An illustrious panel of experts:
Pat Mulloy, CEO, Elmcroft Senior Living
Patricia Will, CEO, Belmont Village Senior Living
Judd Harper, COO, Arbor Terrace Senior Living
Chuck Herman, Executive VP and Chief Investment Officer, Healthcare REIT
Paul Donaldson, AIA, LEED AP, principal, Perkins Will
Stephanie Handelson, President and COO, Benchmark Senior Living, participated in a session, The Future of Senior Living, at the Assisted Living Federation of America (ALFA) conference in Dallas. Ms. Will particularly impressed me not just with her knowledge and experience but with her realistic attitude that assisted living is not in a silo, acknowledging the role of other provider types and the hard and needed role of regulators.
The session started with an easy question! What business are we in?
One panelist offered that the hospitality model does not exist anymore. Clearly a shift into clinical care and therapy is taking place. And panelists agreed that the great rate of cognitive fraility is something that must be addressed. While age demographics seem to be consistent, the real challenge becomes building flexible communities where someone say with a physical disability will feel comfortable in a dining room with a cognitive impaired person.
The acuity issue is one of the biggest issues I noticed being talked about this conference versus last year. And I see a collision between the nursing home industry and the assisted living industry brewing unless cooperation and collaboration start.
Both industries want to be partners with hospitals. The nursing home industry has a leg up. It's reimbursed by Medicare and Medicaid like hospitals. It is regulated similarly to hospitals and they measure key indicators on a more apples to apple basis with their hospital partners.
As an ACO partner, assisted living can not share in bundled payments as they are private pay but hospitals are hinting that they would share some of their gain sharing with assisted living say funding a nurse practitioner to triage and keep people out of the hospital. Going back to statistics cited in another ALFA session, the value proposition assisted living could bring is that they deliver care four percent cheaper.
The conversation moved on to regulations. Will told attendees that to the extent the industry demonizes the regulators because they (the regulators) are looking at choice for consumers, the more the industry performs a disservice to itself. "We need to humanize ourselves," she said.
Regulators want consistency and predictability and that is hard to do when populations are blurring. Still on a state by state basis panelists urged members to get involved with ALFA chapters and to start working with regulators.
Mentioned often during the conference was the need to educate hospitals, regulators and legislators on what assisted living can provide.
Perhaps an example of cooperation, collaboration and education can be found in a new hospital in Voorhees, NJ that is part of Virtua Health. On campus, there is a rehabilitation center and a separate assisted living residence.
The assisted living industry has to come to grips with a strategy for the future and different providers will craft different visions.
Can assisted living really play in the higher acuity space or can it co-exist with others where all players have their place? The regulations for now often answer the question.
Still, I would think the industry has been secretly grateful that they are not as tightly regulated as their SNF and hospital partners.
To get what it wishes, the ability for aging in place in assisted living, the industry may end up receiving something it did not wish for and that is more scrutiny and regulation.
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@ALFA
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