Portage County Health Care Center ©2019 CliftonLarsonAllen LLP

WEALTH ADVISORY | OUTSOURCING | AUDIT, TAX, AND CONSULTINGInvestment advisory services are offered through CliftonLarsonAllen Wealth Advisors, LLC, an SEC-registered investment advisor

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Portage County Health Care Center

Long-Range Strategic PlanSeptember 16, 2020

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Create Opportunities

Table of Contents• Executive Summary and Strategic Alternatives• Defining The Portage County Health Care Center Long-term

Strategic Priorities:– Skilled Nursing– Assisted Living– Amenities– New Services– Workforce

• Appendix – Market Assessment for Assisted Living, Memory Care Assisted Living, and Skilled Nursing in Stevens Point, Wisconsin

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WEALTH ADVISORY | OUTSOURCING | AUDIT, TAX, AND CONSULTINGInvestment advisory services are offered through CliftonLarsonAllen Wealth Advisors, LLC, an SEC-registered investment advisor 3

Executive Summary

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Executive Summary• The primary objective for this session is to inform

Committee members regarding the challenges and opportunities that exist for the health center

• The current senior living environment is changing rapidly which creates risk, but also opportunity

• The Portage County Health Care Center (PCHCC) is not in crisis, however clear direction is important to move forward

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Strategic Alternatives Overview

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Renovate or Build New Campus and Continue

Operations

Sell to External Nursing Care ProviderClose Campus

Transition current residents to other nursing care settings as required by state and federal law and no longer provide services to County residents.

Campus upgrades to short term care units, common areas and technology support to be relevant to the needs and families in the County. Operational changes will be made to continue to balance cost reimbursement.

Engage a broker or independently market the SNF to a provider that will maintain the mission to focus on unmet nursing care needs of families in the County.

There are multiple options to consider to further PCHCC’s mission of serving the frail elderly population of Portage County, including:

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Strategic Alternatives Overview• Key decisions are needed for clarity of strategic direction:

– Is the operation of a health care facility a priority of Portage County? and if so:

– Does the Committee support next steps to explore a collaboration model with Marathon County to achieve operational efficiencies and potential cost savings?

– Does the Committee support next steps to explore an investment to develop the infrastructure necessary to improve operational effectiveness?

– Does the Committee support development of a timeline of actions to reach a decision regarding the future strategic direction?

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The “Status Quo” Scenario• A financial model was developed, based on current services

and expectations regarding revenue and expenses over a 10-year period

• Changing market forces and consumer demands were not incorporated into the status quo assumptions, such as effects of workforce challenges

• The model provides a high-level analysis regarding the effects of status quo operations on the GAAP basis financial statements.

• Building upon the “status quo”, a high-level financial impact of strategic initiatives to enhance the quality services is included in the following pages

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The “Status Quo” Scenario

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Provide quality, individualized, cost effective, residential and rehabilitative services for elderly and adult clients with short and long-term care needs.

We promote resident choice and individualized care to improve quality of life. It has been found that active participation in the activities of daily living fosters longevity, happiness, contentment, self worth and dignity. Recognizing the obligation of a health care facility to help restore the resident to the best possible state of physical, mental, and emotional health, and to maintain his/her sense of spiritual and social well-being, we pledge our every effort.

Mission Statement

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Current Service Offerings• Short-term post acute care – Following hospitalization, the Portage County Health Care

Center (PCHCC) team provides medical and therapy services, bridging the transition between hospital and home. Services provided include:

– Complex medical management – Wound care – Post surgical orthopedic – IV therapy – Respiratory care – Diabetic management – Physical/ Occupational/ Speech therapies

• Long-term care – PCHCC cares for clients in need of a high degree of ongoing medical attention and/or supervision, while helping each individual achieve and maintain an optimal level of self care and independence

• Dementia Care Advanced Stages – PCHCC offers specialized care for residents with Alzheimer's disease or other related dementia, who may require a high level of medical management and physical care

• Hospice Services –Portage County Health Care Center works in partnership with Ministry Home Care Hospice and Aspirus Comfort Care & Hospice Services to provide this supportive end of life care

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Market Area and Region

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ZIP Codes included in the Market Area:

Source: Maptitude

• 54467• 54481• 54482

Source: Maptitude

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Executive Summary

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Portage County Health Care Center (PCHCC) has several competitive advantages which can be enhanced to better meet the needs of Portage County residents in the future. The programming provides much needed services to senior health care issues. The site location and beautiful outdoor setting is a unique asset that that can lift the spirits of residents and their families along with staff. Consistent key quality measures are meeting high standards of care as well.

As the senior healthcare landscape continues to change, repositioning of the community is needed to deliver services appropriately and competitively. Based on our review, the market can support a between 88 and 96 licensed beds related to the current services offered. PCHCC has 70 of the 130 licensed beds in the market areas, however continued ability to attract residents is likely to be dependent upon operational improvements and capital improvements, including:

• Renovation or replacement of the skilled nursing facility is crucial to PCHCC’s future success.• An investment in technologies allow the staff be more efficient and technology options that provide for

resident connection with family will provide for improved quality of life. • Continued focus on referral relationships and how PCHCC can provide value.• Exploration of collaboration with Marathon County in order to maintain service, while decreasing

overhead.

These renovations will allow PCHCC to maintain census and adjust the payor mix to create a more sustainable revenue stream.

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Executive Summary

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Skilled Nursing Services

• If the long-term vision of Portage County is to continue to provide skilled nursing services, a significant renovation or replacement of the current skilled nursing facility should be considered. PCHCC first opened at the current location in 1931 and was expanded in 1964 and 1994. Based upon tours of the building and discussion with the leadership team, the building has limitations in the provision of services, as compared to current expectations, including:

• Not designed for efficient staffing• Lack of air conditioning in many rooms• Insufficient lighting in resident rooms• Electricity in the resident rooms is not adequate to support clinical

equipment needs• Design does not incorporate accessibility and overall aesthetics in order

to remain competitive in the market area• A significant renovation of the space may provide for improved operational

efficiencies, but these are likely to be limited by the overall layout.

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Executive Summary

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Skilled Nursing Services

• We would recommend exploring three strategic options in moving forward:• Significant renovation of the current building to incorporate current

aesthetics and infrastructure to remain competitive in the market area• Significant renovation of the current building, decreasing the licensed

bed capacity and converting vacated space to assisted living.• Replacement of the skilled nursing facility to incorporate current design

for increased efficiency in delivering high-quality skilled nursing services

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Executive Summary

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Enabling Technologies and Expanded Services

• Investment in technology upgrades, both operationally and clinically, appears to be a barrier to efficiency and quality improvements

• Replacement of the current electronic medical record (EMR) which requires significant manual / duplicate entry

• Remote monitoring systems to provide for staffing efficiencies in the existing building

• Development of additional service offerings will provide value to existing residents, including the potential to expand such service offerings to those outside of PCHCC. There are numerous senior services not currently offered at PCHCC that residents need to travel off-site to receive, including:

• Mental care support• Locked dementia units• Dialysis• Home care• Transportation Services

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Executive Summary

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Collaboration

• Hospital referrals are vital to maintaining a strong Medicare census. While most Wisconsin markets have experienced increased discharges to home, PCHCC has experienced stable rehabilitation census. This should be monitored, as residents begin to utilize hospital care differently. PCHCC can use this information to capitalize on their ability to manage complex cases and increase their revenues and rehabilitation resident percentage.

