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Sarah Thomas and Bob Kramer

Let’s Quit Talking to Ourselves: Sarah Thomas and Bob Kramer on the Future of Senior Living

“They’re coming for our space,” said Sarah Thomas, CEO of Delight by Design, and a Nexus Insights Fellow. Thomas is an accomplished leader of innovation and a global aging expert, advising startups, large corporations and investors.Those of us in senior living and senior care need to lift our heads to see what’s coming. We need to see how we can be part of creating what’s ahead of us.” 

Thomas recently joined Bob Kramer, Founder & Fellow at Nexus Insights and Co-founder and Strategic Advisor for NIC, for a conversation on Senior Living Foresight TV, entitled “Let’s Quit Talking to Ourselves: Moving the Conversation Outside Senior Living.”

The two discussed the increasing presence of investors and large corporations in the aging industry. Kramer and Thomas agreed that outside companies can be perceived as threats. But a wiser approach, they advise, is to see opportunities for productive partnerships.

“We must elevate our voice to be heard beyond our own walls,” said Thomas. “If we don’t want to partner with them, we may be replaced. So we need to look at what is not our domain expertise, and to identify gaps and consumer expectations that we’re not meeting.” Kramer agreed, observing that larger companies have greater logistical support, and greater expertise in certain domains. The key is to look for partners who can help close those gaps.

“We must elevate our voice to be heard beyond our own walls.” – Sarah Thomas

Thomas and Kramer discussed the importance of ageism, which is everywhere, and impacts everyone, and not just the older demographic. Thomas’s consulting work includes helping investors understand the marketplace, and to see the true needs and not the perceived needs “that are often misperceived,” and based on ageist ideas and stigmas. The two agreed that communities need to know their own value proposition, and to know how to communicate it, if they want to have a bigger seat at the table.

The discussion also touched on the value of universal design. “If we’re designing for all instead of designing for old, then we have beautiful designs that are also functional,” Thomas explained. Her experience includes work with the integration of robotics and fashion. The lesson for the aging industry, she suggested, is that beautiful designs help accelerate the adoption of new ideas, a philosophy that should be applied to senior living and senior care.

The two also talked out the potentially lasting impact of the pandemic on the industry. “The pandemic reinforced the idea that senior living is all about care,” Kramer said. “Ultimately we have to offer an experience that is aspirational, that is about a sense of belonging, about the joy of being alive, and not just making it through the day.”

See the whole conversation:

Bob Kramer speaks on senior living post-covid at Living Well

Bob Kramer Speaks on Aging and Senior Living Post-COVID-19 at Living Well

“We’ve all learned lessons, painfully, during this pandemic,” said Bob Kramer, Founder & Fellow for Nexus Insights, and Co-founder and Strategic Advisor at NIC. “Let’s seize the opportunity from the crisis so we can say we learned from it, and we won’t be here a year or two from now saying that nothing is different.”

Kramer was speaking as part of a panel at Living Well, a forum to advance important aging-related issues that is hosted annually by A.G. Rhodes. This year’s event, which was held virtually for the first time, addressed the topic Aging and Senior Living Post-COVID-19. A.G. Rhodes is a top nursing home provider of senior rehab services and long-term care in Atlanta and Marietta, and one of Atlanta’s oldest nonprofit organizations.

Kramer was joined on the panel by Becky Kurtz, Director of the Atlanta Area Agency on Aging, Elise Eplan, Founder & Principal of The Eplan Group, and Deke Cateau, CEO of A.G. Rhodes. The panel was moderated by Jocelyn Dorsey, Former WSB-TV Broadcast Manager and Member of the A.G. Rhodes Board of Directors.

The discussion addressed a number of important issues facing senior living administrators today, including the role of leaders in managing the crisis, response to issues of safety and social isolation and how to balance the two, the challenges of aging infrastructure for infection prevention in skilled nursing facilities, as well as the importance of transparency in addressing problems spotlighted by the pandemic.

