FEBRUARY 2016 VOL. 14, NO. 1
Photo: John Merkle @ The Springs
MONTH 2015 VOL 13, NO X
Carle’s aim: shaping future leaders
Carle’s focus: nuts and bolts BY JOHN HALL
Workforce development stands out as the preeminent issue facing the senior living field this year.
He’s highly regarded and admired in every sector of the healthcare industry he’s dedicated a career to over the past few decades. His name is synonymous with so-called Nana Technology for older adults, and he’s credited with identifying the new senior living category of university-based retirement communities. But what Andrew Carle seems to beam about most these days is his self-imposed mission to shape and steer tomorrow’s leaders in senior living as professor and executivein-residence and founding director of the program in senior housing Continued on page 6
Bracing for labor pains
Senior living’s top leaders agree that finding and keeping the best possible workers will be tougher than ever during the year ahead
BY LOIS A. BOWERS
Relatively new leadership at three associations representing senior living providers are facing several established and evolving issues in 2016, they tell McKnight’s Senior Living. Perhaps the biggest issue on the list, however, is attracting and retaining high-quality workers. Workforce development was the top concern that members expressed to Argentum President
and CEO James Balda and other association leaders on a recently concluded “listening tour,” Balda says. “It was what people wanted to talk about and what people actually couldn’t stop talking about,” he adds. “Operators are starting to feel more and more pressure from a wage perspective. It’s what I would call the ‘Walmart effect,’ in terms of a lot of their direct care workers Continued on page 3
IN THIS ISSUE Strategy & Innovation
4
Marketing Moves
6
Design Success
8
Feature: There’s an app for that
22
Feature: Maintaining memory
24
Feature: Bathed in benefits
26
A few minutes with ...
30
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TOP DEVELOPMENTS
Photo: Office of the President of the United States
Brookdale seeing progress in wake of Emeritus acquisition BY JOHN HALL
President Obama largely ignored health-related issues in his 2016 State of the Union address. Photo: Ridofranz/ iStock/Thinkstock
Brookdale Senior Living says it’s confident it has calmed much of the 2015 tumult in the wake of an Emeritus acquisition that led to short-term occupancy dips, management turnover and less-thanexpected earnings performance. “We’re encouraged by the progress we’ve been making on the basic blocking and tackling of our business, aided by having the bulk of our systems integration activities now behind us,” Rob Borella, the vice president of corporate communications and marketing tells McKnight’s Senior Living. “Integrating a platform as large as Emeritus has obviously required a monumental amount of work and has certainly been a challenge.” The Emeritus acquisition in July 2014 made the Brentwood, TN-based company the nation’s largest senior living operator. But the company faced criticism in the coming months over challenges in absorbing Emeritus, as well as community management turmoil and some minor marketing glitches. In February 2015, following a period of disappointing earnings perfor-
The Emeritus deal has caused short-term challenges for Brookdale.
“We’re encouraged by the progress we’ve been making.” Rob Borella, Brookdale
mance to some, one major shareholder even demanded the company spin off its real estate holdings and revamp its governance board. The following September, the company
was identified as one of a half-dozen possible takeover targets in a report by Goldman Sachs Group. Analysts cited the Emeritus flap as a contributing factor. “We are not yet finished with the overall integration, as there is still work to do to optimize the use of the systems and processes that are now in place throughout the organization,” Borella adds. “We’re also excited about the recent additions we have made to our executive leadership team.” n
Workforce issues top senior living concerns Continued from page 1
may prefer to go across the street and work at Walmart as opposed to what is hard work in terms of providing care for seniors.” Indeed, competition for workers can come from outside the industry, says Katie Smith Sloan, who began 2016 as LeadingAge’s president and CEO after serving as chief operating officer since 2002. The challenges can vary geographically, she adds. “For example, Minnesota members are telling me it’s the lure of the oil fields in North Dakota,” Sloan says. “That’s not even necessarily in
our field, so I think we have some work to do to come up with more effective strategies for attracting people to our field.” The National Center for Assisted Living will be announcing new tools to help members recruit and retain staff members, says the organization’s executive director, Scott Tittle, who joined NCAL in mid-2015 after serving as state executive for the Indiana Health Care Association. The issue is one of quality as well as quantity, says Balda, who celebrated his first anniversary at the helm of the former Assisted Living Federation of America on
Jan. 15. He was formerly senior vice president of innovation and business development at the National Restaurant Association. “It’s something folks are concerned about even longer-term, as we’re going to need more workers in the industry,” he says. An Argentum committee is considering ways that the industry can recruit employees, perhaps through training programs at high schools and community colleges as well as through visa program reforms, he says. Read more about the organization’s plans for 2016 online at http://ow.ly/WBer0. n
Final address a victory lap BY JOHN O’CONNOR
President Obama’s legacy may be forever linked to healthcare reform. But you’d never know that based on his final State of the Union address. Most of his 58-minute speech instead lauded a growing economy and jobs market. Obama did briefly note that the Social Security and Medicare programs are “more important than ever,” and that they need to be strengthened. He also called for a “moon shot” initiative to hasten a cure for cancer. He noted many people have soured on a political and economic system they view as rigged against their interests. He also singled out Donald Trump for pointed criticism, saying that Americans must resist calls to stigmatize all Muslims. The Republican front-runner quickly shot back. Trump Tweeted that the speech was “really boring, slow, lethargic — very hard to watch!” n McKnight’s Senior Living is published in February, April, June, August, October and December by Haymarket Media, Inc., 114 W. 26th Street, 3rd Floor, New York, NY, 10001. Tel. (646) 638-6000. POSTMASTER: Send address changes to: McKnight’s Senior Living, 114 West 26th Street, 4th Floor, New York, NY 10001 or telephone (646) 638-6048. Printed in U.S.A. © 2016 Haymarket Media, Inc. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form by any means (electronic, mechanical, photocopying, recording or otherwise) without prior written permission of the publisher. McKnight’s Senior Living is a registered trademark used herein under license.
www.McKnightsSeniorLiving.com • February 2016 • McKnight’s Senior Living 3
STRATEGY & INNOVATION YOU’VE GOT QUESTIONS? ... WE’VE GOT ANSWERS BY JIM MOORE
Q: Do I need an exit strategy? A: Many owner/operators say they don’t intend to sell; they plan to ride out the various business cycles and they’re not about to leave the senior living industry. But having a sound exit strategy doesn’t necessarily mean you’re actually planning to get out. It’s somewhat like thinking about our life expectancy. To stay healthy, should you do anything differently? In early 2016, you can use an exit strategy for several beneficial reasons. Here is a simple strategy for estimating the approximate value of this exit strategy by determining today’s valuation, using a capitalization rate of 7%. Simply divide your actual annual net operating income (NOI) by 0.07. If your community has annual revenue of $3.6 million and expenses of $2.3 million representing an operating profit margin of 36%, then the NOI from this performance would be $1.3 million. Dividing that annual NOI figure by 0.07 reflects a preliminary value of approximately $18.6 million. Many who went through that simple exercise have changed their attitude about whether to consider an exit strategy. Whether you actually decide to sell is an important decision. Whether you plan to fold your cards soon or hold them for a long time, having a sound exit strategy can only help. Jim Moore runs a national senior housing and healthcare consulting firm based in Fort Worth, TX. He has written several books about assisted living and senior housing, including Assisted Living Strategies for Changing Markets.
Some wonder if building spree will damage occupancy levels BY JOHN HALL
Many financial experts look at the current senior living construction boom as a foregone conclusion. After all, markets and the investors who shape them did what they’re expected to do when riding the crest of a healthy economic recovery: they built. But an unexpected thing happened along the way: the seniors didn’t come to this field of dreams, at least not in the numbers many had hoped. How they got ahead of the curve is a subject of much debate, but every banker and analyst interviewed for this article agree on one thing — we won’t see what happened the last time an over-supply of senior living units sprouted in the late 1990s, a boondoggle that left a lot of entrepreneurs red-faced and bankrupt.
