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long-term care infrastructure op-ed in The Hill

America’s long-term care infrastructure: A road to nowhere – Op-ed in the Hill co-authored by Nexus Insights

In a recent op-ed in The Hill, Nexus Insights Fellows Anne Tumlinson, David Grabowski and Robert Kramer, raise an important point that has been missing from recent discussions around transforming long-term care following the pandemic. The Biden Administration has proposed a $400B investment in home- and community-based services (HCBS). We assert this investment is necessary but not sufficient. Without additional spending on services to help families navigate and manage long-term care services, this HCBS investment is basically a “road to nowhere.” We argue for the need to create a network of long-term care service hubs across the country to help families navigate services.

As you know, there have been A LOT of thought pieces around improving long-term care going forward, but we have not seen this point made elsewhere. Thus, we believe it would be an ideal time to make this point as policymakers consider the Biden proposal.

Excerpt:

Long-term care is complex. Few Americans plan ahead and most wait until a crisis pushes them into a frantic search for solutions. It doesn’t have to be this way.

Every day older adults lose their ability to care for themselves. Often, they are discharged from the hospital too weak or confused to be left alone or care for themselves. Now what? Who will take care of them? Is home- or facility-based care the best option? How much will it cost and who will pay? Does Medicare cover it? Does Medicaid? If home care is the answer, how do you find a qualified and affordable caregiver? Where do you even start? Life-changing decisions must be made, and fast.

Read the full op-ed in The Hill.


Anne Tumlinson is CEO of ATI Advisory and the Founder of Daughterhood. David Grabowski is Professor in the Department of Health Care Policy, Harvard Medical School. Robert Kramer is the founder of Nexus Insights, and the co-founder and Strategic Advisor & former CEO of the National Investment Center for Seniors Housing & Care (NIC).

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Update on Nexus Fellow May 21s

Nexus Fellow Flash Feature: May 2021

As the United States shifts gears from pandemic crisis management to a new post-COVID normal, we must now deal with the aftermath and identify what went wrong and what we can do better. Issues of transparency and loneliness in nursing homes linger. Large corporations that once were oblivious to the older population have found a new market. How will we address the age-old problem of social connection for those who are still isolated, a problem seniors have faced for decades? The entire industry, the way we view older adults, the options for living independently and the implementation of technology, must all be urgently addressed and thoughtfully designed into an actionable plan for the future of aging and longevity.

Our Fellows continue to strive for innovation and reform. Here’s what they’ve been up to:

NEWS:

  • Nexus Fellow David Grabowski, was quoted in an article by the Associated Press on nursing homes’ requirement to report COVID-19 vaccinations at nursing homes. “This is an important development that is months overdue,” said David Grabowski, a Harvard health policy professor who has tracked the industry’s struggles with the outbreak. “Many of us argued that this information should have been published starting in December when the federal long-term care vaccination effort began.”

 

  • Dr. Bill Thomas, Nexus Fellow and creator of The Eden Alternative, Minka, and the Green House Project, is helping value-based care innovator Lifesprk (which acquired Tealwood Senior Living.) Dr. Thomas will be leading the efforts to combine the two companies’ operations. He has also created Kallimos Communities, new multi-generational communities with small dwellings clustered around shared green space. Additionally, he has a new project he’s working on with Signature Healthcare — currently called “Canopy” — a cluster of small ADA-accessible houses built close together.

 

  • Bob Kramer, Founder and Fellow of Nexus Insights, was interviewed by Nancy Griffin for SeniorTrade Blog. He defines 5 Boomerville Segments likely to flourish in the future: Wellnessville, where residents will focus on healthy lifestyle, diet and exercise; Margaritaville, resort-style independent living (Minto Communities’ Latitude Margaritaville has three wait-listed locations with more in development); Serviceville, where the emphasis is on volunteerism, mentorship and giving back; Collegeville, where residents focus on continued learning in a communal living environment, and Changeville, for those concerned with making a difference in the world and creating a legacy.

 

  • Preordering is now available for “Right Place, Right Time, a book by Nexus Fellow and CEO of SmartLiving 360, Ryan Frederick. “Place plays a significant yet often unacknowledged role in health and happiness. The right place elevates personal well-being. It can help promote purpose, facilitate human connection, catalyze physical activity, support financial health, and inspire community engagement.”

 

  • Nexus Fellow Kelsey Mellard, CEO of Sitka, sat down with Sanjula Jain Jo on Her Story for a candid conversation about being a healthcare leader and her transition from the Midwest to DC to Silicon Valley, building a resilient team, and overcoming challenges.

 

  • Will seniors continue to buy groceries online post-pandemic? Nexus Fellow Jody Holtzman, longevity economy expert, formerly of AARP, thinks seniors will split their shopping, using online for staples such as canned goods and going into stores for fresh foods. Some senior consumers claim it’s a social outlet for them. “As the necessity imposed by the pandemic lessens,” Holtzman says, “retailers will have to start to play the price game.” Read more at Blomberg.com.

