Case Study: Eaton Senior Communities Connect Housing and Health Care Services to Improve Wellness

Eaton Senior Communities illustrates a multi-faceted wellness initiative that brings a wide array of health and community services to its campus.

In Lakewood, Colorado, low-income older adults living in Eaton Senior Communities have access to on-site service coordination and an extensive set of wellness services and supports. The Eaton campus has housing subsidized by the U.S. Department of Housing and Urban Development (HUD) that also pays for 97% of a full-time, on-site service coordinator position. The nonprofit also has a market-rate apartment building with a part-time supportive services coordinator. Together, the residences serve 225 people. The campus also has both a fitness center and a wellness center.

Eaton’s service coordination program is a cornerstone of its multi-faceted wellness initiative. Over the years, Eaton has cultivated and sustained partnerships with a wide array of community organizations, professionals, and student volunteers to enhance access to health, wellness, and other supports. Using their own funding sources, these partners bring supportive services on Eaton’s campus so that people have ready access to:

On-site meals and other nutrition services
Fitness and wellness classes
Primary care and limited specialty care
Other health and wellness offerings that respond to community interests and needs

Impact of the Resident Care and Services Model

Emergency department visits and hospital utilization rates among Eaton residents remain low, indicating the preventive impact of bringing health and wellness services directly to residents.

Keys to Success

Use a mix of funding to support the service coordinator and wellness director, such as a service coordination grant from HUD, operating funds in the market-rate building, and philanthropic support.
Cultivate and sustain an extensive group of community partners to provide critical health and wellness services on campus.
Embrace innovation and partner with organizations seeking a real-world testing ground for models, then leverage those successes to open new opportunities.
Maintain an organizational culture and set budgets that consistently prioritize health and wellness.

Service Coordination Model

Service coordination assists individuals with accessing health and supportive services as their needs change. All of Eaton’s service coordinators are either social workers or experienced in health navigation or health care management.

This foundational support is part of Eaton’s broader wellness initiative. At Eaton, service coordination begins when someone moves into a residence. The service coordinators introduce themselves, explain how they can assist with finding and connecting with supportive services, and offer to interview them to begin the process. The coordinators develop an initial profile, which they continue to build over time as informal and formal communications deepen understanding of each person’s needs and their priorities. Using the profiles, coordinators assist individuals in finding, selecting, connecting with, and managing the supportive services they want and need. These team members review and update each profile at least once a year for individuals who agree to follow-up interviews.

Wellness Initiative

Eaton’s wellness initiative extends beyond service coordination to ensure its campus has an extensive array of wellness, health, and chronic care supports through community partners as described in Table 1. The nonprofit has a full-time wellness director with expertise in integrative health care or health care management. Working in tandem with service coordinators, the wellness director manages, evolves, and expands the set of community partners. Most of the health care services are available at Eaton’s wellness center or fitness center.

Table 1: Overview of Service Coordination and Other Wellness Supports Available on Eaton’s Campus

Type of Support	Examples of Supportive Services Available
Service Coordination	Service coordination, annual wellness interviews, basic health screenings, and benefits eligibility assessments
Health Care	Physical, occupational, and speech therapies from clinical therapy providers Dermatology, podiatry, dental hygiene, optometry, and audiology care from local clinicians Vaccinations Chiropractic care and acupuncture
Community Spaces	24-hour fitness center, wellness center, community rooms and library, garden, and biweekly farmers market (seasonal)
Other Wellness Services	Exercise classes, fall prevention, self-care education, massage therapy, intergenerational programs, digital tablet classes, and social connectedness Other wellness initiatives through health technology pilot programs (see next section)
Transportation	Multiple transportation options: city transit service, regional paratransit, and Eaton's own bus service for regular trips to the grocery store

To coordinate resident care and address any challenges, Eaton has an internal community consultation team that meets weekly, which is a best practice for service coordination. This interdisciplinary team brings together key Eaton staff members—including the executive director, leasing managers, wellness director, service coordinator, and plant operations supervisor—to ensure comprehensive support. Through these regular meetings, the team identifies issues early, coordinates services across departments, and develops collaborative solutions that enhance residents’ overall well-being.

Further, Eaton routinely provides education and training for their staff on self-care, trauma-informed care, and Mental Health First Aid. This professional development better prepares them to respond to people’s needs and may also contribute to Eaton’s workforce retention.

