Meg LaPorte

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Recruiting for the future? Find your ‘why’ first

Posted by Meg LaPorte

Sep 4, 2018 12:06:00 PM

How are you going to attract future generations to join your workforce? Experts recommend these best practices:

 

  • Be purpose- or mission- driven
  • Listen to your staff
  • Empower workers with some level of autonomy
  • Be a diverse and inclusive organization.

 

Blogger Alaina Love, chief operating officer and president of Purpose Linked Consulting, in a recent post on Smartbrief.com, outlines what Generation Z—individuals born between the mid-1990s and mid-2000s—is looking for in their work and their careers.

 

According to Love, research backs her assertion that Gen Zers are “among the most purpose-, passion- and values-driven talent cohort in the workforce.” This is evident in how they make purchasing decisions, what they seek in their employers and the direction of their career trajectories.startwithwhy

In fact, a recent Deloitte study of Gen Zers and millennials—those born in the early 1980s through the mid-1990s—found that both generations want business leaders “to take the lead in solving the world’s problems, to shift organizations’ motives from inordinately focusing on making profit to balancing social concerns, and to be more diverse, flexible, nurturing of and generous with its employees.”

In other words, organizations that meet these criteria will attract and retain the best of both generations and be better for it. How so? Love cites yet another recent survey of Gen Zers, in which half of the respondents are influenced in their purchasing by “a brand showing dedication to social impact, by giving proceeds to charity, being environmentally conscious, having strong values, or projecting an impact-driven image.”

Find your why

The evidence for becoming a purpose-driven organization is more overwhelming today than ever before. And one proven way to make purpose a priority is to discover your organization’s “why”—as in, why your company exists and why it does what it does. Known for delivering one of the business community’s most popular TED Talks, Simon Sinek has helped thousands of companies and millions of people identify their whys.

As a senior living provider, whether you are for-profit or not-for-profit, finding your why is an imperative that yields many benefits. In most cases, your why is not your official mission statement. Rather, it’s a simple, yet compelling statement that stimulates buy-in from others. An authentic why helps you maintain perspective, build a positive corporate culture and create a trustworthy organization that is connected to a purpose-driven business.

What’s more, living that why will help you attract others who are driven by purpose, inclusiveness, diversity and empowerment. As Love notes, next year, Gen Z will comprise 32 percent of the population, surpassing millennials as the most populous generation. How prepared is your organization?

To learn more about how Quantum Age can help you identify, cultivate and execute your why, contact us.

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Your Cheat Sheet for 2018 Senior Living Trends & Predictions

Posted by Meg LaPorte

Jan 18, 2018 12:00:00 AM

It’s another new year and that means new forecasts about trends in aging services. Instead of making my own crystal ball predictions, I examined some trusted sources and digested them for you. Following is my take on 2018, based on the many predictions put forth already:

Predictions 2018

1. Staffing and Workforce Issues

Lisa McCracken, senior vice president of senior living research and development for specialty bank Ziegler, offered her projections for McKnight’s Senior Living. She found that while it may not be a surprise that staffing and workforce issues will remain at the forefront of challenges for providers, she believes that skilled nursing and post-acute providers face a “’perfect storm’ of an increasing minimum wage, numerous retirements, and evolving staffing requirements due to changes in the resident/patient mix, healthcare reform, and other issues.” To address the problem, she cites operators that have created pools of staff members from which they can draw as needed. While this sounds like a modified staffing agency (the chronic use of which is generally frowned upon), they may be onto something. A recently launched company known as CareForce Elite is a staffing firm that caters only to long-term and post-acute care. Founded by two former nursing home CNAs, the company specializes in training their CNAs in geriatrics and long term care. Whether this represents a trend, I am not certain, but it does represent an innovative solution to an age-old challenge.

Also weighing in on workforce concerns in the year ahead was Andy Smith, president and CEO of Brookdale Senior Living, who told Senior Housing News that demand for talented, dedicated employees will keep growing in 2018. “We are in an environment where new jobs are being created and unemployment rates are dropping, so companies will have to step up to improve and communicate about the employee value proposition they offer,” he said. “This employee value proposition is not just about the job, the wages or the benefits, but also about the culture, growth opportunities, and the leadership offered.”

Doug Leidig, president and CEO of Asbury Communities, also gave a nod to staffing and workforce issues in 2018 with a prediction that companies will offer “creative adjustments and changes in benefits to attract a new workforce.”

