SENIORS HOUSING IS ABOUT TO BE TURNED ON ITS HEAD: 5 STEPS TO TAKE RIGHT NOW
Independent and Assisted Living sales and marketing as well as operational strategies must be put in place right now to pivot and ensure viability as our industry once again transforms
I have a quote that hangs on my bathroom mirror, that I posted during one of the most taxing times in my life. That quote says, “The universe has shaken you to awaken you.” I have had this front and center for the past five years and what I know to be true is that moments like this can redefine you and your company; depending on how you respond. As an executive, never has your team needed you more, never has your company needed you more and never have seniors needed you more.
I’ll never forget working with independent, assisted living and memory care operators as well as continuum of care communities, some with upwards of $1M entry fees during the Great Recession. One of our clients had a portfolio of communities in Detroit, the heartbeat of the then defunct auto industry. Despite everything going on, the Bild team was tasked with driving occupancy and failure was not an option. I learned more in those four years than I had learned in the ten years prior combined and as a result we grew occupancy by 5% in that Detroit market; while the industry saw occupancy decline (without the use of discounts).
These were incredibly challenging times and when it was all said and done, our industry 
would never be the same. Post Great Recession we saw an influx of seniors move in who had postponed their moves during the financial crisis. They were older, frailer and had an average of five levels of care; much unlike their predecessors who had one, maybe two levels of care. New residents were in their mid-eighties rather than mid-seventies.
Because of their poor health and age, length of stay dropped from an average of three years to twelve, maybe eighteen months. Salespeople had to sell double the number of move ins than they were used to only to net zero and operations had to come to terms with how to care for such high acuity residents. While this was done incredibly well and with what looks ease today, back then, it was unchartered territory.
I’ll never forget the scramble as I witnessed independent living becoming assisted living and assisted living become essentially long-term care. Even today, operators and developers are still trying to determine how to position independent living. Many platforms launching right now are in an identity crisis and asking, “are we an independent living, active adult, or lifestyle option?”
SENIORS HOUSING IS ENTERING A STATE OF TOTAL TRANSFORMATION
We will never be the seniors housing industry we are right now again. Post COVID-19, we will look entirely different. The types of residents we will accept, the increased acuity levels, and new payment models will be introduced from Medicaid and Medicare to insurance coverage that doesn’t currently exist. Hospitals will finally see us as part of their care coordination plan and as partners.
While the Great Recession presented incredible financial pressure, the COVID-19 pandemic presents a healthcare challenge with seniors being the most vulnerable. As an industry we must get this right. I have no doubt we will persist and perhaps thrive even in what could end up being another recession. Keep in mind, that depends on how quickly we can contain this virus. Seniors housing proved a winner post Great Recession and brought an influx of new investors and capital into the industry which lead to the development pipeline we are benefiting from today.
This time around, we may see investors who don’t have the stomach for true healthcare exit; while those who have been in the business for decades dig in. Only time will tell.
WHAT SHOULD ASSISTED LIVING OPERATORS BE DOING RIGHT NOW TO PREPARE FOR POST-COVID?
Strategically, you should begin mapping out your plan to engage with hospitals, insurers and making it a point to become part of the healthcare conversation. Never has the door stood further open for senior living operators to walk through and introduce themselves.
With hospitals limited on beds and seeking to discharge patients to make room for new ones, their greatest barrier is where exactly to discharge to. Skilled nursing facilities are either unprepared, unwilling or simply unable to take hospital discharges in many cases right now with COVID-19 in play, which again, leaves an opening for you to step up and show your capabilities as an operator.
When putting your strategy together, it is critical that you do the following:
- Discover WHAT constraints your local hospitals have right now
- Determine WHAT your solution is to those constraints
- Decide proactively HOW you will communicate that solution easily
- Establish WHO will be the messenger on behalf of the communities in each MSA
- Clarify HOW often and in WHAT CAPACITY you will follow up and communicate in real time
This is not a one and done strategy. It needs to be executed with precision and requires relentless follow up. Ever wonder why third party paid referral agencies gain access to those valuable referrals from discharge planners? They do the work, dig in and don’t give up. Now is your opportunity to become part of the conversation and get discharges directly referred to your communities. This is not the time for a middleman to refer. We need strong conversations with hospitals to move patients quickly and safely out of already congested ERs.
SUCCESS DOESN’T COME WITH OUT RISK
Keep in mind, this may require you to get out of your comfort zone, take risk and do what’s never been done before, such as:
INCREASE the level of ACUITY you will admit which means training and even investment in equipment. To effectively partner you must understand what your hospital partners need and then work like crazy to deliver it. In truth, it’s now or later because this crisis is going to result in increased acuity, especially if we end up in a recession due to pent up demand. Residents moving in may be in their early nineties.
RECONFIGURE residents with an emergency request that all residents do their part, moving if need be to open-up a wing within the community that can be sealed off and used for hospital discharges. Partner with local healthcare officials and government to move fast and show up in a way that transforms your brand within the community at large.
BEGIN DISCUSSIONS with insurers, as well as other potential payor sources to determine what funds, if any, can be used to move residents into your communities; particularly for those with higher levels of care that would otherwise go to a skilled nursing facility.
PROVIDE much needed RESOURCES to your staff now. Don’t just guess but ask what they need to do their job. Be willing to get creative as many caregivers have children at home and are distressed over childcare. Do you have ancillary space you can convert onsite to provide childcare for employees? Can you get a temporary license to do so in order to provide for your residents? Can you send home meals with staff at the end of each shift and enough to provide for their immediate family? Yes, this means increased food expense but maybe your chef can get more creative on what is being prepared, portion size servings and share with residents the steps being taken to keep caregivers working (they want to give back too). Many healthcare workers have expressed the concern about bringing the virus home with them, can you offer to launder their scrubs to limit contamination?
STEP UP sales and marketing with laser focus on those seniors in your existing pipeline. Never has it been more important to reach out, offer resources and dig into what they need right now. For many, it’s a simple conversation. Seniors were isolated prior to COVID-19 and now with families in quarantine, most have no engagement with others at all. Identify which sales directors have the best people skills and can hit the phones with confidence. It doesn’t matter which community they are calling on behalf of right now, these individuals are essentially ambassadors for your company and are acting on your behalf.
Now more than ever your salespeople need to be focused on creating emotional connections, listening skills and problem solving which sadly doesn’t come natural for most. This can’t be put off to another day, it must be happening now if you don’t want to dig out of a net negative occupancy hole during the last six months of 2020. You get what you put your focus on and right now you must be organized, specific in what expectations are and communicating daily with site-level teams.
These are discomforting times, and no one knows how long this will last, if we will come out of COVID-19 economically okay or in a recession. As an executive, it’s critical you plan for the best but prepare for the worst. Never has our industry had a moment like this, in full view of the world, to show our capabilities. We need to move these conversations and stories from social media feeds to boardrooms and C-Suites nationally with solid solutions that will ensure we come out of this stronger and better positioned to do what we do best; take care of seniors.
