A.  The primary market area, or PMA, for a senior living community should represent the area from which a community likely will draw the majority of its residents.

Traditionally, the PMA has been defined as a radius around a site location – many have erroneously assumed a one-size-fits-all approach. Actual PMAs often are irregularly shaped and represent different sizes with respect to overall population and geography. A defined PMA in a densely populated urban area typically will be much smaller than in a low-density rural area.

Consideration for the PMA definition should include drive times, natural and man-made barriers, psychologic boundaries and potential affiliations with relatives or affinity groups. For ease of access to or acquisition of demographic data, PMAs typically are defined using discrete political subdivisions such as cities, counties, ZIP codes, census tracts or other geographic considerations.

Existing senior living communities have a wealth of information at their disposal if they have properly recorded the background on their residents. Analyzing the ZIP codes that their current existing residents actually came from can allow an operator to compare the assumed PMA (prior to opening) with the actual PMA being served. This information can assist with future target marketing and communication activities.

Accurately defining and understanding the PMA is critical to assessing the potential demand and success of any new senior housing community or healthcare facility.

Dina Capek, health services director at Royal Oaks, a Sun City, AZ, retirement community with independent living, assisted living and memory care, recently spoke with McKnight’s Senior Living about how COVID-19 has resulted in changes in the use of technology in senior living.

Q: Before COVID-19, how was Royal Oaks using technology?

A: We use a lot of different technology in our community, and we have for a long time. We have had an electronic medical record since 1999. We were the first long-term care community in Arizona to convert to an all-electronic medical record. And we use a whole host of technology, from our in-house TV to technology for human resources processes to logging in visitors and guests.

Q: How did the pandemic change the community’s use of technology?

A: We started using the secure messaging part of our family engagement platform (Royal Oaks is a Caremerge client). I asked our families early on, “Do you know of anybody who’d like to make face masks for our staff and our community?” We’ve had face masks mailed to us from so many places. But we also let them know what we’re doing and how we’re doing. That’s been something that’s been very well-received by our family members.

We also have a great resident portal, so we were able to add some services to our community. Primarily for independent living residents, but also for assisted living residents who want to use it, we set up an go onto our portal, where we have a list, and they can check off what they want and how many and then submit that list. We have personal shoppers here who can bag those items and deliver them to their door.

We also have Gourmet to You, meals to everyone’s rooms. Residents can go onto the portal and select what items they want to order for each of their meals. Our staff  takes those orders and makes sure we deliver what they ordered.

When COVID happened, we had to close our 12,000-square-foot fitness center, which was logging 3,500 to 4,000 visits each month. That was devastating to so many residents. We have a very active population. So we immediately began using our in-house TV to do live broadcasts every day. In fact, almost all day long, we’re offering something on our TV — fitness, spiritual and devotions and meditation, trivia games, lectures, storytelling and educational programming. A lot of these programs are done by our volunteer independent living residents.

An event coordinator formerly was planning live events for people in independent living, so she has converted to providing a variety of options through the in-house TV. 

Our life enrichment staff members also have time slots each day to provide activities for our residents in assisted living and are setting up video chats for assisted living residents and family members. Some assisted living residents have their own devices and go onto the portal themselves, and others use a community computer.

Many of our memory care residents are able to use a community computer to check email with some assistance from our life enrichment staff. We want to be sure they still can keep what skills they’ve had or what routines they’ve had for as long as they can in those settings as well.

Q: Do you think that some of these things will continue after the virus no longer is a threat?

A: I absolutely do. Our management team has talked a lot about that. Obviously, we want to get to the point where we can responsibly open all of our dining venues, but that will look a little different. We recognize that, and we’ve received a lot of positive feedback from our residents, who say, “This is so convenient” and “Could we continue to order in if we don’t want to come down to one of the dining venues?” We’re looking at a number of things that may stay in place after things restabilize.

Q: What other lessons have you learned from this experience?