2. Technology

Surprise, surprise—the continued adoption of technology among senior living operators is also in the forecast—and for good reason. One source suggests that the ubiquity of wearables, watches, gaming consoles, Alexa, Siri, Sonos, Netflix, and other streaming services will require throttling, or intentionally slowing down of community networks, in order to minimize bandwidth congestion on a campus or within a building. The byproduct of this could be tiered pricing of services, a la cable companies, the source suggests. Another factor that could have an impact on such services is the reversal of net-neutrality, as it will bring greater uncertainty around how content is delivered to senior living communities and its residents.

3. Design

Senior Housing News notes that with such dramatic shifts for owners and operators in 2017, skilled nursing is “rebooting” thanks to aging skilled nursing buildings that are motivating owners, operators, and developers to “rethink how to use these obsolete buildings to propel future 

growth and adjust strategies for their existing buildings and campuses.” While not an earth-shattering discovery, the author believes that “SNF 3.0 may mean repurposing or converting existing nursing homes into assisted living and memory care units.”

Another points to new campus developments that are designed and completed without the SNF component “to round out the continuum of care as operators are choosing instead to partner with local skilled nursing and post-acute providers.”

Yet another soothsayer envisions that builders and operators will continue to seek innovative alternatives to traditional housing models. According to a Senior Housing News survey, this means units that are getting smaller, not bigger. The end result of this approach is ostensibly more affordability. The examples offered include Benchmark Living’s newest community in North Attleboro, Mass., where two resident units share a common space, “creating roommate dwellings the company likens to college suitemates.” Another example is Dr. Bill Thomas’ Minka project, which is a small, modular home with a universal design. Thomas is promoting Minka as part of his MAGIC approach (multi-ability/multi-generational inclusive communities)—small dwellings that will be constructed at the University of Southern Indiana in Evansville.

4. Dining
It’s also not a surprise that innovations in dining have been a major focus for operators across all sectors within the industry, with some believing that it will continue to be a drive for marketing and satisfaction ratings. In my opinion, the takeaway here is that many dining operations are now beginning to mirror their local restaurant counterparts. “No longer is the restaurant-style approach a nice-to-have, it’s a need-to-have in order to remain competitive,” Senior Housing News reports. In other words, a cheap rip-off of Starbucks will not cut it. That said, the authors cited a CCRC that opened its station-style restaurant to the surrounding community for paid lunches. One assisted living community in California holds its own “Taste of” event each year. “Those who stop by for a sample of the food are motivated to ask where they can get a sit-down meal—and presto!” The idea is that such endeavors can create excellent leads.

Another clever marketing effort is the use of branding as a way to stand out from the crowd. Apparently, some senior living companies are creating house-branded coffee, wine, signature sauces, desserts, and more, thus “inciting pride among residents who enjoy an exclusive and individual experiences.”

5. Partnerships and Collaboration

Sean Kelly, president and CEO of the Kendal Corporation, believes that providers will be compelled by market forces to “establish deeper partnerships with hospital systems, institutions of higher learning, and community organizations.” He alludes to the importance of fostering communities on or off of a campus “where residents and staff are engaged in meaningful ways with one another and the wider world.”

Asbury’s Leidig suggested that more and more competitors will take on partnerships. For example, he says, CCRCs “will join together to offer services both on their campuses and outside the walls to reduce duplication of services, create efficiencies, and increase market share.” He says he expects much more actual collaboration activity between hospitals and CCRCs, “versus just talking about it.”

My own prediction: Innovative intergenerational programs that involve individuals of all ages will explode within the senior living sector, especially in assisted living. As my colleague cites in another post, the most common activities taking place in this sector are “friendly visiting,” arts programming, health and wellness activities, oral history/reminiscence interviewing, and language/literacy programs.” These are great but there needs to be more substantive and innovative approaches, such as new housing models and new collaborations, to bringing generations today.

If you want a focused approach to staying on top of industry trends that is facilitated by experts in the senior living field, contact Quantum Age today.

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Five-Star Calculations Demystified

Posted by Meg LaPorte

Aug 16, 2016 10:02:26 AM

The Five-Star Quality Rating System is getting lots of attention these days. Not only did CMS announce that the six new quality measures have been officially added to the rating system, but the program has also drawn criticism from a U.S. senator. According to an Aug. 10, McKnight’s news story, Sen. Robert Casey (D-Pa.) Stars_blog_image.jpgbelieves that while “the updated measures give prospective nursing home residents and their families more information when choosing a facility, they do little to ‘impact the accuracy and reliability of the measures reported.'"

