 18th in quality. That’s reflective of a larger trend in the U.S.—high spending on health care isn’t translating into longer lives, as this interactive graphic demonstrates.”



Washington State and California do a better job of translating higher costs to better-quality care…





“Higher costs show more of a payoff in Washington state and California. Washington is 38th for cost and is the top state for quality of life and health care. California has a cost ranking of 36 and quality ranking of 3 (it’s tied with Oregon for quality).”



According to Bloomberg, the lighter the color, the higher the overall ranking of the state as a place to grow old.


The study was conducted by Caring.com, which ranked states on 13 categories, including quality, cost, and availability of health care for seniors. The study’s authors used a range of data sets, including Census data and proprietary data sets from AARP.






“The ranking, which drew on data from the U.S. Census, the insurer Genworth, AARP, the Commonwealth Fund, and Gallup-Healthways, among others, also factored in 150,000 consumer reviews from Caring.com’s database of facilities and care providers for seniors. The availability, quality, and cost of care for the elderly got greater attention in the report than some of the common measures used in retirement destination rankings.”



As Tim Sullivan, vice president at Caring.com, explains, the author’s decision to name the study “The Best States To Grow Old In” instead of “The Best States To Retire In” was meant to highlight an important distinction...





“One reason we call this report the best states to grow old, versus best states to retire, is because it’s really important for people to plan out their 60s, 70s, and 80s with as much care as they plan their retirement in their 30s, 40s, and 50s,” said Tim Sullivan, vice president at Caring.com. “Your needs change as you age, and they are not always going to be driven by the sort of leisure or amenities or weather considerations that are what a lot of people think about retirement.”



The report’s greatest utility, according to Bloomberg, is helping to spark a discussion about where millennials should plan on settling down for the long haul. Unfortunately, Utah is largely devoid of the amenities – like comprehensive public transportation and quality night life – that millennials covet. But affordable health care, low taxes and the state’s overall low cost of living make a compelling case for going without.

Saturday, July 8, 2017

Dead Mall Stalking: One Hedge Fund Manager’s Tour Across Middle-America – Part 2

Via AdventuresInCapitalism.com,


Continued from Part 1...


Malls are bearing the brunt of changes in retail, but they’re only the canary in the coal mine.


Let’s start with a simple premise; commercial real estate (CRE) will change more in the next decade than it has in the past hundred years. Anyone who thinks they can fully foresee how it will evolve is lying to you. The only certainty is that highly leveraged real estate investors and lenders will be obliterated as current models evolve faster than anticipated.


In the past, retail was retail, warehouse was warehouse and office was office—the same for all other CRE classes. There was some cross-over, but the main commercial real estate components stayed segmented for the most part. Now, with big box stores, the lowest hanging fruit for online shopping to knock off, going to dodo-land, there will be hundreds of millions of feet of well-located space suddenly becoming available. People act as if there are enough Ulta Beauty and Dick’s Sporting Goods to go around. However, you cannot fill all of this space with the few big box retail concepts still expanding—especially as many stalwarts are themselves shrinking.



As a result, a huge game of musical chairs is about to take place. Why pay $20/ft for mid-rise office space, if you can now move into an abandoned Sports Authority for $5/ft. Sure, it doesn’t come with windows, but employees like open plan space and there’s plenty of parking. Besides, with the rental savings, you can offer your staff an in-house fitness facility and cafeteria for free. Does your mega-church need a larger space? There’s probably a former Sears or Kmart that perfectly accommodates you at $3/ft. Have an assisted living facility with an expiring lease? Why not move it to an abandoned JC Penney—the geriatrics will feel right at home, as they’re the only ones still shopping there.  


Go onto any real estate website and you will find out that huge plan space is nearly free. No one knows what the hell to do with it and the waves of bankruptcy in big box are just starting. As online evolves, these waves will engulf other segments of retail as well.


Type Macy’s into Loopnet.com and look at how many millions of feet of old Macy’s are available for under $10/ft to purchase. Retail’s problems are about to become everyone’s problems in CRE. When the old Macy’s rents for $2/ft, what happens to everyone else’s rents? EXACTLY!!! What happens if a CRE owner is leveraged at 60% (currently considered conservative) and leasing at $15/ft when the old HHGregg across the street is offered for rent at $3/ft? An office owner can lower his rents a few dollars, but at the new price deck, he cannot cover his interest cost, much less his other operating expenses. What happens to a suddenly emptying mid-rise office building? It has higher operating expenses than the box store due to full-time security and cleaning—maybe it’s a zero—in that future market rents no longer cover the operating expenses of the asset, much less offer a return on investment. I know, crazy—that’s how musical chairs works when demand contracts and the supply stays the same.


What happens to the guys who lent against these assets? Kaplooey!!!



America currently has more feet of retail space per capita than any other country. For that matter, America has more feet of office and other CRE types per capita as well. A decade of low interest rates has made this problem substantially worse. Think of the two malls that I spoke about in the last piece—they weren’t done in by the internet, they were done in by a tripling of retail space in a cities that are barely growing. These cities simply ran out of shoppers for all of this space. Now the mall is empty—heck the strip retail is only partly filled in. The next step is that rents will drop—dramatically. The owners of each asset, the mall and the strip center will go bust. Neither has a cap structure that is designed for dramatically lower rents. Neither has an org structure designed for carving up this space for the sorts of eclectic tenants that will eventually absorb it over the next few decades.


CRE has had it so good for the past 35 years, that most owners have never seen a down cycle. Sure, Dallas had too much supply in the early ‘90’s. Silicon Valley over-expanded in the early ‘00’s. It took a few years for it to be absorbed. Anyone who had capital during the bust made a fortune. This time may really be different. There’s too much supply. Short of blowing it up, it will be with us for years into the future. Without dramatic economic or population growth, some of it may NEVER be absorbed.


As an investor, this is all interesting to understand, but you don’t fully comprehend it until you have visited a few dozen of these facilities and seen how owners are trying to cope with the problem. In Miami, space is constricted. In Texas, there’s more CRE than I’ve ever seen. They keep putting it up—even if there isn’t demand currently. For three decades, they’ve always been able to fill it over time. For the first time ever, they can’t seem to fill it—in fact, demand is now declining. It is now obvious; there will be a whole lot of pain for CRE owners and lenders. Of course, someone’s pain can be someone’s gain.


To be continued…

Friday, March 24, 2017

Thursday Humor: Medicare Part G?

Given today"s vote fiasco, this seemed highly appropriate...





If you are an older senior citizen and can no longer take care of yourself and need Long-Term Care, but the government says there is no Nursing Home care available for you, what do you do?



You may opt for Medicare Part G.



  • The plan gives anyone 75 or older a gun (Part G) and one bullet.

  • You may then shoot one worthless politician.

  • This means you will be sent to prison for the rest of your life where you will receive three meals a day, a roof over your head, central heating and air conditioning, cable TV, a library, and all the health care you need.

  • Need new teeth? No problem. Need glasses? That’s great. Need a hearing aid, new hip, knees, kidney, lungs, sex change, or heart? They are all covered!

  • As an added bonus, your kids can come and visit you at least as often as they do now!

And, who will be paying for all of this? The same government that just told you they can"t afford for you to go into a nursing home.  And you will get rid of a useless politician while you are at it.



And now, because you are a prisoner, you don"t have to pay any more income taxes!



Is this a great country or what?






Now that you have solved your senior Long-Term Care problem, enjoy the rest of your week!



Source: Unknown