The first phase of Norterre will debut with accommodations for assisted living, memory care and skilled nursing residents as well as rehabilitation patients; a park for cultural activities; a health and wellness center; retail; child care; and dining. Construction of the second phase is planned to immediately follow, with independent living and non-age-specific housing options as well as more dining and retail.

Housing will follow the Household Model of Action Pact, Norterre’s developer, architect, construction manager and operator. Other partners in the effort include Liberty Hospital and Healthy Living Centers of America.

Steve Shields, CEO and managing partner of Norterre and CEO of Action Pact, recently spoke with McKnight’s Senior Living Senior Editor Lois A. Bowers about the project.

Q: For those who aren’t familiar with Norterre, how would you describe it?

A: Two primary, 30,000-foot-view characteristics make Norterre very unique. One is a multigenerational interconnection that links a set of programs that help people navigate the healthcare continuum seamllessly, to help transition the intent of a healthcare system that treats sickness to one where people can seek and achieve well-being.

Two, all of the common amenity space that normally would be reserved for the people who live in the senior living community — the restaurant, bar, theater, gym, computer lab, library — are part of the commercial and amenity space for the broader community. It’s a first example of a nonsegregated retirement community that also is not just a retirement community.

Q: What was the impetus for the community?

A: Action Pact sought a partnership with a hospital system that wanted to have a broader set of programs in its continuum than has been traditional. So we were coming to the table having short-term-stay households, long-term-stay households, assisted living households, and memory loss assisted living households. And in the process of those dialogues, we sensed a really visionary leader in Liberty Hospital CEO David Feess, who shared our opinion that the senior living piece needed complete reshaping. Our discussions also led to a much broader one about how the silos that are in nursing home care are also present throughout the healthcare continuum. The United States is No. 1 in cost in the civilized world and No. 37 in outcomes. We both agreed that the reason is the disconnectedness of all the components of the system. And because Liberty is a locally based, community-based but very effective system, we began to co-brainstorm about creating a medical fitness and integrated healthcare system along with senior living. And so it all became one project.

Q: Approaches where generations can mix are becoming more common in senior living. Why do you think this is?

A: People in the present generation approaching being old don’t want to live in ghettos. As wonderful as the present model of retirement communities can be — and there are wonderful things about them — it’s still a removal from society. Having a retirement community with a kindergarten is really cool, but it’s still a removal.

In our project, we’ve been careful not to use the word “intergenerational” because what it has come to mean is a senior living program that tries to get other age groups connected but is still segregated.

With a multigenerational approach rather than an intergenerational one, we’re trying to jump on further and say, “This is a complete leap toward people of all ages having life together while still recognizing the very special needs of each individual, regardless of how old they are.”

Then there are those behind the new Salt Lake City senior living community The Ridge, who want to turn that convention on its head. Instead of plain and simple, they went with elaborate and detailed. Old-fashioned got replaced with bold contemporary.

Some may see that approach as risky, but for The Ridge senior partner Dave Farrell and the design team at studioSIX5, it made perfect sense to go in that direction.

“I don’t buy into the notion that ‘old folks want that old folk-look,’” Farrell says. “I wanted something different, something contemporary, and gave designers the latitude to make it cutting edge.”

Opened in December 2016 for $35 million, The Ridge has 138 units for independent living, assisted living and memory care. Living area covers 160,000 square feet and occupies 3.3 acres in a neighborhood near downtown Salt Lake City. The area has spectacular mountain vistas, and Farrell says he wanted the building design to use the beautiful landscape at every turn.

Having worked with studioSIX5 before, he trusted a team of entry-level and senior designers to collaborate on a concept that would stand out and provide a “wow” factor.

“The Ridge was on board to try something new and challenge the status quo, so that’s what studioSIX5 designed,” says Shauna Revo, project design manager. “We sought inspiration from local, domestic and international high- end hospitality projects and challenged the market by making it applicable to senior living in Salt Lake City. It’s a fresh take on what will shape the future perceptions of this level of care.”

