Business opportunity and a tricky balance

Summary

Marketplace Podcast: "Business Opportunity and a Tricky Balance"

Release Date: January 28, 2025

In this insightful episode of "Marketplace," host Kai Ryssdal delves into the intricate dynamics of an aging workforce and its profound impact on local economies. Focusing on Cumberland County, Tennessee, the episode titled "Business Opportunity and a Tricky Balance" explores how demographic shifts create both challenges and opportunities for businesses and essential services. Through engaging interviews and on-the-ground reporting, Ryssdal paints a comprehensive picture of a community grappling with its evolving demographic landscape.

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Demographic Shifts in Cumberland County

The episode opens with Kai Ryssdal introducing the central theme: the demographic changes occurring in Cumberland County, Tennessee, and their ripple effects on the local economy. Partnering with ADP Research, Ryssdal and ADP Chief Economist Neil Richardson analyze data indicating that Cumberland County boasts one of the oldest workforces in the United States. This aging population is increasingly outnumbered by retirees, fundamentally altering the economic and social fabric of the region.

Neil Richardson explains, “If demographics are destiny, as economists like to say, what's happening in Cumberland County is eventually going to play out in every part of this economy” (02:15). This assertion underscores the broader implications of the county's demographic trends, suggesting a nationwide relevance.

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The Line Dancing Class: A Microcosm of Change

To illustrate the human side of these demographic shifts, Ryssdal visits a line dancing class in Fairfield Glade, Cumberland County’s retirement community. The class, taught by Adria Cook, a 67-year-old transplants from New Jersey, serves as a vibrant example of how retirees are active participants in the local economy.

During the class, Adria shares her passion for dancing, highlighting the social and physical benefits it provides. “If I don't call the dance, they stop,” she remarks humorously, emphasizing her role in keeping the class engaged and active (05:54). The class comprises mostly women ranging in age from their mid-50s to over 80, including an 87-year-old former teacher, Marianne Rude, who exemplifies the community's enduring vitality.

Ryssdal observes, “The group moved back and forth across the room, turned to face every wall in turn, helped each other remember the combinations” (06:20). This scene not only showcases the retirees' engagement but also hints at the potential consumer base they represent for local businesses.

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Business Opportunities: Mountaintop Fabrics and More

The episode transitions to Mountaintop Fabrics and More, a small business founded by John Barnwell, a 59-year-old retiree. Barnwell's venture into the fabric and quilting market is a direct response to the growing retiree population in Fairfield Glade. By offering specialized products and services catering to quilters—a popular hobby among retirees—Barnwell taps into a niche market with substantial demand.

John Barnwell shares his entrepreneurial journey, stating, “I just knew there was a lot of quilters here. So I just opened up a quilt store. That was it” (11:26). His business model leverages the community's interests, demonstrating how retirees' spending habits can create viable business opportunities.

Barnwell also discusses the challenges of starting a business in the area, particularly the high cost of retail space. “To rent a place in Crossville is extremely high. You're looking at at least $100 to $150 a square foot in retail space” (12:13). By operating out of his mother's garage, Barnwell minimizes overhead costs, making his business model sustainable despite economic constraints. This strategic move highlights how retirees can successfully navigate the business landscape by adapting to local economic conditions.

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Healthcare Challenges: Cumberland Medical Center Under Strain

As the population ages, the strain on healthcare services becomes increasingly evident. Ryssdal visits Cumberland Medical Center in Crossville, the sole community hospital serving the area. Randy Davis, the Chief Administrative Officer and President of the hospital, provides a candid look into the challenges faced by healthcare providers in an aging community.

Randy Davis explains, “Overall community health here is... classic Appalachia. So you've got a heavy tobacco utilization. We are one of the counties that are in the opioid settlement due to the overprescription of opioids in the area” (19:27). These health issues compound the difficulties of an aging population, increasing the demand for medical services while simultaneously straining existing resources.

