Alexandria Shuell, LaShuan Bethea, Lisa Willams headshots
From left: Alexandria Shuell, vice president of HigherPath, Bickford Senior Living; LaShuan Bethea, executive director of the National Center for Assisted Living; and Lisa Willams, regional director of operations for Maplewood Senior Living / Inspir Senor Living.

A replay of this webinar is available to watch by registering at https://www.mcknightsseniorliving.com/091124webinar.

Innovation, technology, affordable assisted living, dementia and memory care, value-based care and workforce issues were among the hot topics senior living experts discussed during a McKnight’s Senior Living virtual event on Wednesday.

The online panel, scheduled in the middle of National Assisted Living Week, was moderated by McKnight’s Senior Living Editor Lois A. Bowers and highlighted a wide range of important issues facing assisted living providers.

Innovation and technology

To highlight how technology is affecting assisted living, Alexandra Shuell, vice president of HigherPath at Olathe, KS-based Bickford Senior Living, talked about the company’s proactive health model. HigherPath has the ability to affect a resident’s overall health by coordinating care with service providers, she said.

Shuell called HigherPath the most impactful use of technology at Bickford because of its ability to track and trend quality data and provide predictive health insights. The care coordination platform creates a scorecard using data points on everything from falls to hospitalizations to antipsychotic medication use to determine whether a care plan is trending in a positive direction or if there is a need for a course correction.

“Technology has made a huge impact in how we provide care,” Shuell said, adding that she’s excited to see what the senior living industry does to drive quality even higher.

Priding itself on a reputation of being at the forefront of incorporating innovative technology to enhance lives, Westport, CT-based Maplewood Senior Living is focusing on leveraging cutting-edge solutions to improve safety and overall quality of life, according to Lisa Williams, regional director of operations at Maplewood and Inspir Senior Living.

Like many providers, she said, Maplewood uses an artificial intelligence falls prevention program, which allows staff members to prioritize their responses and provide timely intervention, as well as smart home automation, telehealth, virtual reality experiences and fitness-tracking devices. 

Value-based care

An increasing number of assisted living providers are turning to value-based care due to its ability to coordinate care for residents, according to the panelists. National Center for Assisted Living Executive Director LaShuan Bethea said that coordination eliminates medication and service duplication, allowing providers to be more efficient in the care and services provided. It’s also a way to look at and address a resident’s needs, she said.

Value-based care also has been credited with reducing falls and rehospitalization rates.

Williams said that the approach allows providers to emphasize prevention rather than treatment, which improves resident outcomes. Care coordination, she said, strives to provide seamless communication between staff members, residents, families and external healthcare providers by integrating technology and outcomes-based incentives, and also exploring partnerships with insurers and healthcare providers. 

Value-based care also creates “incredible” operating margins, Shuell said, adding that when Bickford implemented value-based care in its Virginia division, it led to a 99.7% occupancy rate. 

“It shows happier residents, better quality outcomes, better business outcomes — value-based care for assisted living is the way to go,” Shuell said. “That value-based care mindset is shifting that reactive approach to proactive. That mindset is really part of our culture and is integrated into all of our training because it’s our way of being as a senior living operator.”

The American Health Care Association / NCAL added an increased focus on assisted living at its Population Health Management Summit to help operators expand or introduce value-based care into their communities. Bethea said the summit is a great place to network and “figure out the pieces to bring back to your community.”

Assisted living affordability

With more than 90% of assisted living communities being private pay-settings, Bethea said, one in three older adults — more than 15 million people — are identified as economically insecure, with income levels 200% below the federal poverty level. That means that a growing number of older adults won’t have the resources to pay for assisted living for the entire time they need it, she added. 

Bethea said it’s imperative for state partners to be aware of their role in encouraging their states to offer affordable assisted living through Medicaid waivers to help some of those economically disadvantaged prospective residents pay for the care and services they need. Just as important is ensuring that the payment for those waivers adequately meets the cost of providing services.

“Having Medicaid waivers that pay adequately is important to get more providers to participate in the program to continue to meet the needs of their community,” Bethea said. “It truly will take a public-private partnership.”

Shuell said that providers also need to continue to educate decision-makers on the role of assisted living in the long-term care continuum. 

“The biggest thing is advocacy efforts — making sure decision-makers know we’re here, we need funding and what we’re using that funding for,” Shuell said. “We’re trying to drive quality and decrease costs to the healthcare system. We need adequate funding to have the technology and optimal staffing and the pieces to ensure we have that.”

Workforce challenges

Retaining and recruiting employees is the No. 1 priority for assisted living providers, Bethea said, adding that she has seen providers use a variety of tools to improve their workforce, including apprenticeships, nontraditional benefits, housing and tuition assistance.

Williams said the key to staffing is to adopt a shift in mindset. Maplewood adapted to being flexible to what works for their employees, whether that is 12-hour shifts or three-day work weeks. Showing staff members they have a career path also can be helpful in attracting people to the field.

“It boils down to flexibility and slowing down to talk to people and meet them where they are, and showing them the benefits of joining the long-term care team in assisted living,” Williams said.

The panel also discussed dementia care, with Shuell mentioning that Bickford is piloting a Montessori lifestyle program in its Virginia and Tennessee communities.

A replay of the webinar is available to watch by registering at https://www.mcknightsseniorliving.com/091124webinar.