Braiding and Partnerships Make Service Coordination

Eaton braids together many sources of funding and has extensive community partnerships to provide service coordination and wellness offerings. On occasion, Eaton has agreed to partner with technology developers to pilot new assistive devices on campus.

Table 2 summarizes some of the health and wellness funding support from community partners. Most of the partnerships have an established memorandum of understanding. When applicable, community partners sign an agreement with guidelines for both serving older adults and using Eaton’s physical property. Most partners have their own direct funding sources, which expand the supports accessible to people who live there.

Table 2: Overview of Funding Types and Related Supports Available at Eaton

Funding Source	Supports Provided
Federal	One Eaton residence is a HUD Section 221(d)(3) property in which the rent that an individual pays is based on income with HUD subsidizing the rest HUD grant covers 97% of Eaton’s full-time service coordinator position, and hosts them in the HUD building HUD considers wellness services part of the contracted rent rate, which supports community spaces
Health Care	Medicare and Medicaid plans cover health care services, with providers billing insurance directly Physical, occupational, and speech therapies; dermatology; podiatry; dental hygiene; optometry; audiology; and other chronic care are covered through health insurance In-home primary care practice provides care to people in their apartments Urgent mobile care provider in partnership with the local fire department and emergency medical services (EMS)
Organizations, Professionals, and Volunteers	Benefits Enrollment Center (using Administration for Community Living funding) provides monthly benefits eligibility assessments Community partners, often using grant and government funding, provide support to residents, including care management, transportation, chores, and in-home care Technology development companies and their partners have piloted an on-campus social-companion robot and a monitoring device for older adults who use walkers Students from local colleges participate year-round and receive academic credit for volunteer experiences at Eaton properties Service professionals discount their services, including massage therapists, yoga instructors, mobile pet groomers, and veterinarians (private pay or insurance covered) Volunteers support for wellness classes and programs
Philanthropic	Foundations and corporations provide grants to Eaton Senior Communities Foundation, which supports Eaton Senior Communities (e.g., a recentNext50 Initiative grant to analyze health and wellness interview data) Grant support covers community spaces, wellness equipment, and special programs
Eaton’s Operational Funding	Eaton's operational budget funds the supportive services coordinator position in their market-rate building and the remaining 3% of the HUD grant-funded service coordinator position Social connectedness activities Subsidized congregate meals (operating at approximately $50,000 annual deficit, partially offset by $30,000 in foundation support) Community spaces and fitness center operations
Residents	Minimal resident fees for select services (e.g., massage therapy at $10 per 15-minute increments) Microloans for resident tablet purchases

Prior to 2025, participants in one of Colorado’s dual-eligible special needs plans (D-SNPs) who lived at Eaton could access various health care services on campus. When this particular D-SNP offering ended in December 2024, Eaton’s service coordinators helped individuals transition to other plans. Eaton is actively pursuing alternative ways to maintain extensive access to on-campus health care services to help older adults get timely care. In the meantime, community clinicians and clinical therapy providers continue to provide services in Eaton’s fitness center or wellness center through a variety of health plans.

"The impact our community partners have in creating a community in which residents can age well is paramount. We rarely see residents in the emergency department or hospital because of the degree of wrap-around services they receive with the myriad of health and wellness offerings on-site. They aren’t just living—they are thriving.” –Diana Delgado, President and CEO, Eaton Senior Communities

Sustainability

Over the years, Eaton’s community partners have encouraged additional organizations, professionals, and philanthropists to become involved. Some organizations have specifically sought out Eaton as a supportive environment in which to pilot innovative programs or technologies. Eaton has received various national, state, and community awards, which have helped attract new partners. One example is the 2021 Lakewood Mayor's Inspiration Award for pandemic response.

Eaton is updating its wellness initiative and, as part of this process, has held exploratory discussions with other D-SNPs and Medicare Advantage plans, in addition to its current partners. Ultimately, multiple partnerships will continue to be Eaton’s main sustainability strategy.

"When you are a willing partner and you want to be an innovative living laboratory, people start paying attention. And they want to work with you. We finally have tipped the scales where it is not just us seeking out partners, but now, people are seeking us out." –Diana Delgado, President and CEO, Eaton Senior Communities

Learn More

Eaton Senior Communities