• PCHCC should continued to develop relationships with area hospitals, focusing on areas where post-acute care can improve outcomes.

• PHCC should also consider collaboration with other area senior living providers. Organizations such as North Central Health Care in Marathon County have realized cost savings by sharing of key resources, technology platforms, and processes.

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Information contained in the following pages is referenced from the complete Market Assessment report included in the Appendix of the report

Defining The Portage County Health Care Center Long-term Strategy

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Strategic Initiatives Summary

Value to Portage County

Residents

Skilled Nursing

Assisted Living

AmenitiesNew Services

Workforce

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Skilled Nursing

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Skilled Nursing

BackgroundPortage County Health Care Center first opened at the current location in 1931 as the Portage County Home. PCHCC was expanded in 1964, and 1994. The PCHCC currently operates with a 70 bed capacity. PCHCC has a 5 Star overall CMS Rating.

The building was seen as the most significant barrier by the majority of the leadership team, including: • Building is not setup for efficiency, given how care is provided• Lack of air conditioning• Insufficient lighting in resident rooms• Electricity in the resident rooms is not adequate to support equipment needs

In general, demand for aging services, including skilled nursing care, is influenced by five main factors (referred to herein as “demand influencers”):• Managed Care, relationships and preferred provider agreements often supersede resident choice• Environmental factors such as population growth, acute care usage and caregiver availability• Lifestyle and consumer choice, such as the substitution of housing and service alternatives for

institutional skilled nursing care• State and public policy, such as home and community-based service funding• Income and wealth, particularly poverty rates and availability of retirement income

Strategic Initiative – Skilled Nursing

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Skilled Nursing

Recommendations• Despite a limited number of skilled nursing beds (130) in the Market Area relative to the

senior population, CLA estimates the bed need will decline by 2025• Replacement of the current electronic medical record (EMR) which requires significant manual

/ duplicate entry• The Market Area is significantly impacted by skilled nursing options nearby, yet outside of, the

Market Area in Marshfield, Wausau, Weston and Wisconsin Rapids


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Skilled Nursing

• The number of beds per thousand in the Market Area is much lower than Wisconsin and the U.S. in 2020

• As projected in 2025, the Market Area remains significantly lower than Wisconsin and the U.S.• The ratio decreases for seniors age 65+ and 85+ in the Market Area from 2020 to 2025 given

the projected increase in the senior population during that time period


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Skilled Nursing

• The baseline demand in the Market Area in 2020 is estimated at 96 beds, which represents an average occupancy of 74.2 percent

• Assumptions for changes in population, length of stay, hospital utilization and other environmental impacts are estimated to result in a decrease in demand for nursing beds in the Market Area in 2025 to 88 beds (a decline of 8.3%)


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Assisted Living

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Assisted Living

Background• There is estimated population and household growth in the Market Area from 2010 to 2020.

Growth is projected to continue from 2020 to 2025 in all three senior age cohorts• Incomes in the Market Area are similar to the State of Wisconsin overall.

• Seniors in the 65-to-74 age cohort are estimated to have a slightly higher incomes in the Market Area than in the State of Wisconsin overall

• For the 75-to-84 and 85+ cohorts, estimated incomes are slightly higher in the State of Wisconsin than in the Market Area

• Nearly 73% of seniors in the Market Area owned their homes in 2010 and could use money from the sale of their home towards senior housing

• There are 234 RCAC assisted living beds in the Market Area with an overall occupancy of 91.5 percent

• There are 233 CBRF assisted living beds in the Market Area, which reported a 95.7 percent occupancy (Point Manor Assisted Living was the only community to report an occupancy below 90 percent, which may indicate pent up demand for CBRF assisted living)

• The majority of the existing CBRF assisted living beds in the Market Area offer small units, including shared studios, private studios, but no one-bedroom or two-bedroom units

Strategic Initiative – Assisted Living

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Assisted Living

Recommendations• CLA recommends PCHCC consider development of RCAC assisted living, and/or CBRF assisted

living and memory care assisted living• Despite limited 75+ population projections in the Market Area, there is estimated future

demand for both RCAC and CBRF assisted living units• The strongest estimated demand is for RCAC assisted living with monthly rents starting at

$2,500 per month and for CBRF assisted living with monthly rents starting at $4,500 per month

• Many of the shared units in both CBRF assisted living and memory care assisted living in the Market Area were occupied by residents utilizing Medicaid Waiver funding

• PCHCC may have advantages if it chooses to expand, pairing its reputation for quality care and staff continuity, with a new building


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Assisted Living

The following table shows the demand for RCAC assisted Living, CBRF assisted living and memory care units in 2020, 2022 and 2025 in the Market Area.


2020 2022 2025CBRF ASSISTED LIVING SENIOR HOUSING:Rents starting at…$3,500/Month in 2020 dollars 2 6 12 $4,500/Month in 2020 dollars 37 39 43

CBRF MEMORY CARE SENIOR HOUSING:Rents starting at…$5,500/Month in 2020 dollars 31 33 35

Source: CliftonLarsonAllen LLP

Estimated Demand

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Amenities and Services

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Develop On-Site Amenities

BackgroundExpanded amenities meet the evolving needs and expectations of seniors and their families. As a new generation of seniors enters the marketplace, new demands surface. Drawing in this next generation will be challenging as many seniors want to stay in the comfort of their homes longer and are nervous to give up the “outside experience”. Expanding amenities available could increase the marketability of PCHCC’s and draw in that next generation or younger senior.

Recommendations• Expanding on-site amenities has minimal potential for additional revenue, yet it can enhance

residents’ experiences at PCHCC by providing the “outside experience” that many seniors feel they are giving up when moving in a senior community

• Amenities can enhance the marketability of PCHCC, as well as improve the quality of life of the residents, by giving residents additional gathering spaces to allow them to socialize and create a sense of community

• Consideration should be given to the cost benefit relationship of adding each of the additional on-site amenities, along with the potential to share space (for example, a game room could easily convert to a movie theater when not in use, or to a lunch café’)

Strategic Initiative – Amenities

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New Service Offerings

BackgroundDevelopment of additional service offerings will provide value to existing residents, including the potential to expand such service offerings to those outside of PCHCC. The ability to limit resident transfers will also improve their quality of life and reduce complications in getting to another site for such services. There are numerous senior services not currently offered at PCHCC that residents need to travel off-site to receive. Additionally, there are services that would draw in new residents and community members. Available options discussed with the management team include:• Mental care support• Hospice care• Locked dementia units• Dialysis• Home care• Transportation Services

Strategic Initiative – New Services

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Provide Other Service Offerings

Recommendations• The primary benefit of expanding service offerings is that it can be accomplished with limited

additional up front capital and additional debt• Risk can be further reduced by partnering or contracting with an external organization• Residents will benefit by having these services on site to enhance the worry-free lifestyle• Onsite services also limit the need to transport residents elsewhere to receive services• Consideration should be given to space and accessibility requirements for being able to

contract out these services• There are multiple factors that need to be taken into consideration with offering dorm style

housing for nursing students at local tech schools• This opportunity should be taken into consideration with other initiatives currently

being explored, such as building a new AL building and renovating the current space• This option could be a good fit for the existing AL space if that decision is being

considered • Constructing new space specifically for dorm style housing would not likely produce a

positive cost benefit relationship• Contracting with transportation services companies, such as Lyft, should be considered to

provide consistency in transportation needs of residents

Strategic Initiative – New Services

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Workforce Development

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BackgroundThe availability of a qualified workforce has reached crisis levels. The senior living industry continues to experience challenges in attracting and retaining clinical, dining, housekeeping and other resident support resources. Furthermore, the number of Wisconsin residents living in long-term and residential care facilities has grown 18% since 2003. To mitigate this risk, the following opportunities can be explored:

• Develop relationships/programs with technical schools

• Collaboration with external entities (hospital or senior living) for training

• Re-assess employee benefits available to workforce

• Provide child care vouchers for employees


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February 6, 2020

Market Assessment for Assisted Living, Memory Care Assisted Living, and Skilled Nursing in Stevens Point, Wisconsin

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Scope of WorkCompleted a Market Assessment for RCAC assisted living, CBRF assisted living, memory care assisted living, and skilled nursing for Portage County Health Care Center in Stevens Point, Wisconsin.

