Sage Oak CEO Loe Hornbuckle recently joined the Senior Housing News Transform podcast to talk about where senior living is headed and what personalization actually requires from an operator.
When the host asked him for the best example of curated care in the company, he did not reach for a concept. He described Lake Charles.
Five homes, and no two are the same
Our campus in Lake Charles is five homes with 16 residents in each, 80 living spaces in total. Most communities of that size would run as one building with an assisted living side and a locked memory care side. We run it as five distinct environments.
As Hornbuckle laid it out in the interview, that includes an independent-leaning assisted living home, a higher-needs assisted living home, and an advanced care home for our highest acuity residents. The remaining homes are split between higher-functioning dementia care and higher-needs dementia care.
The advantage is that when a family calls, we have a real chance of having an environment that fits the person rather than a room that happens to be open. A resident who is socially engaged and independent is not placed in the same living room as someone who needs hands-on support for most of the day. Both are better off.
He was also honest about the tradeoff, which is worth repeating. The more specialized each home is, the narrower the group of residents it fits. Some weeks the inquiries do not arrive neatly allocated across five houses. Sometimes the right home is full and the next closest is not close enough. That is the cost of doing it this way, and we would rather pay it than blend everyone together.
Why Louisiana rewards this approach
There is a regulatory reason curated care fits particularly well in Louisiana, and Hornbuckle called it out directly.
Louisiana strongly favors placing residents in the least restrictive setting appropriate to their needs. If a resident has dementia but is not an elopement risk, the state would rather they not be confined to a locked unit.
A single-building operator has a hard time honoring that. There is a memory care wing and there is an assisted living wing, so residents get sorted into one or the other. With five separate homes, we can build an advanced care environment where dementia care and assisted living merge for residents whose acuity has moved past elopement risk. They get support without a locked door they do not need.
For families in Calcasieu Parish weighing a dementia diagnosis, that distinction changes the quality of daily life significantly.
What a caregiver ratio really means
Ratios get quoted on every tour in Southwest Louisiana and almost never get explained. Hornbuckle gave families a simple way to translate them.
Divide the ratio into 24 hours. A common industry staffing level is roughly 18 residents to one caregiver, which works out to about an hour and 20 minutes of theoretical direct care per resident, per day. That has to cover bathing, dressing, medication, meals, redirection, and every conversation in between.
Sage Oak of Lake Charles runs between 1:5 and 1:8. At 1:8 that is three hours. At 1:5 it is closer to five.
He also introduced a second measure that does not appear in any brochure: caregivers per square foot. Any provider can change a staffing ratio. No provider can change the size of their building. A generously staffed large community still has caregivers standing well down a hallway from the resident who needs them. In a 16-resident home, that distance does not exist.
Two chefs per house, and why the math works
The interview spent real time on food, and Lake Charles is where our approach shows up most clearly.
Small residential care homes are not typically known for excellent food. Hornbuckle explained why that is an economics problem rather than a caring problem. Spread the cost of a strong chef team across eight residents and the per-resident cost is high. Spread it across 16, and a house can support two chefs working an A and B rotation without the price becoming unreasonable.
Group several 16-resident homes on one campus, the way we have in Lake Charles, and you can staff a full dietary team of cooks and chefs. We do not employ servers or hosts, because there is no dining room to seat anyone in. The kitchen is the middle of the house, open plan, and residents watch their food being made.
The result looks less like restaurant service and more like a private chef. A private chef asks what you like, what you cannot eat, and what your family prefers when they visit, then cooks for those answers. Hornbuckle shared a moment from a Sage Oak home where a resident was near end of life and family had been at the bedside for days. The chef noticed and made them grilled salmon, potatoes, and broccoli without being asked. That is not a program. That is a kitchen close enough to notice.
The industry is doing well. Personalization is what is still missing.
Hornbuckle pushed back on the idea that senior living has an image problem. Occupancy in assisted living and memory care has climbed for years running and now sits at record highs, both as a percentage and in raw number of residents served.
His view is that the industry does not need to be torn down and rebuilt. What it needs is more personalization and more genuinely new ideas taking real market share. He put his own philosophy bluntly: he is not in the business of finding efficiencies to shave costs, he is in the business of making an audacious promise and then keeping it.
Listen to the episode
You can hear the full conversation on the Senior Housing News Transform podcast, available here on Apple Podcasts.
If you are researching assisted living or memory care in Lake Charles, come see all five homes. We will be straightforward with you about which one fits and which one does not.