CARING FOR SENIORS:

KEYS TO OPERATIONAL SUCCESS

Alice Walker

Vice President of Operations Administration

Belmont Village Senior Living

AMAR

San Antonio, Texas

May 7, 2010

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• Fully integrated developer and operator of first-quality assisted living communities

• Serves top tier of private pay segment exclusively; sites are chosen in high-rent markets with high barriers to entry

• Communities are larger than average and generate economies of scale and market-leading operating margins

• 17-asset development portfolio completed on time and 2% under budget

• Institutional capital partners include:

BELMONT VILLAGE TODAY

SF Bay Area (2)

Los Angeles (5)

Chicago (4)

Louisville (1)

San Diego (2)

Houston (1)

Atlanta (2)

Memphis (1)

Nashville (1)

Orange County (1)

20 Existing Communities

6 In Development / Pre-Development

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INDUSTRY OVERVIEW

1Personal care is assistance with “Activities of Daily Living” and includes bathing,

dressing, and grooming.

Nursing Home

Minimum activities

Ill and very frail

Need driven

Full medical care required

Government reimbursed

Independent Living

Active senior

Mobile

No support needed

Private pay

Lifestyle

Continuum of Care

Assisted Living

Less active

Healthy, but frail

Personal care1

Alzheimer’s/

memory impairment

Belmont Village

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SENIOR HOUSING:

REAL ESTATE OR OPERATING COMPANY?

Yes.

Belmont Village Sabre Springs (San Diego)

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KEYS TO BELMONT’S SUCCESS

• Best-in-class facilities

Steel and concrete construction in prime locations

State-of-the-art life safety

Distinctive interiors and landscaping

• Focus on quality

Research-based operational approach

Hospitality-oriented culture, first-rate amenities

Lifelong learning

• Investment in people

Rigorous selection and training

On-site licensed nurses

• Operational innovation

Ongoing development to address evolving resident needs

Circle of Friends® memory care

Mind Body Awareness (MBA) for brain health

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• Consistent quality in service delivery assures

operating excellence

• Best practices assured through regional infrastructure

• Proven food service program developed with Hilton

College of Hotel and Restaurant Management

• Community leadership teams with 7 managers lend

expertise and redundancy at point-of-service

• Proprietary operating system (SenSys) enables

consistent service delivery and management

• Business risk is mitigated by operating

infrastructure

• Rigorous HR systems for recruitment and screening

• Extensive training and development at community level

(multi-media and hands-on)

• Licensed nurses on-site 24/7 for medication management

and care supervision

• Proactive compliance monitoring

OPERATING STRATEGY

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CUSTOMER NEEDS AND EXPECTATIONS

HospitalityDining

Concierge Services

Activities

Housekeeping

Laundry

Environment/AmenitiesDecorations – high-end or home-like

Pool, Golf Course

Computer Center

Exercise Room

Library

Private Dining Room

Theater

Multi-purpose/Meeting Room

ProgrammingDaily Outings

Computer Classes

Exercise Classes

Physical Therapy

Academic Classes

Memory Programs

Crafts

Games

CareActivities of Daily Living

– Bathing, Dressing, Grooming

Incontinence Care – Toileting reminders

Medication Management

– Reminders and/or distribution

Diabetes Management

Escorting

One-on-One Care

Hospice Care

Nursing Care

Special Diets-Nutrition Counseling

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STAFFING: EXECUTIVE DIRECTOR SELECTION

• Strong leader is most important

operational element

• Favorable outcomes of a strong

Executive Director

Low Employee Turnover

- 2009 Annualized Belmont Average: 46%

- 2008 Industry Average: 75-80%

Low Resident Turnover

High Employee and Resident Satisfaction

2009 Annual Resident Satisfaction Survey Results:

95% residents recommend Belmont Village as a good place to live.

95% employees recommend Belmont Village as a good place to work

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STAFFING CONSIDERATIONS

• What services will you offer and what

kind of expertise will you need?

• How many residents will you have?

Belmont 150 residents in a 156-unit building.

Requires about 75 FTEs

• What management team members will

oversee what areas?

Executive Director

Director of Care

Sales Personnel (2)

Activity Coordinator

Chef Manager

Memory Program Coordinator

Human Resources Coordinator

Building/Maintenance Engineer

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RISK AND COMPLIANCE

• In the US, we must be concerned with the

following:

State Regulations for Seniors Housing

State Regulations for Employees

General and Professional Liability Insurance

Worker’s Compensation Insurance

• Though these concerns do not exist to the

same degree in Mexico, operating risk and

compliance are still important

For example, Belmont operates with nurses in the

building 24-hours per day.

This is not required by in most states.

However, this staffing model provides consistency

in operations and needed oversight to reduce risk.

• Reputation is everything!

Multiple care levels with 24/7 on-site

nurses

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EVOLVING PRODUCT

• Since Belmont’s inception in 1997, Alzheimer’s

Care has moved to the forefront as a demand

driver.

• 5.1 million Americans have Alzheimer’s

Disease (mostly age 65 and over)

• 42% of seniors age 85+ have Alzheimer’s

Disease

• In response to customer demand for dementia

programming, Belmont introduced a program

called Circle of Friends®

Specialized care for Mild Cognitive Impairment

Quickly embraced by families and professionals

Source: Alzheimer’s Association

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FOUNDATIONS OF OUR SUCCESS

• Strong Product

• Exceptional Leadership

• Operating Consistency

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Belmont Village of Rancho Palos VerdesQ&A