A: From a technology standpoint, we are able to put our interdisciplinary team into the family chat, so it’s a collaborative approach to information that keeps everybody informed of what the families are interested in but also what we’re sharing with the families.

COVID itself has really broken down silos for us. Not that we were such a siloed community, but it’s just the nature of the beast. Food service, environmental services, security, maintenance, healthcare workers — by nature, people are doing very precise and different types of jobs. 

What we’ve seen is a partnership with all of our staff. We had to look at how we were working. Our marketing team members have all become personal shoppers and are helping our food service staff take orders. Our resident service coordinators, because they have fewer appointments and less paperwork to process and things to coordinate for residents, are helping food service confirm food or grocery orders, and they’re helping to bag and deliver. Some people from environmental services and transportation are helping to manage our gatehouse or helping to screen our residents and visitors coming on the property. 

We’ve seen such camaraderie with our staff saying, “Yes, I can help.” That’s just been beautiful. So even in the worst of times, we’ve seen the best of each other.

The Overland Property Group puts a capital “B” on boutique for its new community in Leawood, KS, The Boutique Retirement Club at Ironhorse. Also referred to as The Fairways of Ironhorse, the independent living community aims to be a pre-eminent luxury living center in metropolitan Kansas City.

Not only does the new community focus on elegance and ornate details, it also incorporates 21st- century technology to provide a new level of service for its upscale residents. Overland Property Group jointly owns BRC at Ironhorse with partner Midwest Health and promotes the new community’s “stunning architecture and environment, dining run by professional restaurateurs and staff dedicated to a new high end for boutique retirement.”

From a design perspective, each space is intended to convey luxury, comfort and a refined aesthetic, says Steven Fox, director of marketing for Overland Property Group.

“The textures, materials and furnishings are all the finest available and attention to detail is evident in every space,” Fox says. “Each space is complemented by fine art, curated by the Eva Reynolds Fine Art Gallery, and the community is also home to their satellite gallery space.  Both local and nationally recognized artists are represented.”

The foyer is designed to be spacious and airy, the Belle Elegant Dining Room is designed for fine dining and overlooks the patio and putting green, while the Reckless Wine Bar is a club-like space that encourages conversation over drinks. Other features include an indoor salt-water pool, full-service salon and spa, theater, art room, heated underground garage and dog park.

A wellness studio features advanced equipment from senior living fitness provider HUR USA. Along with stationary bikes and elliptical equipment, the wellness studio offers yoga, tai chi and other therapy options provided by a staff physical trainer and in-house therapists.

In keeping with the equine-themed brand, the inspiration for the dining room, wine bar and other formally named spaces comes from famous horses.

21st-century tech

Beyond the aesthetics, BRC at Ironhorse partnered with senior living digital communications firm Touchtown to build an information technology infrastructure that includes a customized app to connect residents with their community.

“Older adults enjoy the convenience and connection technology offers as much as anyone,” says Lindsay Evans, Touchtown’s director of product management. “The BRC team recognized that and has over-delivered on the wants and needs of their residents in every way, including through the app.”

The app can be downloaded for use and is accessible through the voice-activated Alexa system so residents can orally ask for community information. Digital signs throughout the community and an in-suite TV channel also keep residents informed.

To manage and maintain the IT infrastructure, the community has its own tech support department at residents’ disposal. Having that help “makes it easier to learn and be more comfortable with all the technology in the community,” Evans says.

Atria eyes summer opening: As of press time, Atria Highland Park planned to begin offering assisted living in Highland Park, IL, this summer. The community will offer studio, one- and two-bedroom apartments with flexible leases and no buy-in fees. Among the on-site amenities are an art studio, full-service salon and spa, movie theater and restaurant with table service. The service portfolio includes chef-prepared meals, scheduled transportation and discrete care available 24/7.

The Springs opens doors: The Springs at Lake Oswego (OR) held a ribbon-cutting in January to celebrate its opening for more than 250 residents aged 62 or more years. The community features independent living, assisted living and memory care.