• Defined Market Area – The market area (“Market Area”) uses ZIP Code boundaries and is based on admission data provided by management, geographic barriers, transportation patterns, discussion with Portage County Health Care Center (“PCHCC” or “The Community”) and our knowledge of the draw areas for senior housing.

• Demographic Analysis – Examined 65+ senior demographics from U.S. Census Bureau data for 2000 and 2010, as well as estimates for 2020 and projections through 2025. (Note that all 2020 and 2025 demographic data is estimated/projected by Environics Analytics, a nationally recognized demographic data services company).

• Competitive Inventory – Inventoried RCAC assisted living (“RCAC AL”), CBRF assisted living (“CBRF AL”), memory care assisted living (“MC”), and skilled nursing facilities (“SNF”) in the Market Area.

• Pending – Inventoried pending senior living projects in the Market Area.

• Demand Analysis – Estimated demand for RCAC assisted living, CBRF assisted living, memory care assisted living, and skilled nursing facility units in the Market Area to 2025.

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AL/MC Licensure in WisconsinIn Wisconsin, there are three licensed categories of senior housing that can be considered assisted living (memory care is a subset of this category and is usually a secured area within an assisted living building or a separate component that offers specialized programming and more intensive supervision than standard assisted living developments). Each of these is described as follows:

• Residential Care Apartment Complex (“RCAC”) are places where five or more adults reside. Apartments must have a lockable entrance and exit; kitchen, including a stove (or microwave oven); an individual bathroom, sleeping and living area. This living option also provides to persons who reside in the place, not more than 28 hours per week of supportive services, personal assistance, nursing services, or emergency assistance.

• Community Based Residential Facilities (“CBRF”) are places where five or more adults reside. Services provided include room and board, supervision, support services, and may include up to three hours of nursing care per week. According to the Wisconsin Department of Health and Family Services, “CBRFs can admit people of advanced age, persons with dementia, developmental disabilities, mental health problems, physical disabilities, traumatic brain injury, AIDS, alcohol and other drug abuse, correctional client, pregnant women needing counseling and/or the terminally ill.”

• Adult Family Homes (“AFH”) are for persons seeking a small congregate setting. They house up to four persons. Care guidelines are similar to CBRF’s except that they can provide up to seven hours of nursing care per week. Because of the very small size of these facilities, they were not included as comparable for the purposes of this study.

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Market Area and Region

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ZIP Codes included in the Market Area:

Source: Maptitude

• 54467• 54481• 54482

Source: Maptitude

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Portage County Health Care Center first opened at the current location in 1931 as the Portage County Home. PCHCC was expanded in 1964, and 1994.

The Community has an easily accessible location along Whiting Avenue and Water Street. Water Street is a major thoroughfare providing direct access to downtown Stevens Point.

PCHCC currently operates with a 70 bed capacity. Services include short term care, long term care, physical therapy, and occupational therapy. PCHCC has a 5 Star overall CMS Rating.

The Community

Source: Google Earth

PCHCC

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Population• In 2020, seniors (persons age

65+) were estimated to total 8,807 persons, an increase of 2,232 persons or 33.9% from 2010.

• The senior population is projected to increase by 1,331people or 15.1% from 2020 to 2025.

• The largest projected growth from 2020 to 2025 is among seniors age 65-74 at 21.6%.

• Overall, seniors age 75+ are projected to increase by 227 persons or 6.1% from 2020 to 2025.

Demographic Analysis – Population

Age Cohorts 2000 2010 2020 2025 2000-2010 2010-2020 2020-202565-74 2,694 3,273 5,112 6,216 2.0% 4.6% 4.0%75-84 1,866 2,170 2,538 2,735 1.5% 1.6% 1.5%85+ 747 1,132 1,157 1,187 4.2% 0.2% 0.5%Total 65+ 5,307 6,575 8,807 10,138 2.2% 3.0% 2.9%

Population % Annual Change

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Households• In 2020, senior households in

the Market Area are estimated to total 5,708, an increase of 1,372 households or 31.6% from 2010.

• An overall increase of 716 households or 12.5% is projected for 2020 to 2025.

• Senior households 75+ are projected to increase by 114 households from 2020 to 2025, or 23 households per year.

• Senior household trends closely parallel population trends: The 65-74 represents the strongest projected growth at 19.0% from 2020 to 2025, or 602households.

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Demographic Analysis - Households

Age Cohorts 2000 2010 2020 2025 2000-2010 2010-2020 2020-202565-74 1,736 2,048 3,175 3,777 1.7% 4.5% 3.5%75-84 1,379 1,500 1,729 1,833 0.8% 1.4% 1.2%85+ 429 788 804 814 6.3% 0.2% 0.2%Total 65+ 3,544 4,336 5,708 6,424 2.0% 2.8% 2.4%

Households % Annual Change

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• Overall population of the Market Area (in all age groups) was 51,930 in 2010. By 2025, the population is projected to increase to 53,910 people, an increase of 1,980 or 3.8%.

• The proportion of seniors age 75+ in the Market Area is projected to increase from 6.9% in 2020 to 7.3%in 2025. This reflects a greater projected growth among seniors age 75+ compared to the overall population growth projected over the same time period.

• A higher proportion of seniors can indicate a greater need for care in a formalized setting.

Proportion of Seniors in the Market Area Compared to Overall Population

Demographic Analysis – 75+ Proportion

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Demographic Analysis – Senior Income

• Senior household incomes impact choice of housing.

• 2020 projected median household incomes are estimated to be slightly higher in the Market Area as compared to Wisconsin for the 65-to-74 age cohort and slightly lower in the 75-to-84 and 85+ age cohorts.

Senior Household Incomes

65-74 75-84 85+ Market Area 52,421$ 36,807$ 28,889$ Wisconsin 51,076$ 37,910$ 30,152$

2020 Median Incomes

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Tenure - 2010Among all Market Area senior households, 72.6% owned their housing in 2010. This ownership rate is lower than the homeownership rate in Wisconsin overall, 74.9%.

Home ownership declines with age. In the Market Area, 81.1% of seniors 65-74 owned their housing in 2010, compared to 73.1% of seniors age 75-84 and 49.9% of seniors age 85-and-over.

According to Environics Analytics, the estimated median home value of owner occupied housing in the Market Area for 2020 is $173,284. This compares to an estimated median value of $199,321 for Wisconsin.