No matter what one thinks about Five-Star, it’s certainly not expected to go away anytime soon. And according to American Health Care Association Senior Vice President for Quality and Regulatory Affairs David Gifford, MD, MPH, the new quality measures will have a modest impact on overall five-star ratings for nursing homes.

However, Gifford, who presented at the eHDS/Ability user group conference in Chicago earlier this summer, explained that the impact on individual quality measures for nursing homes will be more pronounced.

In light of this news, I feel obligated to share Gifford’s compelling presentation about how the staffing measures—as well as the overall stars—will be calculated. Here’s a synopsis:

  1. Staffing Measures: Using a matrix on the staffing measures (see graphic below), Gifford explained that the measure is calculated by combining registered nurse (RN) and direct care staff hours.
    • Each row of the matrix contains the RN hours for each patient day, and each column includes the total direct care staff hours per patient day.
    • Nursing homes with scores that appear in upper-left red box will lose a star, while those that fall within the lower red box area will gain a star.

five_star_graphic.png

Gifford explained that CMS has established threshold rates for each measure to determine the points for that measure. “They don’t change those rates,” he said. “They’ve stayed fixed since February 2015.”

With regard to staffing scores that fall within the one-star ranges, Gifford believes that one major reason why a nursing home gets there is its location. If it’s in Texas, for example, the Medicaid reimbursement is “really bad” there and staffing numbers will be low as a result, he said.

The other reason for low staffing scores is related to Form 671–Long Term Care Facility Application for Medicare and Medicaid. “When surveyors coming in and yell at you for obstruction of justice for not filling out Form 671, your staff will, of course, fill it out and hand to the administrator, who will sign it,” he explained. “The problem with this is that no one is likely to check the staffing numbers on it. If that’s the case, unfortunately, there is no way to change it,” and it becomes part of the nursing home’s record. “There is no changing it,” Gifford said. “I’ve never seen it changed in 10 years.”

Finally, don’t forget that starting in 2018, CMS will use data submitted from your time and attendance systems into CMS Mandatory Payroll-Based Journal (PBJ) to report staffing levels and turnover and retention.

  1. Overall Star Ratings: Calculate your overall five-star rating as follows:
    • Assign 20, 40, 60, 80, or 100 points for each quality measure based on the quality measure rate against a set of threshold cut-points.
    • Add up the points for all 11 quality measures.
    • Compare your aggregate score of the 11 quality measures against the threshold cut-points to determine your stars (see graphic below).

Five_star_graphic_2.png

All the points will be added together to come up with the final five-star rating, and since there are 11 measures currently, 1,100 is maximum number of points you can get, Gifford reported, while 225 is the minimum number (see graphic 2). “When adding the five measures to the eleven they do roughly the same thing,” he notes. “So there will 16 measures, so your score will be between zero and 1,600.”

If you calculate 760 points out of 1,100, you will get five stars. “So the magic number is 760,” said Gifford. “If you’re less than 544 you’ll get one star, and you will lose a star. Everywhere else, there will be no impact.”

Gifford emphasized that the biggest impact of the new measures is “the fact that the measures will be used by hospitals and ACOs for network selection.”

Half of nursing homes will see their individual quality measures star ratings change at some level, and half of those will go up, while the other half will likely go down, Gifford noted. “The impact on overall star rating will be a lot less, with about 15 to 20 percent seeing changes in their overall star ratings.”

In conclusion, Gifford said that CMS will likely make changes to Five-Star again in a few years. For example, in 2018 staff turnover will be added. In addition, CMS will, at some point, add SNF Quality Reporting Program (QRP) measures, resident review measures, and measures on functional improvement.

Gifford noted as well that customer satisfaction measures will likely be added in about four years.

Keeping those stars aligned will help you stay on track with the news measures 

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Topics: long-term and post-acute care, CMS, quality, five-star, Medicare

Harnessing Longevity For Senior Care

Posted by Meg LaPorte

Apr 20, 2016 3:14:55 PM

Humans are living much longer than any other time in history, and according to a recent study this phenomenon will translate into a tremendous boon of volunteerism and charity—to the tune of an $8 trillion dollar windfall—for American society.

