NIC Awards $3M to Milken Institute to Establish Groundbreaking Aging Innovation Collaborative

NIC Awards $3M to Milken Institute to Establish Groundbreaking Aging Innovation Collaborative

New Collaborative will reimagine aging, leveraging nationally renowned experts from different economic sectors to collaborate to improve the lives of older adults.

The National Investment Center for Seniors Housing & Care (NIC) awarded the Santa Monica, Calif.-based Milken Institute $3 million to establish the Aging Innovation Collaborative (AIC) within the Institute’s Center for the Future of Aging, which advances healthy longevity and financial security through policy, research, convenings, and multisector partnerships.

As part of the creation of the AIC, Nexus Insights will share intellectual and human capital with AIC, and merge with the new collaborative. Its fellows — including its founder, NIC strategic advisor Bob Kramer — will contribute to its day-to-day work, becoming AIC fellows.

The AIC will engage experts to develop bold new models of housing, healthcare, and community that meet the needs of a growing U.S. population of older adults. By removing silos between industries and incorporating innovations in housing, healthcare, technology, and more, the AIC will identify and scale comprehensive solutions that improve the lives of older adults.

“Housing and long-term care stand at a crossroads as millions of Baby Boomers think about how they want to live their best life after retirement,” said Raymond Braun, president and CEO of NIC. “This commitment to the Milken Institute brings talented individuals from diverse backgrounds together to transform how we think about aging in the United States. The Aging Innovation Collaborative will become a font of ideas for consumer advocates, real estate developers, senior housing operators, healthcare providers and payers, policymakers, and others.”

The AIC will initially focus on three core offerings:

  • A Landmark Tracking Study. This research study will track attitudes and preferences of older adults aged 50-80 over time. It will be conducted in collaboration with a nationally recognized research partner and leading experts in the field. Initial results are expected in 2024.
  • Aging Innovation Council. This advisory council will include leaders from consumer goods and retailers, housing, government, healthcare providers and payers, technology, and capital markets. By removing silos across industries to share ideas and technologies, the Council will create new housing, healthcare, and community solutions for the aging population.
  • Advisory Services. The AIC will provide advisory services to organizations wanting to enhance the health and housing of older adults but that lack the capacity or expertise for innovative solutions. Advisors will help companies navigate the complexities of the aging sector, identify opportunities for innovation, and accelerate time to market.

“It’s an exciting time to join forces with the Milken Institute to help people meet their expectations for aging,” said Kramer. “Older adults have diverse backgrounds, interests, healthcare, and social needs, and they want and expect housing and care that is as unique as they are. Aging is a good thing, and we need disruptive innovation to create housing and care that supports older adults’ ability to not just age but thrive.”

“I am honored to work with NIC in the establishment of the AIC at the Milken Institute,” said Diane Ty, senior director of the Institute’s Center for the Future of Aging. “I look forward to bringing in outside entrepreneurial experience to lead the AIC and examine the intersection of sectors to create new solutions and platforms that benefit older adults. The Milken Institute’s core maxim is ‘turning ideas into action,’ and that is exactly what the AIC plans to do.”

Want to be notified when a new blog is posted? Subscribe to our blog and receive posts in your inbox.

Disrupting Aging Services Through Citizenship

The Citizenship Approach to Community Living

Health, community and housing are three vital and intertwined components associated with healthy longevity. For community to be achieved, Nexus Insights believes we need to shift from the current primary focus on what is done ‘for’ and ‘to’ older adults, to a focus on what is done ‘by’ and ‘with’ older adults.

Nexus Fellow and President & CEO of Christian Living Communities, Jill Vitale-Aussem, recently led a discussion on the importance of community. CLC’s citizenship model is rooted in the belief that each individual, at every age and level of abilities, has gifts, passions, talents and experience that make the community stronger and better.

She was joined by Maddy Chapman, the Associate Executive Director at Holly Creek, and Andrew Sharp, the Community Life Director at Clermont Park, to discuss how citizenship helps to revolutionize aging services.