Demographic Analysis – Homeownership

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The table is a summary of RCAC AL units in the Market Area. The total number of units is used later in the report for estimating demand in the Market Area.

Competitive Summary – RCAC AL

Competitive RCAC Assisted Living Units No. of Beds Occupancy

Brookdale Stevens Point 75 97.3%River View Lodge (Point Manor) 51 76.5%The Lodge at Whispering Pines 68 100.0%Willow Brooke Point 40 85.0%

Total 234 91.5%

Source: Personal visits, phone interviews, and/or other research conducted in December 2019.

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Source: Maptitude

RCAC AL Competitor Map

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Competitive CBRF Assisted Living & Memory Care Units No. of Beds Occupancy No. of Beds Occupancy

Brookdale Stevens Point 0 N/A 16 100.0% 16 100.0%Care Partners 32 96.9% 0 N/A 32 96.9%Maple Ridge of Plover 18 94.4% 20 100.0% 38 97.4%North Crest 14 96.4% 13 96.4% 27 96.4%North Haven 11 100.0% 11 100.0% 22 100.0%North Ridge 12 95.8% 12 95.8% 24 95.8%Point Manor Assisted Living 29 89.7% 0 N/A 29 89.7%Sylvan Crossings of Stevens Point 19 94.7% 0 N/A 19 94.7%Wellington Place at Whiting 28 92.9% 0 N/A 28 92.9%Whispering Pines 40 100.0% 0 N/A 40 100.0%Willow Brooke Point 30 96.7% 10 100.0% 40 97.5%

Total 233 95.7% 82 98.8% 315 96.5%

Overall Occupancy

Source: Personal visits, phone interviews, and/or other research conducted in December 2019.* bl b d f h f l

CBRF Assisted Living Memory Care Total CBRF AL & MC

Beds

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Competitive Summary – CBRF AL/MC

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Source: Maptitude

CBRF AL/MC Competitor Map

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• Activity of daily living (“ADL”) needs were applied to the age/income qualified base for RCAC, 5.7% for ages 65-74 (1-2 ADL needs), 22.2% for ages 75-84 (1-2 ADL needs) and 31.8% for ages 85+ (1-2 ADL needs).

• RCAC monthly service fees were tested at $2,500 and $3,500 per month with 80% of annual income allotted to pay for assisted living services.

• For homeowners who are able to draw on the equity of their home, an annual income of $25,000, $30,000 and $35,000 was used, respectively, for the different rent levels.

• Gross market penetration of 45% was used, based on the number of RCAC units in the Market Area.

• 20% allowance for residents outside the Market Area, based on admission data provided by PCHCC.

Demand Assumptions – RCAC AL

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Estimated RCAC AL Demand

The following table shows the demand for RCAC assisted living in 2020, 2022, and 2025 in the Market Area.

The estimated demand shown in the tables in net of existing units and those under construction; that is, demand for new development. Demand at the higher rent level is included in demand at the lower rent level.

2020 2022 2025RCAC ASSISTED LIVING SENIOR HOUSING:Rents starting at…$2,500/Month in 2020 dollars 50 53 56 $3,500/Month in 2020 dollars 5 6 7


Estimated Demand

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• ADL needs were applied to the age/income qualified base for CBRF, 5.2% for ages 65-74 (3+ ADL needs), 8.7% for ages 75-84 (3+ ADL needs) and 17.6% for ages 85+ (3+ ADL needs).

• CBRF monthly service fees were tested at $4,000, and $5,000 for assisted living and $5,500 per month for memory care assisted living. Each service fee was tested with 80% of annual income allotted for assisted living and 90% to memory care assisted living.

• For homeowners who are able to draw on the equity of their home, an annual income of $25,000, $30,000 and $35,000 was used, respectively, for the different monthly service fee levels.

• Incidence of dementia was applied to the age/income qualified base of residents living alone for memory care 3.2% for ages 65-74, 17.6% for ages 75-84 and 32.8% for ages 85+.

• Gross market penetration of 60% was used for CBRF assisted living, and 30% was used for memory care assisted living. Both percentages are based upon the number of existing beds and the CBRF specific ADL need percentages included in the qualified population pool.

• 30% allowance for residents outside the Market Area, based on admission data provided by PCHCC.

Demand Assumptions – CBRF AL/MC

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2020 2022 2025CBRF ASSISTED LIVING SENIOR HOUSING:Rents starting at…$3,500/Month in 2020 dollars 2 6 12 $4,500/Month in 2020 dollars 37 39 43

CBRF MEMORY CARE SENIOR HOUSING:Rents starting at…$5,500/Month in 2020 dollars 31 33 35


Estimated Demand

51

The following table shows there is no demand for assisted living and memory care units in 2020, 2022 and 2025 in the Market Area.

The estimated demand shown in the tables in net of existing units and those under construction; that is, demand for new development. Demand at the higher rent level is included in demand at the lower rent level. Demand for assisted living and memory care assisted living overlaps.

Estimated CBRF AL/MC Demand

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CLA contacted staff at planning departments in the Market Area to determine if any new senior housing was being proposed in the Market Area. At the time of research, the following project was identified within the Market Area:

• Stevens Point Commercial is a mixed-use development currently under construction at 1443 North Water Street in Stevens Point (54481). The development will house 88 affordable senior independent living units along with retail and office space. The project is planned to be complete in the fall of 2020. Since the project is affordable and only offering independent living, it was not included in demand estimates.

Pending Projects

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Competitive Summary - SNF

Number Double Private Five-Profit Part of Miles of Room Room Star

or a from the Beds in Current Daily Daily Quality

SNF's in the Market Area Non-Profit CCRC? Community Service Occ. Rate Rate Rating (1)

Portage County Health Care Center Non-Profit No N/A 70 74.7% $285 $310 5825 Whiting AvenueStevens Point, WI 54481Portage County, WI

Atrium of Stevens Point Profit No 1.4 60 75.0% N/A $320 21800 Sherman AvenueStevens Point, WI 54481North Shore Healthcare

TOTAL/OCCUPANCY 130 74.8%

Source: Personal visits, telephone interviews, and other research conducted in February 2020.Notes:(1) From www.cms.gov, February 2020.

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Source: Maptitude

SNF Competitor Map

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Market Area Hospital Discharges

Number of Number of Percentage Percentage Percentage Percentage PercentageLocation Referrals to

Client SNFMedicare

DischargesDischarged

HomeDischarged to

SNFDischarged

to HHADischarged to

HospiceOther

Ascension St Michaels Stevens Point 127 1,268 55.3% 17.7% 13.0% 3.1% 10.9%

Source: Definitive Healthcare

Top Hospital Referring to PCHCC

Notes: Annual Medicare Data is from the Medicare Standard Analytical Files (SAF). Data shown is from the 2018 calendar year.

The following table summarizes the number of Medicare discharges and the percentage discharged by location for the top hospital discharging to PCHCC, based upon 2018 Medicare cost report data.

• Ascension St. Michaels referred 127 residents to PCHCC in 2018.• Approximately 18% of Medicare discharges in the Market Area were to SNF locations. • While other hospitals outside the Market Area referred residents to PCHCC, the total was significantly

smaller.

