Senior Living: Challenges and Opportunities Update on Argentum Initiatives
Argentum is the largest national association exclusively dedicated to supporting companies operating professionally managed, resident-centered senior living communities and the older adults and families they serve. Since 1990, Argentum has advocated for choice, accessibility, independence, dignity, and quality of life for all seniors.
2
SENIOR LIVING 2025 Until the 1980s, seniors who could not live safely in their own home or with family had few alternatives to institutional care.
They get assistance they need while maintaining privacy, dignity, and respect.
National Study of Long Term Care Providers, 2013 Overview
3
SENIOR LIVING 2025
The nation’s aging demographic will create unprecedented demand for the services of the senior living industry.
U.S Department of Health and Human Services
4
SENIOR LIVING 2025
The nation’s aging demographic will create unprecedented demand for the services of the senior living industry.
There will be approximately 1.1 million daily residents at residential care communities in 2025, an increase of 50 percent from 2012. Argentum projections based on data from the National Study of Long-Term Care Providers (NSLTCP)
In 2012, there were 22,200 assisted living and similar residential care communities.
In 2014, there were 30,200 assisted living and similar residential care communities.
Centers for Disease Control, National Center for Health Statistics
5
ABOUT ARGENTUM
ADVOCATE
EDUCATE
INNOVATE 6
ADVOCATE • Federal and State Level • Proactive/ Reactive
7
8
9
10
Political Landscape • Republican majorities at federal and state levels • Opportunities and challenges for Senior Living • “Generally” less regulatory oversight • More business friendly
11
Federal issues will move to State • Labor issues: minimum wage; employee benefits, check the box • Use of arbitration agreements • Medicaid Waivers & reimbursement
12
What is Trending in the States? • Number on Argentum 2017 State watch List: 300 Elder Abuse Dementia & Alzheimer’s
Minimum Wage
Electronic Monitoring
Staff training
CCRCs
13
Proactive State Advocacy Efforts • • • •
Many models of senior living No “ one size fits all” Some regulatory consistency is beneficial Meaningful state regulations are a good defense against federal oversight
14
What’s trending on the Hill • De Regulation: for every new reg 2 must go • Pro Business: NLRB is now republican and business friendly • Union focused rules: legislation introduced to rescind Ambush- Quickie elections Specialty Health Care – micro unions Persuader struck down by court
15
Federal Issues • DOL Overtime Rules would have increased threshold for Exempt employees from $23,000 - $47,000 Court struck down the rule in August DOL new request for Information Argentum still opposed
16
HCBS Waiver • CMS effort to define Home and Community Based Setting • Argentum support of intent of rule: Focus on resident centered care plan, choice, dignity
17
HCBS Waiver • Challenges to implementation • Inconsistent interpretation state to state • State agencies still lack understanding of AL • Administration extended time for compliance from 2019 to 2022
18
Elder Abuse Receiving national press attention • ACL • Legislation to reauthorize Elder Justice Act • Elder Justice Caucus in House • SCOA Fraud hotline
19
Elder Abuse • Kansas AG, President of NAAG, has selected Elder Abuse as the main issue for his term as President • Argentum developing guidelines/ best practices
20
Advocate
21
Educate • Communication Strategy
Senior Living Executive Magazine Argentum Daily Argentum Advocates for You Argentum Quarterly
• Events Argentum Conference and Trade Show May 14- 16 San Diego PPI/ Fly In Workforce Development Symposium
22
Innovate • Research Perceptions of careers in Senior Living Memory Care Innovations Quarterly Workforce reports
23
SENIOR LIVING 2025
OUR CRITICAL IMPERATIVES
24
SENIOR LIVING 2025
WORKFORCE DEVELOPMENT AN INDUSTRY OF CHOICE Growing a workforce of trained professionals to serve America’s seniors.