“Citizenship is the ultimate goal of a person-directed culture.” Jill Vitale-Aussem.

Continuum of Person-Directedness

Previously, the traditional framework was provider-driven, where management made decisions for elders and staff, but organizations like Christian Living Communities have moved a new model – one that CLC calls the citizenship model – where elders contribute to their community and play important roles.

Provider Directed – Management makes most of the decisions with little conscious consideration of the impact on elders or staff. Elders are expected to follow existing routines.

Staff Centered – Staff consults elders or put themselves in elders’ place while making the decisions. Elders have some choices within existing routines and options.

Person Centered – Elder preferences or past patterns form the basis of decision-making about some routines. Staff begin to organize routines in order to accommodate elder preferences, either articulated or observed.

Person Directed – Elders make decisions every day about their individual routines. When not capable of articulating needs, staff honor observed preferences and habits. Staff organize their hours, patterns and assignments to meet elder preferences.

Citizenship – Elders influence their community, they are problem solvers, share responsibility for each other and are expected to contribute. The organization, leadership, management and staff support others to exercise autonomy, connection and well-being, and work to remove systemic barriers.

(Source: Pioneer Network, Continuum of Person Directed Culture, modified by Christian Living Communities to include the Citizenship model.)

During the presentation, Sharp shared a video, “I am”, from Clermont Park where residents explain their roles. “It’s ‘I am’ because it’s right now. Not I was or back in the day I did. It’s ‘I am’,” said Sharp. Examples of residents’ roles included Gallery Committee Chair, Conversation Connections, Campus Gardner, Chronicle Editor, Ambassador, and Researcher.

The Five Rs of Citizenship

The Five Rs of Citizenship published by the Journal of Community Psychology are Rights, Responsibilities, Roles, Resources and Relationships. In reference to community living, rights refer to the Rights of the residents that need to be upheld. Responsibilities are the duties residents are responsible for. Roles are the titles the residents hold. Resources are time, money and training that need to be given to residents. Relationships are people getting to know one another.

“We need a life with purpose. We need true belonging. We need roles to play. There’s not been one study that says to live a long and healthy life you should live a life of leisure and have everything done for you.” Jill Vitale-Aussem

Disrupting Aging Services Through Citizenship

Watch the full discussion:

Related:

Want to be notified when a new blog is posted? Subscribe to our blog and receive posts in your inbox.

Unpacking the Future of Senior Living with Bob Kramer

Unpacking the Future of Senior Living – Positive Aging Community Interviews Bob Kramer

Founder and Nexus Fellow, Bob Kramer joined Steve Gurney on the Positive Aging Community podcast to discuss the future of aging and aging services in America.

Kramer kicked off the conversation stating that at this moment we are in a very key transitional shift as we move from the ‘Greatest Generation’ to a new customer, the ‘Boomer’. The Boomer population is looking for something different.

“I could spend our whole hour, Steve, just unpacking [this]…The sort of what I’ll call, frankly at times, condescending, patronizing and, and also ageist view that older adults lack independent agency and lack the ability to continue to make a difference in the broader community. I don’t buy any of that. Increasingly, older adults are not willing to settle for whatever society provides for them as they live longer than anyone anticipated. What they want is purposeful longevity.”

“Older adults want not just to add years to their life, they want to add life to their years.” – Bob Kramer

“In the past, senior living and aging services has been about what we do for and to older adults. In the future, it will be about what is done by and with older adults. And that is a huge shift.”

Kramer also noted that the seniors housing and care industry has gone through three shockwaves. The first was COVID, where staff scrambled to keep residents alive. The second crisis is the staffing shortages. The third challenge is the financial crisis, “not just the capital markets, but inflation, interest rates rising and now real capital market turmoil where investors are very much on the sidelines and concerned about preserving their capital.”

But Kramer isn’t ready to throw up his hands in despair.

“One of the things that I look for in each of those is, what’s the silver lining that enables us to emerge stronger and with a better product, with better services, and doing better with and for older adults?”