One of the main ideals of the contemporary scheme is to combine aesthetics and function to create resident engagement. So “human-scale” artwork doubles as an interactive display. For instance, the assisted living dining room features a dividing wall that also serves as a functioning abacus.

Another key design element is bringing the outdoors inside, so the decor features natural materials. Carpets in the corridors have an asymmetric pattern that simulates how the foothills meet the neighboring mountains. The corridors also feature decorative wood ceilings that mimic the natural geometry of the surrounding views.

Farrell wanted a contemporary feel for the community because he believes it offers the amenities that baby boomers want — panoramic mountain views, resort-style ambience, elevated food service and an active, youthful culture.

“This is a design that will be viable for the long term,” he says. “We have everything the boomers want, even if they are not quite ready to become residents. It already has impacted our current population, who, while not being younger themselves, are a young-thinking group.”

• Primrose Retirement Communities recently started construction on a new $4.9 million memory care residence in Lancaster, OH, which upon completion in spring 2018 will feature nearly 25,000 sq. ft. of living space for memory-impaired residents. The community will feature 24 private suites and will include a spa and beauty salon, coffee bar, library, dining and living rooms and an interior courtyard with a fountain.
• The historic Residences at Thomas Circle in Washington, D.C., recently completed an extensive modernization of its 63-year-old property. Located in a residential neighborhood blocks away from the White House, the refurbished interior now showcases the natural light and historical architecture of the surrounding community. The upgrades include a new space plan with multifunctional areas serving as social gathering spots and décor with classic furnishings and fine art landmark photography.
• Cedarhurst Assisted Living and Memory Care recently broke ground in Yorkville, IL. Along with 53 assisted living apartments, the memory care wing will host 20 residents.

A few things are abundantly clear:

• Surprisingly, the healthcare laundry business has fewer parallels with the hospitality industry than it seems at first glance.
• Although people who live in assisted living and long-term care communities want the same things hotel guests do when it comes to their linens, they’re likely to complain loudly and more often if they aren’t available, clean or comfortable.
• Seniors have a profoundly different set of physical issues, many serious, that a typical churn-and-burn hotel laundry isn’t built to handle. If factors like pH and caustic chemicals aren’t addressed, little problems get big very quickly.
• Residents also have expectations that typical hotel guests abandoned long ago.
• Owner-operators continue to make inexplicable mistakes, most of which are unavoidable. Others, including those influenced by strapped budgets, simply aren’t.

Resident expectations

One doesn’t have to go far to see just how much of a connection seniors make between the life they left behind and the smell and feel of clean fresh bed sheets. When it surveyed 500 long-term care employees, Procter & Gamble found 85% of them agreeing with the statement that residents who are surrounded by familiar sensory [laundry] experiences, such as softness or fragrances, say they feel more comfortable and at home in their living environment.

As Barbara Richter, healthcare segment manager at P&G Professional, explained in a recent blog for sister brand McKnight’s Long-Term Care News, “Rising expectations among family members of seniors are inspiring many extended care providers to offer more comforts and amenities to their residents.” Richter referenced a 2014 P&G survey of long-term care nurses, 98% of whom agreed that “the quality of the laundry system, including detergent, is important to a resident’s well-being.”

Still, the complaints roll in. “Residents today are more aware of their surroundings and the services that they receive from the retirement community,” says Bob Dibble, a director of business development for EMS. “They express their expectations quite well and let us know when we fail to meet them. Residents who are alert and accustomed to their quality personal linens at home may be vocal about the linen that is used in a nursing facility. Failure to meet their expectations will result in frustration and dissatisfaction with the entire facility experience, not just the laundry/ linen service.”

Among the complaints, according to Dibble, are stained towels and wash cloths, stained, holey or torn bed linens, missing or ruined personal clothing and poor laundry turnaround.