Davis highlights the hospital's capacity issues, particularly in the Intensive Care Unit (ICU) which is “nearly always at capacity” (22:14). Additionally, staffing shortages exacerbate the problem, as many healthcare professionals approach retirement, further limiting the hospital's ability to meet growing demand.

Randy Davis articulates the dilemma: “What we're going to do is... our 12-bed ICU is nearly always at capacity” (22:14). This statement underscores the critical need for expanding healthcare infrastructure and workforce to accommodate the rising number of elderly residents requiring intensive medical care.

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Balancing Act: Business Growth vs. Community Needs

The juxtaposition of Mountaintop Fabrics and More with Cumberland Medical Center illustrates the delicate balance between business growth and community needs in an aging population. While retirees provide a lucrative market for certain businesses, their presence also demands enhanced public services and infrastructure, particularly in healthcare.

Ryssdal captures this tension through interviews and observations, noting that businesses like Mountaintop Fabrics thrive by catering to retirees, yet the local hospital struggles to keep pace with the increased demand for medical care. This dynamic creates a scenario where economic opportunities exist hand-in-hand with significant societal challenges.

Neil Richardson comments on the situation, “This is one of the tensions that Randy's got running this facility. There's the growing population in Fairfield Glade that wants more medical care and is willing to spend to get it. But he's also got the people of Crossville with less money to spend, but more acute needs” (21:59). This duality highlights the complexity of managing resources in a community with diverse needs and financial capacities.

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Community Insights: Voices of Cumberland County

Throughout the episode, Ryssdal incorporates voices from various community members to provide a multifaceted view of life in Cumberland County. From Adria and Wendell Cook's active participation in social classes to John Barnwell's entrepreneurial endeavors, each individual illustrates a unique aspect of the county's demographic evolution.

Wendell Cook, Adria’s husband, offers a personal perspective on the physical demands of staying active in retirement. “I have to say, having done that dance, at first I was like, wow, this is really slow. And then as the song progresses, you realize that your heart is pounding a little bit and you're getting into the flow of it” (07:34). His reflection emphasizes the health benefits and personal satisfaction that retirees derive from such activities.

Conversely, Randy Davis provides a more critical view of the healthcare landscape, highlighting systemic issues that require immediate attention. “Access to care has always been a challenge in this area. Not enough primary care physicians” (19:27). His insights reveal the underlying struggles that come with an aging population, particularly in rural settings where healthcare resources are limited.

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Conclusion: Navigating the Future

"Business Opportunity and a Tricky Balance" adeptly captures the multifaceted impact of an aging population on Cumberland County, Tennessee. Through the lens of local businesses and essential services, the episode elucidates how demographic shifts present both challenges and opportunities. Retirees like Adria and John Barnwell are driving economic activity by creating and sustaining businesses tailored to their interests. However, the increased demand on healthcare services, as exemplified by Cumberland Medical Center, underscores the need for strategic planning and resource allocation.

The episode serves as a microcosm for a national trend, offering valuable insights into how communities can adapt to changing demographics. By highlighting both successful business adaptations and the pressing needs of local services, "Marketplace" provides a balanced examination of the complexities involved in an aging society.

Neil Richardson aptly summarizes the overarching theme: “This is a series about how any place changes when the balance between retirees and people still in the workforce” (24:44). His perspective reinforces the notion that as the workforce ages, communities must evolve to address both the economic opportunities and the societal challenges that arise.

Ultimately, the episode encourages listeners to consider the broader implications of demographic shifts, advocating for proactive measures to ensure that communities remain vibrant and sustainable in the face of an aging population.