The new community has a full range of amenities designed to encourage social interaction as appropriate.

Wellness maven Cristina Cuomo (wife of CNN host Chris Cuomo) recently advocated taking baths with a quarter cup of Clorox bleach added to the water. In a blog, she noted the practice helped her “combat the radiation and metals in my system and oxygenate it.”

Clorox bleach contains water, sodium hypochlorite, sodium chloride, sodium carbonate, sodium chlorate, sodium hydroxide and sodium polyacrylate. It is widely used in senior living settings as a cleaning disinfectant. Several of its ingredients may be harmful to humans, however.

In a post addressing possible dangers, manufacturer Lenntech noted: “After swallowing sodium hypochlorite the effects are stomach ache, a burning sensation, coughing, diarrhea, a sore throat and vomiting. Sodium hypochlorite on skin or eyes causes redness and pain.”

In a related development, the firm that makes Lysol has urged customers not to consume its cleaning products. The warning came after President Donald Trump suggested that injected disinfectants might protect people from coronavirus.

Reckitt Benckiser noted that human consumption of disinfectant products is dangerous. It issued the statement following “recent speculation and social media activity.”

“As a global leader in health and hygiene products, we must be clear that under no circumstance should our disinfectant products be administered into the human body (through injection, ingestion or any other route),” the firm said in a statement.

RB said products should only be “used as intended and in line with usage guidelines.”

Following widespread criticism, Trump later said his suggested remedy was made sarcastically. Currently, there is no approved cure or vaccine for COVID-19. At press time, more than 4.8 million people worldwide have tested positive for the novel coronavirus, according to data from Johns Hopkins University. More than 319,000 people have died.

FOCUS ON BATHING / LIFTS BRIEFS

• Arjo recently announced a new distribution partnership with therapeutic seating provider Seating Matters. The partnership will give Arjo exclusive access to the entire Seating Matters collection of tilt-in-space chairs for patients and residents at risk of pressure injuries and falls, as well as bariatric patients and those with dementia. “The Seating Matters line of chairs fits perfectly within the current Arjo portfolio,” said Anne Sigouin, North American president of Arjo. “Both companies promote safe, early mobility, and we both have the goal of helping our customers to reduce pressure injuries and falls.” Arjo is a global supplier of medical devices – including bath tubs – intended to improve quality of life for people with reduced mobility and age-related health challenges.

• Hill-Rom Holdings Inc. reported second-quarter fiscal 2020 adjusted earnings of $1.28 per share. The figure marks a 12.3% increase from a year prior and surpassed the Zacks Consensus Estimate by the same margin. 

• Invacare saw improving sales in the first quarter of 2020, thanks largely to a 4% increase for mobility and seating products. The firm expects the coronavirus pandemic to negatively affect second quarter earnings, however. “We were very pleased with the mobility and seating performance in first quarter 2020,” said Matthew Monaghan, chairman, president and CEO. “We have been growing our commercial organization and improving our new product launch processes. The results in mobility and seating, especially with power wheelchairs, were strong.”

• The patient-handling market, which includes lifts, currently totals $8.9 billion. The number is projected to surpass $12.6 billion by 2024, however, according to a new MarketsandMarkets report. The analysis credits three likely growth drivers: a rising geriatric population, caregiver injuries and likely safety regulations.

“We really are agnostic from a vendor perspective,” said Cheryl Field, chief product officer of PrimeCare Technologies, a data warehouse and claims clearinghouse. “Facilities have so much of this technology, and it’s challenging to get it all to make sense. Can you imagine having a separate iPhone for every app you use?”

The amount of data now being mined from resident behaviors by way of wearables, smart devices and sensors is mind-boggling.

“Whether you’re living at home, a residential community, a skilled nursing facility or another kind of senior living environment, combining the concept of the connected home with connected care is extremely powerful,” said Robert Venditti, director of research and development for Philips Lifeline, a medical alert solutions company. “There are devices today that can compile data and sense different aspects of engagement with the senior, whether passively or actively.”