Many vendors say more and more non-skilled senior living communities are installing or adding new space for on-premise laundries, or OPLs. The primary motivation is better control in hopes of not getting all of the aforementioned complaints. As Ricky Munch, on-premise laundry manager for Pellerin Milnor Corp., observes, “residents want clean, quality linen delivered on time. An OPL gives the operator full control of the linen and the amount of inventory they have on hand to meet their residents’ expectations.”

“In terms of linen quality, most seniors want softer sheets and luxury towels with higher thread counts,” notes Seth Willer, national sales manager for Girbau Industrial. “With an on-premise laundry, operators enjoy complete control over quality, inventory, labor and production.”

“On-premise laundries are a big deal,” adds Bill Brooks, UniMac North American sales manager. “There’s a reason that facilities hire their own nursing and care staff and devote resources to train- ing. It’s about quality and ensuring that quality service is always delivered to residents. The same is true of the laundry. Processing laundry in-house not only is less costly than outsourcing, but perhaps more importantly, nobody will be more focused on the quality of finished linens than in-house staff.”

Willer claims the payback makes OPL a wise investment. “The value-added benefits of in-house laundry can typically outweigh the price,” he says. “Senior centers are looking to add amenities such as high-end sheet/bed packages to attract more customers at a higher premium. Equipment improvements can help you achieve better quality and production while maintaining a higher level of service.”

Willer said it’s futile to try to pull the sheets over residents’ eyes. “In many cases seniors are well aware of wash quality and the way in which linens feel and smell,” he adds. “Highly programmable washers and dryers and automatic chemical injection allow laundry operators to consistently clean a wide array of items according to fabric specifications.”

Still, Brooks and others believe higher-quality linens are only part of the solution. “For facilities opting for higher thread count linens, this is no small expenditure,” he said. “Therefore, the laundry must employ the proper processes to ensure not only a maximum lifespan for linens, but that linens emerge from the laundry with a high-quality look and feel.”

Meanwhile, Jim Keeley, vice president of management development for Healthcare Services Group, downplays the importance of expensive linens. “Upgrading linens [and] buying sheets and towels like they use at the Marriott or the Hilton does not really resonate with residents or families,” he says. “Higher-end sheets and towels are much more expensive and put even more pressure on the budget, making it even more difficult for the facility to buy what they need monthly. Secondly, no matter how top-end the linen is, the facility still only gets a limited amount of washings before the quality of the sheets and towels is compromised.”

Common mistakes

Owner-operators may look at the issue through a different lens, but vendors are quick to point to a few badly needed areas for improvement.

One of them boils to lack of education about laundry operations. “Whenever I’m asked about where laundries are falling short, it doesn’t matter if the industry is long-term care, hospitality or something else; most of the issues are due to a lack of information,” Brooks says. “Most laundry managers think they have a handle on quality, chemical usage, costs and labor. But few could quote the actual cost-per-pound to process laundry or whether quality procedures and prescribed cycles are being followed. This is exacerbated when it comes time to replace equipment or a facility looks at outsourcing laundry. There is no baseline on costs. So I think the biggest mistake I see is just not having an overall handle on the operation, figuring that if nobody throws a flag on costs or quality, everything must be operating efficiently. That is usually not the reality.”

Hector Loureiro, on-premise laundry business development manager for Laundrylux, asserts that too many OPL managers, wrestling with both facility and resident personal garments made of myriad materials, grossly under- estimate their capacity, and end up grappling with stockouts and a host of service complaints. A simple fix would be a sorting system, which many don’t have. There’s a more serious effect, however. “The proper separation between residents and wash classifications can put a strain on the daily wash process,” Loureiro adds. “Proper cross-contamination procedures is an area that any healthcare facility needs to look closer at. Some of these issues can be addressed by adding a smaller capacity washer to supplement the room laundry.”

Another common mistake is the dearth of “science” about the effect of laundry chemistry on linens and seniors. For example, harsh chemicals, and even seemingly benign things such as fabric softeners, can reportedly impede or even aggravate wound care or bed pad absorbency.

