Executive Forecast 2021: A New Era Begins for Senior Living

“Last year, we thought that the 2020s would be a transformative decade — what an understatement. 2021 will set forth a new era in health care and senior living at large as a result of the pandemic.”

These are the words of Ascension Living President Danny Stricker, but numerous other top executives in the industry harbor similar sentiments about the year ahead.

They are optimistic that the vaccine will beat back Covid-19, and that their organizations will be able to recover and move in new directions in 2021. But, they see that the path forward is difficult.

They are taking stock of the many changes caused by the pandemic, assessing where to focus on damage control and where to push forward with new operational initiatives and ways of doing business with health care and capital partners.

In addition to a renewed — and in some cases heightened — commitment to clinical care, other top priorities include new ways of harnessing technology, restoring consumer confidence, and addressing workforce fatigue and staffing challenges.

As Trilogy Health Services CEO Leigh Ann Barney puts it, the dawn of 2021 brings uncertainty but optimism.

To learn more about how senior living executives are feeling heading into the new year, Senior Housing News connected with a handful of industry leaders. What follows is the first part of a two-part series sharing those responses:

Brenda Bacon, CEO of Brandywine Living:

Looking forward is always more energizing than looking backward! It will be exciting to see how we shape the new normal.

My predictions include that we will see a significant change in our industry’s consumer-facing messaging. While health care has clearly been the focus this past year, the importance of socialization has also been reinforced. It’s our job to show our customers that the pursuit of both a social and safe environment is time well spent. It’s our job to bring energy to that message, not just to regain census … but to grow census by becoming the environment of choice.

Secondly, assisted living has proven its position as a core component of the nation’s healthcare industry. As leaders we need to ensure that our industry associations, all of whom bring value, continue to build on the power they have created working together. It may have been because there was no choice as we sought relief for our apparent political invisibility, but going forward we will be able to be recognized as a key player in the healthcare marketplace.

Finally, while the lessons learned are too many to enumerate here, I believe that we will see a major post-COVID realignment in the investment world. Both operators and investors who have talked about alignment for years will go through a realignment process like nothing we have seen before. Overbuilding, under-managing, alignment-in-word-only, will all generate many serious and consequential conversations in 2021 which will have the potential to strengthen our foundations, our progress, our margins, and our recognition as a valued industry. And then investor interest will soar to new heights.

Randy Richardson, President of Vi:

Having been through almost nine months of Covid management in our communities, we’ve become pretty good at it. But managing the infection within our communities is going to be even more difficult coming into 2021 than it has been in 2020, as this resurgence in outbreaks is proving to be even more powerful than I think people might have suspected.

Coupled with general fatigue, it could be a little more tough to continue the rigor that we’ve established. I do think that we’ll manage just fine through this next wave if we encourage people to keep doing the right things, and if we’re aware of morale among our employees and residents.

We’re going to be dealing with the pandemic for at least several months into 2021, if not the better part of the year. That’s not necessarily the most rosy outlook. However, I do think that, as things improve, we will have an incredible recovery economically.

We developed a virtual marketing campaign and launched it officially on the first of July. And it’s proven to be working very, very well. It has been encouraging to us because of the lead generation that we’ve seen from that program. In many communities, we’re back to selling. And I’m pleased to say in August, September, and then November, we were selling at a pace that’s very close to what you would expect in a normal environment. That tells me that people still are interested in our product, and they have a desire to move forward. I think they’ve seen how we’ve managed through this crisis, and we can offer them a little bit of hope that they’ll be taken care of.

So, going into 2021, assuming we can continue to manage the situation as well as we have, that we don’t have any surprises, and that we have a vaccine available, I expect our selling activity to improve, and I think there is a lot of pent up demand out there.

Next year, our primary focus is going to be on keeping our employees and residents as safe as we can. We have a number of capital projects that we’ve been able to kind of re-engage with, and I expect in 2021 we’ll be moving forward on it. As an organization, going through the budgeting process was really interesting this year because there are so many uncertainties. We’ve got a lot of assumptions built into the numbers that we’re saying we’re going to live with, but I actually think we’ll probably outperform where we believed we’d be in 2021 even a month or two ago.

Danny Stricker, President of Ascension Living:

Last year, we thought that the 2020s would be a transformative decade — what an understatement. 2021 will set forth a new era in health care and senior living at large as a result of the pandemic.

This year presented our industry with both challenges and learning opportunities around providing compassionate, personalized care in the midst of a pandemic. In 2021, as we deal with Covid-19 and the hope for successful vaccines and treatments, we will continue to adapt to new work environments, new consumer expectations and the economic impact of the pandemic.

I appreciate the opportunity we have been given to redefine our industry to meet the needs and expectations of the new Covid-era consumer and employee. As an industry, we need to collaborate to ensure that our sector is able to thrive under additional regulatory and financial pressures, while recognizing that health care at home is a viable option for complex care. In 2021, Ascension Living will focus on expanding services to meet the needs of current and future consumers, including the Program of All-inclusive Care for the Elderly (PACE) and memory support services. We understand that skilled nursing facilities and senior living communities will look different in the future and we are learning more about the demand for those services in 2021 measured by occupancy recovery.

I imagine our industry will also witness significant advancements in technology, some accelerated by the pandemic from a regulatory perspective. I anticipate that the further evolution of telehealth and other virtual care services will continue to support higher acuity care in lower cost settings. Given this, it is time as an industry to reexamine our growth strategies and put in place solutions to meet the non-traditional demands that have emerged out of the pandemic.

