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Jody Holtzman interview

Trends, Challenges and Opportunities in the Longevity and Aging Industry – A Jody Holtzman Interview

COVID-19 has been a tremendous challenge for everyone, but it has shone an especially bright spotlight on how underserved our aging population really is. We sat down with Nexus Fellow and Senior Managing Partner at Longevity Venture Advisers, Jody Holtzman, to discuss trends, challenges and opportunities in the longevity and aging industry in this new world.

Jody is a well known leader in the aging and longevity world, having spent the past 15+ years in the field, preceded by a career in strategy consulting. His work in aging includes a 12 year stint at AARP where he ran research and was senior vice president of thought leadership and market innovation. 

 

NEXUS INSIGHTS – You have spoken about Baby Boomers and their lack of interest in traditional long-term care communities, especially assisted living. Tell us more about that.

JH – First, it is hard to generalize when you are talking about a population of just over 70 million people, which is the current Boomer population in the US. That’s more people than in the UK, France, or Italy. So, let’s just establish that one size does not fit all and there will always be a segment of Boomers for whom traditional long-term care settings are attractive. However, even before the pandemic, occupancy rates across independent and assisted living already were at a low, while the age of new residents continued to climb well into the 80s. And the mental image and mental model of long-term care communities for Boomers was one of nursing homes where people are warehoused to die. Since the pandemic this image has only been deepened as Boomers saw nursing home death rates, as well as experienced such with their own older loved ones.

There also is something else going on when we look at how Boomers view long-term care. And that is, they simply do not see themselves in those settings. It does not jive with their own self-image. This came out in spades to me the first time I spoke to a LeadingAge conference and did this exercise with the audience. I asked everyone to stand if they proudly participate in the management of any type of long-term care community. Three hundred and fifty people jumped up. Smiles all around! Then, I asked them to remain standing “if you are looking forward to the day you live in your own facility.” And the overwhelming majority of the audience sat down. These were people on the front lines of senior living, committed to making life better for older people. But they also, overwhelmingly, were Baby Boomers. And they did not see themselves in senior living. So, something has to change.

There is something else going on when we look at how Boomers view long-term care. And that is, they simply do not see themselves in those settings. – Jody Holtzman

NEXUS INSIGHTS – You talk about how the pandemic has shaped how and where health and healthcare happen. Tell us about the trends that you are seeing.

JH – Trends over the past year, both within and outside senior living, have increasingly confirmed that the home is and will continue to be the focus of health, care, and connected living. The growing consensus across the healthcare community got a boost from the orientation embedded in the concept of social determinants of health (SDOH) which is encapsulated in the view that health is a function of one’s zip code and the conditions of life in a geographic area. Health is now, officially, “beyond medicine.”

In parallel with the new focus on SDOH over the past year, digital health has exploded. While the health benefits of home-based care were being proven, along comes COVID and people are told to lock down and remain in their homes. Telehealth, telemedicine, and other virtual communications, became the dominant market response in healthcare and society more broadly. All in combination reinforcing the centrality of the Home and further boosting demand for more home and community-based products and services.

 

NEXUS INSIGHTS – You work with a lot of healthcare companies in the aging space. How are they dealing with these new trends and market opportunities?

JH – In response to the pandemic, and to both longstanding needs and those recognized by looking at health through the lens of SDOH, CMS has added a growing list of non-traditional, supplemental benefits that may be reimbursed through Medicare Advantage, but not traditional Medicare. Startups and others have responded with an array of new offerings covered by new reimbursement codes. And MA plans have been increasingly adding them to services already offered in their plans. While payers have had the near-term benefit of attracting new customers through product/service-based competitive differentiation during Open Season, the longer-term health benefits and attendant cost savings have yet to be proven. And this brings us to a dilemma. While the need and availability of a growing list of technology-enabled products and services has been established, customer/patient adoption is still low, and returns on investment have been as well.

