Senior living providers across the country continue to grapple with the ongoing impact of Covid-19. The current landscape, however, can be an ideal foundation for providers to take stock of their current development and operational issues, and retool for a post-coronavirus world.
Many providers are retooling development plans to meet current and future demand, and others are adapting service models to better meet the needs of residents. Most important, the strongest providers are rethinking how they communicate with stakeholders.
That requires significant soul searching and a thorough audit of operations and pain points, Greystone Communities First Vice President Justin Spooner said recently during a presentation at the LeadingAge Annual Meeting, which was held online.
“Do more than the minimum,” he said.
Irving, Texas-based Greystone is a third-party manager and consulting firm for senior housing providers that offers guidance related to strategic planning, occupancy improvement, redevelopment and expansion, and more. The biggest lesson learned during the pandemic: A decentralized approach to leadership and operations is key to success.
“We couldn’t be on site as corporate and regional staff, so we had to rely on our teams to understand and listen to the guidance and understand the leaderships’ intent, and then go execute,” Spooner said. “This requires trust and communication with occasional correction.”
Revisiting redevelopment plans
Developers and providers across the country are postponing projects until Covid-19 is under control, either from a lack of financing or the need to focus on the safety of residents and staff.
Forward thinking providers are using the pandemic as an opportunity to rethink design, with an eye toward the future safety of buildings. Providers with stalled projects, and even some where construction is progressing, should be using the present to rethink how they want their developments to look, and to serve seniors, Greystone Senior Vice President Stuart Jackson said.
One example he cited was Waterman Village, a life plan community in Mt. Dora, Florida. The provider could have halted construction on an expansion of its independent living cohort, including duplexes, villas and — in a new venture for the provider — apartments. Instead, the organization doubled down and pushed forward, closing on the necessary financing for the expansion in mid-November. Plans call for breaking ground in the upcoming weeks.
What gave Waterman Village the confidence to push forward was the strength of demand for independent living in the market — its waiting list for independent living includes over 200 prospective customers.
Stevenson Oaks, a life plan community in Ft. Worth, Texas operated by Methodist Retirement Communities, is also expanding its campus while cutting out the skilled nursing cohort. Instead, the provider is adding assisted living and memory care services to accommodate residents aging out of independent living, allowing them to remain on campus longer.
Rockwood Retirement Community, a life plan community in Spokane, Washington, is moving forward with a two-phased repositioning plan in response to growing demand in its market for higher levels of care. Originally weighted toward independent living, Rockwood is adding assisted living and memory care units to its campus. The independent living cohort, meanwhile, is 80% sold and will include a mix of courtyard homes and apartments. Construction will begin next spring.
“It’s going to lead to this complete transition and restatement of the entire campus,” Jackson said.
Adapting approaches to serving seniors
While nonprofit providers have led the way in recent years in innovation within the industry, their for-profit peers have learned how to scale those innovations. This is something that the nonprofit space should pay attention to as they migrate to a post-pandemic environment, Jackson said.
Greystone, via its management group, has worked with a half dozen for-profit providers over the past couple years in a third party management role. Some of these for-profits are looking at how to bring independent living with care coordination to markets, a trend that is now gaining momentum in the nonprofit space. Notably, Greystone is discussing ways to create independent living with limited services, further advancing the aging-in-place model, with Acts Retirement-Life Communities, which ranks third on the LZ 200..
Nonprofit providers considering such a strategy will have to account for how incorporating limited services into independent living will impact fee structures, and embrace flexibility to court a wider range of customers.
“You’re going to see there is a host of unit sizes and offerings for two-bedroom apartments, up to cottages and duplexes,” Jackson said. “We’re going to bring that, with limited independent living services that are focused on utility, security, maintenance, maybe a little bit of dining.”
A post-pandemic senior apartment will likely incorporate larger unit styles and footprints.
Covid-19 is expected to significantly alter the life plan rental model, as well. Jackson envisions a unit style resembling a one-bedroom assisted living unit, with a rich package of services attached. The pricing structure will hew closely to a traditional assisted living model. But it will include new wrinkles such as a tiered pricing structure that can then be layered onto an existing independent living pricing structure.
“You’re going to bring all of those care services into their independent living units within the community,” he said.
Stronger operators adapted as the pandemic continues, in part because of how they approached how they communicated their actions to staff, residents and their families, Spooner said.
The Buckingham, a senior housing community in Houston offering independent living, assisted living and memory care, responded to an initial wave of positive Covid-19 cases among residents and staff by communicating to stakeholders early and often about measures to bring the virus under control.
The Buckingham was aggressive early with frequent testing, and went to a weekly testing schedule long before the Centers for Disease Control and Prevention (CDC), state and local public health authorities mandated it. Greystone also worked with the Buckingham’s PR firm and board of directors to control its message, opting for transparency in all cases.
“Even though we had positive cases, we were able to say, hey, look, we were identifying asymptomatic cases early and isolating them,” Spooner said.
Another early lesson in communications was the creation of a feedback loop. The Buckingham would reference an email address and a listserv in its email updates, which granted the executive director access immediate feedback and questions and clarifying questions. Over time, that allowed the provider to hone its message, as received real-time feedback from stakeholders.
Greystone also helped The Buckingham leverage multi-channel communication platforms, including social media and internal community channels such as distributing paper copies of updates to some residents who preferred that. Texting apps were implemented with prompts, letting stakeholders know that new information was available.
As more information became available, The Buckingham conducted weekly and sometimes twice-weekly updates, responses subsided and more stakeholders thanked the provider for the transparency.
“You can’t communicate enough,” Spooner said. “[Controlling] your message [helps] to avoid generic PR speak.”
Moreover, Spooner is particularly excited about the growth Greystone sees in younger community leaders, and he is confident that the experience of the pandemic is going to be invaluable in their development.
“I can’t wait to see what some of these newer and younger leaders do as we come out of [the pandemic],” he said.