A fundamental understanding of managing material resources is the root of yet another major mistake: inventory management. Munch asserts that major outages simply can be avoided with the OPL approach because it “allows the operator to carry less inventory … [and] no longer depend on an outside company to deliver clean linen on time. Less inventory and less storage means the operator saves money.”

Keeley believes, in fact, that inventory, or lack thereof, is the biggest challenge long-term facilities face today with laundry. “Beside the requirement of meeting state regulations, not having enough linen in inventory leads to most of the issues facing the laundry and their attempts to provide quality service to the residents,” he says. The reasons for inventory snafus are influenced heavily by strained budgets, which force facilities to stock the bare minimum of linens needed. The problem is, something always happens to cause a sudden drop in supply.

“It’s the number one reason old and worn linen makes it to the floors,” Keeley said. “Facilities often do not have the proper monthly linen replacement dollars budgeted and, even when they do, administrators often see this area as a place to control their costs by only spending a part of their overall linen budgets.”

Finally, simple, yet misguided, organizational issues can lead to a host of mistakes. One solution — a good labeling system — could stave off common issues like misplaced or lost linens or personal garments, according to Grant Lorge, associate product manager, foodservice and environmental, for Direct Supply.

“In some facility laundry operations, the staff fail to sort the residents’ soiled clothes and check to see that each garment is labeled,” says Randy Brown, a director of business development for EMS. “They just load the washers and after drying, rely on memory, possibly returning the wrong item to the resident. Or, the item might just sit in the laundry until a resident inquiries about the missing item.”

Simple fixes

To recap: Seniors in assisted living can be demanding with laundry — to a point. They value thread counts, but even more, they value 24/7 availability and the TLC when handling their personal laundry. Check. More than anything, they attach value to the memory of cleanliness they were assured in the former lives. As Lorge observes: “We have seen that cleanliness in general can be linked to the perception of quality care. Having a reliable, fast and efficient laundry service helps to increase that connection. Also, as always, having a dependable laundry service also can help with an operator’s infection control program.”

P&G advises the appropriate use of fabric softeners, whiteness enhancers (to rejuvenate the dingy), phosphate-free cleaners with a near-neutral pH and pre-treating stains. It also encourages OPL staff to keep a 2-4 par linen level inventory at all times (to extend linen life), energy-saving machines, proper staff training and staying on top of things like “unique laundry room conditions such as hard water, aging equipment and water temperature.” It also strongly urges OPL staff to inspect every piece of linen and laundry before it gets sent to a resident’s room — something that dramatically cuts down on phone calls and nasty emails.

Over the past decade, assisted living residents have entered communities with more complex healthcare needs – especially with regard to physical, occupational and cognitive rehab. And based on the observations of rehab specialists, this trend has continued to grow.

“I can say very tangibly that assisted living was 10% of our business five years ago and now represents 25% to 40%,” says Paul Riccio, vice president of finance and development for Vertis Therapy. “That’s a huge uptick. It’s like a lightbulb turned on for senior living communities, that if they could offer the same rehab services, those residents wouldn’t have to go to a nursing home.”

In Riccio’s view, the trend toward rehab in senior living stems from a mindset change about optimal square foot usage. In the past, a senior living provider might have opted for a maximum number of residential units, whereas now rehab is seen as the key to higher occupancy rates.

“A rehab area may generate fewer dollars per square foot, but if they can keep 10 residents a year at the community, it pays off tenfold,” he says. “It has become a matter of maximizing the health and stability of the resident rather than looking at revenue generated per square foot.”

Matthew Mesibov, clinical physical therapy specialist for Centrex Rehab, says the trend accounts for a senior living environment that is designed for effective aging in place.

“Senior living communities recognize that quality and necessary therapy services help residents to function much better,” he says. “As a result, longevity of the residents remaining in the community can improve. In the current environment where aging in place is highly valued, providing rehabilitation services in a senior living community is consistent with this value.”

