A year ago, nobody in the U.S. senior living industry would have predicted that a pandemic would upend everyone’s personal and professional lives in 2020. But COVID-19 undoubtedly was the story of the year, permeating almost all other news in some way from March onward.
Although it’s difficult to know all of the long-term effects that the coronavirus ultimately will have on the industry, it’s safe to say that senior living will never be the same.
Bringing care — and tech — to the forefront
For example, for an industry that differentiates itself from skilled nursing in part by marketing freedom and choice to prospective residents — and, often, services rather than care — the pandemic accelerated operators’ moves to directly or indirectly provide medical care to residents. It also forced most to implement strict visitation policies, symptom screening and mitigation measures such as physical distancing, mask-wearing, hand-washing and the limiting of group activities, including dining.
As operators sought solutions to the isolating effects of their safety efforts, technology use across communities increased greatly, enabling residents to visit with family members via video conferencing and to address health issues via telehealth, to limit their exposure to the potentially infectious outside world. And robotic pets, robots and drones were commissioned to help keep residents engaged and to solve other challenges.
And on the marketing front, virtual tours became a more popular way to show communities to prospective residents and their families.
In the federal eye
Advocacy efforts by operators and industry trade associations were especially visible this year as companies and groups sought personal protective equipment, testing, funding and vaccine prioritization from the federal government. The efforts continually have put the senior living industry, primarily regulated by state governments, in front of federal politicians and officials as industry representatives made the case for equal footing with skilled nursing providers and other healthcare providers when it came to having their COVID-19-related needs met.
The spotlight on the industry was shining especially brightly in late April, when three members of Congress gave the CEOs of 11 of some of the country’s largest senior living companies just a few days to detail the extent of COVID-19 at their communities as well as the actions they were taking to prevent or mitigate the disease. Answers in hand, in early July, the lawmakers introduced the Assisted Living Facility Coronavirus Reporting Act, which they said was meant to address issues related to COVID-19 infections, hospitalization and fatality rates, sick leave policies for employees, testing and PPE in senior living communities. The bill never went anywhere, but numerous industry experts believe that some sort of federal regulation is not out of the question as operators continue to seek aid. (Industry trade associations vow to fight such efforts.) The industry is eagerly awaiting the outcome of two Senate races in Georgia to be determined by a runoff election in January, which will decide whether both houses of Congress, in addition to the presidency, are controlled by Democrats, who historically favor regulation more than Republicans.
In addition to educating members of the federal government, the industry’s advocacy efforts may have helped clarify the differences between senior living and skilled nursing for members of the lay media and the general public and contributed to the public’s appreciation of frontline workers such as those in senior living.
Occupancy drop records
Independent living and assisted living communities saw their largest occupancy drops on record in the third quarter of 2020, according to quarterly data released in October by the National Investment Center for Seniors Housing & Care’s NIC MAP Data Service. And intraquarterly data released after the third quarter show continuing downward movement.
But the pandemic may contain a “silver lining” for the industry, NIC Chief Economist Beth Burnham Mace said in October: Weak construction starts mean that the supply challenge will dissipate in 2021 and 2022.
By October, assisted living operators already were seeing pent-up demand for their needs-based services, as evidenced by waiting lists, she said.
As the threat of the virus continues for the foreseeable future, the industry is in a better position to battle it, Mace said.
“The ‘new normal’ is still emerging, but in the current normal, we better understand the virus,” Mace said in the fall. “We understand that it’s airborne; we understand safety protocols that need to be put in place; we have better access to PPE, better access to testing, and better guidelines about how to work with people coming into properties — staff or delivery people or family members.”
The battle against COVID-19 is not over, but senior living operators have risen to the unexpected challenge.
Other big stories of 2020
The news in 2020 wasn’t all related to the pandemic. Here are a just a few more stories that drew attention.
Disagreement on industry standards
The pandemic moved to the back burner an argument that had been brewing as 2020 began. Then, the major trade associations representing senior living found themselves with differing opinions about whether industry-initiated national standards would hasten or delay the federal regulation of senior living and whether they would encourage or prevent lawsuits against operators.
On one side was Argentum, which applied to the American National Standards Institute in April 2019 to become an accredited developer of standards for the industry. On the other side were the National Center for Assisted Living, LeadingAge and the American Seniors Housing Association, all of which had appealed ANSI’s September 2019 approval of Argentum’s application.
ANSI ultimately ruled to uphold Argentum’s application, and the trade associations in April said that discussions would continue about the best way to ensure quality in senior living communities.
More victims for a potential serial killer — and more potential regulation for senior living
In early 2020, a Texas senior living operator found itself the defendant in two new lawsuits — each seeking more than $1 million — from the adult children of two former residents. They asserted that the community didn’t do enough to protect their mothers from a man indicted in the deaths of several older adults, most of whom were female senior living residents. The alleged incidents spurred some family members to press state legislators for increased regulation of independent living communities.
By December, Billy Chemirmir, accused of suffocating older adults so he could steal their valuables, was facing three new capital murder indictments on top of 17 counts of capital murder and two counts of attempted capital murder of older adults. And a Lone Star State legislator filed the state’s first bill in response to the string of suspected murders.
Many of the resident deaths initially were ruled to be from natural causes. Their families didn’t learn the true suspected cause of death of their loved ones until Chemirmir’s arrest in 2018. The proposed legislation would require officials to notify next of kin when a death certificate is amended.
A Kardashian connection
In February, a Florida woman sentenced to 35 years in prison for orchestrating a $205 million Medicare fraud scheme that involved paying bribes and kickbacks to owners and operators of assisted living facilities and others had her incarceration commuted by President Trump.
The December 2011 sentence of Judith Negron, the former co-owner of Miami-based American Therapeutic Corp., at the time was one of the longest prison terms ever imposed in a Medicare Fraud Strike Force case, according to a 2011 Justice Department press release. The sentence also included three years of supervised release, and Negron and two co-defendants also were ordered to pay $87 million in restitution.
Negron told the Associated Press that her case was brought to the attention of the president by people such as Alice Johnson, who received clemency in June 2018 after lobbying by reality TV star Kim Kardashian West. Johnson, according to the AP, had been serving time since a 1996 conviction on charges related to a Memphis, TN-based cocaine-trafficking operation.
Trump’s commutation of Negron’s sentence “may well encourage lawlessness in a federal program that can least afford it,” according to Paul Pelletier, the former supervising federal prosecutor who authorized her indictment.
Editor’s note: On Dec. 22, after this article was written and posted, Trump commuted the remainder of Negron’s term of supervised release and also commuted the sentence of Philip Esformes, who had made our Big Stories lists of 2019 and 2016. Read more here.
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