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Demand for nursing beds has been declining overall nationally as more seniors with less acute medicalneeds are accessing other forms of care. One way to assess the potential for nursing beds is to comparethe beds-per-thousand ratios for the population age 65-and-over and age 85-and-over in the MarketArea with ratios in the State of Wisconsin and the United States. The ratios are as follows:

• The number of beds per thousand in the Market Area is much lower than Wisconsin and the U.S. in 2020. Asprojected in 2025, the MarketArea remains significantly lower than Wisconsin and the U.S.

• The ratio decreases for seniors age 65+ and 85+ in the Market Area from 2020 to 2025 given the projected increase in the senior population during that time period.

Age 65 + Age 85 +SNF Beds Age 65 + Age 85 + Beds/1,000 Beds/1,000

Market Area 130 (2) 8,807 1,157 14.8 112.4

Wisconsin 29,278 (3) 1,025,861 128,994 28.5 227.0

United States 1,677,474 (3) 54,964,989 6,584,557 30.5 254.8

Age 65 + Age 85 +SNF Beds Age 65 + Age 85 + Beds/1,000 Beds/1,000

Market Area 130 (4) 10,138 1,187 12.8 109.5

Wisconsin 29,278 (4) 1,173,776 133,110 24.9 220.0

United States 1,677,474 (4) 63,790,899 6,994,842 26.3 239.8

Source: CLA, Environics Analytics, LTC Stats: Nursing Facility Operational Characteristics ReportNotes to Table:(1) Population data from Environics Analytics.(2) The number of nursing facility beds in the PMA is from page 20.(3) Total nursing home beds are based upon data from the American Health Care Association "LTC Stats: Nursing Facility Operational Characteristics Report”, October 2019, and represents total beds. (4) For 2025, the number of beds is assumed to equal the number of beds in 2020.

Population (1)

Population (1)

2020 SNF BEDS PER 1,000

2025 SNF BEDS PER 1,000 (4)

Skilled Nursing Beds Per Thousand

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SNF Demand Analysis - Influencers

In general, demand for aging services, including skilled nursing care, is influenced by five main factors (referred to herein as “demand influencers”):

• Managed Care / ACO / Medicare Advantage Part C referral sources, relationships and preferred provider agreements that often supersede resident choice;

• Environmental factors such as population growth, acute care usage and caregiver availability;

• Lifestyle and consumer choice, such as the substitution of housing and service alternatives for institutional skilled nursing care;

• State and public policy, such as home and community-based service funding; and

• Income and wealth, particularly poverty rates and availability of retirement income.

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SNF Demand Analysis - Assumptions

• Baseline demand for 2020 is based upon utilization data from 2018 Medicare cost reports.

• Market Area population growth projections indicate 2.9% annual growth from 2020 to 2025 for seniors age 65-and-over.

• A 5% decrease in short-stay lengths of stay is estimated from 2020 to 2025, correcting towards the national average.

• Hospital utilization is estimated to decrease by 9% from 2020 to 2025, based upon the Wisconsin and national averages.

• These demand projections represent gross demand, including the existing supply.

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TotalMarket Short Stay (MC) Market

Area Referring Hospitals Area Long Stay Short Stay TotalMedicaid Other Total Medicare MC Adv Total

Baseline Demand 2020 31 32 62 21 13 34 96 34 25 58Impact of Changes in Population (CAGR) 1 1 2 3 2 5 7 1 4 5

Market Area Total - Population Adjusted 2024 31 33 64 25 15 39 103 35 28 63 2025 Impact of Environmental Variables-9% Changes in Hospital Utilization Rates (3) (3) (6) (2) (1) (4) (10) (3) (3) (6)

-10% Changes in Length of Stay 0 0 0 (2) (1) (4) (4) 0 (3) (3)

0% Other Environmental Impacts 0 0 0 (2) 0 (2) (2) 0 (0) (0) Estimated Environmental Impacts (3) (3) (6) (7) (3) (9) (15) (3) (5) (8) Total Demand 2025 28 30 58 18 12 30 88 31 23 55 % Change vs. 2020 -6.9% -6.9% -6.9% -17.3% -4.7% -12.6% -8.9% -6.9% -6.2% -6.6%CAGR -1.4% -1.4% -1.4% -3.7% -1.0% -2.7% -1.9% -1.4% -1.3% -1.4%Note: the sum for each category may not equal the total, due to rounding estimates.

Market Area

PCHCCLong StayLong Stay Days Short Stay Days

59

SNF Demand Analysis - EstimatesThe following table shows demand for short stay and long stay beds in the Market Area.

• The baseline demand in the Market Area in 2020 is estimated at 96 beds, which is made up of 62 long stay and 34 short stay beds. This represents an average occupancy of 74.2 percent.

• Assumptions for changes in population, length of stay, hospital utilization and other environmental impacts are estimated to result in a decrease in demand for nursing beds in the Market Area in 2025 to 88 beds (a decline of 8.3%).

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• There is estimated population and household growth in the Market Area from 2010 to 2020. Growth is projected to continue from 2020 to 2025 in all three senior age cohorts. The majority of the senior population growth is projected in the 65-to-74 age cohort.

• Incomes in the Market Area are similar to the State of Wisconsin overall. Seniors in the 65-to-74 age cohort are estimated to have a slightly higher incomes in the Market Area than in the State of Wisconsin overall. For the 75-to-84 and 85+ cohorts, estimated incomes are slightly higher in the State of Wisconsin than in the Market Area.

• Homeownership rates and estimated median home values are lower in the Market Area compared to the State overall. However, nearly 73% of seniors in the Market Area owned their homes in 2010. This indicates a majority of seniors who could use money from the sale of their home towards senior housing.

• There are four RCAC assisted living providers in the Market Area with an overall occupancy of 91.5 percent. River View Lodge had the lowest occupancy, at 76.5 percent. River View Lodge staff indicated the recent ownership change and subsequent staff changes may have driven down the occupancy.

• Among RCAC assisted living communities, Brookdale Stevens Point and The Lodge at Whispering Pines had the highest occupancies. These two communities are the only ones offering one-bedroom and two-bedroom units. Brookdale Stevens Point had the greatest range in pricing, from $2,700 to $5,100 and staff noted there is typically high demand for all unit types. They said occupancy is consistently very high.

• There are 233 CBRF assisted living beds in the Market Area, which reported a 95.7 percent occupancy. This is above the stabilized occupancy of 93.0 percent. Point Manor Assisted Living was the only community to report an occupancy below 90 percent. This could indicate pent up demand for CBRF assisted living. Point Manor Assisted Living (part of the same campus as River View Lodge) could also be experiencing a drop in occupancy after recent staff and ownership changes. Staff that met with CLA was new to the community.

• The majority of the existing CBRF assisted living beds in the Market Area are offering small units, including shared studios and private studios. None offer one-bedroom or two-bedroom units.

Observations

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• Memory care assisted living also had a very strong overall occupancy in the Market Area, at 98.8 percent. There is not a large existing supply of memory care assisted living beds in the Market Area. Some of the CBRF assisted living communities in the Market Area did not offer memory care specific programming or a secured community, but did have residents in assisted living with dementia. This could indicate some pent up demand for memory care assisted living.

• Copperleaf Senior Living’s three adjacent buildings (North Crest, North Haven, and North Ridge) offer both assisted living and memory care assisted living together, all licensed for CBRF. Staff estimated half to be residents in need of dementia care and said the buildings typically go through cycles as a resident group ages in place. The buildings are well designed with a more modern décor than the majority of the other CBRFs in the Market Area. Staff said the three buildings are typically very full.