Overall, senior living communities are positioning themselves to offer all necessary services to their residents to help them regain function and live independently as possible, says Kathleen Weissberg, director of education at Select Rehabilitation. One reason why rehab hasn’t made inroads into senior living before now, she reasons, could be due to communities wanting to avoid the perception of being more “healthcare” than “hospitality” oriented.

“For many residents, there is a negative stigma associated with the ‘health center,’” she says. “For this reason, therapy services are available in the home, apartment or outpatient clinic.”

To be sure, senior living communities avoid the “healthcare” connotation, and that includes the rehab segment. “Wellness” is a term that seems to be much more palatable for all concerned, says Erik Painter, national director of community rehab services for RehabCare.

“Many communities have wonderful wellness centers, but the missing piece with these wellness spaces is that there are no structured programs for the residents, and often the residents don’t understand how the equipment works,” he says. “When the community has a strong rehab program, wellness is something that can be incorporated in their goals. Having the ability to address residents’ needs in their own environment is a huge benefit. You don’t need to have a full-fledged gym in order to address those functional goals.”

Different strokes

Rehabilitation is a multi-dimensional discipline designed for each individual’s unique situation. The skilled nursing sector has thrived on furnishing short-term post-surgical rehab, typically covered by Medicare or private insurance.

As senior living invites more rehab services into its fold for a higher-acuity resident base, is short-term post-surgical recovery part of their service offering? Based on rehab specialists’ observations, there is no definitive answer, but it’s a situation that can be assessed on a case-by-case basis. 

Pam Brooks, clinical occupational therapy specialist for Centrex, says regulations and reimbursement play a differentiating role in how rehab is provided in both skilled nursing and senior living sectors.

“As providers of therapy services in senior living, skilled nursing and home health, we find that rehab in senior living and home health allow patients to progress functionally in their own environment and is a good progression for patients who initially require more intense therapy and nursing services in a skilled nursing community,” she says.

Multi-sector rehab providers are equipped to handle whatever red tape is necessary for therapies, no matter the physical site. So for senior living communities to bring in the post-surgical rehab population, they can rely on a contractor like Vertis to meet all the requirements. Even so, there are financial considerations senior living providers need to make to determine whether the effort is worthwhile, Riccio says.

“All the appropriate equipment and staff can transfer over from one sector to another,” he says. “We have the expertise to do that, and they can lease to any provider that is the best service fit. But the double-edged sword is that the only revenue they get is fair market value from renting square footage, and we assume the financial and regulatory burden. That can be a scary proposition.”

Ultimately, though, Riccio says “we don’t look at the license on the wall. We look at that the elder in the room. The best tools aren’t focused on high-end knees and hips, but those focused on engagement.”

Christopher Krause, director of rehab for It’s Never 2 Late, also has seen the trend of senior living communities receiving more clients that “historically fit those normally seen in skilled nursing facilities.” Rehab therapies, he says, “are pretty much the same,” with the difference being “how the therapies are deployed.”

For example, he says that in senior living, rehab is used more as part of an outpatient benefit.

“An assisted living environment often lends itself to wellness programs and general health activities, where in skilled nursing environments, rehab is more clinically based due to the acute nature of the clientele,” he says.

As more patients and residents are receiving services through bundled payment arrangements and accountable care organizations, the emphasis is on providing the right amount of care in the right setting, Weissberg says.

“Providers are following sometimes detailed and complex algorithms to help them determine the best and most cost-effective setting to complete the patient’s rehab,” she says. “There are times when the patient’s complexity does not warrant a lengthy skilled stay, and these patients do go back to assisted or independent living and receive services through a home care agency or outpatient services.”

Boosting memory care

With senior living communities, most notably assisted living, bolstering cognitive rehab services comes as a natural extension of focusing on Alzheimer’s and dementia residents and adding memory support wings.