The discussion also highlighted some of the silver linings from the pandemic, such as the impact of vaccines, and the new spotlight on the issue of loneliness. “One benefit of this horrible pandemic is that it has brought empathy to the issue of social isolation and loneliness for older adults. I can now talk to any college student and they will get it, because they too miss getting together with their friends,” Kramer observed.

View the discussion:

 

Nexus Fellow

Nexus Fellow Flash Bulletin – March 2021

COVID has caused dramatic disruption in our education and healthcare systems and long term care environments. We wear masks, we distance, we stay home. So what have we learned? How can we come out stronger on the other side? Despite the massive challenges and barriers to implementation, there is a strong sense of hope on the horizon.

“Out of the tragedy of COVID, there are a lot of silver linings, a lot of good things we’re learning. Let’s seize the opportunity from the crisis so we can say we learned from it, and we won’t be here a year or two from now saying that nothing is different.” Nexus Founder & Fellow, Bob Kramer

While the pandemic has had a devastating impact on the seniors housing and long-term care industry, it’s also shed a big spotlight on this industry like never before. And that has advantages. After all, how could anyone identify a problem if they aren’t looking. People are paying attention now, and if we take this opportunity and make the changes needed, the senior living and long-term care industry will vastly improve post-pandemic.

Our Nexus Fellows are front and center. They’re experts, thinkers and entrepreneurs, bringing fresh ideas and important insights to the industry at this critical time. 

What’s the latest? Here’s a Nexus Fellow Flash Bulletin:

  • Bob Kramer, Founder and Fellow of Nexus Insights joined Jocelyn Dorsey, Becky Kurtz, Elise Eplan and Deke Cateau on a panel last month for A.G. Rhodes Living Well-Virtual to discuss the stark realities of what is happening with COVID19, aging, and in the senior housing world. “What became clear in our conversation is that, despite the overwhelming challenges and difficulty in pandemic protocols and vaccine strategies, there was a sense of hope throughout.
  • Jay Newton-Small, CEO of MemoryWell, announced $2.5 million in new Series Seed funding. The company will use this funding to scale its platform and to continue to build its predictive social determinants of health AI rating system.
  • Nexus Fellow Kelsey Mellard, CEO of Sitka, announced that Sitka has raised $14 million in Series A financing led by Venrock, with participation from existing investors Optum Ventures, Homebrew, First Round Capital, and Lifeforce Capital. This round of funding will enable Sitka to accelerate product development and expand growth with new and existing partners.
  • Jill Vitale-Aussem, president and CEO of Christian Living Communities, and Nexus Insights Fellow, was featured in a McKnight’s Senior Living piece on how the senior living industry needs to change. “We need meaningful purpose in our lives. We don’t need to live in a hotel. We need to belong…to continue growing and learning…I am a huge proponent of shifting our thinking of residents as customers, which really creates helplessness, and moving to a model of citizenship”
  • In an op-ed piece in The Dallas Morning News, Jacquelyn Kung, CEO of Senior Care Group at Activated Insights and a Nexus Insights Fellow, with Nexus Insights Founder and Fellow Bob Kramer and author Ed Frauenheim offered five practical solutions for “repairing and renewing the industry.”
  • In a recent interview, Nexus Fellow Jody Holtzman cited four important trends to consider as we embark on a rebuild of a broken industry. Three of them are driving a changing view of health: the expanding holistic view of health that started with a focus on social determinants; the growing list of non-traditional supplemental benefits reimbursed by CMS; and, the increasing centrality of the home as the locus of health, care, and connected living. These are tempered however by a counter-trend: the slow uptake and limited usage of new supplemental benefits.
  • In a recent article for the journal Health Affairs, Nexus Fellow David Grabowski, along with Charlene Harrington, Anne Montgomery, Dr. Terris King, Sc.D., and Mike Wasserman, discussed recommendations for changes to public policy that would “make ownership, management, and financing more transparent and accountable to improve US nursing home care.”
  • In his latest piece on the SmartLiving 360 blog, Nexus Fellow Ryan Frederick explains that while Zillow provides comprehensive information about homes to purchase or rent, it can’t answer the question of what happens when you lose electricity and water for days, as happened in Texas recently. Whether neighbors come together as a community to help each other through the crisis has a big impact on whether you’ve chosen the right place to live.
  • Long-term services and supports (LTSS) when provided in the community as home and community-based services (HCBS) can be a lifeline to help a person live safely at home and age with dignity. In a position paper on HCBS, A Blueprint for Reforming Medicaid Long-Term Services and Supports and Creating Good Caregiving Jobs, ATI Advisory CEO, and Nexus Fellow, Anne Tumlinson shared three recommendations for legislators and regulators to expand access to home-based care services sustainably and equitably. 
  • Sarah Thomas, CEO of Delight by Design and Nexus Fellow, was keynote speaker at the Rehab Tech Summit in February. In her speech titled, Designing the Future: Creating Your Own Path Through a Lens of Innovation, she said,  “It’s time we challenge our own views on aging. As we design products, services, spaces and communities we must design for ALL. Our designs should delight our consumers at every age. It was such a pleasure to share my professional journey that has taken me around the world changing the global perspectives on aging.”
  • Caroline Pearson recently completed a project looking at consumer experience measures for Medicare Advantage plans. The report recommendations holding plans accountable for aspects of consumer experience that are meaningful to beneficiaries and within the health plans’ control to improve. Caroline’s team at NORC continues to examine the impact of COVID-19 on older adults in seniors housing. Look for their report due out soon.
  • Dr. Bill Thomas will be featured in the 30th Annual Aging Well Conference hosted by the University of Wisconsin-Parkside Professional and Continuing Education Office on April 23 & 30. In his keynote, Dr. Thomas will deliver a multi-part interactive keynote “What if Everything we Know About Aging is Wrong?” followed by a Q&A session. In his breakout session “MAGIC:  Exploring Intergenerational Communities,” Dr. Thomas will share new concepts in Multi-Ability, Multi-Generational, Inclusive Communities that brings together people of different ages, abilities, and backgrounds.