Adding new jobs by 2025, senior living employment will exceed 1.1 million. The industry will need to recruit million new employees by 2025. Argentum analysis of Bureau of Labor Statistics data, 2001-2014
The senior living industry outpaced average U.S. job growth by
. 25
Work Force Development Opportunities • Partner with Universities and Colleges to offer senior living courses/ degrees • Research on perceptions of careers in senior living • Retention / Turn Over metric
26
SENIOR LIVING 2025
QUALITY IMPROVEMENT AN INDUSTRY OF SERVICE Nurturing environments that enhance the quality of life for senior living residents
NCAL, National Survey of Residential Care Facilities
27
SENIOR LIVING 2025
QUALITY IMPROVEMENT of senior living residents currently are diagnosed with at least two chronic conditions. 1
Americans will be eligible for Medicare in 2030, causing significant strains on the program.2 1. Centers for Disease Control
of states made changes to assisted living regulations in 2012-2013.3
2. Centers for Medicare & Medicaid Services, Kaiser Family Foundation
3. “Best Practices in Managing Acuity Creep in Assisted Living� presented to a 2015 American Health Lawyers Association meeting
28
Quality Improvement Opportunities • Development of Industry Standards • Metrics/ Benchmarking • Center for Excellence – help all providers improve their quality
29
SENIOR LIVING 2025
OPERATIONAL EXCELLENCE AN INDUSTRY OF INNOVATION Improving the senior living business through innovation and technology.
Total wages within assisted living communities rose an average annual rate of 4.8% between 2001 and 2013 compared to all industries, which rose an average of 2.6%.1 of residential care communities used electronic health records for purposes other than billing or accounting.2
The senior living industry’s three main expenses are labor, food and utilities.3
1. Bureau of Labor Statistics, Social Security Administration 2. October 2015 Health Affairs
3. 2015 “State of Senior Living”
30
SENIOR LIVING 2025
OPERATIONAL EXCELLENCE Of top performing communities in the
area of quality of management, of residents, families, and staff would recommend their community.
National Research Corporation
31
Operational Excellence Opportunities • Continue to identify best practices for Labor, food and utilities • Increase efficiencies in senior living • Explore new partnerships – i.e. Lyft
32
SENIOR LIVING 2025
CONSUMER CHOICE AN INDUSTRY OF INDEPENDENCE Promoting strategies for financing long term care services and supports
Between 2015 and 2055, the number of older Americans with several long term services and support needs will increase 140%, reaching 15.1 million.1 Less than of Americans have purchased long term care insurance through the private market.2 2. Robert Wood Johnson Foundation, Congressional Budget Office
33
SENIOR LIVING 2025
CONSUMER CHOICE
1. U.S. Administration on Aging 2. Kaiser Family Foundation, 2015
34
SENIOR LIVING 2025
CONSUMER CHOICE Average life expectancy reached the high of years in 2014.
Aging baby boomers will lift the number of households aged 65 and over by 2025.
Centers for Medicare and Medicaid Services
Health insurance does not cover LTSS and Medicare does not cover most of these expenses.
35
SENIOR LIVING 2025
CONSUMER CHOICE 1/3 of Americans report they have no retirement savings 23 % have less than $10,000 saved
36
Consumer Choice Opportunities • Advocate for incentives to help people save • Educate consumers on cost of LTC
37
SENIOR LIVING 2025
MEMORY CARE AN INDUSTRY OF DIGNITY AND RESPECT Enhancing quality of life for senior living residents with Alzheimer’s disease and related dementias from care to cure. Today Americans are living with Alzheimer’s including an estimated 200,000 under the age of 65.1
older Americans are living with the disease.2 1. Alzheimer’s Association 2. Centers for Disease Control
Every 67 seconds someone in the United States develops Alzheimer’s disease.2 38
SENIOR LIVING 2025
MEMORY CARE More than of assisted living residents have Alzheimer’s disease or other dementias. Senior living industry best practices for dementia care include building design, memory boxes, Snoezelen rooms, enhanced dining experience and purposeful living. Centers for Disease Control
39
SENIOR LIVING 2025
MEMORY CARE Goal is Cure Identify innovations in Care
40
Future
41
Prediction • Someone is Always Watching • Good and bad events go viral in an instant • Be prepared to see yourself or your neighbor on Morning Joe or Jimmy Kimmel
42
Public Policy • Policy makers, regulators lawmakers have to respond to these viral media events • More knee jerk reaction to legislation
43
The Perfect Storm Terrible incident in Nursing home in Florida SCOA hearing Governor’s emergency rule All SNF and AL communities had to have generators within 60 days
44
Prediction for 2018 legislation • • • • •
Generator/ emergency preparedness bills Electronic Surveillance Protections from Elder Abuse Independent Living licensed as AL Increased training requirements for AL staff
45
SENIOR LIVING 2025
CONCLUSION • The next 10 years for the senior living industry is full of promise and opportunity. • Industry must embrace change and forge new alliances. • Stay focused on challenges in workforce shortage and public scrutiny on quality.
46
Maribeth Bersani – COO mbersani@argentum.org