You can listen to the full discussion at Positive Aging Community’s website.

Related:

Want to be notified when a new blog is posted? Subscribe to our blog and receive posts in your inbox.

NIC spring conference 2023 - Partnering for the Future

Nexus Insights Convene for the NIC Spring Conference

Nexus Insights will be joining senior housing and aging service leaders in San Diego on March 1st for the National Investment Center for Seniors Housing & Care (NIC) Spring Conference. Conference sessions will discuss new opportunities that provide better outcomes of care for older adults through more effective integration of healthcare services and senior housing. Anyone in healthcare or senior housing looking to connect, develop long-range strategic partnerships, and innovate new models of care and housing on behalf of older adults should plan to attend.

“Integrating healthcare services with housing is mission critical for a new generation of senior living,” said Anne Tumlinson, founder and CEO of ATI Advisory, and a Nexus Fellow. “It means better care and quality of life for residents, and rewards operators and investors for addressing healthcare spending.”

Several Nexus Fellows are attending the conference including Bob Kramer, Anne Tumlinson, and Sarah Thomas. Nexus friend and alumna, Kelsey Mellard of Sitka, is speaking on one panel and interviewing Dr. Sachin Jain at the Friday morning keynote session.

Want to attend? Visit springconference.nic.org for more information. Already going and want to meet? Ping us or reach out directly to our Fellows.

Nexus Picks

Sessions you won’t want to miss at the 2023 NIC Spring Conference:

Emerging Value Based Care Opportunities for Seniors Housing & LTC Operators
Wednesday, March 1, 2023 | 4:30pm
Speakers:
Anne Tumlinson, Founder & CEO, ATI Advisory
Grant Severson, Vice President, Optum Senior Community Care
James Lydiard, Chief Strategy Officer, HarmonyCares
Brian Cloch, CEO, Cloch Management
Chris Dawe, Acting President, Curana Health Medical Group
Laurie Schultz, Principal & Co-Founder, Avenue

Taking Your Show on The Road: Bridging Care Gaps by Extending Services Into the Community
Thursday, March 2, 2023 | 1:00pm
Speakers:
Kelsey Mellard, CEO, Sitka
Michael Kurliand, Clinical Quality and Integration, MedWand
Peter Longo, Principal & Managing Partner, Cantex

The Trends and Opportunities in Medicare all Types of Operators Should Be Tracking
Friday, March 2, 2023 | 8:30am
Speakers:
Kurt Read, Partner, RSF Partners
Kelsey Mellard, CEO, Sitka
Dr. Sachin H. Jain, MD, MBA, FACP, President & CEO, SCAN Group and Health Plan

 

Related:

 

Want to be notified when a new blog is posted? Subscribe to our blog and receive posts in your inbox.

Human Growth and Nursing Homes

Human Growth and Nursing Homes – a 2002 Interview with Dr. Bill Thomas

What can the United States do to make senior housing and the lives of older adults better? This is a particularly hot topic throughout the nation, especially in the aftermath of COVID-19.

A recent report with seven bold, actionable and important recommendations was recently released by the National Academies of Sciences, Engineering, and Medicine. These recommendations, when implemented, will transform nursing home care, to make it person-centered, transparent, affordable, and create living situations that are good for residents, families, and staff.

Where did these revolutionary ideas come from? Let’s turn our calendar back a few decades and spotlight Dr. Bill Thomas, a physician specializing in geriatrics and a visionary ahead of his time. Thomas founded The Eden Alternative, The Green House Project, Minka and is currently the Chief Independence Officer for Lifespark as well as a Nexus Fellow. He has long been a driving force behind the vision that is transforming care for seniors. And he has been putting his vision into practice, piloting his ideas to demonstrate that nursing homes can be places for elders to thrive. We are delighted to have him on-board as a Fellow for Nexus Insights.

In a PBS interview that aired 20 years ago, Thomas said, “There has to be a commitment to ongoing growth…Even the frailest, most demented, most feeble elder can grow…And those words, human growth, nursing home, they’ve never gone together before.”