• Many of the shared units in both CBRF assisted living and memory care assisted living in the Market Area were occupied by residents utilizing Medicaid Waiver funding. None of the Medicaid Waiver beds in the Market Area were included in the competitive supply for the purposes of estimating demand.

• There is estimated demand for RCAC assisted living, CBRF assisted living, and memory care assisted living. The strongest estimated demand is for RCAC assisted living with monthly rents starting at $2,500 per month and for CBRF assisted living with monthly rents starting at $4,500 per month.

• Despite a limited number of skilled nursing beds (130) in the Market Area relative to the senior population, CLA estimates the bed need will decline by 2025. The Market Area is significantly impacted by skilled nursing options nearby, yet outside of, the Market Area in Marshfield, Wausau, Weston and Wisconsin Rapids.

• CLA recommends PCHCC consider development of RCAC assisted living, and/or CBRF assisted living and memory care assisted living. Despite limited 75+ population projections in the Market Area, there is estimated future demand for both RCAC and CBRF assisted living units. PCHCC may have advantages if it chooses to expand, pairing its reputation for quality care and staff continuity, with a new building.

Observations - Continued

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• The objective of this engagement was to collect and analyze as much data on the market as outlined in the Process Outline. CLA assumes no responsibility for matters legal in character. Certain information and statistics contained in this report, which are the basis for conclusions contained in the report, have been provided by other independent sources. While we believe this information is reliable, it has not been independently verified by us and we assume no responsibility for its accuracy. The conclusions in the report are based on our best judgments as market research consultants. CLA disclaims any express or implied warranty of assurance or representation that the projections or conclusions will be realized as stated. The result of the proposed project may be achieved, but may also vary due to changing market conditions, changes in facts that were the basis of the conclusions in the report or other unforeseen circumstances.

• Note that this Market Assessment should in no way be used to finance a project. Once a final housing concept has been defined, a full market Feasibility Study should be conducted prior to making a decision to proceed with a project. This document is for the internal-use-only of Portage County Health Care Center and should not be distributed to third parties.

Disclaimer

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APPENDIX A – Detailed Competitor Tables

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Brookdale Stevens PointRiver View Lodge

(Point Manor)The Lodge at Whispering

Pines Willow Brooke PointStreet Address 5625 Sandpiper Drive 1800B Sherman Avenue 3450 Bridlewood Drive 1801 Lilac LaneCity/State/ZIP Code Stevens Point, WI 54482 Stevens Point, WI 53073 Plover, WI 54467 Stevens Point, WI 54481Owner/Sponsor Brookdale Senior Living North Shore Healthcare Privately Owned Willow Brooke LivingNumber of Beds

RCAC AL studio-shared 0 0 0 0RCAC AL studio-private * 51 34 40RCAC AL one-bedroom * 0 34 0RCAC AL two-bedroom * 0 0 0

Total RCAC AL Beds 75 51 68 40RCAC AL Square Footage:

RCAC AL studio-shared N/A N/A N/A N/ARCAC AL studio-private 300 * 481 400RCAC AL one-bedroom 600 N/A 630 N/ARCAC AL two-bedroom 1,000 N/A N/A N/A

RCAC AL Monthly Service Fees:RCAC AL studio-shared N/A N/A N/A N/ARCAC AL studio-private $2,700 $2,420 $3,800 $3,000RCAC AL one-bedroom $3,700 N/A $4,800 N/ARCAC AL two-bedroom $5,100 N/A N/A N/A

Occupancy Rate-RCAC AL 97.3% 76.5% 100.0% 85.0%Included in Monthly Service Fee:Meals 3 meals/day 3 meals/day 3 meals/day 3 meals/dayHousekeeping Weekly Weekly Weekly WeeklyLinen service Weekly Weekly Weekly WeeklyLaundry service Weekly Weekly Weekly WeeklyPersonal Care A la carte A la carte (1) A la carte A la carte

64

RCAC AL Competitor Detail

Source: Personal visits, phone interviews, and/or other research conducted in December 2019.Notes to Table:* = Unable to obtain information from the facility.N/A = Not applicable to this facility.River View Lodge(1) Care can go as high as $2,090 per month.

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Brookdale Stevens Point Care Partners Maple Ridge of Plover North Crest North Haven North RidgeStreet Address 5625 Sandpiper Drive 3349 Whiting Avenue 2831 Maple Drive 2225 Eagle Summit 2301 Eagle Summit 2201 Eagle SummitCity/State/ZIP Code Stevens Point, WI 54481 Stevens Point, WI 54481 Plover, WI 54467 Stevens Point, WI 54482 Stevens Point, WI 54482 Stevens Point, WI 54482Owner/Sponsor Brookdale Senior Living Care Properties LLC Tanglewood Senior Living Copperleaf Care Copperleaf Care Copperleaf Care

Number of BedsCBRF AL studio-shared 0 8 0 4 4 0CBRF AL studio-private 0 24 18 23 18 24CBRF AL one-bedroom 0 0 0 0 0 0CBRF AL two-bedroom 0 0 0 0 0 0

Total CBRF AL Beds 0 32 18 14 (1) 11 (1) 12 (1)

MC studio-shared 0 0 0 4 4 0MC studio-private 16 0 20 23 18 24MC one-bedroom 0 0 0 0 0 0

Total MC Beds 16 0 20 13 (1) 11 (1) 12 (1)

Total CBRF AL/MC Beds 16 32 40 27 (1) 22 (1) 24 (1)

CBRF AL/MC Square Footage:CBRF AL studio-shared N/A 300 N/A * * N/ACBRF AL studio-private N/A 250 150 * * *CBRF AL one-bedroom N/A N/A N/A N/A N/A N/ACBRF AL two-bedroom N/A N/A N/A N/A N/A N/AMC studio-shared N/A N/A N/A * * N/AMC studio-private 295 N/A 150 * * *MC one-bedroom N/A N/A N/A N/A N/A N/A

AL/MC Monthly Service Fees:CBRF AL studio-shared N/A $4,200 N/A Waiver Waiver N/ACBRF AL studio-private N/A $5,200 $4,200 $3,850 $3,850 $3,850 CBRF AL one-bedroom N/A N/A N/A N/A N/A N/ACBRF AL two-bedroom N/A N/A N/A N/A N/A N/AMC studio-shared N/A N/A N/A Waiver Waiver N/AMC studio-private $4,195 N/A $4,500 $4,350 $4,350 $4,350MC one-bedroom N/A N/A N/A N/A N/A N/A

Occupancy Rate-CBRF AL N/A 96.9% 94.4% 96.4% 100.0% 95.8%Occupancy Rate-MC 100.0% N/A 100.0% 96.4% 100.0% 95.8%Included in Monthly Service Fee:Meals 3 meals/day 3 meals/day 3 meals/day 3 meals/day 3 meals/day 3 meals/dayHousekeeping Weekly Weekly Weekly Weekly Weekly WeeklyLinen service Weekly Weekly Weekly Weekly Weekly WeeklyLaundry service-CBRF AL N/A Weekly Weekly Weekly Weekly WeeklyLaundry service-MC Weekly N/A Weekly Weekly Weekly WeeklyPersonal Care-CBRF AL N/A All inclusive A la carte Levels of care (2) Levels of care (1) Levels of care (1)

Personal Care-MC A la carte N/A A la carte Levels of care (3) Levels of care (2) Levels of care (2)