Demographics trump worries BY LOIS A. BOWERS
Overbuilding-related concerns could fuel pricing and sales declines this year, Integra Realty Resources predicts in its Viewpoint 2016 report. “Despite these concerns, the asset class remains an attractive arena for investors due to favorable demographic trends,” write authors of the report from the New Yorkbased independent commercial real estate market research, valuation and counseling firm. Most leading-edge baby boomers aren’t quite ready to move from their homes or rental properties into seniors housing, the report notes. Development of independent living properties has picked up, however, because they attract a younger resident base. Development has continued, the authors state, thanks to the sector’s resiliency. ■
“There’s certainly been a lot of shovels in the ground.” Jason Stroiman Evans Senior Investments One reason stems from baby boomers’ health and resiliency. “In the ‘90s, people said, ‘OK, the baby boomers are coming.’ Well, those baby boomers today are running companies,” observes Michael Gehl, chief investment officer for Housing & Healthcare Finance LLC. “The 65- and 70-year-olds aren’t yet moving into assisted living. It’s growing and there’s demand for it, but the question remains, are we getting overheated?”
LABOR UPDATE The U.S. Department of Labor has sued a California residential care provider for gross violations of federal wage and hour regulations after “having exhausted all attempts to reach a settlement,” the department said in a statement. The lawsuit is against the owners of San Miguel Homes for the Elderly LLC, which operates three residential care facilities. Regulators in Washington state recently fined a senior living operator $102,060 for failing to correct “excessive and repetitive” lifting hazards. Columbia Heights by Bonaventure Retirement and Assisted Living facility in Wenatchee was cited after regulators determined the community still had not fixed violations cited last May.
4 McKnight’s Senior Living • February 2016 • www.McKnightsSeniorLiving.com
Still, the numbers put forth by the National Investment Center for Seniors Housing and Care (NIC) over the past 18 months are collectively described by most observers as “sobering.” (By early January, however, NIC reported seniors housing occupancy increased to 90.1% in the fourth quarter of 2015 — still 20 basis points below a late 2014 surge.) Most lenders confidently shrug off the current housing swell, pointing to numbers that show a steady uptick in the 85-and-up age group in the next 15 years. “There’s certainly been a lot of shovels in the ground, especially on the private equity side, but it is way too early to say there’s any oversaturation going on,” says Jason Stroiman, president, Evans Senior Investments. ■
POLICY UPDATE The Supreme Court declined to take up another challenge to the Affordable Care Act at press time. Iowa artist Matt Sissel alleged that the measure violates the U.S. Constitution’s requirement that revenue-raising legislation must originate in the House of Representatives. The Department of Health and Human Services needs to develop a better plan to address the needs people who work in healthcare, notes a new report from the Government Accountability Office. The department lacks comprehensive oversight and has not fully addressed how programs can improve care in underserved areas. Investigators also alleged that current workforce performance measures are biased toward specific programs.
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MARKETING MOVES
Senior living operators would be well advised to include social media in marketing efforts, suggests new research from the Pew Research Center. Its analysis found that social media use among those aged 65 or more years has more than tripled since 2010. Now, 35% of those in this age group report using social media compared with just 2% in 2005, when Pew began tracking usage. Sunrise Senior Living recently captured the 2016 MarketingSherpa Readers’ Choice award for its business-to-consumer marketing campaign. Sunrise Senior Living’s program centered on an online questionnaire that allowed the company to capture the specific information that seniors were seeking related to immediate care options. This capability resulted in a 5.8% conversion rate by questionnairecompleters, an overall 12% lift in online leads within a year and a 4% lift in total site conversion rate since the site launched in September 2014. Companies that use predictive marketing and analytics significantly outperform others across many business metrics, such as revenue growth and customer engagement. Additionally, these firms are more effective at balancing the full customer lifecycle instead of focusing just on early stage activities, according to a survey by Forrester Consulting.
Selling ‘life plan communities’ likely to require a deft touch BY LOIS A. BOWERS
LeadingAge is not requiring its continuing care retirement community members to start calling themselves life plan communities, but the organization’s research indicates that doing so might help those members attract a new generation of prospective residents, representatives say. The new name for CCRC was unveiled at the group’s annual meeting in November. Over three years, a task force led in part by LeadingAge conducted 34 focus groups and polled more than 4,000 current and prospective community residents in all 50 states. The effort found that 84% of those under age 65 years preferred a name other than CCRC for the category, Alishia Parkhill, LeadingAge’s director of marketing, told operators during a December Q&A webinar. Language matters, said Brenda Schreiber, vice president of marketing of CCRC owner Mather LifeWays, which also led the task force. Because of the word “care” in CCRC, she said, “People are viewing
Photo: Fuse/Thinkstock
Photo: Rawpixel Ltd/iStock/Thinkstock
BRIEFS
Supporters of the new moniker have opted to use gentle persuasion.
CCRCs as something they may eventually need as their health changes, which is really counter to what our desire is, to attract younger older adults” who want to lead active lives. Lana Peck, director of research for Brooks Adams Research, added that research participants said they liked the term “life plan community” because it was easy to remember and piqued their interest in the category.
Just don’t call it an LPC. “I think we just have to police ourselves, knowing the need to educate the market, who need to understand what a life plan community is,” said Rob Love, president of the marketing firm Love & Company, which also was involved in the renaming effort. “LPC has none of the value of life plan community. It loses all of the benefits that are behind the change.” n
Carle’s on a mission to prepare future leaders Continued from page 1
Administration at George Mason University in Fairfax, VA. Carle tells McKnight’s Senior Living that part of the exclusive program’s success stems from the fact that students earn degrees in health administration, with a concentration in senior housing administration. “This is critical, because at the end of the day, assisted living and memory care in particular are not only healthcare facilities but will become increasingly significant players in the healthcare continuum,” he says. “By housing our program in health administration — versus hospitality management, gerontology or
even business administration — our students complete additional coursework necessary to the skill set they will need for success in the field.” Some courses have been created “from scratch. These are not nursing home administration courses that touch upon senior housing, nor gerontology courses covering the general domains of ‘aging,’” he adds. “They are senior housing-specific, going department-by-department, function-by-function, focused largely on assisted living and memory care on the health services side, but also hospitality services on the active adult, independent living and CCRC side, as well as assisted living and memory care.”
6 McKnight’s Senior Living • February 2016 • www.McKnightsSeniorLiving.com
And because senior housing predominantly is a private-pay industry, Carle has helped design coursework to train students in senior housing sales and marketing. The program also puts students through rigorous real-world training and highly structured internships with leading senior communities. To gain “executive empathy,” students are exposed to fundamentals like setting department budgets, staffing and “operational priorities” as mundane as dish washing, laundry and “pushing wheelchairs,” he adds. For their efforts, Carle’s students proudly wear T-shirts proclaiming their membership in the “Toilet Hall of Fame” club. n
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DESIGN SUCCESS
New ‘Traditions’ in memory care
LifeCare Services announced that construction for Trillium Woods, a $161 million life plan community in Plymouth, MN, has been completed. The two-level commons building includes a swimming pool, auditorium, spa, multiple dining rooms and numerous amenities with high-end finishes throughout. The three-level health center building contains 44 memory care and skilled nursing rooms, support areas, laundry and maintenance. The Village at Mapleshade, a new assisted living community in Plano, TX, recently celebrated its grand opening. The 88,500-squarefoot property offers residents a private dining room, bistro, restaurant, salon and day spa, fitness/wellness center, library, movie theater and rooftop patio for entertaining. Company officials say a wide range of services and activities are provided for residents who require assistance with their daily needs as well as for those who wish to remain independent. Maplewood at Weston (MA) senior living has converted 13 assisted living units into a new memory care neighborhood. The project included demolition of the existing apartments to accommodate a new palette of finishes, reconfiguring the rooms and updating mechanical, electrical, plumbing, HVAC and fire suppression systems.