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Notable Quotes:

• Neil Richardson (02:15): “If demographics are destiny, as economists like to say, what's happening in Cumberland County is eventually going to play out in every part of this economy.”
• Adria Cook (05:54): “If I don't call the dance, they stop.”
• John Barnwell (11:26): “I just knew there was a lot of quilters here. So I just opened up a quilt store. That was it.”
• John Barnwell (12:13): “To rent a place in Crossville is extremely high. You're looking at at least $100 to $150 a square foot in retail space.”
• Randy Davis (19:27): “Overall community health here is... classic Appalachia. So you've got a heavy tobacco utilization. We are one of the counties that are in the opioid settlement due to the overprescription of opioids in the area.”
• Randy Davis (21:59): “There's the growing population in Fairfield Glade that wants more medical care and is willing to spend to get it. But he's also got the people of Crossville with less money to spend, but more acute needs.”
• Neil Richardson (24:44): “This is a series about how any place changes when the balance between retirees and people still in the workforce.”

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This episode of "Marketplace" offers a compelling exploration of the economic and social dynamics influenced by an aging population. Through detailed reporting and engaging interviews, Kai Ryssdal provides listeners with a nuanced understanding of how demographic changes shape communities, presenting both hurdles and avenues for growth.

Transcript

[Adria Cook]

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[Wendell Cook]

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[Adria Cook]

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[Randy Davis]

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[Kai Ryssdal]

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[Neil Richardson]

You know that saying, it's not how old you are, it's how old you feel for the economy. It kind of is how old you are. From American Public Media, this is Marketplace in Los Angeles. I'm Kyle Rysdal. It is Tuesday today, the 28th of January. Good as always to have you along, everybody. This job, as I believe I've said before, takes one to some unexpected places. She keeps going faster and faster and faster and faster. Man, this is hard. I would totally get lost. We start today in the middle of a line dancing class because silly as it might seem, the people in this class are the driving force behind a changing economy. We kicked off our new series yesterday. The Age of Work, it's called, about how the demographic shifts happening here in the United States and abroad are shaking up the global economy. And we started in in Cumberland County, Tennessee. This project, we should tell you, is in partnership with ADP Research. They crunched the numbers for us and they found that Cumberland county has one of the oldest workforces in the United States. And what we found there is a story about what happens to a place as the working age population becomes more and more outnumbered by retirees with time on their hands and money to spend. And if demographics are destiny, as economists like to say, what's happening in Cumberland county is eventually going to play out in every part of this economy. Line dancing at 9:30 on a Thursday morning. I don't know. I just don't know. Suffice it to say, I will not be line dancing. ADP Chief Economist Neil Richardson and I are outside a library in Fairfield Glade. The median age here is about 70 the library is home to that line dancing class that we started with. And we're here because the people in this class are driving the demographic change in Cumberland County.

[Wendell Cook]

Hi.

[Neil Richardson]

Hi. I'm Kai. Nice to see you. How are you?

[Adria Cook]

Kai? Nice to meet you.

[Wendell Cook]

Good morning.

[Neil Richardson]

Sorry about the microphones.

[Adria Cook]

Okay, morning.

[Neil Richardson]

I'm Kai. That's Adria cook. She is 67 years old and like pretty much everybody in Fairfield Glade, she and her husband Wendell are transplants. Moved here from New Jersey in 2020.

[Adria Cook]

Jersey Girl met at Ohio State.

[Wendell Cook]

There you go. That completes the survey.

[Neil Richardson]

How did we come to be standing outside the multi purpose building a library here in Fairfield Glade, Tennessee?

[Adria Cook]

Because I teach line dancing here.

[Neil Richardson]

Of course you do.

[Adria Cook]

Yes. And I teach ballroom in the afternoon.

[Neil Richardson]

Dancing, in case you can't tell, is kind of Adria's thing. Wendell is basically her assistant.

[Adria Cook]

I have the radio on and I'll. We'll be having breakfast and I'll just get up and start. We do a dance to that and I'll just start doing it. And when we built the house, everybody's like, man cave upstairs. I'm like, no dance room.

[Wendell Cook]

And you have a partner. You have a built in partner, which is fantastic too. That's the hardest part.