Thomas explained the inspiration for his ideas. “In the early 1990’s I took a job as a physician at a nursing home…and I fell in love with the work. And I fell in love with the people. And I came to detest the environment in which that care was being provided. The nursing home takes good loving, caring people and plugs them into an institutional factory-like arrangement. And it’s no good. I believe that, when we make a place that’s worthy of our elders, we make a place that enriches all of our lives, caregiver, family member and elder alike.”

“He was right and ahead of his time 20 years ago. He’s still right today. Unfortunately, the tragedy of COVID has revealed how much we devalue the lives of our older adults,” said Bob Kramer, Founder and Fellow at Nexus Insights.

“We need to be concrete about it. If we want to improve life for everybody in our society, one of the very best places to begin is changing how we think about, care for and honor our elders,” said Thomas.

Read the full interview.
See a clip from the PBS 2002 broadcast.

 

Want to be notified when a new blog is posted? Subscribe to our blog and receive posts in your inbox.

 

Impact of COVID In Nursing Homes

Problems We’ve Ignored for Too Long: A Hearing on the Impact of COVID In Nursing Homes

“COVID completely devastated nursing homes in the U.S.”

Dr. David Grabowski, a professor of health care policy at Harvard Medical School, and a Nexus Fellow, made this statement before a House subcommittee hearing on the impact of the coronavirus in our nation’s nursing homes.

Among the staggering statistics Grabowski shared with the subcommittee:

  • There were more than 1.2 million cases of COVID among nursing home residents, which led to roughly 172,000 COVID-related fatalities.
  • More than 2,600 nursing home staff members died from COVID, “making nursing home workers the most dangerous job in America.”
  • In the aftermath, both resident census levels and staff employment levels were down by more than 10% from pre-pandemic levels.

Drawing on his research, as well as his work on a commission with the National Academies of Sciences, Engineering, and Medicine, Grabowski made recommendations for reform to improve the situation for caregivers and residents going forward.

Grabowski urged policymakers to take a system-level approach to policy reforms to protect residents and caregivers. He emphasized that it is not too late. “We have an incredible opportunity right now to address problems that we have ignored for far too long.”

He proposed recommendations for short-run policies in two areas:

  1. Increase vaccination levels
    1. Extend the federal vaccine mandate for nursing home staff to include booster doses. Currently, only about half of all staff are fully vaccinated.
    2. Provide federally supported vaccination clinics for facilities with lower booster vaccine rates for staff and residents, to ensure that residents and staff have access to a vaccine clinic.
  2. Improve staffing
    1. Introduce a federal minimum staffing standard
    2. Increase staff pay and benefits
    3. Provide opportunities for career advancement
    4. Create a better work environment

“The way the U.S. finances and regulates care in nursing home settings is ineffective, inefficient, fragmented and unsustainable.” – David Grabowski

As a move towards a federal long-term care benefit, Grabowski suggested an approach for locally testing and creating benefit implementation with established criteria to evaluate success. He also emphasized the importance of accurate financial information to ensure payments are adequate to cover comprehensive nursing home care. In addition, value-based nursing home payment models should be created to reward facilities for providing better quality.

Additional panel members of the expert witnesses testifying before the House subcommittee included: Alice Bonner PhD, RN, FAAN; Adelina Ramos, Certified Nursing Assistant and 1199NE member, from Greenville, RI; and Jasmine Travers, AGPCNP-BC CCRN PhD RN, Assistant Professor of Nursing, NYU Rory Meyers College of Nursing.

See a video of the full hearing:

Want to be notified when a new blog is posted? Subscribe to our blog and receive posts in your inbox.

Nursing Home Reform

Swinging for the Fences: 7 Recommendations for Nursing Home Reform

“Our whole policy infrastructure for nursing homes is broken in many respects: how we pay for them, how we regulate them and how they deliver services,” said Dr. David Grabowski, Professor of Health Care Policy at Harvard Medical School and a Fellow for Nexus Insights.

