In the U.S., senior care is not something many entrepreneurs are thinking creatively about. Not so in Japan: In the past year, 60 gambling-themed senior-daycare centers have opened up, giving some of the nation’s elderly not just basic shelter, but a place to spend time that’s appealing and fun. (Since gambling is illegal in Japan, participants are playing with fake currency earned through physical activity, but they don’t seem to mind the lack of authenticity.) The owner of one such themed center told the Financial Times that the offerings of most such places “are too childish, patronising even. These are adults and they want serious activities.”

Perhaps it’s time for the operators of American adult-daycare centers, which, unlike nursing homes, are places where older adults spend only part of their day, to think more inventively. The 5,000-odd adult-daycare centers currently in the U.S. cater to about 250,000 people—but that’s only a small fraction of the 40 million Americans over the age of 65. While businesspeople may slowly be catching on—the share of these centers that were for-profit increased from 27 percent in 2010 to 40 percent in 2012—the closest the U.S. has come to something like Japan’s gambling homes is Bingo Night, which is decidedly not Vegas-like.

In the U.S., there are three types of adult-daycare centers: social, medical, and specialized. The social centers promote interactions with other residents through planned activities and meals. Medical daycare centers are focused mostly on rehabilitation, and specialized centers can focus on everything from Alzheimer’s to managing diabetes. Regardless of which category a center falls into, almost all of them are places people wish they didn’t have to be.

Adult-daycare centers don’t only exist because older Americans want them—they also exist because insurance companies like that they tend to reduce the incidence of lengthy, hospital stays, which are very costly to cover. At a daycare center, someone can be regularly tended to by knowledgeable healthcare professionals, which makes it less likely that something unnoticed will flare up, necessitating a costly ER visit. For this reason, the financial pressure on the Medicare system would ease up if more older adults went to daycare centers.

Plus, if America follows the Japanese example very closely and reins in healthcare costs with gambling-themed daycare centers, that might another problem at the same time—finding a use for Atlantic City’s abandoned casinos.