“There is a relationship between the growth of memory care in senior housing and rehab in this sector,” Brooks says. “Therapy services help maintain functional levels for those with cognitive impairments.”

Weissberg adds that although memory care has grown as a market niche for senior living, therapy services need to grow to keep pace.

“In settings such as assisted living communities dedicated to memory care that provide a specialized, safe and secure care environment for those living with cognitive impairments, they are often void of comprehensive rehabilitative services,” she says. “When rehabilitative services are available, they are often ‘as needed,’ not full time, and sometimes not on-site.”

As it relates to senior living, memory care has become “inextricably connected” to the sector, Krause says, citing a Centers for Disease Control & Prevention statistic that more than 16 million U.S. residents currently live with some kind of cognitive impairment. Alzheimer’s incidence is expected to rise to more than 13 million by 2050, when there will be more than 88 million Americans over the age of 65.

“The costs of caring for these individuals is already incredibly high and is only going to get more challenging as time goes by,” Krause says. “This, more than anything, is why memory care cannot be viewed in isolation anymore. Rehab is driving the intervention.”

A: Focus on fundamentals.

Many stabilized occupancies have dropped from the 90% plateau to the mid-80% range. Increased new competition has intensified demand versus supply balance. Many operators are struggling to sustain the critical 0.5% to 1.0% spread between annual operating expense escalation while executing market-responsive monthly service fee increases. Older communities are facing stiff competition from new competition. The average age of a new resident is increasing along with typical acuity levels. Direct care costs, in terms of minutes per resident-day, frequently are not measured accurately or monitored resulting in uncompensated cost creep. Increases in the minimum wage in a number of markets is affecting labor costs beyond just entry level workers as many other staff members also expect traditional increases in their wages. Staff turnover is increasing. The list continues.

The good news is that there are a number of practical, cost-effective strategies that can be implemented if we just … focus on fundamentals.

Jim Moore is president of Moore Diversified Services Inc., a national senior housing and healthcare consulting firm based in Fort Worth, TX, that has been serving clients for 46 years. He has authored five books about senior living and healthcare, including Assisted Living Strategies for Changing Markets and Independent Living and CCRCs. Jim Moore can be reached at (817) 731-4266 or jimmoore@m-d-s.com.

No matter who the resident is, what diagnoses he or she may have or what his or her preferences are, nourishment is necessary.

That is why senior living and healthcare providers from all across the spectrum are finding innovative ways to make the dining experience more exciting, beneficial and meaningful.

Operators around the country, and companies that serve them, are working to change the face of dining in senior living communities. They are sourcing local food, creating programming and making eating a social outlet for residents.

“We impact the lives of seniors everyday,” said Dori Mendel, senior communications manager for Morrison Community Living. “We are not only serving meals, we are serving socialization. We are entrusted partners helping seniors live their their best lives.”

Create programming

Nutrition is necessary to stay alive, but that doesn’t mean it can’t be an event, too. Many senior living communities are implementing programs to bring food into programming events.

Northbridge Companies, a senior living operator with communities in the New England region, for instance, held a “Chopped” style competition for one of its communities earlier this month. Residents had the opportunity to go to a local farm and pick the mystery ingredients. After, residents joined in on the meal the chefs prepared for the competition.

Jennifer Hastings, director of marketing for Northbridge Companies, said the residents love trips out to the local farm and getting to see the food used in the kitchen.

“They feel like they are part of something, and they are so involved in the choice,” she said.

Morrison Community Living, a comprehensive food and environmental services contract provider that serves all levels of housing and care, offers a variety of programs to its clients. Each year, the company offers an annual dining theme. This year, the theme is “heirloom.” The heirloom program features 12 residents and their traditional family recipes throughout the year. Residents have the opportunity to experience a dish that is an important part of a fellow resident’s past.

The company also offers a variety of programs, such as demo kitchens, where residents can watch live food preparation demonstrations and then join in on eating the creations afterward. Mendel cited an event where a community had featured a superfood such as blueberries and residents joined in making blueberry muffins that they ate for breakfast the next day.