For startups, this is concerning because, in many cases, they are being directed by investors and others to build their channel strategies around Medicare Advantage. Even if the deals with payers are all gain-share arrangements without requiring cash outlays by the payers, they still are making an investment in time and dedicated resources, if only to track progress. The question needs to be asked and monitored – how long will MA plans include offerings that garner limited customer uptake? If nothing else, the current terrain calls for a diversified go-to-market strategy that is not solely dependent on Medicare Advantage.

Stop calling them facilities

Why are We Still Dropping the “F-Bomb”?

If you’ve seen the movie A Christmas Story, you likely remember the scene in which 9-year-old Ralphie is helping his dad change a tire on the side of the road on a dark snowy night. Ralphie is so excited to help but he drops the lug nuts and loses them in the snow. In frustration, he yells out “Fuuuuudggge!” Ralphie then explains through narration, “…only I didn’t say fudge. I said THE word. The queen mother of all dirty words – the F-dash-dash-dash word!” Ralphie ends up being punished with a bar of soap in his mouth.

That’s how we should view the word ‘facility’. As the queen mother of all dirty words: the F-bomb.

Do you dream of living in a facility? Of course not! Facilities are cold institutions where humanity and the human spirit wither and die. Why then do we use this awful term to describe the places older people live and receive support? It denigrates residents and team members alike, yet it’s sprinkled generously throughout the narrative of senior living – by government regulators, by leaders in the field, and even by people living and working in communities.

At Christian Living Communities-Cappella Living Solutions, we’re on a mission to ban the F-bomb because, as Dr. Bill Thomas, Founder of the Eden Alternative, has said time and time again, “words make worlds”.

Our words drive our beliefs and behaviors. Call a building a facility and people will act like they live and work in a facility. Call it a community and the seeds of change are planted.

Community is a word filled with promise, with hope, and with citizenship. In a community everyone is valued and has a role to play. This is the type of culture we strive to build in each CLC-Cappella community. Yes, we provide excellent care and services, but we also purposefully create environments where each person has autonomy, a deep sense of belonging, continued growth and meaningful purpose.

It’s time to eradicate “facility” from our vocabulary and start using words that honor elderhood. So, bust out the soap, implement a “swear jar” if you want. Let’s start changing our world through the words we use.

Written by: Jill Vitale-Aussem, President and CEO of CLC-Cappella Living Solutions and Nexus Insights Fellow

Originally posted in Christian Living Communities.

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:

 

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.

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

From Customer Service to Citizen-Driven Communities – Enabling Life, Purpose and Belonging in Senior Living

Join Linked Senior and Bridge the Gap for an #ActivitiesStrong Executive Edition webinar on April 6th featuring Jill Vitale-Aussem, President and CEO of Christian Living Communities. During this Q&A session, Jill will describe why she believes that ageist beliefs in the senior living industry and society at large result in communities that are built around the idea that older adults have nothing left to give and no purpose. Jill will outline steps that activity and life enrichment professionals can take to disrupt this unhealthy model, shifting a customer service model to a model of citizenship: True community-building happens when purpose and meaningful engagement is an organization-wide effort and successful models of wellbeing are enabled by honoring Elders as contributing citizens of the community.

Participants who attend this webinar will be able to:
• Create a community for residents that is inclusive and celebrate engagement as an organization wide responsibility.
• Learn how to interact with residents not as customers but as active and contributing citizens of the community.
• Advocate for the elevation of the activities department as an essential part of the organization worthy of recognition, respect and funding

Register: https://us02web.zoom.us/webinar/register/WN_CWDJ9-cBRDW0Gozzy0Og6w

Evolve 2021 Virtual Summit

Reimagine Life Enrichment
Join 20 Short Sessions Designed to Inspire and Educate. With keynote speakers Dr. Bill Thomas, Teepa Snow, and Ashton Applewhite. Participate live, online, or view recorded sessions on-demand.

Evolve 2021 Virtual Summit

Reimagine Life Enrichment
Join 20 Short Sessions Designed to Inspire and Educate. With keynote speakers Dr. Bill Thomas, Teepa Snow, and Ashton Applewhite. Participate live, online, or view recorded sessions on-demand.

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.