Download the 2021 Technology Supplement (PDF)

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Inside:

• 3 ways tech use during pandemic will change long-term care forever
  • COVID-19 alters technology investment
  • Wi-Fi expected today
  • It’s clear: Internet is a utility
• Technology helps tackle long-term care’s perennial top issue
• Operators pivot with technology to fill beds and units, ease move-ins
• Leveraging tech can streamline tasks in senior living, skilled nursing
• Pandemic sparks renewed focus on tackling infections in facilities
• Will tech continue to help providers combat resident loneliness?
• Tests of drones, Google Health could boost healthcare provision
• And more!

Minneapolis-based Lifesprk recently acquired 35 Tealwood Senior Living communities, bringing them under Lifesprk Senior Living. Lifesprk CEO Joel Theisen recently shared with McKnight’s Senior Living the company’s vision to bring people to services, not services to people, using technology and artificial intelligence. Dr. Bill Thomas, Lifesprk’s independence officer, is a key architect in designing the holistic model that will deliver this new experience.

Q: How did this latest move start? What was the thinking behind it?

A: We’ve been working in senior housing for 13 years with traditional home care, and we’ve been providing assisted living and memory care for quite a long time. About a year ago, we acquired our first full global risk value-based contracts with MA, one of the big payers in Minnesota. We said, ‘This is a great opportunity for us to bring all of our architecture into these aggregated sites, where there are a lot of seniors.’ We were already doing it, but we wanted to do it holistically and have the property management side. Some owners asked us to start providing services. They loved what we were doing and thought it was a good opportunity to come underneath the Lifesprk model.

Q: What will set these communities apart from an existing senior living community, or even a former Tealwood community?

A: We want to think that our design of how we serve people is setting-agnostic. What’s really different as it relates to senior housing is, we’re bringing not just primary care but 24/7 on-site geriatric expert medical services into all of these communities. So if someone has an acute event, we can serve them with a hospital at home or SNF at home, so they don’t have to go through very strenuous and, many times, dangerous, acute care events within a different system.

Another thing that’s different relates to the social determinant side. We built the Lifesprk brand around customer-intimate holistic services, and so we’re bringing that full complement, which we call our Lifesprk experience, where we discover what’s important in people’s lives. We build life plans—not care plans, not disease plans—that are directed by the customer and their family.

Then the third thing, which is really, really big, is the technology side. Lifesprk has probably invested over $30 million in the last three and a half years building two very, very important things. One, what we call our electronic life record, which is a new operating system that we’ve created around building and aggregating a lot of data, including medical data, claims data and other psychosocial and first-party data, to be able to build a pretty big data lake. And we have an insights engine on top that that we’re able to help our providers be able to have the right information at the right time. That’s longitudinal information and data, not just another electronic medical record. This is a very sophisticated operating system that allows us to understand and deliver high-value services to people.

And then on the other side of it is the analytics. We’re saying, ‘We’re going to really be accountable to you and your family to make sure that your outcomes, as they relate to your goals and what you want to see with your mom and what you want to to see in your life, happen.’ We’re going to deliver lower readmission rates. We’re going to deliver lower initial hospitalizations. We’re going to decrease falls. We’re going to decrease social isolation.

Q: Could you talk more about the technology and artificial intelligence Lifesprk is using?

A: Let me just give you a couple of ways we’re using it, from a provider standpoint. One of the things that’s really cool is, because we have a process, this Lifesprk experience, where it is so holistic and deep, we ask a lot of questions. We want to know, do you have food insecurities? What is your relationship with your support systems? What drives your happiness? All these types of things.

Let’s just use an example. Molly loves to go to church. She sees her friends at church. It’s really important for her spiritually. And so it’s important for her to be able to get to church.

So in our technology, we’re putting in some of these behaviors and these activities that are really important. We’re tracking data, lots of datasets, and as we go forward, all of a sudden we see that Molly hasn’t been to church four out of the last 10 Sundays. So it’s signal technology — ‘Hey, let’s make sure we interface there and talk to Molly about what’s going on. What are we missing here? Is this still really a goal? Is it transportation? Is it cost? Let’s go back and do some root cause analysis here and avoid what’s next, which is probably depression, probably a fall, probably failure to thrive.’ Something was maybe going on here that we want to proactively get in front of. We’re able to track where and how her medical situation is, but also how her emotional and psychosocial health is, both self-reported and also based on passive and active information.