[Adria Cook]

It is, it is.

[Neil Richardson]

How did you come to teach line dancing here?

[Adria Cook]

I taught line dancing back in New Jersey and ballroom and swing and Latin and country and yes, all of it. We both did. And then when we came down here and we started taking line dance classes. Teacher. And she'll be here. She's 87 years old and she was like, that's it, I've had it. It's yours.

[Neil Richardson]

We met outside the library because a yoga class was wrapping up inside. When Adria and Wendell first moved to Fairfield Glade, they got a welcome packet full of pages and pages of clubs and classes and other activities. About 75 of them by our count.

[Adria Cook]

My neighbor's in a German club and she plays bridge, but I play mahjong. He plays pickleball and he golfs and sometimes I pickleball and we dance and those are the things we're into.

[Neil Richardson]

Once yoga let out, we went inside so that Adria could set up for class. There's a table for people to sign in and pay their five bucks. It covers the cost of renting the room and maybe gives Adria some pocket money if there's anything left over. She spends about 10 minutes setting up, getting all her gear on. Okay, wait. Sorry. We have to talk about this. You're putting your camel back on why?

[Adria Cook]

Because when I'm. I call every single step to every single song for two hours, I get dry so I have to drink and I tell them it's vodka.

[Neil Richardson]

Honestly, you sound like a little bit of a taskmaster. No, I say that in the frightfulest possible way.

[Adria Cook]

But if I don't call the dance, they stop. So I don't know what to do right. So I, I call it, you know, but it's a test, you know, we all forget we're getting older, you know.

[Neil Richardson]

All 25 or so people in class were women except for Wendell, mid-50s to 80 plus, including the 87 year old former teacher that Adria mentioned who took her spot in the back corner. Adria, of course, was front and center with her camelback and headset with a microphone so that everybody could hear her calling out every single step as promised.

[Adria Cook]

Ready to do it?

[Neil Richardson]

No, ma'am, I'm good. I think Neil is going to join you. You can join us, Neela. For the record, a much better sport than me. She did join the class. She nailed the moves, which honestly were more complicated than I had expected. The group moved back and forth across the room, turned to face every wall in turn, helped each other remember the combinations. Sometimes looking to Wendell for backup, Adria called out modifications for the women she knows have a hip or a knee issue.

[Adria Cook]

How's it feel? Where's your weight Left?

[Neil Richardson]

Yes. After the hour of class, she teaches another second hour. Some women pay a few bucks more and stay for both. You guys were great. Seriously, it was fabulous.

[Wendell Cook]

Thanks for the lesson.

[Adria Cook]

I appreciate you saying to the next dance for you. Okay, thanks. We'll let you.

[Neil Richardson]

That was amazing. It was great. It was great. And the best part was there were some who were like totally into it, knew everything and were actually, you know, jamming. And then there were some that were trying to keep up.

[Wendell Cook]

I have to say, having done that dance, at first I was like, wow, this is really slow. And then as the song progresses, you realize that your heart is pounding a little bit and you're getting into the flow of it. And to do that for two hours.

[Neil Richardson]

And imagine being like 80, right?

[Wendell Cook]

I know the choreography. The brain remembering the steps, looking around, it actually is this mind body connection that I could see how that would be so beneficial.

[Neil Richardson]

It was really cool. It was cool to see actually. This is life in Fairfield Glade. And there are thousands more retirees like these line dancers, each with their own clubs or classes or organizations that they're involved with. This population is changing. Cumberland County's demographics and with it shifting the local economy. We talked yesterday about the influx of retirees driving up housing costs here and increasing demands on local businesses that don't have enough younger working age people to fill jobs to meet that demand. But they present a business opportunity too. These retirees do, if you're in the right industry. Mountaintop Fabrics and More. It's like a home. It's like a house. Not like a house. It is a house. We're about 20 miles from the line dancing library in Fairfield Glade in a rural part of Crossville. Homes on acres of land, some working farms with cattle and the like. We're off a one lane road and up a long windy driveway.