Copperleaf Senior Living

CBRF Competitor Detail

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CBRF Competitor DetailPoint Manor Assisted

LivingSylvan Crossings of

Stevens PointWellington Place at

Whiting Whispering Pines Willow Brooke PointStreet Address 1800B Sherman Avenue 100 N Green Avenue 1902 Post Road 3380 Bridlewood Drive 1800 Bluebell LaneCity/State/ZIP Code Stevens Point, WI 53073 Stevens Point, WI 54481 Stevens Point, WI 54481 Plover, WI 54467 Stevens Point, WI 54481Owner/Sponsor

North Shore Healthcare Sylvan CrossingsWisconsin Illinois Senior

Housing Privately OwnedWillow Brooke Senior

LivingNumber of Beds

CBRF AL studio-shared * 4 8 0 0CBRF AL studio-private * 15 20 40 30CBRF AL one-bedroom 0 0 0 0 0CBRF AL two-bedroom 0 0 0 0 0

Total CBRF AL Beds 29 19 28 40 30MC studio-shared 0 0 0 0 0MC studio-private 0 0 0 0 10MC one-bedroom 0 0 0 0 0

Total MC Beds 0 0 0 0 10Total CBRF AL/MC Beds 29 19 28 40 40CBRF AL/MC Square Footage:

CBRF AL studio-shared * 350 450 N/A N/ACBRF AL studio-private * 280 390 196-350 300CBRF AL one-bedroom N/A N/A N/A N/A N/ACBRF AL two-bedroom N/A N/A N/A N/A N/AMC studio-shared N/A N/A N/A N/A N/AMC studio-private N/A N/A N/A N/A 300MC one-bedroom N/A N/A N/A N/A N/A

AL/MC Monthly Service Fees:CBRF AL studio-shared Waiver Waiver $2,570 N/A N/ACBRF AL studio-private $3,920 $3,800 $3,750-$4,500 $4,000 $3,450 CBRF AL one-bedroom N/A N/A N/A N/A N/ACBRF AL two-bedroom N/A N/A N/A N/A N/AMC studio-shared N/A N/A N/A N/A N/AMC studio-private N/A N/A N/A N/A $3,450 MC one-bedroom N/A N/A N/A N/A N/A

Occupancy Rate-CBRF AL 89.7% 94.7% 92.9% 100.0% 96.7%Occupancy Rate-MC N/A N/A N/A N/A 100.0%Included in Monthly Service Fee:Meals 3 meals/day 3 meals/day 3 meals/day 3 meals/day 3 meals/dayHousekeeping Weekly Weekly Daily Weekly WeeklyLinen service Weekly Weekly Weekly Weekly WeeklyLaundry service-CBRF AL Weekly Weekly Weekly Weekly WeeklyLaundry service-MC N/A N/A N/A N/A WeeklyPersonal Care-CBRF AL Levels of care (1) Levels of care (1) Levels of care (1) Levels of care (1) Based on assessmentPersonal Care-MC N/A N/A N/A N/A Based on assessment

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CBRF Competitor Detail

North Crest(1) There are 27 secured beds that can be used for assisted living or memory care. (2) There are three levels of care, the first of which is required and included in the rents shown. Additional levels are priced at $1,000 and $2,000 per month.(3) There are three levels of care, the first two of which are required for memory care and included in the rents shown. The additional level is $2,000 per month.North Haven(1) There are 22 secured beds that can be used for assisted living or memory care. (2) There are three levels of care, the first of which is required and included in the rents shown. Additional levels are priced at $1,000 and $2,000 per month.(3) There are three levels of care, the first two of which are required for memory care and included in the rents shown. The additional level is $2,000 per month.North Ridge(1) There are 24 secured beds that can be used for assisted living or memory care. (2) There are three levels of care, the first of which is required and included in the rents shown. Additional levels are priced at $1,000 and $2,000 per month.(3) There are three levels of care, the first two of which are required for memory care and included in the rents shown. The additional level is $2,000 per month.Point Manor Assisted Living(1) There are four levels of care, none of which are required or included in the rents shown. Levels of care are priced at: $340, $830, $1,320, and $2,000 per month.Sylvan Crossings of Stevens Point(1) There are levels of care ranging up to $2,797 per month. The average level of care is $819 per resident.Wellington Place at Whiting

Whispering Pines(1) There are four levels of care, none of which are required or included in the rents shown. Levels of care are priced at: $500, $1,000, $1,500 and $2,000 per month.

(1) There are seven levels of care, none of which are required or included in the rents shown. Levels of care are priced at: $275, $390, $500, $728, $950, $1,100, and $1,250 per month.

MC = Memory Care

Source: Personal visits, phone interviews, and/or other research conducted in December 2019.Notes to Table:* = Unable to obtain information from the facility.N/A = Not applicable to this facility.

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APPENDIX B – Detailed Demographic Tables

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2000 2010 2020 2025 2000-2010 2010-2020 2020-2025

Market Area 5,307 6,575 8,807 10,138 2.2% 3.0% 2.9%

Wisconsin 702,553 777,314 1,025,861 1,173,776 1.0% 2.8% 2.7%

2000 2010 2020 2025 2000-2010 2010-2020 2020-2025

Market Area 2,694 3,273 5,112 6,216 2.0% 4.6% 4.0%

Wisconsin 355,307 400,496 610,213 722,006 1.2% 4.3% 3.4%

2000 2010 2020 2025 2000-2010 2010-2020 2020-2025

Market Area 1,866 2,170 2,538 2,735 1.5% 1.6% 1.5%

Wisconsin 251,621 258,313 286,654 318,660 0.3% 1.0% 2.1%

2000 2010 2020 2025 2000-2010 2010-2020 2020-2025

Market Area 747 1,132 1,157 1,187 4.2% 0.2% 0.5%

Wisconsin 95,625 118,505 128,994 133,110 2.2% 0.9% 0.6%

Sources: Environics Analytics and U.S. Bureau of the Census

Total Age 65 & Over Annual Percentage Change

Age 85 & Over Annual Percentage Change

Age 65-74 Annual Percentage Change

Age 75 -84 Annual Percentage Change

69

Senior Population Growth

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2000 2010 2020 2025 2000-2010 2010-2020 2020-2025

Market Area 3,544 4,336 5,708 6,424 2.0% 2.8% 2.4%

Wisconsin 458,646 508,910 661,655 751,092 1.0% 2.7% 2.6%

2000 2010 2020 2025 2000-2010 2010-2020 2020-2025

Market Area 1,736 2,048 3,175 3,777 1.7% 4.5% 3.5%

Wisconsin 224,557 251,260 378,823 445,246 1.1% 4.2% 3.3%

2000 2010 2020 2025 2000-2010 2010-2020 2020-2025

Market Area 1,379 1,500 1,729 1,833 0.8% 1.4% 1.2%

Wisconsin 178,765 176,983 194,695 215,097 -0.1% 1.0% 2.0%

2000 2010 2020 2025 2000-2010 2010-2020 2020-2025

Market Area 429 788 804 814 6.3% 0.2% 0.2%

Wisconsin 55,324 80,667 88,137 90,749 3.8% 0.9% 0.6%

Sources: Environics Analytics and U.S. Bureau of the Census

Age 85 & Over Annual Percentage Change

Age 65-74 Annual Percentage Change

Age 75 -84 Annual Percentage Change

Total Age 65 & Over Annual Percentage Change

70

Senior Household Growth

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Total Population and Household Growth