BY JOHN ANDREWS
Oakmont of Santa Clarita intends to raise the bar for memory care in senior living by establishing new “Traditions” at its recently completed property north of Los Angeles. The 85,852-square-foot community features 60 assisted living apartments and 20 memory care apartments on 7.5 acres. Although it features a host of top-shelf amenities ranging from a movie theater and day spa to a pet park and wellness center, it is the Traditions memory care program that serves as the marquee attraction for residents with dementia and Alzheimer’s disease. Traditions offers residents a safe and comfortable environment with multiple opportunities for social engagement and physical exercise such as yoga, stretching, strengthening and walking, and brain fitness classes to stimulate mental acuity, says Crystal Robinson, vice president of sales and marketing. One of the most interesting features is an indoor aviary where residents can view the hatching and tending of new chicks, Robinson says. The courtyard allows residents to enjoy the warm California sun or harvest fresh vegetables from the resident garden. Activity stations are designed to help residents recall meaningful or familiar hobbies from their pasts. Wandering paths through private gardens will allow program residents to have guided outside walks. Tactile art decorates the hallways for sensory stimulation. For added safety, in-room motion detectors notify caregivers if a resident has gotten up in the middle of the night, and memory boxes are set up outside of residents’ rooms both to help them identify their apartment and to allow families to tell their story. “It’s very close to my heart because I had a personal experience with my own mom with Alzheimer’s, so I am just very, very excited to be a part of this particular
Photos: Oakmont of Santa Clarita
Photo: mihalec/iStock/Thinkstock
BRIEFS
Oakmont of Santa Clarita will market memory care as a top attraction.
part of Oakmont,” says Marketing Director Mary Dembkowski. “Traditions will be a separate wing of the community, entirely dedicated to providing specialized care that meets the needs of those with dementia and Alzheimer’s disease. It offers a secured environment where our families feel like their loved ones are safe in a home-like setting, with features designed to give residents all the dignity that they deserve.” Construction started in early 2015, and the grand opening took place last month. The community is designed for independent and assisted living as well as memory care residents. There are 80 pet-friendly studio, one- and two-bedroom apartment homes with floorplans that range from 400 to 1,300 square feet. The movie theater features comfortable leather seats and has two showings a day with freshly popped popcorn. A bistro offers coffee, tea and snacks throughout the day, and
8 McKnight’s Senior Living • February 2016 • www.McKnightsSeniorLiving.com
the restaurant-style dining room boasts a brick pizza oven and rotisserie as well as a private dining room with fireplace for residents to host family and friends. The new-generation community was built to resemble a five-star hotel, Robinson says, to impress the baby boomers in the present and future. “For many people, the only experience they have had with senior living is what they have seen on TV and in movies, which usually depicts a hospital-like facility where the food is terrible and everyone sits around with nothing to do,” she says. “So it is a great relief to the families and future residents who walk through our doors when the first impression they have is that they have entered a boutique hotel. A concierge greets them in the lobby, there is a full and interesting calendar of excursions and activities, and everyone is raving about the chef.” n
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TECH TOOLS
University of Notre Dame investigators have developed an eSeniorCare application that lets residents connect with care providers by sending questions and concerns through text or voice recordings. Residents also can log updates and track their own health. Researchers have discovered how speech impairments can be used to diagnose Alzheimer’s disease with more than 82% accuracy and have developed automated technology to detect the impairments. The work, led by Frank Rudzicz, Ph.D., a scientist at the Toronto Rehabilitation Institute of the University Health Network, was published in the Journal of Alzheimer’s Disease. Opportunities for caregiver support innovations are “ripe” for the picking, according to a recent study from AARP and Parks Associates. Investigators concluded growing demand represents a $279 billion revenue opportunity over the next four years.”There is an incredible amount of activity that’s going on right now [in this area],” said Jody Holtzman, AARP senior vice president for enterprise strategy. Technology developers need to pay more attention to the needs and interests of older people, according to a story in the Jan. 16 issue of Newsweek magazine.
Game theory: New approach shows promise for memories BY JOHN O’CONNOR
By playing three-dimensional video games, seniors can boost the formation of memories, according to neurobiologists at the University of California in Irvine. In addition to improving eyehand coordination and reaction time, these games also may help people who lose memory as they age or suffer from dementia. Full findings appear in The Journal of Neuroscience. For their work, Craig Stark, Ph.D., and Dane Clemenson, Ph.D., of UCI’s Center for the Neurobiology of Learning & Memory, recruited non-gamers to play either a video game with a passive, two-dimensional environment (“Angry Birds”) or one with an intricate, three-dimensional setting (“Super Mario 3D World”). Participants played the games for 30 minutes each day over two weeks. Before and after the two-week period, players took memory tests that engaged the brain’s hippocam-
Photo: Nintendo of America
Photo: photobac/iStock/Thinkstock
BITS & BYTES
Researchers are finding that playing certain video games can help residents boost their ability to recall prior events.
pus, the region associated with complex learning and memory. They were given a series of pictures of everyday objects to study. Then, they were shown images of the same objects, new ones and others that differed slightly from the original items and asked to categorize them. Recognition of the slightly altered images requires the hippocampus, Stark says, and his earlier research had demonstrated that the ability to do this clearly
declines with age. This is a large part of why it’s so difficult to learn new names or remember where you put your keys as you get older. Those playing the 3-D video game improved their scores on the memory test, whereas the 2-D gamers did not. The boost was not small, either. Memory performance increased by about 12%, the same amount it normally decreases between the ages of 45 and 70. n
Telemedicine can reduce visits to ER: study BY LOIS A. BOWERS
The use of “high-intensity” telemedicine at senior living communities significantly reduces visits to emergency departments, according to research published by Telemedicine and e-Health. “Acute illness among senior living community residents often leads to emergency department visits,” says Manish Shah, M.D., M.P.H., associate professor of emergency medicine, public health sciences and medicine (geriatrics/aging) at the University of Rochester in New York. “We found that these virtual doctors’ visits reduced the rate of ED use by 18% over the course of a year.”
And that 18% reduction was conservative, adds Shah, who also is associate chairman for research in the Department of Emergency Medicine. “We provided telemedicine services only during limited weekday hours,” he says. “So intervention group subjects would have to go to the ED for care during weekends and evenings, reducing the effect on the rate of ED use compared with an always-available telemedicine model.” Shah and his research team offered the option of high-intensity telemedicine to residents of six senior living communities in Rochester, NY. “High intensity” means that the telemedicine visits were assisted
10 McKnight’s Senior Living • February 2016 • www.McKnightsSeniorLiving.com
by a clinical technician at each resident’s side, using equipment found in an ED that allows physicians to perform detailed clinical exams. Results in the intervention group were compared with those of 16 senior living communities that did not offer a telemedicine option. At the intervention sites, residents with acute illnesses were offered telephone consultations, outpatient visits, ED referrals or telemedicine consultations. More than 1,200 residents were followed from May 2010 to November 2013. During that time, 479 patients in the intervention group were provided care 503 times for illnesses. n
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B:8” T:7.75” S:7.25”
¡ Resident information and community message channels
¡ Fully customizable Welcome Screen with interactive apps that allow residents to find and watch their favorite shows and discover property amenities, activities and services1
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¡ Remote management capabilities that can lower servicing costs
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¡ Full residential channel lineup with over 100 HD channels available2
Call 866-945-9089 TODAY to give your senior
community the best TV experience at our best prices.
Welcome Screen PRO is only available with DIRECTV Residential Experience Plus installations and requires a dedicated Internet connection and PMS integration for full optimization of all welcome screen features. Additional fee of $1.25 per room per month applies. Programming, pricing, terms and conditions subject to change at any time. Receipt of DIRECTV programming subject to DIRECTV Customer Agreement; copy provided at directv.com/legal and in your first bill. 2To access DIRECTV HD programming, HD Access ($0.75/room/mo.) and HD equipment required. Number of HD channels varies based on package selection. A DIRECTV System software receiver fee of ($0.25/unit/mo.) required. ©2016 AT&T Intellectual Property. All Rights Reserved. AT&T, DIRECTV and all other DIRECTV marks contained herein are trademarks of AT&T Intellectual Property and/or AT&T affiliated companies. All other marks are the property of their respective owners.
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¡ Customizable technology that’s easy, flexible and compatible with all TVs and wiring
B:10.75”
S:10”
DIRECTV brings a more affordable, more manageable and more enjoyable experience to your community. You get:
ACROSS THE NATION
California and Massachusetts raised their minimum wage to $10 an hour in January. But the Golden State’s threshold could jump to as much as $15. Lieutenant Gov. Gavin Newsom is leading the charge, backed by Service Employers International Union. “Who can live on $21,000 year today? Nobody can,” said San Francisco Mayor Ed Lee. As inaction continued in Congress, more than a dozen states raised their minimum hourly wage this year. Four states — Alaska, California, Massachusetts and Nebraska — approved a $1 uptick. Conversely, South Dakota’s minimum went up by only a nickel. Here’s a breakdown:
Photo: Office of the Mayor
California leads the way among states that are increasing wages for workers
San Francisco Mayor Ed Lee says workers need a living wage.