Aging guru Ken Dychtwald, PhD, and his colleagues presented the study’s findings in his keynote last month at the American Society on Aging’s annual meeting. Released late last year, the report reveals some remarkable findings about the generosity of older Americans. Titled Giving in Retirement: America’s Longevity Bonus, the study offers some food for thought for anyone who serves elders and plans to serve baby boomers.volunteer-gardener-1508838.jpg

The study found that over the next two decades there will be a surge in giving by retirees, leading to what Dychtwald describes as America’s $8 trillion “longevity bonus.” Behind this phenomenon, he says, are three factors: the wave of baby boomers moving into retirement (or something that may or may not resemble retirement), the rise in longevity, and the rather high rates of giving among this cohort.

So what’s the evidence behind his premise? Older Americans have more time, money and skills to contribute to causes they care about than younger adults. For instance, more people age 65-plus donate money or goods than any other age group, and they give the greatest amount—more than double that of younger adults.

The research also found volunteers over age 65 volunteer an average of 133 hours per year, compared to those ages 25-34 and 35-44 who volunteer an average 55 and 58 hours per year, respectively.

In addition, retired women—the predominant gender living in seniors housing—are even more likely than men to say retirement is the best time to give back (68 percent vs. 62 percent). More retired women donate (81 percent of women retirees vs. 71 percent of men retirees) and volunteer (29 percent of retired women retirees vs. 22 percent of men retirees) to charitable causes.

According to Dychtwald, those in the aging services field have a “unique opportunity to harness the wealth of talents, skills, and experiences of the boomer generation as they enter retirement and seek to make a difference.”

Dychtwald is right, and long-term and post-acute care providers are in a unique position to harness this moment in history. Consider the fact that living in a nursing home or assisted living community doesn’t mean you cannot give as a volunteer, as a mentor, or in another capacity. In fact, some providers already offer programs that engage their residents in very successful and purposeful volunteer programs, such as creating items to give to local underserved families, serving as mentors for nearby school children, or making crafts to sell at the community farmers market. It’s also good for you—physically and mentally.

The longevity bonus is also ripe fodder for innovators in the field who may be interested in developing solutions that further enable volunteerism for elders, as well as for providers.

What's more, there can be little downside to activities that have been shown to reduce depression and diminish chronic pain.

Sometimes the best solutions for improving quality care and reducing risk are decidedly low tech. Food for thought indeed.

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Topics: Aging, Senior care

Urban Density, Innovation, and the Future of Senior Housing

Posted by Meg LaPorte

Jan 11, 2016 10:41:25 AM

In addition to becoming more densely populated with the likes of both Millenials and Baby Boomers, U.S. cities of the future will be centers of open innovation, according to a panelist at last month’s Housing for Tomorrow forum sponsored by The Atlantic. The forum, which took place in Washington, D.C., included a number of luminaries in the field of housing, including Vice President and Founding Director of the Metropolitan Policy Program at The Brookings Institution, Bruce Katz, who made the prediction about urban density.

Katz posits that urban areas of the United States are experiencing a “remarkable revaluing” thanks to the interplay of what Millennials and Baby Boomers want and what companies need. He described it as a restructuring of the U.S. economy from what has been a “closed innovation economy, where you had to be out in the middle of nowhere in science parks to keep your secrets secret, to an open innovation, network economy where proximity, density, vibrancy, vitality gets revalued by innovative companies.”

Katz clarified further: “Where once there were major farming companies that had their R & D facilities in the middle of nowhere, they are now moving back into cores of cities, next to MIT,” forStewarts-Lane-Final---Persp-Rail-Depot.jpg example.

Companies want to be near advanced research institutions and hospital complexes, where ideas are being generated and there is speed-to-market, he says.

Innovation Districts

“It’s almost a collapse back into an innovation economy, where talented workers and innovative firms are going to the cores of metropolitan areas.” This, he asserts, will create “a radical change in the spacial geography of innovation.”

This idea seemed very well thought out to me, so I Googled the term “spacial geography of innovation” and found that, indeed, Katz and a colleague had authored a white paper titled, “The Rise of Innovation Districts,” which describes his concept in much more detail.

“America’s family structure has been altered by the simultaneous aging of the population and the tendency of young adults to delay marriage and have fewer children,” the report states.

What’s more, research shows that 70 percent of Americans place a high priority on walkability, proximity to health care, entertainment, recreation, work and school, and social contacts. “Older Americans are increasingly seeking smaller homes and apartments, as well as places with easy access to medical services, shopping, and other daily necessities,” the report states. “Meanwhile, middle-aged couples, whose children have ‘left the nest,’ show greater receptivity to urban neighborhoods, cultural amenities, and shorter commutes.”

