2020 Predictions in Senior Living: Disruption, New Tech, Workforce Challenges, and PDPM.

Posted by CC Andrews

Jan 14, 2020 3:49:31 PM

It usually begins at about the second week of December: articles and blog posts proclaim and predict the future of the following year. In the senior living field, there is no shortage of such prognostications, and I am happy to have devoured them. Many are well thought out and useful. So, similar to what we did two years ago in this space, I have examined the predictions of others and offered here my review of them.

To begin, it’s worth mentioning as an overarching theme for the coming decade a December 27 Forbes article by William Haseltine, chair and president of ACCESS Health International. He highlights the World Health Organization’s proclamation that the 2020s will be “the Decade of Healthy Ageing,” and asserts that health systems around the world “are woefully underequipped to provide the care that healthy aging requires” and that over the next 10 years, “the pressure will be on for national governments, policymakers, and healthcare providers to redress the scarcity of resources available to the elderly and the people who care for them.”

Top Tech Priorities for Senior Living Communities


In addition, Haseltine says that long-term care systems around the world need to be bolstered by research, development, and funding and suggests that for such care “to be accessible, affordable, and equitable to all, they must discard a notion of health overdetermined by illness and treatment in favor of one befitting the full complexity of the person.” In other words, person-centered care should be paramount in long-term care. While not a new suggestion, he is correct. In my opinion, these assertions provide an excellent backdrop for the following overviews:

1. Disruption: Not to overuse a nearly worn-out term but disruption is still a thing, and it’s going to be a thing in senior living until providers catch up with the rest of the world when it comes to inn

ovation and technology. That said, let this paragraph from the Senior Housing News predictor article sink in: “Tech behemoths such as Amazon and Apple have been making moves into the senior health care space and could eventually disrupt senior living—as several industry leaders have warned. And last year, Reddit co-founder Alexis Ohanian—who now runs a venture capital firm—predicted a decade of ‘major change’ is on the way for senior living, and he foresees the rise of a disruptive, tech-forward senior brand.”

In other words, the article states, “in 2020, the disruption threat level will rise.” In my opinion, this news is a long time coming. I see two options for providers and those who serve them: we (as an industry) can wait for the Amazons and Apples to find their blue ocean in our red sea or we can get busy with our own disruption and make something really cool happen.

2. Machine Learning: The abundance of healthcare data available via government records, health care professionals, pharmacies, insurance companies, and others is being used to predict health issues and prescribe medication or lifestyle changes. Adding to this mix, the access to behavioral data of older adults will lead to “improved prediction and accuracy and better services for older adults,” in 2020, according to Senior Living News. This, the writers state, will eventually result in improving the lives of older adults.

3. The Emergence of WiFi Doppler Imaging: Another interesting prediction in from Senior Living News is the idea that WiFi Doppler imaging will bring “new possibilities” to PERS and fall detectio

n devices by deploying a WiFi signal to “generate imaging data that can be interpreted into insights about the movements of people and objects within a given environment.” According to the writers, since academia and industry are working to make fall detection less intrusive, the WiFI Doppler technology has a greater chance of success over the next year or two.

4. Workforce: What would a prediction in senior living be without mentioning workforce? It’s an ever-present topic of course. Here are some good workforce-related 2020 forecasts:

  • McKnight’s Editorial Director John O’Connor predicts that the call for staffing quotas will not go away. “Never mind that finding and keeping workers is arguably the biggest challenge the industry faces. It’s election season,” he says. You can’t really argue with that one especially, as he says, “candidates at every point will be demanding staffing quotas.”
  • Skilled Nursing News published a smart list of predictions based on interviews with senior living executives. Among them is a trend noted among larger operators. “We are receiving a large volume of calls from various SNF operators who are very interested in converting their contract therapy to an in-house model,” said the president of a therapy company. The reason behind this, according to the executive, is two-fold: first, the “SNF operators are realizing therapy is now a cost center and they want to take control of their own expenses.” The second reason is due to an apparent flood of therapists in the labor market.

5. PDPM: As the now ubiquitous new SNF payment model sinks in, “smaller nursing home chains in rural areas that have put their heads in the sand amid the PDPM shift will find ‘reimbursement repercussions to be pretty significant,’” according to Fred Bentley, managing director of consulting firm Avalere Health. He says that although the skilled nursing space won’t fully feel the results of PDPM until 2020, “in some instances, it does mean scaling back on therapy—but not maybe as much as the industry had supposed.”

In another Skilled Nursing News article on 2020 trends, the author states this about PDPM: “if there’s one truism in covering an industry that overwhelmingly relies on government agencies to exist, it’s that operators will quickly adapt to whatever new rules that officials implement in an attempt to control their behavior.” The article cites the example of the industry’s adaptation under the Resource Utilization Group system as proof and adds that “early returns are demonstrating that there are far more reimbursement winners than losers, even when accounting a quirk of the transition process that saw most every operator receive a non-repeated boost for certain residents.”