• Alaska’s hourly minimum wage increased from $8.75 to $9.75. • Arkansas hiked its minimum wage from $7.50 to $8 per hour, with an increase to $8.50 slated for Jan. 1, 2017. • California’s hourly minimum wage went from $9 to $10.
• Colorado’s minimum wage increased from $8.23 to $8.31 per hour. • Connecticut boosted its hourly minimum wage from $9.15 to $9.60, with an increase to $10.10 planned for Jan. 1, 2017. • Hawaii’s minimum wage went from $7.75 to $8.50 an hour, with an increase to $9.25 scheduled for Jan. 1, 2017, and an increase to $10.10 set for Jan. 1, 2018. • Massachusetts raised its hourly minimum wage from $9 to $10 and is slated to increase it to $11 on Jan. 1, 2017. • Michigan’s minimum wage jumped from $8.15 to $8.50 per hour, with an increase to $8.90 scheduled for Jan. 1, 2017, and
an increase to $9.25 set for Jan. 1, 2018. • Nebraska hiked its hourly minimum wage from $8 to $9. • New York’s minimum wage increased from $8.75 to $9 per hour. • Rhode Island boosted its hourly minimum wage from $9 to $9.60. • South Dakota’s minimum wage increased from $8.50 to $8.55 per hour. • Vermont’s hourly minimum wage went from $9.15 to $9.60, with a planned increase to $10 on Jan. 1, 2017, and an increase to $10.50 planned for Jan. 1, 2018. • West Virginia raised its minimum wage from $8 to $8.75.
SOUTHEAST
Photo: tom-ster/iStock/Thinkstock
FLORIDA IS TOP CHOICE FLORIDA — For the first time since 2001, Florida is back on top as Americans’ most desired habitation destination, according to a recent Harris Poll of 2,232 U.S. adults. Sunshine and waterfront acreage are consistent themes at the top of this list, with California (2) and Hawaii (3) rounding out the top three. Turning away from beachfront territories, Colorado (4) and New York (5) close out the top five states where Americans would like to live. Warm winters, sandy beaches and sunshine make Florida an attractive Florida also came in first among destination. The Sunshine State recently passed New York in population. the 51-to-69 demographic, ahead of Hawaii, Arizona, California and and memory care community where who had seen the video via the app. Oregon. It was second among those she worked and then posting it on Riedlinger subsequently was fired aged 70 or older, trailing Hawaii. Snapchat. from Parkside Manor. Grace Riedlinger, 21, worked MIDWEST at Parkside Manor in Kenosha, WEST WI, when she admitted taking the VIDEO LEADS TO ARREST video of a 93-year-old resident with SETTLEMENT REACHED WISCONSIN — A former nursing dementia who was sitting on a bed CALIFORNIA — A $13.5 million assistant has been charged with a wearing only a bra. The incident class action lawsuit settlement against felony for taking video of a partially happened Jan. 5 and was reported the former Emeritus Corp. has been clad resident at the assisted living Jan. 11 by a friend of Riedlinger’s finalized in U.S. District Court for 14 McKnight’s Senior Living • February 2016 • www.McKnightsSeniorLiving.com
the Northern District of California. Plaintiffs in Arville Winans v. Emeritus Corp., residents of Emeritus’ assisted living communities in California between July 29, 2009, and May 15, 2015, alleged that Emeritus misled them about its use of a computerized system to evaluate residents and the system’s role in determining sufficient staffing and care for residents, leading them to pay for additional services that were not included in their contracts. CAMERA BILL INTRODUCED UTAH — If a bill introduced in the state legislature becomes law, Utah would become the first state to require that assisted living communities grant requests from residents or their representatives to operate or install cameras in resident rooms. H.B. 124, introduced by Rep. Timothy D. Hawkes, would require that communities be notified of the intended installation of audio or video monitoring equipment. n
PROTECTING THE GRE TER GOOD As the nation’s leading insurer of religious institutions, we offer our policyholders access to the industry’s most robust network of strategic connections. Our partnerships offer the specialized insight and services you need to succeed in your mission — and you can’t get them anywhere else. When it comes to protecting your people, your property and the traditions you hold dear, you’ll find we’re more than an insurer. We’re a partner who helps you serve the greater good.
Make a strategic connection today. Call (800) 554-2642 or visit www.churchmutual.com.
© 2016 Church Mutual Insurance Company
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EDITOR’S COLUMN
Words matter, particularly in senior living
BY LOIS A. BOWERS
Those working in senior living put much thought and time into naming concepts and choosing words that will appeal to (and not offend) potential customers. A recent example of this effort is the announcement of an initiative to replace the use of the term continuing care retirement community with life plan community, to get away from the words “care” and “retirement.” It’s also reflected in an industry preference for the friendly
Vice President, Publisher Karmen Maurer (970) 689-3813
[email protected] Editorial Vice President, Associate Publisher/Editorial Director John O’Connor (847) 559-2884, ext. 202
[email protected] Senior Editor Lois A. Bowers (440) 641-1182
[email protected] Art Art Director Mark Speakman (847) 559-2884, ext. 206
[email protected] Circulation Group Circulation Manager Paul Silver (646) 638-6063 Advertising Sales Account Manager Lorin Goussard (610) 495-5081
[email protected] Production Production Director Ada Figueroa, (646) 638-6065 ada.figueroa@ haymarketmedia.com
“community” instead of the institutional-sounding “facility,” memory care instead of dementia care, and other changes that have occurred over the years. Those working in the field may have conflicting opinions as to the appropriateness of the evolving terminology, but it certainly makes good business sense to consider language and its effects on people. One term, however, seems to have escaped the scrutiny of well-meaning professionals: baby boomer. In presentation after presentation at industry meetings, speakers warn that the baby boomers will have different expectations than members of previous generations and that senior living communities will need to adapt in order to attract them. After all, we’re told, the baby boomers were hippies, lovers of Beatles music, and war protesters. There’s just one problem with this account: It doesn’t consider the fact
“One term, however, seems to have escaped the scrutiny.” that 18 years separate the oldest and youngest baby boomers. I’d wager that the wants and needs of the oldest members of the generation, who were born in 1946, differ greatly from the wants and needs of its youngest members, who were born in 1964. The reality is, the youngest baby boomers were not even born when the Beatles appeared on the Ed Sullivan Show, were in kindergarten or pre-kindergarten when Woodstock occurred and were 8 or 9 years old when U.S. combat units were withdrawn from Vietnam. The oldest baby boomers, of course, are the more immediate con-
cern for members of the senior living field, and their expectations will differ from those of previous generations. But the next time you're about to utter the phrase “baby boomer,” stop and think about whom you're really talking. Are you really referring to all baby boomers? Maybe it’s time for us to try to devise a new way to refer to the oldest baby boomers. That way, we won’t be making generalizations that don’t apply to the youngest members of the generation, who may be children of your prospects now and may be looking for options for themselves some day. Some have suggested calling the oldest boomers leading-edge boomers. Whether this or other language is adopted, the good news is that when those in senior living address the issue, they'll be better prepared for the millennials, a generation that, like the baby boomers, is large and spans about 20 years. ■
Corporate Chief Executive Officer Haymarket Media Inc., Lee Maniscalco
Ad Index
Chief Financial Officer Haymarket Media, Inc., Donna Santarpia Chief Operating Officer Haymarket Media, Inc., John Crewe Office Information
Phone: (847) 559-2884 Fax: (847) 559-2885 E-mail:
[email protected] Web site: www.McKnightsSeniorLiving.com Business hours: 9:00 a.m. - 5:00 p.m. CST Address: 900 Skokie Boulevard, Suite 114, Northbrook, IL 60062 List rental information: Infogroup Media Solutions Bart Piccirillo, Senior Account Manager (402) 836-6283
[email protected] Subscriptions: Certain individuals qualify for free subscriptions. U.S.: $39.95 for 1 year (prepaid orders only) Canada: $51.95, Foreign: $92.95, Single copies: $20.00 Special issues and back issues: $20 per copy (U.S.), $30 (foreign), prepaid. Please call Customer Service toll-free at (800) 558-1703. Postmaster: Send address changes to: McKnight’s Senior Living P.O. Box 316, Congers, NY 109200103, or telephone (800) 558-1703.