Stay connected and engaged with our Nexus Fellows. Subscribe to our newsletter.

Bob Kramer and John Cochrane

How COVID-19 Has Impacted the Senior Living Industry: Lessons for the Future

“Out of the tragedy of COVID, there are a lot of silver linings, a lot of good things we’re learning,” said Bob Kramer, Founder & Fellow at Nexus Insights and Co-founder & Strategic Advisor at NIC.

Kramer was featured in a session entitled, “How COVID-19 Has Impacted Our Industry, a Conversation with Bob Kramer” as part of The Big Connect 2021, presented by HumanGood. Kramer spoke with John Cochrane, President & CEO of HumanGood, California’s largest nonprofit provider of senior housing and one of the 10 largest nonprofit senior living organizations in the nation.

“The worst may be yet to come in terms of public perception,” Kramer observed. “We’re just now starting to rev up for countless investigations, task forces, hearings, research studies, and so on that will ask one question: What went wrong and how do we prevent it in the future?”

The Big Connect is an annual event that brings together HumanGood’s leadership team, board members and strategic partners to showcase how they are designing experiences that inspire their residents, team members and prospective customers to live their best lives possible.

Click to view the entire conversation.

Five Predictions for Senior Living Trends authors

5 Predictions for Senior Living Trends in 2021

In 2020, COVID-19 slammed many industries, but the hardest hit was definitely senior living.

But 2021 offers leaders in this industry several unique opportunities to turn the corner. An immediate need is to prevent additional infections and make communities safer, in part through effective distribution of vaccines. However, even as senior living executives manage the ongoing crisis, they must build towards the future. The pandemic didn’t create many of the problems that are now being spotlighted as glaring issues in the senior housing world. We are now at a crossroads, a perfect opportunity to renew the mission of senior living.

We predict five trends will be critical to Senior Living in 2021. Will your organization seize the moment or miss the boat?

