San Rafael needs more supportive housing for older adults, and a new assisted living facility that opened last weekend is a welcome addition, but only for those who can afford it.
Aegis Living, which operates 50 assisted living facilities in California, Seattle and Las Vegas, held a grand opening Saturday for Aegis San Rafael at 800 Mission Ave.
Designed in Mission-style architecture, the facility is close to downtown and public transit. Saturday’s event had celebrity appearances by TV journalist and former co-host of “Good Morning America” Joan Lunden and Italian model Fabio Lanzoni. The decorative lobby was packed with excited silver-haired onlookers.
According to Aegis spokesperson Charlie Fusco, the new five-floor facility has over 120 beds, and the first 10 residents moved in this week. In addition to housing, they also provide five levels of care, from assisted living to memory and companion care. Rooms come in a range of options, from studios to two bedrooms, but the average monthly rent is around $6,000, which includes meals, cleaning and activities. The costs for care go on a separate bill.
Fusco said you can’t get into Aegis San Rafael with help from Medicaid.
“This is private pay,” Fusco said. “They don’t take Medicare or Medicaid, but you only pay for the care you need. You might come in at a smaller level of care, and then in a year you need to increase it, so that’s a little sliding.”
The facility has new technologies, like artificial intelligence-powered fall prevention and red-light therapy beds, which radiate a certain light wave that Fusco said has been proven to help with inflammation and energy. The facility has all the things needed for residents to not just age in place, she said, but to reverse aging.
“We are hitting what they call the silver tsunami,” said Fusco. “There are more people turning 80 now than ever. By the end of 2030, there’s projected to be a shortage of beds in general, and there’s no new buildings happening right now at all, from any company.”
A fast-growing city of seniors
San Rafael is the largest city of the most rapidly aging county in the state, according to the city’s website. Out of more than 6,000 senior households in San Rafael, more than half include residents that are 75 years and older, of which 73% are homeowners, the city said.
According to research posted by the housing advocacy nonprofit Marin Environmental Housing Collaborative, almost half of the county’s population is expected to be above 60 by 2041. Less than 1% of Marin County housing stock is accessible to people with disabilities, and even fewer units are both affordable and accessible, the site said.
“Most of our housing, and especially most of our multi-family housing was built before the Americans with Disabilities Act was in effect,” said Jenny Silva, executive director of MEHC. The 1990 ADA mandated accessibility standards for all new construction.
“There are folks within Marin that are living in houses on the hills where they can’t get up and down the steps and they can’t drive. That’s a very secluded life. But by having facilities like this, they can have the option to leave their house and be in an accessible place. Then a family could potentially move into that house,” she said.
Silva said nowhere in Marin County has enough senior living facilities, but San Rafael is better off than other areas.
“Sausalito has no assisted living that I know of,” she said, adding that the biggest challenge will be building senior housing that is affordable.
“It’s always the million-dollar question. There’s a lot of things that get proposed that never get built,” she said.
Staffing strain and affordability
A 2024 Marin County Civil Grand Jury report found that high housing costs and a fast-growing population over the age of 60 are key contributing factors to a potential homelessness crisis among older adults in Marin.
The report said the shortage extends beyond facilities to include staff — low wages and high living costs make it difficult to recruit and retain caregivers in Marin, creating further barriers to adequate care for seniors. The report said most available residential options are not sufficient to meet demand, especially for middle- and lower-income seniors.
“Most caretakers commute into the county,” Silva said. “If you’re in a family that makes $120,000, that is considered low income in Marin County and the housing options that you have will be very, very slim, and probably not suitable for a family.”
“There are more people turning 80 now than ever. By the end of 2030, there’s projected to be a shortage of beds in general, and there’s no new buildings happening right now at all, from any company.” Charlie Fusco, Aegis Living spokesperson
Concerns about understaffing at Aegis Living led to a 2021 class-action lawsuit, alleging that the company set staffing levels on predetermined labor budgets rather than resident assessments. The company’s general counsel Stephen Geissler said the company still disputes the allegations, but they wanted the case to end. In addition to the $16.25 million payment to plaintiffs, the company had to submit quarterly reports on its care, which it recently completed.
Fusco said Aegis San Rafael has care audits where nurses and the doctors come in every 90 days to make sure residents are still getting what they need.
“This resolution, reached years ago, allowed us to focus our full attention on what truly matters — delivering exceptional care, and taking care of the people who trust us,” she said.