 

Out and About:

  • Jill Vitale-Aussem, president and CEO of Christian Living Communities, and Nexus Insights Fellow, recently spoke at a session, “Finding success in increasing diversity and inclusion,” at the 2021 Women of Distinction educational webinar. We’d also like to congratulate Jill on joining the SeniorTrade Advisory Board.

Jill Vitale-Aussem joins SeniorTrade Advisory Board

  • On June 30, Nexus Fellow Sara Zeff Geber will be joining experts and thought leaders in the areas of aging, retirement and thriving for the “Boomers Thriving After the Pandemic” virtual summit, hosted by Wendy Green from Hey, Boomer. Other speakers include Helen Dennis and John Tarnoff. Part of the proceeds will go to Meals on Wheels Greenville and The Walk to End Alzheimer’s. For more info visit the virtual summit’s Eventbrite page.

Sara Zeff Geber on Hey Boomer

  • Sarah Thomas, CEO of Delight by Design and Nexus Fellow, recently presented at the Rehab Tech Summit sponsored by AARP Innovations Labs. She spoke about designing for all, including age tech, universal design, living with purpose and designing beautiful products for everyone at every age.

 

COMPANIES ON THE MOVE:

  • Jay Newton-Small, CEO of MemoryWell, is growing MemoryWell. After a successful capital raise, she’s been adding some amazing new talent to her team including Sarah Jones from Healthsense, GreatCall and Best Buy Health.

 

  • Jacquelyn Kung, CEO of Senior Care Group at Activated Insights, is working with her team to create recognition programs for senior care providers, based on their resident and family surveys. The goal is to tie the data to outcomes and impact metrics, and to use machine learning to identify patterns in those who improve to apply across a broader population of providers.

 

NEW RESEARCH:

 

 

VIDEO DISCUSSIONS:

 

 

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Bob Kramer and Anne Tumlinson discuss HCBS

Foresight TV: Bob Kramer & Anne Tumlinson – What Does HCBS Mean For LTC?

With the federal government considering an investment in the country’s infrastructure, a new light has been shed on the importance of infrastructure. And from the resulting discussion, a broader understanding of what is vital infrastructure is emerging. That infrastructure necessarily includes a system of long-term care for the nation’s aging population and a trained workforce to deliver that care.

“We have an outdated, crumbling infrastructure in nursing homes. We have non-existent infrastructure in home and community-based services (HCBS). And we have millions of older adults living longer, many of whom will need services and supports,” said Bob Kramer, Founder and Fellow for Nexus Insights, and Co-Founder and Strategic Advisor for the National Investment Center for Seniors Housing & Care (NIC).

Kramer recently interviewed long-term care expert Anne Tumlinson about the importance of long-term care and changes needed in how it’s delivered and how it’s paid for. Tumlinson, the Founder and CEO of ATI Advisory, and Founder of daughterhood.org, offered recommendations for the policy changes needed to make long-term care financially viable for more seniors and their families. Her recommendations also addressed the critical need for a living wage for the shrinking pool of caregivers who work in long-term care, and the important role of HCBS in helping seniors thrive.

“We don’t have a system; instead, every single family has to create their own system, over and over again. What is out there that could help me? How do I find it, set it up, coordinate it? There is currently no system or function in our society to handle that,“ said Tumlinson.

The interview was hosted by Senior Living Foresight. View the entire discussion.

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long-term care

The Future of Long-Term Care Depends on Trust, Transparency, Liability Relief – Bob Kramer

In a recent op-ed with Morning Consult, Bob Kramer, Nexus Insights founder and Fellow, argues for the importance of transparency in nursing homes. But the situation isn’t a simple one, as he points out. With transparency comes the need for liability protections, and policy makers must look to history to understand the unique risks and requirements of the skilled nursing industry. 

The following originally appeared in Morning Consult. Reposted with permission.

No one is arguing that America should be satisfied with our current nursing home system. But we can expect to hear a cacophony of arguments on how to fix it over the coming months and perhaps year.

Nursing home operators will rightly point to chronic underfunding and the failure to address the real costs of long-term care for poor, frail seniors on Medicaid. Their critics will demand more regulation and enforcement, higher staffing requirements and better wages. Some will argue that any additional funding for long-term care should go to home and community-based services. If unfunded increases in requirements for nursing homes lead to increased rates of bankruptcy — and closures — across the sector, so be it.

It would be careless and unrealistic to argue that the skilled nursing industry is without value. Harvard’s David C. Grabowski, among other experts, has argued that it is necessary, and requires increased investment. Studies show that Americans are growing older and more frail; many have no family or are beyond the capabilities of those that they have, increasing numbers are homeless and millions will require 24/7 care, often in specially equipped and staffed facilities. Furthermore, as highlighted in the landmark “Forgotten Middle” study conducted by NORC at the University of Chicago, a giant influx of middle-class seniors is coming. Neither qualifying for Medicaid nor being able to afford private-pay seniors housing, many will “spend down” their resources and rely on Medicaid. That is simply not a tenable solution.