1 – Digital Transformation

Prediction 1 - Digital Transformation

Our industry has lagged behind most when it comes to technology. This is no longer an option. The COVID crisis showed that assisted living properties, independent living communities, and skilled nursing facilities must have cutting-edge digital systems for three purposes:

  • Peace of Mind – Residents must be able to communicate from their rooms with facility staff and with family members, even amid lockdowns. Not just audio connections, but video links that prove loved ones are OK.
  • Care Delivery – What used to be “way out there” has become normal. Doctors and other health professionals can use videoconferencing and other tools to diagnose and monitor residents. The Centers for Medicare and Medicaid Services is not only paying for telehealth – CMS is encouraging it.
  • Connection – COVID taught us that physical distancing cannot become social isolation. When disease outbreaks require residents to remain in their rooms, digital activities must replace in-person gatherings. The alternative is depression, aggravated health conditions and rapid decline.

2 – Onsite Healthcare Delivery – With Partners

Prediction 2 - Onsite Healthcare Delivery - with Partners

Healthcare at many senior living communities has long amounted to a van shuttling residents to the doctor’s office or an ambulance ferrying sick residents to the hospital. But this approach caused fear during COVID, given the risks of contracting the disease in hospital settings.

Residents and families will not stand for such physical outsourcing of care anymore. And there is another way. Healthcare services can be delivered onsite where seniors live.

The key is partnerships. During the pandemic, many senior living organizations forged relationships with local providers, who sent healthcare professionals into assisted living and independent living communities. Those same providers can offer remote, digital care to residents as technology systems improve.

3 – Trust Through Transparency – and Data

Prediction 3 - Trust through transparency - and data

Besides elderly Americans dying by the tens of thousands, another casualty of COVID has been trust in senior living organizations. The industry’s black eye isn’t entirely fair. COVID is most lethal to those over 75 with underlying health conditions, which describes the overwhelming majority of senior living residents. What’s more, the media sometimes lumps together outdated and overwhelmed nursing homes with upscale independent living companies.

Still, leading senior living providers will proactively rebuild confidence among residents, family members and the public. Transparency is key.

Any company with a congregate living setting has to be willing to publish real-time information on such matters as COVID infection rates, and deaths, risk mitigation protocols, employee vaccination practices and staffing policies.

4 – Workplace Culture and Servant Leadership – at the Fore

Prediction 4 - Workplace culture and servant leadership - at the Fore

Too many companies in the industry treat workplace culture as a “soft” “nice to have.” That’s a risky approach today. Data from Activated Insights and Great Place to Work shows that the Best Workplaces in Aging Services have lower turnover rates and better care outcomes.

During the COVID pandemic, reliable staffing and sound care have been more critical then ever. Not only to get sick residents needed treatment, but to avoid instances of neglect that ruin reputations.

A great culture is one where staff members feel pride, experience camaraderie and trust leaders. To cultivate that trust, managers and executives must practice “servant leadership” – seeing yourself not as the “superior” but the kidn of boss who will step in to serve meals and unclog toilets as well as to address the family concerns staff often bring with them to work. Humility is the new superpower.

5 – A New Story for Senior Living – and Society Overall

Prediction 5 - A New Story for Senior Living - and Society Overall

In recent decades, our industry has gravitated to a message focused on caregiving. We’ve lost our aspirational north star – that residents in our communities have much to contribute and can feel deeply alive in their later years. COVID gives us a chance to reframe our value proposition and mission.

The new story for senior living has to be about meaning, human connection and community in addition to care. This means redefining our activity directors as “purpose matchmakers,” breaking down the walls that make our complexes a form of “senior apartheid” and looking for language that moves us away from the “declinist” narrative of old-age.

We can turn outside our industry for help. Even as COVID devastated many of our senior communities, it caused you people to empathize in new ways with their older neighbors. And elders are a vital resources to help America recover from COVID – already, they are serving as tutors to help close education gaps that have widened during the pandemic.

