Senior Living 100 Intelligence Group Friday Insights - November 6, 2020 |
|
You’ve come to know Senior Living 100 for the valuable insights we deliver at our in-person conference. Now we’re bringing that experience to our virtual platform – the Senior Living 100 Intelligence Group – with a robust mix of content and connections, anchored by this weekly feed of strategic insights.
2020 has given us much to talk about – a global pandemic, a drop in census, a surge in telehealth, impending industry consolidation, and perhaps the biggest election of our lives. We know this industry has a tough row to hoe ahead – which is why we believe the timing is right for the frequent exchange of proactive solutions. The Senior Living 100 Intelligence Group is a new membership network of leading operators and solution partners in senior living. Two analysts – myself and Jen Cross – are dedicated to providing members with fresh insights into strategy, innovation and leadership. Jen and I see this as an opportunity to help you interpret industry developments, including an understanding of where the proverbial puck is headed in senior living.
In addition to a weekly intelligence feed, here is the full array of Intelligence Group offerings: a monthly video “Think Tank” conference call; quarterly analyst reports; periodic Zoom brainstorming calls; a bi-annual “Executive MBA” program; video recordings of general sessions from the Senior Living 100 Conference; an annual virtual managed care conference; an online forum; and a concierge matching service purpose-built for making connections among our members – whether operators or solution partners.
During this launch period, the Intelligence Group will be complimentary, then will switch to a paid membership model February 1, 2021.
|
|
Election 2020: What it Means for Senior Living |
|
Scenario 1: A Biden Victory
How many times can we say “unprecedented” in 2020? And yet, here we are again. The voting process is complete, but we still don’t know who won. As we await word on who will occupy the Oval Office come January 20, here are my Friday Insights on what a Biden Administration would mean for the senior care industry.
More Funding – Biden has been a vocal supporter of more Cares Act funding and additional stimulus relief. He has also promised to invoke the Defense Production Act to increase PPE supplies. But beyond COVID, the senior living industry – particularly Assisted Living – has been lumped in with SNFs (for better or for worse) as a vital part of the nation’s senior “healthcare” continuum, and the Democrats are pledging more funding across the board for healthcare. In a now-famous report co-authored in July by Senator Elizabeth Warren, who many have cited as a prospect for a cabinet spot in a Biden administration, Democrats concluded: “… assisted living facilities should receive support through federal programs to protect long-term care facility residents and staff.”
More Oversight – The flip side to more federal assistance is more federal scrutiny. And you can be sure that’s on Biden’s radar, too. Take skilled nursing facilities as a proxy for what could be coming to AL. The Biden healthcare plan foresees increasing standards for nursing home workplace safety; more auditing of cost reports and ownership data; mandating the hiring of “infection control specialists”; and restoring bans on forced arbitration agreements. If ALFs taking money from the feds means being associated with SNFs as a single asset class of congregate care setting, it’s only a matter of time before a Biden administration starts to impose more federal regulations on Assisted Living, too. Case in point: The same Warren report that foresees more federal support calls for more federal reporting and more stringent sick leave policies for AL, too.
More Home Care – Finally, one number above all others stands out in the Biden healthcare plan: $450 billion. That’s how much a Biden healthcare plan (funded over 10 years) foresees earmarking for home and community-based services. That’s a big deal – especially since it represents more than half of the entire anticipated healthcare spend of $775 billion. It’s easy to sluff that off as inconsequential to senior housing. But if there’s one message I’ve heard loud and clear in the last eight months, it’s that 2020 has amounted to a coming out party of sorts for home care – specifically private duty services. As ILFs and ALFs have been shut (or stigmatized by the media), the alternative that seniors have turned to in droves are outlets like Right at Home, Home Instead, Visiting Angels, etc. With each passing day, personal care isn’t just an organization that comes into your IL and AL to assist your residents. Personal care is now your competition, too! And with $450 billion on their side, the momentum they’re experiencing will only get stronger under a Biden plan.
To comment or share feedback on this or any other article in Friday Insights, email me at [email protected].
|
|
Home Care Vision Paying Off for Ohio CCRC |
|
It seems every conversation these days makes reference to COVID “accelerating” pre-existing strategies. That’s certainly the case for Ohio Living, a diversified 12-campus CCRC whose burgeoning home care business now represents more than 20% of topline company revenue – thanks in part to high demand during COVID. The timing for Ohio Living’s home care growth could not have been better. As one of the first life plan communities in Ohio to experience COVID cases, the core facility-based business was hit hard early on. (Ohio Living CEO Larry Gumina foresees an 18-month recovery process.) The organization’s growth into home care is noteworthy on two levels. It not only fills the gap left by a dip in the CCRC business. It also defies a common refrain from operators that home care is simply too hard to manage in parallel to the core business. Gumina doesn’t mince words when he talks about home care. “It’s very hard,” he says, pointing to different EMRs, different branding, and a totally different business line. “But it’s very important to our future.” (Contact Larry Gumina at [email protected] to learn more about their home care business.)
|
|
Financial Strategies to Weather COVID, Part I: Cost Reduction |
|
Two constants rule today’s COVID existence. Occupancy is down; and unbudgeted costs are up (PPE, testing, hero bonuses, staffing agencies, overtime). The unfortunate reality of the mid-term outlook is that both of these pressures will be with us for much of 2021. Winter move-ins are historically slow, even in good times. And the current third wave of COVID sweeping the nation will keep us entrenched in an infection control mindset at least through early spring. This outlook has many operators shifting to extreme cost-reduction mode. In conversations with dozens of operators in the last few weeks, the following creative cost control measures have really caught our attention.