Whatever happens in 2020, it is sure to be a year of transition, especially in light of PDPM, as well as the inevitable disruption that comes when significant corporate players realize the vastness and value of the longevity economy.

Read More

Topics: tech, senior housing

Intergenerational Programming Popular But Not Substantive in Senior Housing Communities

Posted by CC Andrews

Feb 1, 2018 10:20:25 PM

Despite the fact that many senior housing providers have incorporated intergenerational activities into their overall programming and see positive benefits for residents and youths, most of those programs are short-term or one-time events that don’t require a major commitment of time. So says a recent report from reading-with-grandmother-in-wheelchair-1432646-638x425Generations United and LeadingAge that distills the results of a year-long study on the nature and extent of intergeneration programming in senior housing.

Titled Intergenerational Programming in Senior Housing: From Promise to Practice, this long overdue initiative examines why, how, and what providers are doing to implement intergenerational programs, including partnerships, activities, participant engagement, evaluation, staffing, and funding/sustainability.

The most common activities taking place at provider communities are “friendly visiting,” arts programming, health and wellness activities, oral history/reminiscence interviewing, and language/literacy programs.

Here are some more key findings:

  • Most housing sites, with some exceptions, focus on engaging residents in specific activities, rather than employing more general strategies to foster cross-age relationships.
  • Residents engage in both active and passive activities and, although residents at some properties are actively involved in planning and implementing programs, members of the housing team plan most activities.
  • Most providers have not identified clear outcomes for older adults or youth, nor have they conducted formal program evaluations.
  • There is limited training of staff and volunteers.

The report also identifies both challenges and effective strategies for overcoming barriers to implementing IG program. Some of those challenges are as follows:

  • Insufficient staffing dedicated to IG programming;
  • Difficulties with engaging older adults;
  • Transportation for both youth and elders; and
  • Lack of time to plan activities with partners due to other responsibilities.

Among the most valuable components of the report are the effective strategies that providers have identified in helping them overcome challenges. Here is a sampling:

  • Utilizing a Volunteer Coordinator or Outreach Manager to develop partnerships and oversee intergenerational-related work has helped to alleviate staffing concerns.
  • Recruiting and training “Lead Volunteers” who can help with activities.
  • Involving staff from partner organizations in planning and facilitating activities.
  • Creating an intergenerational advisory group to help plan and implement programs.
  • Including the marketing department in planning so it can market the program as a property asset.
  • Allowing the community’s property van to pick students up from school.
  • Engaging all partners in short and long-term planning to enhance the quality of programs and ensure that those programs meet the needs of all age groups.
  • Holding regular meetings to provide partners an opportunity to creatively address logistical concerns that could prevent a program’s successful implementation.
  • Planning meaningful programs and activities that are explicitly designed to address the needs, interests and knowledge/skills of participants.
  • Finding partners that have shared interests and values, or a common need that can be met through

The conclusion of the report—which is not difficult to surmise based on the findings—is that while many senior housing providers are engaged in intergenerational programming, it appears the majority of the programs do not rise to the level of being high-quality.

As someone who has long advocated for intergenerational programs in senior living, I hope this will change in the near future, as we continue to hurdle ever so rapidly toward a world where elders will dominate the population.

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.

 

Read More

Topics: senior housing, intergenerational

Will Senior Housing Be Affordable and Meet the Design Needs of Older Adults?

Posted by CC Andrews

Sep 18, 2017 9:55:00 AM

Confidence in the 55-plus housing market and continued spending growth among baby boomers in the remodeling industry are painting a rosy picture of the future of the longevity economy. But will builders, remodelers, and contractors create affordable and accessible housing that is appropriately designed?Remodeling image.jpg

Before we get to that, let’s examine the evidence. There are many factors contributing to this positive outlook, including two recent reports: One is the 55+ Housing Market Index (HMI), published by the National Association of Home Builders, and the other is the Demographic Change and the Remodeling Outlook report from the Harvard Joint Center for Housing Studies.

The first report proclaims that builder confidence in the single-family 55-plus housing market was high for the second quarter of 2017. Builders registered a confidence level of “good versus poor” (above 50) for the 13th consecutive quarter, according to a press release. What’s more, four indices that track production and demand of 55+ multifamily rentals posted gains in the second quarter: Present production rose three points to 53, expected future production climbed eight points to 52, current demand for existing units increased two points to 66, and expected future demand rose five points to 67.

Contributing to the strong demand, said NAHB Chief Economist Robert Dietz, are “favorable market conditions, such as record highs in the stock market and rising home prices.”

Even more interesting than the builder/developer outlook is the Harvard Joint Center for Housing Studies report, which asserts that in addition to baby boomers leading home improvement spending for the past 20 years, “older homeowners will continue to dominate the remodeling market as they make investments to age in place safely and comfortably.”

Indeed—the residential remodeling market, which includes spending on improvements and repairs by both homeowners and rental property owners, reached an all-time high of $340 billion in 2015, surpassing the prior peak in 2007. And homeowners age 55 and over are expected to increase spending in remodeling by nearly 33 percent by 2025, the report predicts. Put another way, the share of market spending by this cohort is projected to reach 56 percent by 2025, up from only 31 percent in 2005.