[Wendell Cook]

Hi. Good morning.

[David Mahan]

Good morning.

[Neil Richardson]

Wow. This is definitely Fabrics and More.

[David Mahan]

Yes, hello. Hello.

[John Barnwell]

I am doing mechanical work this morning, putting together equipment.

[Neil Richardson]

David Mahan is the owner of Mountaintop Fabrics and More. He was in the middle of building a magazine rack when we showed up. David grew up on this property back when the whole thing was a dairy farm. He's 59, recently retired from four plus decades in the ministry.

[John Barnwell]

I quilled for about 25 years. My dream was always one day to do something like this, but never thought it would be a possibility. So when I stepped down, I asked, just jokingly, asked my mother who still lives here, where we raised up, we should say here?

[Neil Richardson]

We're in your mom's garage.

[John Barnwell]

We're in my mother's garage. She built this. And I said jokingly, I said, why don't you let me have that front part to open up a fabric store. And my mother and younger brother who lives with her says, why sure. Well, he ain't doing nothing with it. So it was a dream come true because I wouldn't have the overhead. You know, it's your mother.

[Neil Richardson]

You're not paying your mom rent.

[John Barnwell]

I can pay her when I want to.

[Neil Richardson]

Oh, that must be nice.

[John Barnwell]

She's just glad to have me on this side of the county, I guess. So I just started ordering fabric and opened up the very end of August, the 1st of September, and it's been nonstop since then.

[Neil Richardson]

We visited in November, so the store had only been open for about two months. And first thing on a Wednesday morning, there were two customers walking around taking it all in. Doesn't actually feel like a garage at all. It's big, it's well lit, with David's quilts covering the walls and lots of tables with fabric and patterns and sewing machines. He said customers usually spend an hour in the store and that a lot of them Own what are called long arm quilting machines.

[John Barnwell]

And those start a small economical starting.

[Neil Richardson]

Point is 12,000 for $12,000.

[John Barnwell]

$12,000. A typical quilting machine will run you anywhere from 20 to $60,000.

[Wendell Cook]

This sounds like more than a ho. Just for the fun of it.

[John Barnwell]

They do it for the fun of it. Now we have some that do quilting for other people and that make money. But, you know, being a retirement community, we have a lot of people who come in looking for fabrics and stuff to quilt.

[Wendell Cook]

How did you know the market would be here?

[John Barnwell]

My daughter in law, who is from Traverse City, Michigan, lives in Clarksville and she's in the cosmetic industry and she's in the high end. She goes, so what kind of studies did you do? I said, I just knew there was a lot of quilters here. So I just opened up a quilt store. That was it.

[Neil Richardson]

David saw the demographics in town and found a business opportunity.

[John Barnwell]

I know of three quilting gills, and quilting gills are women who are part of a group. They come together once a month. They meet, they sew together. And again, a lot of these people are in multiple gills. But one gill has 240 some people, one gil has 180 some people. And so we have a large quilting guild society here because of retirees.

[Wendell Cook]

Is it easy to start a business in this county?

[John Barnwell]

It's not easy. And the only reason I was able to do this because I'm just a middle class guy, is because I don't have much overhead. To rent a place in Crossville is extremely high. You're looking at at least $100 to $150 a square foot in retail space. So then when you spend that much money, then you got that much overhead. It's really a struggle for a small business person to stay running it.

[Neil Richardson]

It's worth a mention here that you're a retiree yourself.

[John Barnwell]

Well, in a sense, you are right. I'm only 59, but yeah, you did.

[Neil Richardson]

The pastoring thing for 40.

[John Barnwell]

Downhill slope.

[Neil Richardson]

Okay, hush your mouth, hush your mouth. But you're looking for. And you have found a way to keep yourself engaged and interested.