2000 2010 2020 2025 No. Pct. No. Pct. No. Pct.Total Population

Market Area 49,294 51,930 53,184 53,910 2,636 5.3% 1,254 2.4% 726 1.4%

Wisconsin 5,363,675 5,686,986 5,837,751 5,923,524 323,311 6.0% 150,765 2.7% 85,773 1.5%

Total Households

Market Area 18,455 20,727 21,733 22,228 2,272 12.3% 1,006 4.9% 495 2.3%

Wisconsin 2,084,549 2,279,768 2,380,162 2,427,781 195,219 9.4% 100,394 4.4% 47,619 2.0%

2000 2010 2020 2025Population

Market Area 5.3% 6.4% 6.9% 7.3%

Wisconsin 6.5% 6.6% 7.1% 7.6%

Households

Market Area 9.8% 11.0% 11.7% 11.9%

Wisconsin 11.2% 11.3% 11.9% 12.6%

Sources: U.S. Census, Environics Analytics

2020-2025Environics 2010-2020

AGE 75+ AS PERCENT OF TOTAL POPULATION/HOUSEHOLDS

2000-2010ESTIMATE/PROJECTION CHANGEHISTORICAL

U.S. Census

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2020-2025 2020-2025Number Percent Number Percent Change Number Percent Number Percent Change

Age 65-74Less than $25,000 701 22.1% 767 20.3% 9.4% 79,842 21.1% 80,770 18.1% 1.2%$25,000 - 34,999 392 12.3% 425 11.3% 8.4% 44,836 11.8% 47,284 10.6% 5.5%$35,000 - 49,999 425 13.4% 470 12.4% 10.6% 60,912 16.1% 65,797 14.8% 8.0%$50,000 - 74,999 653 20.6% 749 19.8% 14.7% 72,903 19.2% 83,918 18.8% 15.1%$75,000 - 99,999 340 10.7% 404 10.7% 18.8% 45,450 12.0% 55,136 12.4% 21.3%$100,000 - 149,999 371 11.7% 519 13.7% 39.9% 41,878 11.1% 57,188 12.8% 36.6%$150,000 - $199,999 148 4.7% 217 5.7% 46.6% 15,065 4.0% 23,806 5.3% 58.0%$200,000 or more 145 4.6% 226 6.0% 55.9% 17,937 4.7% 31,347 7.0% 74.8%Subtotal 3,175 100.0% 3,777 100.0% 19.0% 378,823 100.0% 445,246 100.0% 17.5%Median Income 52,421$ 57,034$ 8.8% 51,076$ 57,601$ 12.8%

Age 75-84Less than $25,000 527 30.5% 528 28.8% 0.2% 57,392 29.5% 57,016 26.5% -0.7%$25,000 - 34,999 299 17.3% 291 15.9% -2.7% 32,235 16.6% 33,380 15.5% 3.6%$35,000 - 49,999 246 14.2% 262 14.3% 6.5% 33,840 17.4% 35,877 16.7% 6.0%$50,000 - 74,999 325 18.8% 337 18.4% 3.7% 33,695 17.3% 37,987 17.7% 12.7%$75,000 - 99,999 117 6.8% 132 7.2% 12.8% 15,150 7.8% 18,100 8.4% 19.5%$100,000 - 149,999 138 8.0% 179 9.8% 29.7% 14,372 7.4% 19,398 9.0% 35.0%$150,000 - $199,999 42 2.4% 50 2.7% 19.0% 4,005 2.1% 6,335 2.9% 58.2%$200,000 or more 35 2.0% 54 2.9% 54.3% 4,006 2.1% 7,004 3.3% 74.8%Subtotal 1,729 100.0% 1,833 100.0% 6.0% 194,695 100.0% 215,097 100.0% 10.5%Median Income 36,807$ 39,727$ 7.9% 37,910$ 41,478$ 9.4%

Age 85+Less than $25,000 340 42.3% 329 40.4% -3.2% 35,712 40.5% 33,953 37.4% -4.9%$25,000 - 34,999 142 17.7% 137 16.8% -3.5% 15,028 17.1% 14,868 16.4% -1.1%$35,000 - 49,999 106 13.2% 102 12.5% -3.8% 14,277 16.2% 14,516 16.0% 1.7%$50,000 - 74,999 114 14.2% 117 14.4% 2.6% 12,005 13.6% 13,097 14.4% 9.1%$75,000 - 99,999 40 5.0% 44 5.4% 10.0% 5,407 6.1% 6,205 6.8% 14.8%$100,000 - 149,999 40 5.0% 53 6.5% 32.5% 3,583 4.1% 4,690 5.2% 30.9%$150,000 - $199,999 14 1.7% 20 2.5% 42.9% 1,075 1.2% 1,653 1.8% 53.8%$200,000 or more 8 1.0% 12 1.5% 50.0% 1,050 1.2% 1,767 1.9% 68.3%Subtotal 804 100.0% 814 100.0% 1.2% 88,137 100.0% 90,749 100.0% 3.0%Median Income 28,889$ 30,179$ 4.5% 30,152$ 32,403$ 7.5%

Total Age 65+Less than $25,000 1,568 27.5% 1,624 25.3% 3.6% 172,946 26.1% 171,739 22.9% -0.7%$25,000 - 34,999 833 14.6% 853 13.3% 2.4% 92,099 13.9% 95,532 12.7% 3.7%$35,000 - 49,999 777 13.6% 834 13.0% 7.3% 109,029 16.5% 116,190 15.5% 6.6%$50,000 - 74,999 1,092 19.1% 1,203 18.7% 10.2% 118,603 17.9% 135,002 18.0% 13.8%$75,000 - 99,999 497 8.7% 580 9.0% 16.7% 66,007 10.0% 79,441 10.6% 20.4%$100,000 - 149,999 549 9.6% 751 11.7% 36.8% 59,833 9.0% 81,276 10.8% 35.8%$150,000 - $199,999 204 3.6% 287 4.5% 40.7% 20,145 3.0% 31,794 4.2% 57.8%$200,000 or more 188 3.3% 292 4.5% 55.3% 22,993 3.5% 40,118 5.3% 74.5%Total 5,708 100.0% 6,424 100.0% 12.5% 661,655 100.0% 751,092 100.0% 13.5%Median Income 43,047$ 48,012$ 11.5% 43,526$ 48,851$ 12.2%

2020 2025Market Area Wisconsin

2020 2025

72

Senior Household Income

Source: Environics Analytics

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Senior Household TenureTotal Own Rent Total Own Rent Total Own Rent Total Own Rent

Number:

Market Area 4,336 3,150 1,186 2,048 1,661 387 1,500 1,096 404 788 393 395

Wisconsin 508,910 381,229 127,681 251,260 205,183 46,077 176,983 131,370 45,613 80,667 44,676 35,991

Percent:

Market Area 100.0 72.6% 27.4% 100.0 81.1% 18.9% 100.0 73.1% 26.9% 100.0 49.9% 50.1%

Wisconsin 100.0 74.9% 25.1% 100.0 81.7% 18.3% 100.0 74.2% 25.8% 100.0 55.4% 44.6%

Note: Percentages may not add up to 100.0 due to rounding

Source: 2010 U.S. Census

Total Age 65 & Over Age 65 - 74 Age 85 & OverAge 75 - 84

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