Briggs Healthcare
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Bulk TV
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Church Mutual
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Detex
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Direct Supply
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DIRECTV It’s Never 2 Late
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MatrixCare
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Medline
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Omnicare
“We’re trading our activity director, dishwasher, janitor and a worker to be named later for Brookhaven’s marketing director.” Reprints: Articles can be formatted to an 8½” x 11” size and reprinted in quantities of 100 or more. For more information, prices and samples, contact Wright’s Reprints Brittany Norris , (877) 652-5295 Change of Address Subscribers: For change of address, mail your old and new addresses to McKnight’s Senior Living, P.O. Box 316, Congers, NY 10920-
0103, or telephone (800) 558-1703. Allow 4-6 weeks for correction. All other inquiries call Customer Service toll free at (800) 558-1703. Advertising Subscribers: For change of address, fax your old and new address to (646) 638-6114. All other inquiries call (646) 638-6000.
16 McKnight’s Senior Living • February 2016 • www.McKnightsSeniorLiving.com
12-13
Penner Patient Care Senior TV Space Tables
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Haymarket Media utilizes only US printing plants and US paper mills in the production of its magazines, journals and digests which have earned Chain of Custody certification from FSC ® (Forest Stewardship Council ®), SFI (Sustainable Forestry Initiative) and from PEFC (Programme for the Endorsement of Forest Certification Schemes), all of which are third party certified forest sustainability standards.
RESIDENT SUPPLIES CLOSE AT HAND. Medline’s Resident Care Program delivers right to your door. Inevitably, residents run out of personal care products, leading to last-minute shopping trips. Not anymore. With our program, residents and their families order supplies from an easy-to-use catalog. Orders are delivered to your facility in discreet, resident-specific packaging. Residents receive exceptional customer service and a great selection of best-in-class products, and you increase ancillary revenue per community.
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Call 1-800 MEDLINE to learn more and get started today. © 2015 Medline Industries, Inc. Medline is a registered trademark of Medline Industries, Inc.
OPINION | MY TURN
Six months later, very happy we moved in
BY LINDA MUSTON
Bags of snow melt are piled high in the entrance to Hy-Vee, the local grocery. It made me feel kind of giddy. I will never need to buy snow melt again! Come to think of it, I will never buy water softener salt again. Our move six months ago to an apartment in a continuing care retirement community (CCRC) (life plan community) was a very deliberate choice made over years.
My husband had a number of Excel spread sheets that he prepared as part of a decision-making process. The sticker shock of the endowment buy-in was the scary part. With the thoroughness of the professor/administrator he is, every little expense was identified; nevertheless, I’m not sure even he identified snowmelt and water softener salt savings. I’m not sure that any recruiter or marketing professional can itemize all the little advantages of retirement residence living without personally experiencing: The little list includes: • An in-house car wash that now includes a heavy-duty, wallmounted car vacuum • $5 burger baskets in the bar for Big Ten football and basketball games • Two buses making rounds each day and to evening arts and ath-
“We are now part of an exciting retirement community of 400.” letic events • The original anytime fitness — 24-hour access to the fitness center • Special arts performances and lectures • Resident-involved committees and residents’ council • An apartment nurse for episodic or chronic health issues in independent living • A hair salon with massage, manicures and pedicures available Even this list doesn’t describe the most satisfying asset that could not
be found on that spread sheet of his. We are now part of an exciting retirement community of 400. In one day, I noted two distinguished physicians skillfully hanging art as placed by the art committee; a respected university librarian managing the complex, multi-location recycling program; a group of teachers organizing the library; and two home economics professionals making alterations and completing sewing projects for fellow residents. As the little things list grows beyond snow melt and water softener salt the BIG advantage — our wonderful new community — outpaces it. n Linda Muston was a 25-year public relations professional and hospital administrator after 15 years as a stay-athome mother of three.
Adjustable Table Bases - Amazing Warranty No one else stands up to the demands of the healthcare environment quite like we do, so no one else can offer an unbeatable, unbreakable 25-year warranty on adjustable table bases.. The metal won’t fatigue, and our durability has been proven over the decades. This gives you: Easy Adjustability:: Our metal bases are engineered to adjust as much as six inches up or down to easily and comfortably accommodate wheelchairs, giving every resident a place at the table.
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18 McKnight’s Senior Living • February 2016 • www.McKnightsSeniorLiving.com
Secure their safety, even outdoors. Our weatherized delayed egress panic hardware stands guard in the gardens. Protecting your patients is a job that doesn’t stop at the door. While they’re enjoying a stroll in the courtyard, you must be sure that they can’t wander beyond the gate and are secure from outsiders who might try to get in. Exclusive to Detex, this weatherized hardware provides a 15-second delay when anyone tries to exit—sounding an alarm as well as alerting the inside monitoring station. In an emergency situation such as a fire, it allows immediate egress. Because it’s Advantex® quality, our architect-approved hardware is extra durable and has a safe, smooth surface that’s available in a variety of complementary finishes. It comes in a simple-to-install EasyKit,® or we can custom fit the hardware for your application. Visit www.detex.com/weatherized1 to learn how we can keep your outdoor areas safe.
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866-927-7456
1/8/16 3:26 PM
A free online event for the long-term care industry
March 29-30, 2016 Earn up to 6 Free Continuing Education Units REASONS TO ATTEND • Earn free continuing education credits by attending up to six informative and interactive webcasts that will be presented by leading industry experts. Sessions are approved by NAB. • Explore numerous online booths from top industry vendors. See the latest product information, videos and white papers —from wound care to brain care to information technology. • Take advantage of the Resource Center, including Purchasing Reports and Buyers Guides. • Network online with colleagues and vendors.
SPEAKERS
Leah Klusch, RN, BSN, FACHCA Executive Director
Joyce M. Black, Ph.D., RN, FAAN Associate Professor
David Finkelstein Chief Information Officer
Alliance Training Center
University of Nebraska Medical Center Past President, National Pressure Ulcer Advisory Panel
RiverSpring Health
Elaine Healy, M.D., FACP, CMD Medical Director and Vice President, Medical Affairs United Hebrew of New Rochelle
Paula G. Sanders Chairwoman
Beth Burnham Mace Chief Economist
Health Care Practice Group, Post & Schell P.C.
National Investment Center for the Seniors Housing & Care Industry
Register now for this FREE EVENT @
www.mcknights.com/Expo2016 • Free and easy registration
• Live networking with colleagues
• User-friendly experience
• Virtual exhibit hall
WEBCASTS PAYMENT TRACK
QUALITY TRACK
MDS 3.0 Update: Get ready for more changes
Engaging staff in reducing readmissions to improve quality
Tuesday, March 29, 10 a.m. Eastern / 7 a.m. Pacific The federal government continues to change how residents are classified and paid for under Medicare. Operators can expect more tweaks to the MDS 3.0 in 2016. This session will preview what’s likely to happen from an insider’s perspective. Presenter: Leah Klusch
WOUND CARE TRACK Deep tissues injuries — recognition, strategies and risk Tuesday, March 29, 11:30 a.m. Eastern / 8:30 a.m. Pacific Deep tissue injuries are one of the hottest caregiving issues in long-term care today. This session will examine how to identify and diagnose these types of wounds. It will also discuss best treatment options to head off bigger liability and risk management problems. Presenter: Joyce M. Black
TECHNOLOGY TRACK
Wednesday, March 30, 10 a.m. Eastern / 7 a.m. Pacific New reimbursement methods such as value-based purchasing could put SNFs out of business. Learn how to boost efficiency and quality with a focus on reducing hospital readmissions. Presenter: Elaine Healy, M.D.