Dr. Grabowski was selected to participate in a National Academies of Sciences, Engineering, and Medicine commission tasked in reforming nursing home care. The 19-member committee worked for 18 months to create a report (published April 2022) with seven actionable recommendations to improve every aspect of nursing home care in the United States.

“The recommendations are bold. Nobody has accused us of trying to hit a single. We tried to swing for the fences in each of the areas of the report,” said Grabowski on a recent “Elevate Elder Care” podcast hosted by Susan Ryan of The Green House Project. “They can’t just be nibbling around the edges. They have to be transformative.”

The commission identifies seven key aspects in need of reform:

  1. Deliver comprehensive, person-centered, equitable care: “The system is broken because it’s not about the people receiving the services or the people providing the care,” said Grabowski.
  2. Prepare, empower and better compensate staff: “Everybody knows we have too few staff, training is not always up to par, we don’t pay them a competitive wage and benefits. This goal is around minimum staffing, ensuring that working conditions for staff are better, and improving the way staff are valued, paid and empowered.”
  3. Increase transparency & financial accountability: “This is an issue that predates the pandemic. Ownership is so much more complex, and it’s more necessary than ever that we get accountability and transparency, to make sure money is being spent on what it should be.”
  4. Create a more rational and robust financing system: “We propose a federal long-term care benefit. In other areas we have comprehensive federal benefits, but we piece it together for long-term care,” Grabowski said. “We should be paying a rate commensurate with a high level of quality. We have to figure out how to pay for it.”
  5. Reimagine quality assurance and regulation: “There is very little consistency among states. More data is needed about which quality assurance activities work, how we make sure the regulation is serving the residents well, and how we ensure that we’re improving performance.”
  6. Expand and enhance quality measurement and improvement: “A lot of our quality measures don’t work well. We have to reimagine quality measures, to make sure they reflect what residents and their families want in a long-term care experience.”
  7. Adopt health information technology: “Nursing homes lag behind other parts of the healthcare system, and they aren’t well connected to other parts of the system. It’s so important for care coordination. But they haven’t had the dollars or the incentives to do it.”

Grabowski is hopeful that the time is right for meaningful reform.

“The problems and the solutions have been around for 35 years, but COVID shone a light on it. It’s amazing the attention nursing homes have received. There’s tremendous interest now. Americans are waking up and saying, ‘Hey, this system isn’t working.’ There are long-standing issues that have gone unaddressed for decades. COVID galvanized Americans to look at this issue differently than they had previously.”

Want to be notified when a new blog is posted? Subscribe to our blog and receive posts in your inbox.

Eco friendly housing for seniors

Two Challenges. One Solution. Age-Friendly and Climate-Friendly Housing.

Our growing population of older adults is facing housing challenges. Creative solutions are beginning to find a foothold. Ryan Frederick, an expert on housing and the role of place in healthy aging, looks at how those solutions could be used to simultaneously address issues of climate change in a Generations Journal article, published by the American Society on Aging.

“As a real estate developer and advisor to real estate developers, I see a valuable opportunity to rise to this challenge by developing communities that appeal to the needs and desires of older adults and incorporate design that is eco-friendly and climate change resilient,” said Frederick, CEO of SmartLiving 360 and a Nexus Insights Fellow. “As a concerned citizen, I know this challenge is urgent.”

Where people live has a big impact on their well-being, according to Frederick. “The best place elevates purpose, social connection, physical well-being, and financial well-being. Place can be designed to support our needs as we age and help insulate us from the perils of climate change.”

But he pointed to a variety of issues that make it difficult for people to age in place, including:

  • Housing that is designed for younger people without mobility issues. The statistics are striking. According to Frederick, “Only about 4% of all housing stock in the United States is suitable for people with moderate mobility difficulties.”
  • Single-use neighborhoods without convenient access to needed services and amenities. “Too much housing requires transportation to get to services and a lack of density makes it inefficient for services to come to the home.”
  • Social disconnectedness. “About half of older adults don’t know any of their neighbors,” he said.