The Five Predictions Infographic

Five Predictions for Senior Living Trends 2021

Click to download as pdf

 

Dr. Jacquelyn Kung is CEO of Activated Insights, the senior care partner of workplace culture authority Great Place to Work. Robert G. Kramer is founder of think tank Nexus Insights and former CEO of the National Investment Center for Seniors Housing & Care (NIC), a resource for data and analytics for the senior housing and care industry. Ed Frauenheim is co-author of several books on workplace culture, including A Great Place to Work for All

Dallas Morning News Senior Living and COVID

Nexus Insights Fellows offer 5-point plan for fixing the post-COVID senior living industry

“COVID-19 gave the senior living industry a black eye.”

That is the opening statement of a provocative op-ed piece in The Dallas Morning News by Jacquelyn Kung, CEO of Senior Care Group at Activated Insights and a Nexus Insights Fellow, with Nexus Insights Founder and Fellow Robert G. Kramer and author Ed Frauenheim.

“Few industries have been as wounded by COVID-19 as the senior housing and care sector,” the article claims. It goes on to say, “The statistics are eye-popping. ‘Residents of long-term care facilities constitute less than 1% of the U.S. population, yet 43% of all COVID-19 deaths through June occurred in those places,’ AARP Bulletin reported in December. ‘The number has changed little since.’”

But the op-ed, entitled, “How the senior living industry can heal itself and all of us” provides both hope and a game plan for helping the industry recover.

The authors, all veteran observers of the senior living industry, offer five practical solutions for “repairing and renewing the industry.”

Read the full article here.

Nexus Insights

Nexus Insights: Clearinghouse for Ideas

In April of 2020 I wrote in this blog’s first post, that, “now is the time to understand what is changing, and why – and to plan for the post-COVID world.” Explaining the purpose of Nexus Insights, I wrote, “We recognize that there will be major changes, not just in seniors housing and care, but in all aging services, and in how we, as a society, will view aging itself, as well as older adults. The disruption this will cause will involve a range of industries beyond just healthcare, including hospitality, multifamily, retail, transportation, technology, and more. It will become necessary to create experiences for these customers, customized to their preferences – and demands.”

The Nexus mission

None of that has changed. The question for Nexus was how best to enable leaders to meet the challenges underway and seize opportunities being created.

In working with Nexus’ incredibly talented Fellows, particularly with Kelsey Mellard, Sarah Thomas, Jacquelyn Kung, and Ryan Frederick, it became clear that we all must revisit how we think about aging more broadly. This involves collecting and disseminating new ideas. Nexus Insights’ approach has therefore pivoted – to focus on helping leaders across a range of business sectors to challenge and change assumptions about aging, age-related abilities, and aging services.

To achieve this broader goal, Nexus Insights will become a “clearinghouse” for ideas, spotlighting new thinking on the future of housing and aging services for older adults. More broadly, we seek to encourage debate and discussion on what it means, and what it could mean, to age in America.

Introducing the Nexus “Fellows”

I am very pleased to be able to announce that all twelve of our established, extraordinary, and distinguished advisors have agreed, with enthusiasm, to embrace a more content-oriented approach. Together, this group of Nexus “Fellows,” representing a broad array of perspectives, has committed to help guide Nexus Insights’ initiatives, and to provide insights and provoke discussion and debate via speaking engagements, webinars, podcasts, blog posts, articles, and other published works, all of which will be available here on the Nexus Insights website. I have little doubt that, with this incredibly talented and knowledgeable team of Fellows, Nexus will deliver on its promise not only to encourage new thinking – but to drive transformation in aging and aging services.

Looking ahead – what is next?

Looking ahead, expect to find the latest, most controversial, most thought-provoking, and most important new ideas here on Nexus Insights. As a group of Fellows, we will be regularly publishing original new content – but we will also act as a “clearinghouse” to collect and disseminate high quality content. We will actively pursue a broader audience, promoting these ideas to leaders across a variety of settings, including

  • Business
  • Public policy
  • Academic research across seniors housing and care
  • Medicare and Medicaid services
  • Housing
  • Healthcare
  • Technology.