REGULATORY TRACK The changing compliance and enforcement landscape Wednesday, March 30, 11:30 a.m. Eastern / 8:30 a.m. Pacific An effective compliance program is the key to managing risks and regulations. This session will provide a look at compliance and regulatory updates for the coming year, and give guidance on increasing ownership and board engagement. Presenter: Paula G. Sanders
Technology trends and best practices
CAPITAL TRACK
Tuesday, March 29, 1 p.m. Eastern / 10 a.m. Pacific Long-term care providers are often bombarded by the latest in technology. This session will review best practices in EHR/EMR adoption, discuss advances in patient monitoring and tackle regulatory updates and IT implications. Links to online tools and resources will be provided. Presenter: David Finkelstein
Wednesday, March 30, 1 p.m. Eastern / 10 a.m. Pacific Capital is once again flowing in the senior living sector. This informative session will examine what kinds of capital sources are most prevalent, and how operators can position themselves to take advantage. Presenter: Beth Burnham Mace
The state of capital availability
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THE HELP YOU NEED | INFORMATION TECHNOLOGY
There’s an app for that
Photo: michaeljung/iStock/Thinkstock
Many observers believe that information technology is going to be the next big thing in senior living
W
information company. During an interview with Mr. Damgaard, one could almost feel information. his pulse quicken as he talked The so-called “Information Age” that arguably dawned in the waning about a recent epiphany he had months of the 1990s is now full-bore. And thanks to smartphones, Apple on his first Uber ride. “I used to and Google are in a veritable data distribution frenzy, to date hosting be resistant to Uber, but my chief more than 75 billion downloads of the 3 million-plus unique “apps” to technology officer convinced me billions of users worldwide. The app business is barely eight years old. to try it,” he recalls. “It wasn’t long Lots of numbers. after that I began thinking about a Here’s more: Though they can’t come close to eclipsing the ubiquitous world where Uber meets home care, time-killing apps like Angry Birds, mobile medical apps are now the fast- a world where you find yourself in est growing category on the Internet. Google and Apple now offer more dire need of an agency home care than 28,000 different ones. worker, one in close proximity and And so, in an industry still in the twilight stages of wrestling mountains available now.” It was an easy leap of paper, long-term care finds itself on the enviable receiving end of a when Damgaard began thinking remarkable information innovation wave thanks to newly minted engi- about integrating location-based neers reared on social media, savvy marketers, a ton of private equity and services with the delivery of care. some very smart entrepreneurial-minded executives like John Damgaard. “That is a mind-blowing topic that He’s CEO of electronic health record giant MatrixCare which, thanks we need people whose propellers are to its recent acquisition of AOD Software, is now a leading senior living spinning really fast to think about,”
e all find ourselves literally drowning in
22 McKnight’s Senior Living • February 2016 • www.McKnightsSeniorLiving.com
he adds. “From a business perspective, I see an explosive intersection of two worlds there. By the time you and I are in a senior living setting, it’s going to look very, very different, and it definitely is going to involve location-based services.” Speak to top executives in healthcare infotech these days, and they all seem similarly giddy over big and little data’s potential. Mike MacLeod, founder and self-proclaimed lead strategist of Status Solutions, is one of them. “Whether you’re 65 or 85, if you’re alive, you still matter,” MacLeod says. “If you look at what I do, I try to figure out how to harness all this good technology from networks, devices, databases, etc., and deliver better tools to better manage
people and stuff. Looking around at all the medication carts, the drugs in those carts, the people pushing them and the primary person, the resident, and their whole circle of influence from family and friends to caregivers and merchants, we’re constantly obsessing over how to make their lives better with technology, and how to create situational awareness with our innovative skillset.” Here’s another: Andrew (“Andy”) Carle. The ebullient healthcare executive-turned entrepreneur-turned college professor is immersed in shaping tomorrow’s senior living leaders as executives-in-residence for George Mason University’s pioneering program in senior housing administration. About a decade ago, Carle got bit by the technology bug after seeing his first Nintendo Wii bowling game, now a staple in every nursing home. He also came across a children’s shoe that incorporated a GPS tracking device (ostensibly to defend against abductions or lost kids). That sparked an epiphany in the former memory care executive, and he found himself on the ground floor of helping develop the “Navistar” shoe for Alzheimer’s patients — which made the list of the “100 Most Important Inventions in History” by the National Museum of Science and Technology in Stockholm, Sweden. EHR: THE INFORMATION CORE In the kingdom of senior living information tech, the EMR reigns supreme and in many ways, drives or feeds off many other kinds of innovation. For example, MatrixCare’s EHR system is far more than a fancy electronic resident chart. It’s part of a larger, very complex system that downloads data from various resident monitoring devices like wireless scales and activity trackers; its nutrition management feature records what residents are eating for dinner and lunch and using point-of-sale tech, suggests healthful alternatives; and it tells physicians used to doing exhaustive, old-school, time-consuming
Photo: pandpstock001/iStock/Thinkstock
INFORMATION TECHNOLOGY | THE HELP YOU NEED
Many experts believe that technology tools will continue to proliferate.
“I see an explosive intersection of two worlds here.” John Damgaard, MatrixCare rounds where the facility’s sickest residents are living. Dave Wessinger, chief technology officer at PointClickCare, believes the EHR is at the very core of providers’ insatiable quest “to build a highly valued, sustainable business.” The growing focus on value-based payment models and the need to deliver and demonstrate quality outcomes is driving that, he adds. “Having an EHR in a senior living community helps to improve residents’ living experiences, boosts staff productivity and offers better visibility into residents’ needs,” Wessinger says. “This insight allows staff to plan for effective services and lifestyle management. An EHR that supports a person-centric approach to care, meaning health-related information that follows the patient and places an emphasis on quality and health outcomes, enables care providers and their partners to rely on the most up-to-date information across care settings, ultimately improving quality while reducing costs.” Indeed. Damgaard says one need look no further than the clunky, $25,000 telehealth monitors that used to be mounted in corners
close to ceilings. Today, they’ve been replaced by far more sophisticated, $99 feature-rich wearable tech. HARNESSING THE POTENTIAL Remarkably, only now are providers beginning to understand the full potential of information technology. The obvious benefits are greater productivity and efficiency and better clinical decision support (thanks to EHR and monitoring, to name two). The not-so-obvious payback, meanwhile, is how this kind of technology is helping a larger healthcare system connect all of the dots along each resident’s or patient’s life inside the matrix. “Our enterprise layer is the piece that glues together the full longitudinal record,” Damgaard says. “As a resident moves from home, to a hospital, to a skilled nursing facility, to assisted living, we’re able to chart those progressions. We’re actually able to take the electronic transition of care document, the CCDA, into our EMR system, and parse it so we know everything about meds and nutrition and physician orders, to name just a few.” Emerging information tech also
can play a key role in better outcomes. “Innovations like wearable tech and monitoring in and of itself are cool, but when you take that data, that information, and you feed it into an EMR that has clinical decision support capabilities, all of a sudden you’ve opened up a whole new universe of possibilities,” Damgaard says. FUTURETECH Even as executives like Damgaard ponder the potential for locationbased technologies and care delivery, other things such as wearable tech continue sparking and spawning ideas. Damgaard says he believes wearable tech is only at the “1%” hash mark of its full innovation curve. Engineers from contract manufacturing behemoths like Flex, for example, tell McKnight’s Senior Living they’re out in the fields studying and testing the raw materials for fabrics as they conceive ways of embedding durable sensors inside clothing. Adult incontinence product companies, naturally, are very excited about the potential, Damgaard adds. But the most exciting information tech innovation is just around the corner, according to Damgaard. Even today, he says, medical diagnostics are steeped in the Stone Age when compared to the rapidly emerging potential for DNA testing and consumer-based, personalized medicine. “There is a company now that will take your saliva swab you mail in and in short order and for 99 bucks, send you back your complete genome – your fully mapped genetic profile that is a predictor of disease states at a very high resolution,” Damgaard says. “The potential this holds for saving and extending lives is mind-boggling.” It’s no surprise, therefore, that he believes “personalized genetic testing on a full-scale consumer level is going to intersect into senior living, and it’s going to involve longer lives, higher-quality lives, but yet at a lower cost and a better satisfaction. That is the 800pound gorilla.” — John Hall
www.McKnightsSeniorLiving.com • February 2016 • McKnight’s Senior Living 23
THE HELP YOU NEED | DEMENTIA ENGAGEMENT
Maintaining memory
Photo: John Merkle @ Autumn Leaves of Glen Ellyn
With demand escalating for memory support services in the senior living sector, operators have a full plate of factors they must consider as they improve care and services for residents
S
upport services aimed at residents with dementia and Alzheimer’s disease are becoming more criti-
cal than ever in the seniors housing market. Many new facilities and renovations are including these units. But there are various aspects of providing a comprehensive memory care program that operators must follow, including therapy regimens, engagement strategies and security measures. Cognitive therapy and resident engagement are two important clinical and social services for memory care residents, and with an expanding knowledge and technology base, operators have more and better options than ever before, says Jack York, president of It’s Never 2 Late. “We see a dramatic increase in the demand for engagement,” he says. “We have hundreds of systems set up in various memory care locations and
the families making decisions today are tech savvy — they are starting to demand that tools are available to their parents to Skype, to participate in brain fitness activities, to travel virtually, and to stay connected to the outside world.” This connectivity and cognitive therapy isn’t merely clinical in nature and doesn’t necessarily have to be marketed that way, York maintains. In fact, he says the most effective message that facilities can project is the socially desirable concepts of person-centered care and wellness programming. To be sure, person-centered care is a cornerstone of memory support and a practice that all facilities should be following, adds Peter T. Klug, director of clinical and reha-
24 McKnight’s Senior Living • February 2016 • www.McKnightsSeniorLiving.com
bilitation for Direct Supply. “Person-centered care is extremely important, especially for residents with dementia,” he says. “They need a home that provides safety and security, a calm, reassuring and therapeutic environment — a setting that supports each resident’s strengths and specialized individualized care. And it doesn’t necessarily have to be within a special care unit.” More person-centered approaches, early-stage investment and an increasing focus in product development are actions being taken by companies that specialize in the areas of supporting and enriching the lives of seniors with dementia, Klug says. “I expect there will be a rapid increase in the rate of innovation for products based on basic and
It’s simply common sense to deliver to individuals the content that is relevant to them, and in doing so, the outcomes are remarkable.” Creative communities integrate engagement into their overall wellness and therapy programming, York says, adding that it’s most successful when taking a multidisciplinary approach. When done correctly, he says, residents look forward to participating in the various programs and enjoy the stimulation they offer. “It’s really not that complicated — if you provide meaningful content and engagement that people enjoy, you will attract them,” York says. “The technology has to be relevant for the residents and not for the preconceived notions of what a therapist would assume. The options available are unlimited … something as simple as Google Earth can fascinate and stimulate people and put smiles on their faces.”