While these projections and predictions are heartening, will fever for the longevity economy keep up with the need for affordability, access, and appropriate design? To that end, a QA blog post from last December outlines another Harvard report finding that only 1 percent of the current U.S. housing stock offers the five design elements that would allow older adults to live comfortably. Those design elements include the following: zero-step entrances, single-floor designs, wide halls and doorways, electrical controls reachable from a wheelchair, and lever-style handles on faucets and doors. The report also notes that “public investment and private sector efforts to expand access to affordable in-home supportive services will be critical going forward.”

There you have it. Let’s take some steps now to make housing accessible, affordable, and livable for older adults.

If you would like to take lead on housing access, design, and affordability for seniors and also raise your profile within the longevity economy, contact Quantum Age today.

Read More

Topics: senior housing, older adults, 55+

A Crystal Ball Look at Post-Acute Care & Senior Housing

Posted by CC Andrews

Jan 31, 2017 12:00:00 AM

A recent National Center for Seniors Housing and Care (NIC) blog post caught my attention about a report from consulting firm Alvarez & Marsal (A&M).

The report, which contains some valuable insights about the entire continuum of senior care, serves as a QA Blog Crystal Ball.jpgreminder that post-acute care stands on the precipice of major change. In fact, the opening line of the report alludes to this conclusion: “A&M believes the post-acute sector will be transformed during the next 10 years.”

Titled “Post-Acute Care: Disruption (and Opportunities) Lurking Beneath the Surface,” the report asserts that this transformation will be driven by the IMPACT Act, the Comprehensive Care Joint Replacement (CJR) model, other payment reform initiatives, and the rise of Medicare Advantage plans.

This is not exactly breaking news, I know. But it is yet another signal that providers that serve patients within the entire continuum of care—hospital, nursing home, rehab, hospice, home care—should already be taking the necessary steps to position themselves for a paradigm shift.

That said, A&M’s insights do offer providers some suggested opportunities that could help you thrive in the longevity economy.

Following are my key takeaways from the report:

  • Interoperable and integrated data systems will be necessary to ensure that patients are connected with the most appropriate sites of care. The results have the potential to improve care transitions, care coordination, evidence-based guidelines implementation, and cost management.
  • Improving patient engagement benefits everyone. But it will take “enhanced patient-provider interaction, the self-monitoring of symptoms, and responding with appropriate actions (e.g., adjust medications, call nurse or MD) when symptom levels indicate a problem,” the report states. Some LTPAC tech companies are acting on this already, including some forward-looking clients of Quantum Age.
  • Facility-based management personnel and systems “will need to adapt to the new reality or be at risk for failure,” A&M says. The reason? The shift of reimbursement risk to providers during the transition and afterwards will be very challenging for management, given their traditional focus on providing facility-based care rather than utilization management across the continuum.
  • A&M also predicts that home care offers the best “longer-term investment opportunity,” while long-term acute care hospitals will be the worst investment risk. In addition, inpatient rehab facilities, hospice, and skilled nursing facilities offer “selective opportunities.”
  • Home care may be a good investment but A&M cautions that an increase in the minimum wage “requires monitoring.”
  • Home care may also benefit from shorter hospital and post-acute care facility stays, which are being driven by the growth of at-risk contracts.
  • Hospice providers are in a good position, A&M says, thanks to a number of factors, including an increased use of advanced directives, Medicare Advantage penetration, and rising acceptance of palliative care.
  • Senior housing (assisted living, independent living, and memory care) have an even more favorable outlook. A&M estimates that unit demand will ramp up by 35 percent for independent living and assisted living between 2015 and 2025. This means that there could be a demand of 30,000 to 35,000 units per year.
  • Another insight offered in the report relates to the advent of capitated reimbursement models. It is suggested that providers will have opportunities to form partnerships to advance preventive care for the following conditions: asthma, chronic pain, chronic obstructive pulmonary disease, diabetes complications, hypertension, congestive heart failure, pneumonia and urinary tract infections.

The report also offers myriad stats, figures, and tables that support their assertions.

Accountable care organizations, according to A&M, are “pioneering but not sustainable.” This conclusion is based on CMS reports of the first two years after roll out, as well as a number of challenges, including “governance; data collection, exchange, reporting and analysis; incentive alignment among disparate stakeholders and patient engagement.”

Finally, although you may be tired of hearing about the explosion of aging baby boomers, A&M stresses the importance of differentiating among the “medical, social, and community needs of the different age cohorts,” each of which are of different sizes and therefore will increase at different rates during the next 10 years. As noted in a previous report, baby boomers are not a single, homogenous cohort.

For help tapping into and thriving in the longevity economy, incuding the post-acute sector of healthcare, from experts in the senior living and care field, contact Quantum Age today.

 

Read More

Topics: Senior care, long-term and post-acute care, senior housing