Pool Testing – With the average cost of current PCR COVID testing in the $100 range, coupled with serious supply chain issues with more affordable antigen tests, one way to save big on testing costs is to borrow a practice from universities across the nation that are using group testing (or pool testing) for hundreds of students simultaneously. In a typical senior living facility, you could accurately test 100 residents at a time using a pooled saliva test to determine if COVID was present among the population. At about $500 per pool test, that’s much more economical than testing each person individually at a total cost of about $10,000. One of the first companies to offer pool testing for senior living is SiREM. Contact Duane Graves, US Operations Manager, at [email protected].
Insurance Shopping – A big question among legal circles in the senior care industry is the exposure that operators will have as plaintiffs’ lawyers start bringing wrongful-death suits. One provider I spoke to last week says his legal team is preparing for an avalanche of cases. And they’re not alone. Insurance companies also see this coming, and some are using 2021 coverage renewals to pre-emptively jack up liability premiums. One way to skirt these increases is to shop around among carriers. That’s what Sevy Petras, the CEO of Priority Life Care in West Palm Beach, FL, did recently when her carrier presented newly increased rates. Priority changed carriers altogether, in a move that brought about “significant savings” to the organization. Contact Sevy Petras at [email protected].
Agency Alternatives – If you’re experiencing challenges with recruitment and retention among your caregiving staff, you’re not alone. Operators in almost every market are reporting shortages of RNs, LPNs and CNAs – citing competition, callouts, and an overall fear of working in COVID settings. When a situation becomes desperate, turning to local staffing agencies has been a reliable, albeit reluctant, option for many. But now agencies are charging “COVID rates”, which in some markets are 2.5X the normal rate – which can really sting, especially when operators are learning anecdotally that very little of the upcharge is landing in the pockets of the caregiver. One way employers can combat this price-gouging is to increase the use of app-based staffing networks targeted specifically to frontline caregivers – such as BookJane.com, Kare, MyCNAJobs.com, and Matchwell. They offer many of the same services as agencies (experienced caregivers, screening tools, online interviews) yet their fees are based on a volume play – which means you’re not beholden to a 250% agency markup!
Service Contracts - Another strategy every operator should be considering is an audit of your service contracts. That’s the specialty of Intelligence Group member SIB Fixed Cost Reduction. They will come in and review your service arrangements with just about any vendor you work with – including internet, waste removal, housekeeping, staffing, tax services, landscaping, linens, shipping, etc. According to SIB’s Dan Kaufman, the average audit saves a company 20% or more – often on services you don’t even realize you’re overpaying for. Contact Dan Kaufman, Director of Business Development, at [email protected].
|
|
Leadership in a Time of Crisis |
|
Executive Interview: Pilar Carvajal, CEO and Founder, Innovation Senior Living
Over the course of dozens of executive interviews conducted by the Senior Living 100 Intelligence Group since the middle of March, we have observed that organizations faring best in these trying times are overwhelmingly those with strong company cultures. They tend to be more grounded; they have a strong sense of purpose; and their leaders are poised and compassionate. So it is with Innovation Senior Living, a Florida-based operator of mostly AL and memory care communities, whose CEO Pilar Carvajal attributes their perseverance through COVID to the Latina, family-oriented values she espouses – in addition to a code of honest, open communications. Here is a video clip where Pilar describes how culture has helped Innovation persevere in 2020:
|
|
If you have any comments on this week's content, or ideas for next week, let me know at [email protected] -Tim Craig, Senior Living Analyst
|
|
|
To be connected with other members of the Senior Living 100 Intelligence Group community, please email Jen Cross, Senior Living Analyst, at [email protected].
|
|
|
Thursday, November 19 Think Tank Video Call
3:00 - 4:00 PM EST
Fresh Ideas to Solve the Staffing Shortage
Caring for seniors under COVID is not the same job it once was, and staffing is arguably the single biggest challenge facing senior living operators. We’re canvassing senior living, SNFs and home care providers to present the freshest ideas brewing across senior care.
|
|
The Senior Living 100 Intelligence Group is a membership community of leading senior living operators and solution partners whose goal is to help create exceptional performance for its members. Members benefit from original intelligence and a concierge-connected community.
Creating Exceptional Performance
|
|
To ensure delivery of this email to your inbox, please add [email protected] to your address book and safe sender list.
|
|
|
|
|
|
|