FOSTERING ENGAGEMENT York cautions, however, that operators should not adopt just any technology for technology’s sake — it must be tailored to meet the unique needs of each individual. “And that has nothing to do with aging,” he says. “Personally, I’m 56 years old and really like Bruce Springsteen. When I turn 85, I will still like him, and I won’t have a sudden need for Barbra Streisand.
NEW INNOVATIONS Through ongoing research, the Center for Applied Research in Dementia is working to change the method of dementia care, which Direct Supply is using in its product design, Klug says. “We are taking those principles and using them in the products we design under our own brand as well as how we screen new products being developed for senior living,”
Photo: John Merkle @ Autumn Leaves of Glen Ellyn
applied research as to the needs and desires of persons as they live with dementia,” he says. From a clinical perspective, York says a tremendous amount of research shows how engagement can help reduce the use of psychotropic drugs. “That’s a big deal from a governmental compliance standpoint as well as from a cost reduction standpoint,” he says. “What’s being seen both through research and common sense is that technology is a way to connect people in meaningful ways, whether it be through music, spirituality, or brain fitness and cognitive therapy.” In the span of a few short years, the use of information technology in cognitive therapy has gone from novelty to mainstream, York says. “It is now an expectation,” he says, “that technology will also integrate engagement with clinical and medical software. The market is demanding it, and it will come.”
More research is showing how music can aid those with memory challenges.
Photo: funstock/iStock/Thinkstock
DEMENTIA ENGAGEMENT | THE HELP YOU NEED
Residents increasingly are using social media options to stay connected.
he says. “We have products in resident rooms, common areas, dining and safety that are being designed specifically for those with dementia. We also have therapeutic products in cognitive assessments, exergaming, activities and music that we believe are making a positive impact on the lives of those with dementia.” One of the innovative new products is the CyberCycle, developed on the principles of exergaming research, Klug says. Combining physical exercise with an interactive virtual reality gaming simulated environment is intended to be both engaging and therapeutic. In a study cited in American Journal of Preventitve Medicine, “cyber cyclists” experienced a 23% reduction in the progression of mild cognitive impairment compared to traditional exercisers and yielded greater cognitive benefits in executive function. SOCIAL MEDIA’S VALUE Connectivity with family and friends through social media outlets such as Facebook has become a valuable engagement tool to help seniors keep intellectually stimulated while electronically socializing with the outside world. The growing popularity of social media among seniors is a testament to their cravings for being connected and for staving off loneliness, says Kaleb Scharmahorn, director of marketing for Silversphere. Although therapy and rehab often focus on the resident’s physi-
cal needs — ensuring their safety and physical wellness, their emotional needs also are important to nurture, he says. In fact, in an age where families commonly uproot and move to different states, he says the elderly are becoming more isolated and feel more alone than ever. “There are a number of factors at play here, from the fact that many retirees move to warmer climates when they leave work to the fact that children and grandchildren often move away after college to pursue their careers,” he says. “No matter what the reasons, modern families are scattered more widely than ever before. The typical senior citizen may have children and grandchildren living in several different states or even several different countries, and that can make getting together in person a difficult thing indeed.” So although getting the whole family together in one room might not always be possible, it doesn’t mean residents and their families can’t meet and talk about their lives,” he says. Seniors are starting to become familiar with Facebook, but they may not realize the scope of possibilities the platform provides, Scharmahorn says. “While they may know that Facebook makes it easy to share photos, they may not know that it is just as easy to embed videos and other content,” he says. “To get them engaged with it, take the time to show them all the great things Facebook can do.” — John Andrews
www.McKnightsSeniorLiving.com • February 2016 • McKnight’s Senior Living 25
THE HELP YOU NEED | BATHING/LIFTS
Awash in benefits
Photo: John Merkle @ Autumn Leaves of Glen Ellyn
Old notions of bath time are being replaced by spas and other upgrades that challenge the status quo
S
enior housing providers looking to increase resident and staff satisfaction and gain a stronger competitive
edge in the marketplace should turn their attention to
being bathed, and there’s an emphasis on creating a spa environment and relaxing atmosphere,” says Mary Novotne, co-owner of MasterCare Patient Equipment Inc.
their resident bathing areas. Dreary, dated, cramped and
FIRST IMPRESSIONS COUNT Whether a facility has the budget otherwise uninviting bathing spaces can make residents for a top-to-bottom bathing area and staff dread bath time — and they certainly can turn overhaul or has limited resources and must make the most of an existoff prospective residents. Even worse, outdated bath- ing space, the market is brimming with options. “It’s not about giving a bath ing and transfer equipment coupled with questionable but creating an enjoyable bathing bathing practices, can increase the odds of injury and experience,” reminds Lee Penner, president of Penner Patient Care anxiety for residents and employees. Inc. That experience begins before the resident even makes it to the Fortunately, more operators are taking note. Industry experts agree that bathing unit. As Penner explains, bathing is becoming more person-centered and the dedicated bathing soothing décor and color palettes, areas are less institutional. ambient lighting, plush towels and “More focus is being put on the overall well-being of the individual other designer touches — many of 26 McKnight’s Senior Living • February 2016 • www.McKnightsSeniorLiving.com
which can be offered even on tight budgets — help immediately set the stage for a relaxing, enjoyable experience. Bathing units take center stage in spa areas, and today’s systems offer thoughtful designs and designer touches that don’t disappoint. Modern units come in a wide range of price points and appealing colors, making it easier for senior housing communities to stick to a soothing color palette with more residential appeal. What’s more, bathing units are more innovative and feature-rich than ever before, helping to further convey “luxurious, resident-centric spa” instead of “utilitarian bathroom.” Some relatively simple fixes can have a big impact on a bathing area’s overall appeal. When feasible, Penner recommends nestling
BATHING/LIFTS | THE HELP YOU NEED “It’s not about giving a bath but creating an enjoyable bathing experience” Lee Penner, Penner Patient Care Inc.