In the article, Frederick offered actionable ideas to help communities address these issues, including:

  • Incentives for incorporating universal design principles in all new housing, which both emphasize the use of eco-friendly materials, and reduce the need for retrofitting as residents in the home age.
  • Housing developments that work for people of all ages, to help foster intergenerational connections, and reduce loneliness across all ages. Frederick pointed out the cost incentive for landlords: vacancies are reduced when older adults can remain in their housing even as their physical needs change.
  • Housing design that reflects the role of the home as a place where people increasingly receive their health care.
  • Choosing locations for housing that are less prone to disasters such as flooding and wildfires and therefore are more resilient to climate change.
  • Designing neighborhoods for walkability. Reducing the need for car travel is both age-friendly and eco-friendly.

“Ultimately, as a society and as individuals, we will be defined by our legacy,” Frederick observed. “How did we positively impact the generations following us?”

Read the full article in Generations by the American Society on Aging.

 

Ryan Frederick, MBA, is the CEO of SmartLiving 360, an Austin, Texas–based strategy consulting and real estate development firm focused on the intersection of successful aging and the built environment. He is the author of Right Place, Right Time: The Ultimate Guide to Choosing a Home for the Second Half of Life. He is an Encore Public Voices Fellow, a Nexus Insights Fellow and National Advisory Board Member for Johns Hopkins University School of Nursing.

 

Want to be notified when a new blog is posted? Subscribe to our blog and receive posts in your inbox.

The Challenge of Senior Communities

The Challenge of Senior Communities Staying Affordable in a Time of Rising Prices

Nexus Fellow and CEO of Christian Living Communities, Jill Vitale-Aussem, discussed the challenges senior communities are having in remaining affordable amidst rising costs and staffing shortages on the Senior Housing News’ Transform Podcast with Tim Regan.

Inflation in everything from food to utility costs, combined with continued wage escalation can drive increases in monthly service fees and rent. Vitale-Aussem is concerned that this will lead to shrinking the already limited population of older adults who can afford senior living. Her organization is focused on evaluating opportunities for greater efficiencies, especially in the areas of construction, amenities and staffing.

Staffing continues to be a challenge for her communities, but she’s seeing bright spots. “One of our communities that was having staffing challenges is now fully staffed,” she said. “We now celebrate that the way we used to celebrate 100% occupancy rates.” She said they’ve achieved success by getting more creative in recruiting and casting a wider net. She offered several suggestions, including the importance of explaining the story of why working in senior living is so rewarding. “It’s a pretty amazing work opportunity for people, but they don’t know.”

Watch the full video at Senior Housing News.

 

Want to be notified when a new blog is posted? Subscribe to our blog and receive posts in your inbox.

Bringing together different perspectives with a common passon

Bringing Together Different Perspectives with a Common Passion

Nexus Insights is a think tank comprised of a diverse group of thought leaders and stakeholders in aging and health care (Nexus Fellows) with a shared vision to advance the well-being of older adults through innovative models of housing, community and health care. The goal of Nexus Insights is to affect change by sharing innovation across traditional silos, convening leaders from different perspectives in our Nexus Voices salons, and bringing positive, life-affirming ideas into the public domain.

What makes Nexus Insights truly unique is the diversity of our Fellows. We bring together different perspectives and different backgrounds, leaders with expertise in academic research, government policy, private sector startups, and successful businesses serving older adults. It’s the diversity of perspectives, together with the common passion, that drive the disruptive thinking within Nexus.

Bob Kramer is broadly recognized as one of senior living’s most influential and high-profile thought leaders and connectors. With over 35 years of industry leadership, he has earned the reputation of “agent provocateur” in the seniors housing and care industry and aging services field. He has been described as an ice-cutter and scout in identifying industries and trends that will disrupt the future of seniors housing, aging services, and aging more broadly. Learn more about Bob Kramer at Nexus Insights.

 

Want to be notified when a new blog is posted? Subscribe to our blog and receive posts in your inbox.