MegaCities and the Death of Distance

Related to the Brookings report is a futures study from the Industrial Research Institute that examines, among other things, a scenario titled “Death of Distance vs. MegaCities,” which dovetails with the Brookings concept in that it advances the idea of an “open innovation framework,” similar to Katz’s assertion.

The study alleges that by 2038 cities will become major political forces in countries due to their embrace of smart technologies to manage transportation, energy, and waste.” But IRI’s crystal ball also finds that technology and connectivity will “make distance irrelevant” and enable scientists to work and teach at the “level of entire corporations or universities of the past.”

What does any of this have to do with aging or long term and post-acute care? For senior housing professionals, it’s valuable information about where future customers will choose to live, where their Millienial caregivers will also live and work, and where the innovation and technology to care for Baby Boomers will be generated.

If you happen to disagree with these predictions, all from highly regarded organizations, then at least consider it food for thought.

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Hospitals Are Out (But You Already Knew That)

Posted by Meg LaPorte

Dec 15, 2015 9:08:34 AM

Hospitals are out and community alternatives are in, according to Bill Thomas, MD, aging guru and Harvard-trained geriatrician, who was at University of Maryland Baltimore County recently to share his opinions on long term care, ageism, and the word “continuum,” among other things.

After declaring himself a nursing home abolitionist, Thomas was quick to note that he bears no ill will toward owners, operators, or others who work in such places—he simply wants to abolish institutional models of care.

Dr. Bill ThomasThis assertion is not a new one for Thomas, who had just finished his Age of Disruption tour of 35 U.S. cities. He began his career as a nursing home medical director in New York some 30 years ago, where he encountered poorly run facilities and painfully lonely and isolated residents. Since then, he has founded the Eden Alternative and Green House models of long term care, which eschew models that adhere to institutional dictates.

However you may feel about Thomas' views, he is a force to be reckoned with when it comes to holding sway among long term care professionals. His standing as an aging influencer (a title bestowed upon him by both www.NextAvenue.org and The Wall Street Journal) is undeniable. He is credited by most to be the founder of the culture change movement in nursing homes, and his many followers (nearly 7,000 on twitter and thousands between his Facebook page, blogs, and books) believe him to be a bit of a savior in the field of aging services.

The informal gathering enabled Thomas to wax extemporaneously from his “notebooks of thought” on topics such as aging, grief, and hospital care. Yes, that’s hospital care. The good doctor believes that the law responsible for Obamacare is doing a fine job of steering money away from hospital beds and toward outcomes.

How so? For one, he says the Affordable Care Act (ACA) is creating, slowly and imperfectly, “a movement away from a system where the money follows the bed to one where money follows the risk,” he says. What’s emerging, he adds, are populations of people that become enrolled in an organization or system that takes responsibility for those people and those outcomes (a la accountable care organizations).

“All of the sudden,” says Thomas, “heads in beds is not a winning strategy.” He confessed that he spent years of his career doing the best he could to make a flawed nursing home model work. “But now, provisions of the ACA are changing that far more than I ever did."

Connected to this issue, Thomas noted, is something known as post-hospital syndrome—when someone goes into a hospital and comes out much worse off due to a lack of movement resulting in loss of balance and muscle mass, among other things. 

“What happens in a hospital,” Thomas said, “is they treat a presenting complaint and when it’s been adequately treated, you are discharged. They don’t help you heal; the docs treat the numbers, and not the person.”

So, what is the antidote to this? Thomas posits the following: Move Eat Sleep and Heal, or MESH. He believes that hospitals and the entire health care system have been doing it wrong by focusing on chief complaints and diagnoses when they really need to focus on MESH.

“We spend billions of dollars where it’s virtually guaranteed that Medicare patients will not heal,” he says. “The slope [of decline]Hospital_photo.jpg is of our own creation. We manufacture disability, frailty, weakness, and we create it on a massive scale.”

In short, Thomas says he would like to “free America’s elders from its hospitals.” The real conversation, he adds, is with the payers and with the people who will set up new and different networks that keep people out of hospitals.

The corollary to this, Thomas notes, is to “create a rich set of community-based alternatives that work for people. Get the people who are in hospitals out of hospitals, don’t put them in the nursing home, put them in a place in a neighborhood in a community where they can get MESH care,” such as their homes.

A future post will examine why Thomas wants to wage war on the word “continuum.”

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Topics: Aging, Hospitals

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