Walker Methodist, founded in 1876, has a new mission statement that highlights its evolution from nursing home operator to manager of 11 housing complexes: "Life. And all the living that goes with it."

It reflects the movement away from institutional care, the most expensive and often the least desirable for most elderly, to a model that offers housing with varying level of services. Methodist also is a provider of rehabilitation care, adult day care and related services.

Walker Methodist, which has sold two of its traditional nursing homes, recently completed a 153-apartment community in Lakeville, including 44 assisted-living units and 24 memory-care apartments.

This summer, the Minneapolis-based nonprofit will complete an $18 million complex in West St. Paul, including a rehab center to help area residents who are transitioning from a hospital stay to a return home. Walker Methodist projects 2012 revenue of $63 million and has more than 1,400 employees. Nick Kozel is Walker's vice president of marketing. CEO Lynn Starkovich has been an executive with Walker since 1998.

Q Why doesn't your mission statement say anything about seniors or aging?

Kozel: While we are realistic about life in later years, we focus on what you can do, not what you can't. Consumers and health care are changing and we need to meet consumers where they are and where they are going to be and how we can fit that. Every individual we serve ... has their own needs and wants. That's a change from the nursing homes of the past. The brand is an organizational strategy, not just who we are but how we do it.

Q Your headquarters at 37th and Bryant Avenue S. was once just a nursing home. Now it is a remodeled and expanded complex of different types of housing and varying levels of service. Talk about that transition.

Starkovich: This building started [more than century ago] as a home for unwed mothers. So the evolution has been going on for years. We provide services. We have government-subsidized apartments, different types of housing, 'care suites' ... ancillary programs, adult day care, an incredible chaplaincy program that deals with spiritual or not-so-spiritual needs, an education program. ... We're getting away from institutional nursing homes, [with their] long halls and double rooms.

Q The spiraling cost of health care and elder care has caused state and federal governments to slow and cut nursing home subsidies. How did economics force you to evolve?

Starkovich: Part of the reason is economic. But it's also what our customers want. We knew 10 years ago that institutional nursing homes were not what people wanted. We've seen an evolution. We once had three nursing homes. One of them, with a [federal grant], we turned into housing for low-income seniors and it's now about 160 apartments. We sold another to a competitor at 16th and Portland Av. who had a similar mission in the neighborhood.

The health center at 37th and Bryant was a nursing home with 500 beds. We knew that was too institutional. We looked at what we could do to provide a more positive, enriching environment. We've taken about 200 beds out and put in a new system. Some of the [remaining] 330 beds are transitional ... for therapy and rehabilitation from illness and we provide support services so that they can return to home or go into an apartment.

Q Generally describe your range of housing and services. What's the range variation in monthly rates that residents pay?

Kozel: We have subsidized housing in the [federally financed] sites. The range can starts quite low, could be a few hundred dollars a month, based on ability to pay. The market is higher for some customers, and they ask for and need a wide variety of services ... It can be several thousand dollars a month. The tradeoff is what you get in terms of living the life you want ... and maybe even realizing some dreams.

Starkovich: Our rates are [often] set by a government agency, and we don't have that much input. And we're very conscious of market rates in different geographic locations so they do vary [from the Twin Cities to rural Minnesota or Iowa]. And how much [of] that rate is paid by family and government is going to depend upon what the person wants, where the person lives and what services are needed. A resident could pay nothing or a resident could pay a few thousand a month. We do take everybody.

Q Do folks on government housing or medical assistance get the same treatment as affluent private-pay residents?

Kozel: Absolutely, our mission and values guide everything we do for everyone we serve.

Starkovich: We serve a wide variety of economic backgrounds and cultural diversity and all are treated equally. Our staff is very diverse, all religions, and ethnic backgrounds. Many languages. The staff can get very close to customers and especially here at the health center because people are fragile.

Several weeks ago we had staff in with the family and a patient [near the end of life] ... praying in Hindu, Islam, Christianity ... it's amazing. We call it spiritual care. It's what that person wants and needs. It could just be meditation and relaxation. We are supportive of our customers' autonomy.

We use philanthropy to provide extra programs, such as spiritual care, to include acupuncture, healing touch, serenity rooms, rest and shower areas for family members. Charity and philanthropy are big for Walker.

Neal St. Anthony • 612-673-7144, nstanthony@startribune.com