As we begin a new calendar year and look ahead to what is in store for the next 12 months, it is worthwhile to also have some context with the year 2019.

Ten years ago at this time, we were still in the midst of an economic recession, the national unemployment rate was 7.6%, skilled nursing occupancy was nearly 90% and the Affordable Care Act was not yet in existence.

Today, most senior living organizations are struggling to find staff to fill vacant positions, and the dynamic healthcare environment and payment reform trends have redefined the skilled nursing landscape. There has been significant change during these past 10 years. I think we all can agree that the pace of change has accelerated and the sector is being reshaped in many ways. The year ahead will be no exception.


It does not require a skilled prognosticator to predict that workforce pressures will continue into 2019. We hope, however, that 2019 proves to be a year in which we move the needle on solutions and best practices. We need to spend more time exploring alternative staffing models, we need to implement creative benefits that get to the heart of employee needs, and we must to work together to create meaningful change for the sector at state, regional and national levels.

Recruitment and retention challenges arguably are most pronounced in skilled nursing settings. This is one of several pressure points being felt within our healthcare offerings. For 2019, it is anticipated that the skilled nursing business will continue to change. More than ever, providers need to be savvy operators and be able to thrive as the shifts continue toward value-based reimbursement. The October 2019 transition to Patient Driven Payment Model will demand that providers enhance operational efficiencies and focus on healthy outcomes. Providers have 10 months to prepare for this significant change.


Technology solutions will continue to grow. The demographic trends have caught the attention of many entrepreneurs and companies and, as a result, we have a steady stream of new innovations entering the senior living sector.

Many technology-based solutions can assist providers with their most pressing needs:

  • Data analytics software and web-based platforms are growing tools in the battling workforce pressures.
  • Telehealth solutions are enabling providers to reach elders in rural markets and to connect with specialists from afar.
  • Amazon Alexa and other voice-recognition software is increasingly being integrated into resident units.

It is important that senior living organizations designate resources to invest in these technologies and establish leadership positions to oversee strategic innovation and technology adoption.


We need to use the year ahead to explore partnership opportunities. Doing so will mean different things to different organizations, but we are confident that providers will turn to one another to navigate the increasing complexity of our business.

Every year, we see growth in joint venture relationships as providers create new models of service, particularly across home- and community-based service lines. We anticipate that affiliations and mergers will continue, but there will be just as many examples of providers partnering without moving through a formal merging of organizations. Size, scale and sophistication will be even more important to thrive in 2019.

Exciting times

There may be some surprises along the way in the year ahead, but we are in a position where we are fairly well-informed of changes to come. We are in exciting times, where our services are in great demand, and senior living providers are perfectly positioned to respond to the demographic age wave. Competition will continue to be fierce as today’s seniors have more options than at any other time in the history of our sector. As many of the baby boomers retire from C-suite positions, we will see the evolution of the next generation of leaders who will redefine business models and adapt to the plethora of changes ahead.

We need to be bold. We need to be comfortable with calculated risk. And we need to embrace collaborative work. These are challenges, but also exciting times with numerous opportunities. It is a good day to be in senior living.

Here is to a healthy and thriving 2019!

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