Employees at Morning Pointe, an Ooltewah, TN-based senior living operator, agreed that meals are an important way for seniors to socialize.

“Mealtime to this generation is still an event,” said Bruce Fisher, senior food services director at Morning Pointe of Lexington-East in Kentucky. “It’s a social hour.”

Morning Pointe offers a Farm to Table program that uses in-season, local produce for daily meals. The program is made possible through partnerships with local farms.

Greg Vital, president and CEO of Morning Pointe, said Morning Pointe’s partnership with local farms gives residents a unique opportunity for life enrichment. They can take field trips to the farms and when they come back, do things such as snap beans or clean strawberries.

“With this program, we’re going back to our roots,” Vital said. “We want to show importance to our residents’ traditions and values by bringing this wholesome dining experience to the table.”

Keep it sustainable

Given the number of people residing in senior living communities, providers have the opportunity to make a difference environmentally by buying local.

Hastings said one of Northbridge Companies’ communities, Stroudwater Lodge, has a menu with 90% to 95% locally sourced food. The Eat Fresh, Eat Local program has been around since the company was founded in 2004. The company, which operates 16 (soon to be 17) communities, partners with 40 New England farms to bring fresh and local food to senior living dining.

Being a local business, it was important to support other local businesses, Hastings said.

“It is an opportunity for us to build our menu around seasonal ingredients,” she said. “Anyone wants that when they go out to eat a restaurant, so we knew that was something our residents would want.”

Morning Pointe’s Farm to Table program is a similar concept. Vital values it because of his commitment to the agriculture economy and local farms.

“Why shouldn’t we buy local if we can?” he said.

Taking a different spin on sustainable dining, Morrison Community Living offers a program called Imperfectly Delicious. This program partners with farms that have crops that come out looking less than beautiful, but they still have the same nutritional value as normal fruits and vegetables.

The program helps cut back on environmental waste, because the “imperfect” produce otherwise would end up unused. Last year, the program rescued 2 million pounds of produce, said John Rifkin, the senior corporate executive chef at Morrison Community Living. It even reduced food costs by 23%.

“It doesn’t matter if it’s not the perfect pepper,” he said. “We buy it, slice it, dice it and get creative with it.”

Residents and families both enjoy the priority Morrison Community Living puts on the environment, Rifkin added.

“Every generation has a sweet spot for giving back to the environment,” he said. “Once you tell people exactly what you’re doing, they feel proud that we go through such lengths to worry about environment, waste and resident health.”

It’s all about the resident

In the end, it really is all about how can the dining experience help residents.

Increasing nutrition is probably the first benefit of dining programs that comes to mind. The locally sourced fruit and vegetables is a great way to ensure residents are getting proper nutrition, Morning Pointe’s Vital said.

Teaching kitchens also can be a great way to show rehab residents proper cooking techniques, Rifkin said. Often, they are there for a reason, such as heart disease, that is linked to food.

It goes far beyond nutrition, however. There are many benefits for residents’ mental health as well. Food can help stimulate memories, which is beneficial for residents who have Alzheimer’s disease or dementia.

“If you cook something and they remember something like, ‘My wife used to cook chicken and dumplings,’ it’s just like that,” Morning Pointe’s Fisher said. “It goes back to the meaningful day where you cooking food that our residents used to eat, and prepare it the way they used to prepare it.”

Vital agrees. He said he believes residents find it reminiscent of the time they spent growing up on a farm or sitting on the front porch with their grandparents, snapping beans.

Northbridge Companies take it one step further. It offers a program called Memory Making Baking. The program allows memory care residents to bake an item. While they are preparing the dish, the same thing already is baking, so they can enjoy the smells of the dish while they are physically preparing it. Then they get to immediately enjoy the baked treat once preparation is done.