Twenty years ago, another industry crisis precipitated a dramatic decrease in the availability of skilled nursing facilities. Lawsuits had become so damaging that nursing home operators began to flee certain states in which plaintiffs’ attorneys, seeking insurance-mandated settlement payoffs, triggered a feeding frenzy. Insurance for operators became either unaffordable or unobtainable. As a result, many families who found themselves unable to care for an elder at home were left without appropriate options, unable to secure care for their loved one at any price.

In response, nursing home owners and operators began to develop limited liability partnerships in increasingly complex — and opaque — business relationships, all designed to shield assets from trial lawyers. That system exists today in many places, particularly with respect to larger, multi-facility operators. It enables these businesses to exist — but it also raises questions as to where the money is going.

This is why I have been advocating for even greater transparency throughout the long-term care industry. To be entrusted with a greater investment from government, owners and operators of care facilities must open up their books and allow regulators and policymakers to see that their investment is going to increased staffing, pay and benefits for those on the front lines, as well as toward improvements in technology, and enhanced infection prevention and control. In short, they need to build trust in order to gain dollars.

But should skilled nursing providers provide real transparency into their financials, without liability reform or relief from lawsuits? It would only benefit the same attorneys who benefitted from transparency in the 1990s. It would quickly become impossible or prohibitively expensive to get insurance again — and again, operators would seek to protect themselves. And again, dollars intended to go to the care and housing of our low-income seniors would go instead to ever more expensive legal actions or insurance premiums.

This is where policymakers must step up. Without liability protections, increased transparency will lead only to increasing costs, as opposed to improving the wages and benefits for front-line workers. The real losers will be the millions of poor, frail, complex-care residents who need 24-hour care, and the staff to care for them. Operators will have to agree to greater transparency and accountability. Advocates will have to understand that targeted liability relief is essential. Policymakers hold the keys to both sides working together.

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.


Bob is founder and Fellow at Nexus Insights. He co-founded the National Investment Center for Seniors Housing & Care (NIC), where he now serves as strategic advisor. Nexus Insights is a think tank that brings together a diverse group of researchers, policy experts, entrepreneurs, and executives, each of whom are distinguished and well-established thought leaders on aging and aging services.

Read the op ed

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reform in nursing homes affects residents and caregivers

Seize the moment: Bob Kramer lays out path for meaningful reform in nursing homes in new Health Affairs blog

“The American long-term care system, particularly in skilled nursing facilities, has been exposed as deeply flawed, chronically underfunded, and in need of reform.” This bold statement is from Robert Kramer, Founder and Fellow of Nexus Insights, and Co-Founder and Strategic Advisor for NIC. It’s the opening line of his recent blog in Health Affairs.

Kramer delves deeply into the urgent problems facing nursing homes that have been spotlighted on the national stage by the pandemic and its tragic death toll among nursing home residents and staff. Kramer predicts the likely responses we can expect to see from nursing home operators, federal and state regulators and policy makers, and seniors and their families. But he urges, instead, a more thoughtful, complex and multi-faceted approach to solving the challenges of long-term care in nursing homes that involves dispensing with out-of-date assumptions, acknowledging the problems, and aligning the different stakeholders involved.

The problems he sees stem from undervaluing and undercompensating the work of caregivers, and the too-narrow focus of regulatory metrics on physical care needs, rather than the personal goals and aspirations of the residents themselves, and their quality of life. Other challenging problems include the long-term shortage of caregivers for a rapidly growing population of seniors, the lack of financial transparency, inadequate reimbursement models that incentivize the wrong behaviors, the age of nursing home infrastructure, and the financial impact of the COVID-19-related lawsuits that are certain to hit the beleaguered industry as the pandemic winds down.

“Every stakeholder must understand that this is a disruptive moment.” – Bob Kramer

The solutions Kramer proposes will require thoughtful cooperation and coordination among all the players in the industry, including industry providers, organized labor, consumer advocates, investors, and regulators. And it won’t be easy. But as Kramer points out, “Every stakeholder must understand that this is a disruptive moment. SNFs and long-term care are, for a moment, center stage. Those of us who care about this sector, and the millions of Americans it serves, must seize this moment.”

Link to full blog

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future of senior living

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:

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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:

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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.
  • 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.
  • 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.

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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.

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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

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Events

Foresight TV with Anne Tumlinson & Bob Kramer

Join Anne Tumlinson, CEO of ATI Advisory, and Nexus Fellow, and Bob Kramer, Nexus founder & Fellow, on a special Wednesday episode of Foresight TV hosted by Senior Living Foresight. Steam live via YouTube.