So how do we get passive and active information? We also have the internet of things. We have a lot of [application programming interface] to a lot of products. We’re using everything from smartwatches, which are passive, to active Alexas, smartpads, telehealth. We have all of it, because we’re not just one-trick ponies.

So we’re connecting. And not only are we able to get information, but we’re able to curate content around education, advancement. If Molly likes basket-weaving, let’s push content to Molly around basket-weaving. It’s not that hard. Let’s make sure that we understand that this is part of her life plan. So we’re going to curate content based on that life plan.

It could also be medical things that we all know, algorithms for certain disease states and certain processes, but more importantly on the life-affirming type stuff. We’re able to push content as well through this electronic life record and database. I don’t know of anybody that’s able to pull that off in a macro way that’s really affecting these communities or these environments as globally as we’re going to be doing.

We really believe in population health. A lot of people say they do population health, but they don’t do population health. They do value-based services. Population health is really helping the community, helping the clients. We really want to be population health people and let people make informed choices. And this is such a great feeling to have this housing platform. Most people would like to stay in their own home, but at the same point, that’s kind of a little misnomer, because they don’t know any different. Nobody wants to go to a long-term care bed. That’s a given. A lot of people do better in their residential home in their community, and there also are people who do better in independent living or in an assisted living environment with people around them who care about them, who are meeting with them and talking to them everyday and engaged.

Q: How do you see these efforts helping to address some of the challenges that are facing senior living right now, such as occupancy or costs or workforce issues?

A: I don’t see us as having problems with occupancy, because people need and want social environments. It’s a good thing to be connected to a lot of other people. The differentiation is really key. We’re not that worried about occupancy, because the senior population is just going gangbusters. We’re on the front side of the age wave, and if you have really good services and you have a really good brand and a really good reputation, those properties are always going to be full.

As it relates to some of the challenges around workforce, we have dedicated a lot of resources to what we’re calling our Lifesprk University, where we’re developing real skills around this holistic model and customer service and service in general.

We recently had five home health aide positions that were open, and we had 50 people apply. Lifesprk never has used pool staffing. We’ve never used outside staffing, ever, and we won’t, because when you do the right thing in the world and you really commit to your culture and you really create the experience for people, that they can take their gifts and bring them to people in a real way, you draw people. Don’t get me wrong. Is it hard? Yes. But we have really worked hard on it.

Q: How has Dr. Bill Thomas been involved?

A: I’ve known Bill for about 15 years. He started working more with us about two years ago. Bill’s building out a whole new experience. It’s an intergenerational community aspect where we start to really, truly knock the walls down and instill community in these new buildings.

We’re going to create a much different connection on the technology side, where families will have deep access into this electronic life record so they not only can see what is going on but how they can participate in Mom’s or Dad’s experience.

As it relates to the greater community, we’re going to educate people already receiving services from us that they can become involved in the buildings we have near them.

As we think about intergenerational more deeply, we have some commitments to start to integrate additional housing for people who work on site.

Q: Will this model result in physical changes to the former Tealwood communities or new communities?

A: We are talking about physical adaptations. It’s evolving.

Q: Are you going to expand beyond Minnesota and Wisconsin?

A: Yes, 100%. We’ll probably start scaling nationally within 24 months. This housing piece was the last one we wanted to connect in there.

Editor’s note: An abbreviated version of this article appears in the June 2021 issue of the print magazine as the “A Few Minutes With…” department. 

A.  Yes, but creative thinking and innovative approaches will be required.

The middle market is comprised of older adults who have too much income to qualify for affordable or subsidized housing but cannot afford most of the private-pay options available in the market. They typically have incomes ranging from $25,000 to $75,000.

This affordability gap group is larger than the low-income and high-income groups combined and represents the fastest-growing segment of the senior market. It has been projected that the number of middle-income seniors aged 75-plus will nearly double by 2029 to 14.4 million.

Baby boomers are going to represent a significant portion of this middle market. The first boomers are turning 75 this year, and many have not saved enough money to get them through their retirement years. They have experienced life-changing events, including boom/bust cycles over the past 20 years, low savings rates and now the COVID pandemic. The future financial implications could be significant and will affect their ability to pay for senior housing.

Addressing these middle-market challenges will require creative thinking and innovative approaches. Some innovative solutions being investigated include public/private partnerships, repurposing existing/older buildings to senior housing, better use of technology and alternative service delivery systems.