The company even is planning to create a “Memory Making Baking” cookbook for residents.

“It was developed to tie together the senses of touch, smell and taste with nostalgia,” Hastings said. “It is simple, but it has been hugely successful.”

Aside from all the health benefits, food is a common thing all residents share, so it is a step toward creating more connected and meaningful experiences for residents.

“We really are of the mindful that food and taste are so important to all of us as individuals,” Hastings said. “That doesn’t change as we age.”

This year, the number of businesses, public schools, universities, tribal governments and nonprofit organizations victimized by W-2 scams increased to 200 from 50 last year, the agency said. Although the number may seem small, W-2 thefts at those 200 employers translated into several hundred thousand employees whose sensitive data were stolen, the IRS said.

In fact, earlier this year, the FBI said that there has been a 1,300% increase in identified losses — with more than $3 billion in wire transfers — since January 2015.

“These are incredibly tricky schemes that can be devastating to a tax professional or business,” IRS Commissioner John Koskinen said in a statement. “Cybercriminals target people with access to sensitive information, and they cleverly disguise their effort through an official-looking email request.”

In a W-2 scam, a cybercriminal impersonates a company or organization executive’s email address and targets a payroll, financial or human resources employee with a request. In some cases, the fraudsters will try to trick an employee into transferring funds into a specified account via a wire transfer or will request a list of all employees and their W-2 forms.

National and international organized crime groups are behind the scams, according to the FBI, and those groups have targeted businesses and organizations in all 50 states and 100 countries worldwide.

W-2s contains employees’ names, addresses, Social Security numbers, income and withholding amounts. That information can be used to file fraudulent tax returns or can be posted for sale on the internet.

The IRS shares three tips for employers regarding W-2 scams:

• Businesses and organizations affected by W-2 theft can report it to the IRS at dataloss@irs.gov. Include “W-2 scam” in the subject line, and in the body of the email include company contact information.

• Businesses and organizations that receive suspicious emails but do not fall victim to a scam can forward the email to phishing@irs.gov with “W-2 scam” in the subject line.

• The IRS recommends that employers review their policies for sending sensitive data such as W-2 forms and making wire transfers based solely on email requests.

“QCP has no credible party or plan for taking on HCR ManorCare’s industry-leading role,” ManorCare told employees Friday in a letter obtained by McKnight’s.

The letter followed the Bethesda, MD-based QCP’s Thursday evening press release indicating that the real estate company was exercising a provision in its lease agreements with Toledo, OH-based ManorCare that enables it to ask for the receivership, since ManorCare has defaulted on its rent obligations.

“QCP believes the independent receivership agreed in the lease will address conflicts of interest at HCR ManorCare corporate headquarters, serve the interests of patients and residents, save jobs for facility employees and, ultimately, position QCP to deliver long-term value to its shareholders,” the real estate company said in the statement.

The ManorCare letter called QCP’s action “hostile” and said it had made a good faith effort during master lease negotiations.

The legal complaint “is an insult to our frontline caregivers and the corporate staff who provide support to their coworkers in the field,” ManorCare told employees. Further, the company said, QCP’s assertion that executives have conflicts of interest “grossly mischaracterizes the actions of our board, investors, management team and the confidential settlement discussions that have occurred between the two parties to date.”

QCP said that if the California court grants its request for an overseer, it will work with the receiver to transition ManorCare’s properties to new owners or operators.

“Looking ahead, QCP intends to pursue a regionalization strategy that will offer new investment and new opportunities to local managers, capitalizing on the strong teams already working at the company’s facilities,” the real estate company said.

In the meantime, all ManorCare facilities are open, and QCP said it expects care and services to be uninterrupted.

ManorCare serves more than 195,000 people annually at 59 assisted living communities, including independent living or memory care at some locations; 237 skilled nursing facilities; 108 hospice and home health agencies; and 50 outpatient rehabilitation clinics, according to a 2017 report from the company. Those properties and services employ more than 50,000 people.