Photo: Penner Patient Care
bathing units against the wall for a more residential, built-in appearance, as opposed to placing the unit in the center of a stark room. Not only does this create a homier, more custom look, but it frees up valuable floor space that simplifies maneuvering and transferring, and it also can help reduce the risk of trips, slips and falls. Side-entry bathing equipment with integrated transfer devices makes transferring residents to and from the bathing unit a snap. As Penner points out, such transfer systems eliminate the need for independent transfers with separate, space-robbing transfer equipment that require residents to be lifted up and over the sides of the bathing unit. For added safety and ease of entry, the integrated transfer systems on Penner bathing units transfer residents in and out at wheelchair height. Units with auto-fill features and water reservoirs that keep water warm and ready for the next resident improve resident comfort, while keeping wait times to a minimum between resident baths. Apollo Corp.’s Rapid Fill Reservoir, for example, holds temperature-controlled water until the resident is secured in the tub and can then fill the tub in about a minute, says David Anderson, Apollo’s national sales manager. Increasingly, modern bathing units are keeping infection control and prevention at the forefront. Pipeless jets that circulate warm air instead of water help simplify cleaning and disinfection while cutting contamination risks. Backflow preventers, which reduce the likelihood of water entering the air line when the air blower is turned off, further aid the infection prevention process. The same is true of smallerdiameter air lines that allow disinfectants, fresh water and air to do their job better by making greater contact with the surfaces of the lines, according to Penner. Anderson considers the Remedy Ultraviolet Light Water Purification System one of Apollo’s most exciting innovations. “The UV system helps minimize exposure to harm-
A virtual cornucopia of new options help make bathing more enjoyable.
ful pathogens during the bath, as bacteria wash off their bodies,” he says, adding that the technology has been clinically proven to help reduce urinary tract infections among nursing home residents by 50%. Moving forward, the market will see the introduction of even more refined clinical applications, such as weighing scales and bariatric models, predicts Joe Chesnutt, head of marketing development at ProCare Medical Company. He also anticipates improved disinfecting systems and antimicrobial materials, as well as the increased availability of hi-lo shower chairs for seated and supine showering. “This will greatly reduce stress on caregivers and integrate with safe resident-handling best practice initiatives.” The new and improved shower chairs would replace the PVC and plastic basic chairs currently in use, he says. MasterCare’s Novotne says the senior housing segment can expect more demands for top-quality services that pamper residents. Heated air and aromatherapy technology also is standard on all MasterCare BathAire spa bathing systems.
Innovation doesn’t always mean high-tech, however. As Chesnutt explains, many bells and whistles offered in the past revolved around digital features, including electronic controls, displays and sensors. “What was discovered is, not only did these features add a layer of complexity to the operation of the bathing system, these features [could prove] problematic regarding reliable operation. A basic rule of thumb is, electronics and high humidity and high moisture environments don’t mix well. The movement back to traditional analogue controls and displays will gain momentum over time.” PRACTICE MAKES PERFECT Even with the exciting innovations taking place in the bathing equipment market, no bathing experience will fully benefit residents and staff unless effective, resident-specific practices are consistently adopted. For starters, experts stress the importance of allowing residents enough time to fully relax. “I often see the bathing process get rushed due to time constraints,” says Anderson. It’s a mistake that
diminishes the health and wellness perks associated with spa bathing, he reasons, such as improved circulation, debridement of open areas, blood sugar stabilization, release of natural pain-relieving endorphins and more. “Residents sit almost the entire day. Buoyancy provided by a relaxing spa bath takes pressure off the gluteal area and facilitates muscle relaxation,” Anderson says. Detailed and ongoing education and training is critical for all staff involved in the bathing process, so that they understand the benefits of bathing, reduce risks of injury and keep resident safety, comfort and dignity a top priority. Unfortunately, it’s a need that remains unmet at many senior living communities. “Often, management gives the least amount of training to bath aides, who have the most personal of all interactions with guests in the community. Who among us is comfortable with getting undressed in front of someone we don’t know?” Novotne asks. Silverado Senior Living strives to create a pleasurable bathing experience that’s anything but one-size-fitsall. Although each resident room has its own full bathroom, dedicated spas are incorporated into the design of each memory care unit. Another practice adopted by all Silverado bathing staff is to inform residents before spraying them with a shower nozzle. To promote comfort and dignity, residents also have their bodies covered with a sheet or bath towel on areas not being directly bathed. “Keeping the area warm also helps to reduce anxiety,” says Kathy Greene, Silverado’s senior vice president of programs and services. Silverado residents who fear traditional bathing are given bed baths that incorporate a massagelike experience. Bathing staff keep residents covered with a heavy bath sheet or blanket, lifting it as each different body part is bathed. “There are also many no-rinse dry shampoos that can be used to wash someone’s hair, when needed,” Greene notes. — Julie E. Williamson
www.McKnightsSeniorLiving.com • February 2016 • McKnight’s Senior Living 27
PRODUCTS YOU NEED
Single-glove system
Anti-choking device
FoodHandler Inc. announced the launch of MedHandler® oneSAFE system, which includes the oneSAFE Single-Glove Dispensing System line. The new gloves are in powder-free vinyl and blue nitrile. They can be accessed from single and triple wall-mounted dispensers. The oneSAFE system is proprietary and lets users pull out a single glove by the cuff and put it on without touching the glove’s handling surface.
Dechoker LLC has created an anti-choking device that can clear an obstructed airway. The device is placed over the mouth and nose and creates suction to dislodge food or debris blocking a victim’s airway. The Dechoker also has a tube that holds the tongue back.
FOR MORE INFO:
FOR MORE INFO:
(502) 292-3307 www.dechoker.com
(800) 338-4433, ext. 2 www.FoodHandler.com
Have you checked out our new website?
www.McKnightsSeniorLiving.com Delivering the news, perspective and analysis that senior living operators need to succeed
Visit our new site today! 28 McKnight’s Senior Living • February 2016 • www.McKnightsSeniorLiving.com
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A FEW MINUTES WITH...
Meeting the changing needs of residents Mather LifeWays’ Mary Leary talks about life care communities — and senior living’s challenges Senior living operator Mather LifeWays and LeadingAge recently helped lead an initiative, in partnership with other industry marketing and research professionals, to find a new name for “continuing care retirement community.” Numerous discussions, focus groups and surveys led to the winner, “life plan community,” which was announced at LeadingAge’s annual meeting in November. Mary Leary, president and CEO of Mather LifeWays since 2002, recently answered some questions for Senior Editor Lois A. Bowers.
is being offered. That said, senior living is a dynamic industry, and I think we’ll continue to see an evolution toward greater integration within communities, with access to all that is offered, from cultural and educational opportunities, to coffee shops and public transportation. What boomers want, regardless of their housing options, are lifestyle choices.
Q: What do you see as the biggest issues facing senior living providers, imminently and long-term? A: The biggest issues are:
Q: What might you say to someone who expresses some trepidation about using the term life plan community?
• Attracting people to work in the field, especially healthcare professionals • Increasing the rate of implementation of innovations • Meeting the expectations of the next generation of customers • At least on a short-term basis, overbuilding Luckily, some of the challenges also may provide the solutions. By evolving to meet the needs of future residents, we’ll also grow in our ability to attract the best-qualified candidates with new ideas and innovation strategies. ■
A: I would suggest talking to the residents, sales team and other key team members. Review the research report and white paper where it highlights some key information that communicates the rationale and findings very well. [These documents are available at www.lifeplancommunity.org/what-we-learned.] We recently received a letter from a resident at one of our communities. He shared that he understood the reason in changing the name from continuing care retirement community to life plan community. In fact, he shared that “life planning” is the way most residents prefer to think about it. And, of course, our lives may not even require continuing care. As the song goes, accentuate the positive. I’d also tell them that the new term doesn’t replace what you are as an organization and what you stand for. It is a way to focus on what’s working today and speak to the consumers of tomorrow.
WHAT I’VE LEARNED ALONG THE WAY ■ When sharing the news about the category rename change to life plan community with residents, families and staff, it is important to reiterate that only the name and how we describe what we offer is changing.
Q: In addition to a change in terminology for CCRC, in what other ways will senior living providers be changing to respond to the tastes, needs and wants of future residents?
■ Reassure them that the value and continuing care protection are still there should they need them. Most people want to ensure that there is no change to their continuing care contract.
A: Senior living providers already have begun to provide services and amenities that reflect the changing tastes and desires of future residents. The name change helps more accurately describe what, in many cases, already
Photo: John Merkle
30 McKnight’s Senior Living • February 2016 • www.McKnightsSeniorLiving.com
■ Start using it! Don’t wait to make updates to every document, marketing piece, contract, etc. Start incorporating it into your vernacular right away and people will follow.
Finding a
for more than 40 years. Our Spas Are Better Better Design Easy Operation Simple Cleaning Process LOW Maintenance
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h el pin g y o u f o cu s o n w hat m at t ers mo st Learn more about the many ways Direct Supply can help you build, equip and run better Senior Living communities at DirectSupply.com.
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