The data then can be used to spawn alerts and notifications, or to provide a dashboard showing the senior’s status, he added.

More and more senior living organizations are finding all kinds of ways to leverage all of this data, said Jim Rubadue, chief customer officer at OnShift. Some are leveraging technology to drive efficiencies and optimize business processes that can point to tangible data and outcomes to prove results and share this information with their partners.

“In addition, many senior living providers now have teams of data analysts looking at their data from a holistic viewpoint, so managers and others can more easily take action based on this information, ideally in real-time,” he said.

In the end, resident security tech also is providing much-needed eyes, ears and hands for senior living workforces decimated by staff turnover and attrition, and it is showing providers how to marry their labor, clinical and employee satisfaction data to uncover trends and opportunities at a large scale.

Most experts agree that data’s role in this sector will only grow. Analysts see it helping improve both resident services and the bottom line in ways that would have once seemed unimaginable.

Across the skies of west central Florida, drones are retrieving prescription medications from CVS Pharmacies and delivering them to The Villages, one of the country’s biggest retirement communities. The first flights will be less than a half mile, with the potential to expand deliveries from two additional CVS pharmacies in the area, according to UPS. The ultimate goal of the program is to make deliveries directly, with the drone lowering packages by winch, according to the company.

Meanwhile, Connecticut-based Maplewood Senior Living found a creative way to support its residents while maintaining their overall health and wellness by introducing robot “friends” to its 15 communities in five states.

The COVID-19 pandemic and its attendant lockdown inspired Maplewood to introduce  “Temi” robots, including Quincy, MA-based Connected Living, to residents of its communities ahead of a planned rollout at its Inspir Carnegie Hill luxury high-rise in New York City.

Brian Geyser, vice president of clinical innovation and population health at Maplewood Senior Living, said the plan was an opportunity to “pull the trigger” on a program to help residents cope with social distancing.

“They’re cute. They’re entertaining. The residents love them,” he said of the robots. “They have kind of personalities. They tell jokes, and they’ll give the weather and they’ll ask questions. They’re just nice to have around.”

Equipped with pre-configured tablets, the robots come with Alexa-enabled skills, a TV channel with programming designed for seniors and a smartphone app to help residents stay connected with their families.

A 2018 study by Perkins Eastman predicted that artificial intelligence and robots would be the leading disruptors of the senior living market.

FOCUS ON FURNISHINGS BRIEFS

• Senior living communities across the country faced mounting uncertainties in the early days of the global pandemic. A major unknown: when to push “go” on a host of unfinished renovation projects. That didn’t preclude the need for furnishings, however. For example, Stance Healthcare, parent company of Open Road Furnishings, found itself fielding a slew of urgent orders for furnishings to outfit “pop up” testing clinics and temporary hospital spaces. In response, the company implemented a “quick ship” program to expedite facility requests. The company was able to get furniture to clients in fewer than 15 days.

• Mark Huxta, director of healthcare for Ecore, said the company focused on assuring customers that its plants were building furniture for facilities and shipping samples to architects’ homes, all while the provider community found itself in the fog of COVID chaos.

• Sherwin-Williams has created an Architect and Designer Support Center, a dedicated website to point professionals to educational tools and creative resources to help them navigate today’s challenging times. The online resource center provides access to Sherwin-Williams insights, continuing education and news. Key sections of the center include business resources, educational opportunities and a special COVID-19 response hub, where visitors can read inspiring articles.

• Kwalu has partnered with Clorox Healthcareto target the reduction of healthcare-associated pathogens. Kwalu’s non-coated, non-porous Clorox compatible furniture can withstand the most rigorous cleaning protocols while exceeding hospital furniture standards, the company said. Through the partnership, Kwalu will combine Clorox Healthcare’s portfolio of disinfectants with Kwalu’s non-porous, non-coated furnishings.

