As St. Louisans age, senior living providers like EverTrue are in high demand

One of the common reasons people tend to land in St. Louis is to be closer to family and the care that comes with that proximity.

Not so for Adam Marles, who moved here from the East Coast four years ago to be the president and CEO of EverTrue. 

“I didn’t know a single person in the state of Missouri when I made the move, but I saw an organization that was doing good work with a ton of potential to serve more people well,” Marles says. “It was a no-brainer to take a bit of a risk moving my family halfway across the country to do more good work.”

The St. Louis-based nonprofit runs several kinds of communities serving older adults, such as affordable housing communities for low income seniors, independent living apartments, and “life plan communities,” developments that offer independent and assisted living, nursing, and memory care facilities as a resident’s needs change. Most of its facilities are concentrated in St. Louis, St. Louis, and St. Charles counties, with a small footprint in Illinois and Pennsylvania as well.

To Marles, EverTrue (formerly known as Lutheran Senior Services) is focusing on serving older adults at a critical moment for the region and nation. St. Louis is at the leading edge of an impending demographic winter, bringing with it the reality of more adults over the age of 65 than those younger than 18, he says.

“We’re going to have a lot of people who are aging. We’ve got people living longer than they ever have, and the need for services, whether that’s in their own homes or in a residential setting, is going to be extraordinary,” Marles says. “The need for older adults to receive services is going to be unlike anything we’ve ever seen in this country’s history.”

Already EverTrue has multi-year wait lists for its affordable housing communities and hundreds of people waiting for a spot in one of its life plan communities.

“That’s today,” Marles says. “The demographics are going to continue to accelerate; the demand is going to be extraordinary. [Neither] we, nor any other organization in the country, could ever keep up with the demand that’s going to be there.”

But he contends the nonprofit he runs is in a better position to grow to meet this demand than other organizations that haven’t “evolved quickly enough.” Marles explains that a big problem is a “woefully inadequate” reimbursement rate from those who use Medicaid to pay for one of their care centers.

“Typically, if someone is relying on Medicaid in our care centers, it costs us. We lose about $300 per person per day in serving those people,” he says. “We have to have a viable financial model where we can find some areas to make margin and offset some of those losses.”

EverTrue’s life plan communities bring in enough money to subsidize some of its other services, such as some in-home services or what it can offer at its affordable housing developments, Marles says. And the nonprofit has done well under this paradigm, he adds.

“Our growth as an organization over the past four years has been rapid,” Marles says. “Our operating budget in the last four years has gone from $232 million a year to $409 million. We’re serving thousands more people than we were four years ago.”

What Marles finds more gratifying than dollar figures is the feedback he hears from EverTrue residents, particularly those living in its affordable housing developments. Some, he says, wouldn’t have a place to live but for his nonprofit, and others share their residences are the nicest and safest places they’ve ever lived. They also do a great job of fostering community, he says.

“One of the starkest realities that was brought into relief by the pandemic was the impact of isolation on everybody, but in particular the impact of isolation on older adults,” Marles says. “There is no doubt that there is a correlation between social interaction and engagement and quality of life in lots of different ways.”

He contends the communities his nonprofit runs help people live longer and better lives. 

EverTrue is set to open another housing development this spring just across from the Bevo Mill, offering a mix of market rate and affordable units for seniors. The Crossroads development (which came together in partnership with the Tower Grove Community Development Corporation) will soon be home to 64 new residents after a years-long process to secure funding from almost 10 different sources, Marles says, including the Department of Housing and Urban Development, Low Income Housing Tax Credits, and other sources.

Marles says EverTrue is gratified by the way the neighborhood has accepted what he hopes will be a new anchor point that can allow lifelong St. Louisans to age in the city.

“The only part of it that I lament is that we can’t do more of it because the need is so great,” he says. “There are pieces of land all over the city where we would love to build the next Crossroads for the next 60 or 70 or 80 affordable housing residents, but the money is not in the system right now to do it.”