Pathway to Living COO: New Community Shows Our Progress in Managing Covid-19

Pathway to Living was ready to receive its first move-ins at Aspired Living of LaGrange, a 117-unit assisted living and memory care community in LaGrange, Illinois, in early April. Construction was completed. The facility received a provisional license from the Illinois Department of Public Health.

Then the coronavirus pandemic intensified across Illinois, forcing the owner and operator to rethink that target opening date, Chief Operating Officer Maria Oliva told Senior Housing News.

Pathway eventually postponed the opening and turned its attention to controlling the spread of the virus across its portfolio. And as more was learned about the virus, the operator was able to incorporate that knowledge into its Covid-19 response and open Aspired Living of LaGrange in mid-May.

“The delay allowed us the opportunity to continue to learn and evaluate what was happening,” Oliva said. “It also gave us the opportunity to take a look at LaGrange and see what we can modify now because it’s new.”

In fact, alterations were quickly made to the new building in order to make it more secure from the virus, and to operate more smoothly under the new protocols developed by Pathway. In a recent interview with Senior Housing News, Oliva shared further details about how the company has adapted to operational and financial challenges posed by the pandemic, including how it is leveraging a relationship with real estate development and investment firm Waterton to execute a more sophisticated strategy than would have been possible in the past.

Based in Chicago, Pathway to Living owns and operates a portfolio of 33 communities across the Midwest under three brands: Azpira Place, Aspired Living and Victory Centre. Waterton acquired a controlling stake in Pathway in January 2019.

This interview has been edited for length and clarity.

Were there any concerns about postponing opening Aspired Living of LaGrange?

It was originally slated to open as Covid-19 cases intensified in Chicago and suburban markets. We felt that we needed to take an abundance of caution, and that’s how we approach everything that we do as an organization.

Our initial thinking was [postponing] until mid-May and, at the latest, we’ll have to push it into June. We were in a good position to do that.

Did postponing have any impact on the community’s lease and operating proformas?

We were ahead of our pro forma in this building, so we had some savings from our construction. We did have a list of potential additional expenses that we wanted to do, once we opened the community. That was very helpful for us to be able to utilize some of those savings to modify rooms, install UV lighting and additional air filtration.

What other changes were put into place?

We focused on how to create an environment where we can minimize the high-touch areas. So we replaced all of our light switches so that they’re touchless. We repositioned one of our discovery rooms at the front entrance of the community into a room where team members would change into clean scrubs at the beginning of a shift. They then leave them in laundry bins and change back into their [civilian] clothes before they go home. That ensures that when they’re on duty, they are wearing clean scrubs in addition to their PPE, depending on the risk level of the community.

And we’re creating external access from our courtyard into an apartment that will be repositioned as a family visitation room. We’ll have all those same safety protocols: high disinfection; UV lighting. We’re doing that for this community so residents have the ability to get together in groups of 10 or less, inside the community.

Are new move-ins required to quarantine?

We require two negative tests for residents before they move in, as well as once they arrive. It gives us, them and their families a sense that the community is Covid-19 free.

We want [the new community] to open with some ability for residents to have smaller group gatherings inside the community, while also encouraging them to use the outdoor spaces. This community has a large courtyard in the front of its building which also allows for significant family visits. They are not necessarily coming into the building but they’re able to visit while maintaining social distance guidance.

What is the pace of move-ins at Aspired Living of LaGrange currently?

The community is ahead of our [lease] pro forma. The majority of our depositors were excited to move in. We had some of the individuals that were in other communities that planned to move in, pre-coronavirus. That was a little slower because those communities had shelter in place protocols.

We’re seeing pent-up demand and continued interest in the community from prospects and their families, because of the lifestyle afforded the residents who live here.

How has the pandemic pressured operations and move-ins across Pathway to Living’s portfolio?

We didn’t see any move-outs related to fear from the pandemic. We saw a decline in occupancy for a couple months as we had to delay move-ins, but as we reopened, we found that demand is still there. Aspired Living of LaGrange shows that people are looking at senior housing as a safe environment.

The operational pressures stem from the slow occupancy. We’ve experienced higher costs associated with managing the virus, and they are the same regardless of the brand, such as increased sanitation, sourcing PPE, and testing early on. We leveraged relationships with our own private labs where we paid for the tests, beginning in late February and early March. We provided premium pay, which has been the biggest impact on expenses.

Do you envision the premium pay structure and increased incentives establishing a new, post-pandemic wage baseline?

I think it will require that we look at compensation, and require that we look for efficiencies in how we operate, to offset some of those costs.

As an industry, we have to be able to recognize the value of the roles in this space. The ability to attract and retain talent are now highlighted as are how critical workers are to the health and safety of the residents in our communities.

That gives us an opportunity to evaluate how we compete in the long-term care environment and how we establish new rates. We’ve been trying over the last several years to increase wages in every state where we could hire team members and retain them. We’re constantly looking at how we compete in our markets where we operate — not just in health care, but beyond — to attract talent.

Pathway’s Victory Centre communities are an affordable model, licensed for supportive living. Has that made the company available for advance Medicaid relief under the CARES Act stimulus?

We’ve applied for funds but have yet to receive any. We’re also participating in the payroll tax deferral program.

Has Pathway’s relationship with Waterton provided efficiencies for slowing the pace of cost increases?

We share a robust, fully integrated infrastructure. The relationship has been extremely beneficial. We have leveraged resources from both sides, which I think has made us, as a senior housing operator, somewhat unique. We’re able to look beyond what the industry is doing responding to the virus. We communicate with each other on the types of disinfecting products we’re using. We’re sharing expertise on improved air filtration and UV lighting, and how do we source PPE, beyond our normal channels.

It gave us a broader approach to supply chains and resources to help manage the pandemic.

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