[John Barnwell]

Yes.

[Wendell Cook]

I almost see this. More of a second career than a retirement. You're growing a business.

[John Barnwell]

It is. And you know, of course I know it's gonna be at least six months to a year before I begin to turn a profit.

[Neil Richardson]

I want to let you get back to business because this lady's ready to check out and she's been very patient with us. She's been walking around with a handful of stuff for 20 minutes. Yeah.

[John Barnwell]

You're getting into my profit margin.

[Neil Richardson]

I know, I know. I'm sorry about that. Like David said, owning this shop was his dream. The retirees and their money to spend. And being able to work out of his mom's garage helped that dream come true. Coming up, how the aging population is affecting another business in town.

[Randy Davis]

Community hospital. Sole community provider. We're anywhere from.

[Neil Richardson]

Sorry. Sole community provider. You're it around here.

[Randy Davis]

We are it.

[Neil Richardson]

But first, let's do the numbers. Dow Industrials gained 136 today. 3. 10% finished at 44,850. Did the blue chips. The NASDAQ rose 391 points, about 2%. 19,733. The S&P 500 picked up 55 points. 9. 10%. 6,067. Tech stocks bounced back after yesterday's rout. Nvidia recovered 8.9% today. Broadcom improved 2.6%. Oracle grew about 3.6% today. The Fed started its two day meeting on interest rates this morning. Announcement coming tomorrow as it always does. And we will have it for you. It is worth taking a minute here to explain, I think, why we didn't blow up the show today, why we didn't put the months of work that we put into this Tennessee series on the shelf and pivot instead to the President of the United States unilaterally pausing trillions of dollars in federal spending. And it's a fair question, but here's why. If we learned anything in the first Trump administration, it's that losing focus every time the White House does something just isn't a constructive way to cover this economy. And it's not what this program does best. Marketplace exists to help listeners understand why something's happening and why it matters to them over the long haul. So today we decided we were going to stick to the plan. You're listening to Marketplace.

[Kai Ryssdal]

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[Neil Richardson]

Look, payday's awesome.

[Kai Ryssdal]

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[Neil Richardson]

Remarkable.com this is Marketplace. I'm Kai Ryssdal. Not far from Crossville's downtown is a set of buildings that takes up a whole block and it's a place everybody in Cumberland county is going to wind up going at some point.

[Randy Davis]

Welcome to Cumberland Medical center here in Crossville, Tennessee. I'm Randy Davis. I'm the chief Administrative officer and president here.

[Neil Richardson]

Randy's been running this hospital for two years now.

[Randy Davis]

Community hospital, Sole community provider. We're anywhere from.

[Neil Richardson]

Sorry, sole community provider. You're it around here.

[Randy Davis]

We are it.

[Neil Richardson]

Wow.

[Randy Davis]

And so because of that, outpatient services in terms of things like, hey, come on the elevator.

[Neil Richardson]

Let's get the elevator.

[Randy Davis]

Yeah, let's get the elevator. We have a fire drill brought you.

[Neil Richardson]

In right at a fire we're having.

[Randy Davis]

A fire drill come on in.

[Neil Richardson]

This one place kind of shows all the things that demographics can do, from increasing demand for certain services to shifting the workforce. The fire drill, we should say stopped once we got up to Randy's office.

[Randy Davis]

Okay. A little bit quieter. So again, welcome. But yes, sole community provider. Yep. Which means that even from a lab medical imaging standpoint, everybody comes here for all the outpatient services. So if a physician puts an order in, you're. You're coming to us.

[Neil Richardson]

How is overall community health here?

[Randy Davis]

Overall community health here is. Is kind of classic Appalachia. So you've got a heavy tobacco utilization. We are one of the. One of the counties that are in the opioid settlement due to the over prescription of opioids in the area. So we've got a lot of addiction. Overall. Access to care has always been a challenge in this area. Not enough primary care physicians.

