Promise keeper

Patrick Bismuth might be more tortoise than hare in the race to build senior living facilities in the region, but the deliberate pace suits him.

“I'm surprised there are so many memory care places opening,” says Bismuth. “Sometimes, it seems like it's unsubstantiated enthusiasm.”

Bismuth, instead, has taken a counterintuitive approach: Go small. His company, Lily's Promise LLC, offers senior care, specializing in residents with Alzheimer's and dementia, in five- or six-bedroom homes in the Sarasota-Manatee area. The homes are in residential neighborhoods, and comply with all zoning and elder care laws and regulations.

Bismuth opened the first Lily's Promise house in 2015, a five-bedroom, 2,360-square-foot home east of Interstate 75 off of Bee Ridge Road in Sarasota. He opened another house, a six-bedroom, 3,000-square-foot home in east Manatee County, near Lakewood Ranch, last summer. Lily's Promise only accepts private-pay residents, with no Medicare or other programs.

Bismuth says the first 18 months or so in business have proved that there's a need for small, residential elder care in the region. Both homes are fully occupied, and Bismuth has bought two more homes he plans to open in 2017, one off the University Parkway exit of I-75 and one off the Fruitville Road exit. “If all goes well, we will have a third one by the end of the year,” Bismuth says.

One goal, in locations, is to track I-75. Each new Lily's Promise home, Bismuth says, will be off a different interstate exit.

Another goal with the homes, Bismuth says, is a lesson learned from the previous locations. He won't open up in existing homes going forward, like the first two. Bismuth spent about $800,000 on those homes, and at least another $100,000 on renovations.

“We now will only go with new construction,” Bismuth says in an interview in late November. “That will allow us to customize the home to meet regulations.”

Bismuth's first career was in IT consulting. He ran his own business working with Fortune 500 companies worldwide, based in California. He got into senior living in 2008, when he took over operations of a struggling 200-unit retirement community in Columbus, Ohio.

He decided to move to Florida to try the residential model, where the demographics are an obvious fit.

Bismuth says the mission at Lily's Promise, named after his mom, Liliane, is also to care for people with a higher medical acuity, people who can be more difficult to work with. Several Lily's Promise residents were turned down from other larger standard facilities.

“We offer something unique that isn't really available anywhere else,” Bismuth says.

One of the biggest challenges Bismuth faces with Lily's Promise is staffing, a common theme in health care. His labor costs are higher than larger facilities because of the more concentrated care. He offers higher pay than the industry average, in addition to a bonus for meeting work attendance and performance goals, in an effort to boost retention.

On the flip side, his construction costs per bed are generally less than the senior care industry average.

Another challenge is a familiar entrepreneurial one: to make sure the growth doesn't outpace the high-touch customer service. “I'll continue to expand as the market supports it,” Bismuth says. “But I don't want to expand too quickly.”