Even with a successful Covid-19 vaccine, during 2021 we will continue to focus on mitigating exposure risks related to communicable diseases for associates who are essential as well as for those we serve. We also will continue to focus resources on care and support of our associates who have faced a stressful and difficult year. In addition, we will concentrate significant efforts on transforming our HR and recruitment processes to support and train future industry leaders, who have shown dedication, resilience and a drive to transform senior living. As an industry, we will need to come together to address our workforce challenges and ignite a passion for senior care.

Leigh Ann Barney, President and CEO, Trilogy Health Services:

Heading into 2021, there is still uncertainty, but I believe we have reasons to be optimistic. Having a vaccine available changes our outlook for the future, but there are still a lot of unknowns, including long term efficacy, ease of procurement, and the likelihood that staff and residents will want to receive a vaccination. That said, it is a step toward recovery and will help us move forward from the grip Covid has had on us in 2020.

Recruitment and retention of staff were probably the highest concerns in the senior housing industry prior to Covid. Add in Covid testing, PPE requirements and the overall stress of the pandemic, and recruiting and retaining staff has become even more challenging.

Prior to Covid, I would say we were cautious adopters of new technology, but the pandemic has really pushed us forward. Now we are offering multiple telemedicine options, and we’re stepping up our communications with our families and employees. We have always used Red e App as an internal communication platform, but today we also have Regroup, which lets us send emails and SMS notifications to our families.

I am most excited about the development of our own resident health app called FamilyPulse, which gives designated family members access to their loved one’s basic health stats like their blood pressure, temperature, and medications. It also contains info on their loved one’s meals and activities.

During the pandemic, we conducted pulse surveys with our families and the feedback we received was their need to have more information about their loved one during a time when they were more isolated from them. I think FamilyPulse is going to be a game-changer in this respect. Since our pilot began, we have seen really strong early adoption numbers, which makes me very excited about our full company rollout.

My top priorities: continue to improve base and minimum wage scales for staff recruitment and retention. We made significant wage investments this past October for our certified caregivers, but we understand we will need to continue to make investments in wages in order to stabilize our workforce.

Also, building market confidence in the services we provide to seniors. Our industry has been asked to do so much during Covid. We have adapted and pivoted frequently to new policies and protocols, all while doing everything in our power to keep our residents and employees safe. Long-term care has not historically been heralded for our clinical excellence, but I think our industry has shown our clinical capabilities during the pandemic, despite limited resources. Our goal is to build on this platform and advocate for more resources to support the level of service we are asked to provide.

Diversity in service lines is going to be another key to our success. Trilogy’s operating model is diverse, which spreads risk. Our campuses have a well-designed mix of health care, assisted living and independent living, so we are not overly dependent on any one service line. Ancillary business lines, primarily pharmacy and therapy, are another way we diversify our revenues. A priority for our future is to continue down the path of diversification. We are reviewing further additions to our current campus communities as well as expanding our ancillary umbrella of services.

Adam Kaplan, CEO of Solera Senior Living:

I’m most worried about continued fatigue/burnout among front line team members and management, as well as escalating risks of a Covid outbreak, and lengthy lockdowns/restrictions leading to isolation/anxiety and depression. Also, vaccine-related logistical issues and impact of an anti-vaccine sentiment.

I’m excited for a day in which close to 100% of our residents, family members and team members have been vaccinated, and thus the risk of a Covid outbreak is reduced to the degree in which almost all of the restrictions are lifted and thus the focus/energy can be re-weighted to other priorities.

So, my top priorities are successful vaccine planning and implementation, and keeping residents safe, healthy and engaged. Also, sourcing and developing high-quality talent that has been adversely impacted by Covid, and implementation and adoption of innovative technologies and services.

Earl Parker, President and COO of Commonwealth Senior Living:

What has me most worried?

First and foremost is the fatigue of our community leaders and front line associates. We have a robust communication program, and we know that they are feeling supported with having PPE, information, policies, protocols, et cetera, but the ongoing stress on the teams is significant.

We had good success with a teamwork-oriented contest, where we awarded a new car and numerous cash prizes across the portfolio earlier this year, and we intend to initiate a similar program in Q1 2021. We are also proactively tracking who hasn’t taken time off, and reaching out to encourage and support them to take some time for themselves, away from the community.

I wouldn’t be honest if I didn’t also add occupancy to my list of concerns. I tend to be an optimist, so my belief is that there will be pent-up demand and that when people’s confidence regarding the vaccine really kicks in, that we are going to see a rebound and the opportunity to grow occupancy in 2021, though I do anticipate it taking about 18 months to get back to pre-pandemic occupancy levels for AL and IL, with MC rebounding more quickly.

Rounding out the top 3 would probably be litigation surrounding Covid-19. While I am confident that our teams — and I would propose most in our industry — did everything that they possibly could to deal with the pandemic, I am certain that there will be individuals that seek to capitalize on the crisis and end up driving insurance prices higher, and consuming a lot of time and resources that could be better spent on other, more productive pursuits.

I think the thing that I am most excited about is getting our communities back to normal, and having the opportunity to interact personally with our residents and their families to better learn their perspectives on how we did. Based on the feedback I have received so far, I believe that in most cases we have gone beyond “satisfaction” and created a deeper sense of “loyalty” throughout the pandemic. We have been incredibly transparent with our residents, families, and associates throughout the entire pandemic, sharing with them not only what we were doing but also the “whys” along the way. We have listened to feedback and in some cases made changes to our plans and in other cases taken the time to explain why we weren’t. I anticipate a significant increase in our family and friend referrals when things return closer to normal operations.

I am also excited about the capital investments we are making in our communities as a result of Covid. We are installing automated check in and screening kiosks, touchless door openers, touchless faucets, et cetera. I believe that these investments will not only help us in the near term deal with Covid, but also make our communities safer for the future.

With reporting from Tim Regan and Chuck Sudo

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