[Neil Richardson]

Cumberland Medical is the only hospital within about a 40 minute drive. It's licensed to run 189 beds. It's typically got around 100 staffed. It's part of Covenant Health, which is a hospital system based out of Knoxville. And the people who work here, all about 800 of them, are on the receiving end of the demand for new medical services as Cumberland county gets older. What we're looking at in this series of stories is what's happening here as retirees move into Fairfield Glade, right?

[Randy Davis]

Yes, sir.

[Neil Richardson]

And you have, you know, people in Crossville.

[Randy Davis]

Yes.

[Neil Richardson]

And so the question is, somebody retiring into Fairfield Glade from Chicago who's three blocks from 17 different kinds of medical centers.

[John Barnwell]

Right.

[Neil Richardson]

Comes out here and are you able to meet their needs?

[Randy Davis]

We're absolutely not. And so you know what they're used to. One is choice. So we're it. And we are not have able to have that full breadth and depth of services that they're used to seeing in that major metropolitan area.

[Wendell Cook]

How do you delegate resources? So you have a more affluent Fairfield Glade resident versus a traditional Crossville resident. And they're both aging, Right?

[Neil Richardson]

Right.

[Wendell Cook]

How do you know how to resource your care? How do you make those decisions?

[Randy Davis]

Yeah. So first and foremost, you have to satisfy the immediate needs of your immediate community. It's the reason that we're here both historically and currently. When you're starting to look out at these growing communities like Fairfield Glade, there are a lot of times that I'm sitting in front of them saying, I need to satisfy my primary care physician need in Crossville proper before I begin really trying to get aggressive in putting primary care, additional primary care, physician resources out here.

[Neil Richardson]

This is one of the tensions that Randy's got running this facility. There's the growing population in Fairfield Glade that wants more medical care and is willing to spend to get it. But he's also got the people of Crossville with less money to spend, but more acute needs.

[Randy Davis]

What we're going to do is walk over into kind of the old original portion of the hospital. It's going to have the er, all of our outpatient services, as well as our cath lab. We have a 12 bed ICU which is nearly always at capacity.

[Neil Richardson]

Really?

[Randy Davis]

Yes.

[Neil Richardson]

The hospital opened here in 1950. It's had lots of renovations and expansion since as the population has grown. In fact, you got to go outside to get around.

[Randy Davis]

So we'll turn right on the sidewalk right here and what it is is going to be the ambulance entrance and then right beside that is the main er.

[Wendell Cook]

Are there any nursing homes nearby?

[Randy Davis]

There are, there's several. Always working with them too, to maintain good partnerships. Because I need to get patients that need to go to nursing home discharged to the nursing home in a timely manner. Because then I need that bed.

[Neil Richardson]

Because you need the bed. Right. It's not just a capacity problem, it's a staffing problem.

[Randy Davis]

Our physician base is older for the most part, and that is because even as I'm doing the physician recruitment, you've got a lot that are saying, Look, I'm 55, I want to work for 10 or 15 more years, and I love where you are. They're looking at it strategically, but they do have retirement on their minds. They're saying, this is where I want to retire.

[Wendell Cook]

You have a lens on this community that I think is very unique. Can you speak to the complexity of aging, especially in a rural community like this one?

[Randy Davis]

Right. So I do think that the rural communities are very unique in that. And so you're going to see females during their child rearing period of time in their life, and they're going to be pretty aggressive users of healthcare during that. The guys know once mom's no longer responsible for making sure they get the appropriate care, they disappear from the healthcare system. You will not see those males reappear in the healthcare setting until there's an acute illness or you're not gonna see them again until they hit the age of 60 and they become Medicare eligible. And then we begin trying to piece together this horrific health and wellness plan for someone who's basically been absent from the healthcare system during that period of time that's just the way it works.

[Neil Richardson]

That's the baseline reality for this hospital. What the Crossville population needs isn't going to change no matter how much the customer base in Fairfield grows.

