Knoll Communities

In the quaint town of Sparta, New Jersey, I had the opportunity to meet with three passionate advocates for local seniors. At Knoll Communities, a senior living center with Section 8 housing, these advocates are committed to providing affordable housing options to the growing senior population. They are guided by the principles of respecting senior’s dignity and improving their quality of life. 

As we gathered for lunch, Ernie Hofer, Board President, Francesca McKernan, CEO/Executive Director, and Ray Manning, Director of Operations, expressed sincere compassion for Knoll residents. From the very beginning, it was evident that they were highly aware of the needs of the residents. Though their day-to-day interactions, they prioritized the needs of the residents to improve their standard of living. Projects central to their guiding principles currently include maintaining affordability despite the increasing program costs, modifications to homes into the 21st century, and reduced-price meals. 

For many seniors, access to ongoing medical care, including specialists, is imperative to independent living. However, assistance with navigating the process is becoming a common concern across the country, and as Francesca explained, Knoll Communities is no exception. 

Medicare is the most popular insurance plan in the United States. Seniors are generally happy with the benefits included in the program. Most doctors accept Medicare patients, and the Center for Medicare Services (CMS) is easy to work with once you have successfully applied. 

“The insurance piece is tough. We try to make sure everything is paid because the resident really doesn’t have anything to come out of pocket with.” ~Ray

But that’s the catch. Enrollment is one of the more frustrating challenges for seniors, as it requires a moderate level of technological literacy and keeping track of deadlines for the open enrollment periods. 

Since the Affordable Care Act and the transition to online marketplaces, Medicare applications are typically completed online through This system provides convenience to many, but others are unable to navigate the online process, and some cannot access a computer. Francesca expressed frustration with this process, saying that assistance with enrollment often falls on those who work within these senior living communities, or the adult children. 

These gaps in access speak to a unique intersectional issue in senior healthcare. Those with higher technology literacy and relative comfort with computers are far more likely to be able to enroll in Medicare independently. The need for a personal device with internet connection adds additional burden, particularly for those who cannot afford such devices or don’t have internet access. 

Technology in healthcare is an unfortunate dilemma. While it increases access for certain populations, such as those who have benefitted from telemedicine, it can be cumbersome for others that feel they need to adapt their skillset. Knowing how to use a computer shouldn’t be a roadblock for those who wish to receive care. In the digital age, we must continue to be sensitive to the limitations that technology and automation provide. 

“The problem I have is when you try to call somebody, and you can’t get a person to talk to. Even when you’re trying to renew a prescription, you have to go through so many numbers to finally get to a real person. For older people, that’s troublesome.” ~ Ernie

We have all experienced this before, dialing into a large company, only to be met with prompted answers from robots. For younger people, it is what we expect to hear on the other line. However, this leads to a generational gap in expectation for how we receive care. Whether it be filling prescriptions, speaking with insurance providers, or making doctors’ appointments, a human connection can ease the process and support senior independence. 

Ernie, Francesca, and Ray stressed the importance of the patient’s voice being “heard” by senior care teams. Not only does this mean talking to a real person on the other end of a line, but it also means the face time between the doctor and patient. 

Growing up, many who are now in retirement were seen locally by neighborhood physicians. This was fundamental to a meaningful relationship that seniors have come to expect as the standard of care. In northern New Jersey, what were once independent hospitals have now formed a conglomerate under Atlantic Health System. Ernie explained how the consolidation of hospitals has led to missed expectations during appointments. Seniors are frustrated with this new cookie-cutter system, and often believe the experience to be less friendly from engaging with the office staff to the physician themselves. 

“With the consolidation of individual doctors into groups… they have less time with each patient… or they spend 80% of the time typing when they should be talking.” ~ Ernie

While senior healthcare remains a topic of constant attention, there is a limited conversation about the sensitivities that surround cultural shifts in access. In a world hyper-focused on efficiency through technology, senior living communities remind us about the limitations and frustrations to navigate a system that disregarded the needs of the population it intended to serve. 

For more information about Knoll Communities, please visit

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