• H Contract has debuted in the tablet and power source seating category. Developed for senior living common areas, the chairs were designed to “float” in a room.

The move, Gleckman suggested, could be an opportunity for the federal government to shift the blame to providers. Operators reluctant to reopen also could be forced to deny resident family members’ visits, thereby opening them up to criticism from relatives. 

“Like the administration’s move to shift responsibility for reopening businesses to states, this also would put the burden of deciding who is allowed to visit on states, as well as on facilities themselves. And it would create White House deniability when angry family members confront management of nursing homes and assisted living facilities, demanding to be let in,” Gleckman wrote. 

“If a facility turns relatives away, it is the facility’s fault. If it lets people in, and cases accelerate, it is the facility’s fault,” he added 

Gleckman said that although residents are “paying a severe price for being isolated,” it doesn’t make sense to allow visitors again without ensuring that providers have adequate and immediate testing and personal protective equipment. The decision to reopen facilities, he suggested, should be “based on careful benchmarks that all parties adhere to.” 

“The U.S. has failed to establish coherent, enforceable protocols for much of its COVID-19 response. It would be a tragedy if it fails to do so when it comes to opening up long-term care facilities that have seen so much death already,” he wrote. 

In a related development, President Trump urged states May 11 to universally test all nursing home residents and staff and suggested that such testing should have happened earlier.

FOCUS ON RESIDENT SAFETY BRIEFS:

• Zeally Health is among the latest telehealth services available over video or phone. The cloud-based software as a service lets doctors consult with a patient in a HIPAA/HITECH-compliant environment and can be licensed to an individual provider, practice or physician group. “As we learned with the COVID-19 outbreak, the demand on the healthcare system can change literally overnight,” said Rey Colon, founder and CEO of MyTelemedicine, Zeally’s software engine. “We want to ensure that people can get the medical attention they need 24/7, no matter where they live.” MyTelemedicine has been serving patients since 2015. Since its launch, the company’s virtual care platform has helped almost 2 million patients and facilitated more than 125,000 virtual consultations nationwide.

• Digital engagement provider iN2L has launched enhanced tablets as a tool for family and telehealth connections during precautionary isolation measures taken by senior living communities.The senior-friendly tablets come with video chat and other tools to bring families together during the COVID-19 pandemic — and afterward. With a tap on the iN2L tablet touchscreen, residents can “visit” with loved ones whenever they want. Residents initiate a video call to friends or family and can talk to up to seven people simultaneously in one session.

• A new study shows that the HEPA filtration incorporated into the XLERATOR Hand Dryer can contribute to improved hand hygiene. New viral filtration efficiency testing conducted by LMS Technologies found that XLERATOR and XLERATORsync Hand Dryers with HEPA filtration systems remove 99.999% of viruses from the airstream. “In these unprecedented times, the health and well-being of our customers is our main concern and it was important for us to confirm how our products interact with viruses,” said William Gagnon, vice president of sales and marketing at Excel Dryer.

Download the 2020 Technology Supplement (PDF)

View the digital edition of the 2020 Technology Supplement.

Inside:

• McKnight’s Tech Awards open for entries
• More embracing EHRs, HIEs, study finds
• Initiative may quicken COVID-19 testing
• Older adults like email, looking up weather
• Study finds ‘digital divide’ with internet use
• Drug info now accessible via Alexa queries
• Tablets to the rescue: Devices facilitate family communication when in-person visits aren’t possible
• Flipping the switch: Operators across the senior living and care spectrum embrace telehealth
• Robots and drones: Pandemic shapes use of technology for older adults
• Tech use balloons in shrinking COVID-19 world: Devices and virtual care capabilities have become more than accessories
• 4 costs associated with tech adoption
• 2 steps to help with cyberattacks, data breaches
• Telehealth innovations are on the horizon
• AI and predictive analytics are coming