This column appears as “You’ve Got Questions? We’ve Got Answers” in the June print issue.

Jim Moore is president of Moore Diversified Services Inc., a national senior living and healthcare consulting firm based in Fort Worth, TX, that has been serving clients for 50 years. He has written five books about senior living and healthcare, including “Assisted Living Strategies for Changing Markets” and “Independent Living and CCRCs.” He has published senior living bimonthly columns for the past 28 years. Moore may be reached at (817) 731-4266 or jimmoore@m-d-s.com.

The firm dispenses prescription drugs primarily through onsite automatic dispensing units.

LCS is rolling out a new initiative under its EverSafe 360° program to provide healthcare services to residents after hours.

The service provides access to healthcare services after hours, on weekends and holidays to residents in senior living communities managed by Des Moines, IA-based Life Care Services.
The program, a partnership between LCS and Tacoma, WA-based Sound Physicians, allows residents greater access to healthcare from their homes rather than leaving a community for a trip to the hospital.

A Tennessee senior living community was fined $2,000 by the state after two residents eloped from the memory care unit undetected last spring.

The couple, residents of Elmcroft of Lebanon in Lebanon, TN, walked out of a secure memory unit in March 2020 after the husband used his Morse code training from his military days to decipher the security combination used by staff members for the front doors. The couple reportedly live with dementia.

“The safety of our residents is the top priority at our senior living community,” Jamison Gosselin, vice president and chief marketing officer of Eclipse Senior Living, told McKnight’s Senior Living in a statement. “We reported the situation to the state and their family immediately after it happened and fully cooperated with the state during its review.”

Gosselin said the community has adjusted its safety measures, including but not limited to changing the exit codes. Eclipse also provided additional re-training to the care team at the community, he said.

“We may want to think about restructuring or rethinking the notion of separating post-acute care from residential long-term care, at least in some instances,” he said.

Older adults currently living in assisted living could be combined with traditional skilled nursing patients in a new, combined payment category, Mor said.

“Someone has got to make that decision, and it’s probably a good time, in general, for the United States to think about retrofitting or altering the physical plant of [communities],” he said. “How to do that in a way that is fiscally viable … is a real challenge.”

During the National Association for the Support of Long Term Care’s 2021 Legislative & Regulatory Conference, Mor questioned whether the current long-term care model is sustainable given design weaknesses revealed by the pandemic.

Long-term care facilities built in the 1960s and 1970s, he noted, served residents whose lives started in the 1800s. A new generation has “different expectations, different quality standards, different policy requirements and different preferences,” he said. “That means [operators] are going to have to respond in some way to that new world.”

The key to quality care for long-term care residents who need social support more than medical intervention may be in private rooms and smaller, Green House-style facilities, Mor said. Their small residential groupings and staff assignments were associated with lower COVID-19 risk.

These smaller facilities would have different missions, regulatory structures and quality metrics than buildings where post-acute care is provided, he added. But Mor acknowledged that separating out residents who have medically complex needs from those who need end-of-life or long-term care for chronic care won’t be easy unless policymakers tackle the costs of infrastructure and reimbursement.

This article appears in the June 2021 print issue as part of FocusOn: Design.

“The senior living space has been particularly negatively affected by the pandemic,” said architect Heidi Wang. She said that the new approach has been influenced by the COVID-19 pandemic
“We know that safety and health are now top of mind for everyone who is a part of senior living communities” she added.

Furniture prices rose sharply in April as the nation’s stimulus-fueled economy continued to rebound. In fact, almost all major components of the government’s inflation measure increased during April, the Bureau of Labor Statistics found.

Overall, April consumer prices rose by 4.2% from a year earlier. This marked the highest 12-month increase in more than a decade.

Former Treasury Secretary Larry Summers said he is concerned about recent spending increases under President Biden. Current Treasury Secretary Janet Yellen, however, countered that inflation remains under control, and that the federal government has numerous tools it can use to prevent a surge.

Home Instead recently made $30,000 available for local franchises to donate to senior living organizations.

The United States is well-equipped to provide more home- and community-based care, a public policy expert recently told an audience of senior living operators.

“There is untapped opportunity for more home- and community-based care,” said Stuart Butler, a senior fellow in economic studies at The Brookings Institution.

Such a shift would have major technology and design implications for operators. “We have the ability to make it safer for people to age in their own homes, to have medical care in their own homes, to have smart homes,” he added.