[Randy Davis]

It's a different consumer of healthcare. They are going to. In fact, they get upset. I can't get in for my preventative appointment. I have to have my primary care physician appointment. My mammogram is done on time, my colonoscopy gets done. And it's just, it's a different clientele.

[Neil Richardson]

It's easy to think that that clientele is just affecting this one hospital or quilt shop or line dancing client bringing business opportunities to this one place. But really, this is a series about how any place changes when the balance between retirees and people still in the workforce. Tips tomorrow on the program, two service providers that focus exclusively on helping the Crossville population. That's coming up in our next installment of the Age of Work. We visited a whole lot of small businesses while we were in Tennessee. Not all of them make it to air. Obviously, we've only got so much time. But here's another one.

[David Mahan]

My name is John Barnwell and I am the owner of Cumberland Exterminating. When I was young, I dropped out of school at an early age and got a ged, went to work early, did not know what I was going to do with my life. And I was in a rock and roll band with a guy that owned a pest control company and this was in 1990. And so I worked for him part time and he was wanting to get out of the business. So I owned that business for about 10 years. Went through some hard times in my life, drug addiction, a lot of terrible things. After I got my act together, I worked and managed another pest control company for a couple of years. And then I started Cumberland Exterminating. And when I went to open up the bank account in 2000 for Cumberland Exterminating, that's where I met my wife, Tina. We have about 6,000 customers right now, which is about 10% of the county. And so if you don't have the personnel to do that, it can lead to big trouble. Fairfield Glade is a big area of growth for us because so many people are moving in and we have so many customers in that area. Anyway, word of mouth is wonderful. We talk every day to people from California, New York, Illinois, everywhere, Florida. People that are moving here, they need a report because they're closing on a house. So we can see the growth firsthand in here because we do so many inspections on new transactions for real estate. Our son, he's in the military right now. He's planning on coming on board with us when he gets out. He's actually a diver in the army. He is my key to retirement.

[Neil Richardson]

John Barnwell Cumberland Exterminating Crossville, Tennessee this final note on the way out today, you remember at that line dancing class how Adrian mentioned the 87 year old former teacher. Her name is Marianne Rude and she still comes to class every week. She's actually filling in right now while Adria and Wendell are on vacation. When we were there back in November, we caught up with her right before class. Do you have to go warm up before you dance? I don't want you to hurt. No, you don't. You have to warm up. Come on. No.

[Kai Ryssdal]

What do you think it is?

[Neil Richardson]

All it is is you're just moving around.

[Wendell Cook]

Is there a favorite dance that you have? Is there a dance that just.

[Neil Richardson]

September in the rain.

[Wendell Cook]

September in the rain, yeah.

[Neil Richardson]

She does it. The second hour that I taught the.

[Wendell Cook]

Class is more than one hour. It's two hours.

[Neil Richardson]

Two.

[Wendell Cook]

Wow.

[Neil Richardson]

When I started out, I taught three hours.

[Wendell Cook]

Really?

[Neil Richardson]

So people are getting soft now. That's what I hear you saying.

[David Mahan]

That's it.

[Neil Richardson]

That's it. That's what I hear you saying. 87 years old, line dances twice a week, walks three miles a day every day. She doesn't dance. Our Digital and On Demand team includes Kerry Barber, Jordan Manji, Dylan Mientanen, Janet Wynne, Olga Oxman, Ellen Rothfuss, Virginia K. Smith and Tony Wagner. Francesca Levy is the executive director of Digital and On Demand and I'm Kai Rysdal. We will see you tomorrow, everybody. This is apm. Hair thinning can happen for so many reasons, whether it's stress or hormones or anything. At Nutrafol, we've learned that real change starts below the surface. Our hair growth supplements take a whole body approach and target the key root causes of hair thinning. So you can see visibly thicker, stronger hair in three to six months.

[Wendell Cook]

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