As I wrote back in April 2020, “There is a great deal of opportunity, once we’re past the crisis – but there’s a lot of risk, too. If leaders don’t adapt during this period of immense disruption in attitudes, demographic shifts, technological capabilities, and customer expectations, then others will. Those offering old models from the old world will soon find themselves out-moded, the disrupted instead of the disruptor, in a new world order designed and built by their competitors.” Our mission today is to help ensure that as many leaders as possible have access to the newest and best ideas on aging and quality of life, catalyzing meaningful, market-driven reform at a time when it is needed the most.

CALA Summer Symposium

Bob Kramer Provides Insights on Finding Opportunities Amidst Disruption at the CALA Summer Symposium

COVID-19 has brought new challenges to senior housing and the aging services industry. Those challenges can be framed as hurdles, or they can compel us to rethink how we do things, and can provide a catalyst for innovation.

How do you make that switch, to finding the opportunities in the midst of difficult times? Join Bob Kramer, president of Nexus Insights, at the CALA Summer Symposium, where he will discuss how disruption can lead to opportunities to challenge the status quo. “The scope of the disruption and the speed of the changes triggered by the response to the COVID-19 pandemic can be overwhelming, even as they are unprecedented,” said Kramer.

“What does this mean for the future of senior living?” he asked. “How will we change how we communicate with residents, family members and staff, how we think about the delivery of healthcare to our residents, and how we describe and deliver an attractive value proposition to prospective residents and their families? Why is a strong culture so essential in a crisis and why must we better segment our market and differentiate our products in the future?” Kramer is excited to address the difficult questions.

The founder of the National Investment Center for Seniors Housing & Care (NIC), Kramer is a mentor to the industry, and an aging services entrepreneur. He recently started his newest venture, Nexus Insights, an advisory firm that helps clients by leveraging a network of leading thinkers and thinking leaders to develop provocative ideas and new models for the future of aging services. The company aims to help the industry and society rethink aging from every angle.

This presentation is part of the CALA Summer Symposium, which is being held virtually this year on June 23 and 24th. The annual symposium provides participants a chance to gather the information and encouragement that will bolster you in your work and help you fulfill your priority of making sure residents and team members stay safe and healthy.

The mission of the California Assisted Living Association (CALA) is the betterment of Assisted Living, Memory Care and Continuing Care Retirement Communities. It represents over 660 providers, and more than 150 associated businesses, and provides tools and resources to support day-to-day operations and quality of care for residents. It also supports ongoing advocacy efforts to help shape policy and clarify regulations.

In Kramer’s session, “Opportunities Amidst Disruption,” you will gain insights into how providers will rise up to meet current and future challenges, through grit, resilience, patience, innovation, and collaboration. The session is on Wednesday, June 24 at 1:15pm PT.

CALA Summer Symposium
June 23-24, 2020
Registration

Bob Kramer on Opportunities Amidst Disruption
Wednesday, June 24
1:15pm – 2:15pm PT

Events

SLF Foresight TV

Foresight TV with Sarah Thomas & Bob Kramer

Join Senior Living Foresight’s Steve Moran as he discusses current topics in the senior living industry with Sarah Thomas, Executive Strategist at Aging Innovation and Bob Kramer, Founder of Nexus Insights and Strategic Advisor for NIC. Watch live on YouTube.

Erickson School of Aging at UMBC lecture

Presentation to the Aging, Policy and Management class on Disruptive Innovation – The future of senior living

Living Well – Virtual

Topic: Aging and Senior Living Post-COVID-19
A panel discussion featuring Bob Kramer, Founder and Fellow at Nexus Insights and Deke Cateau, CEO of A.G. Rhodes, among others.

The Big Connect 2021

A virtual event involving residents, team members, Human Good board members and leaders who will gather online to explore opportunities to keep inspiring the best life for hose we serve. Bob Kramer will be interviewed by Human Good CEO, John Cochrane, and then respond to questions.

Living Well 2021 — Virtual

Aging and Senior Living Post-COVID-19

A.G. Rhodes is proud to once again offer its acclaimed annual Living Well event, which will be held virtually this year as we continue adapting our operations and programs to address and overcome challenges presented by COVID-19.

Nexus Fellow Bob Kramer will be a panelist.