Cindy Baier
Lucinda “Cindy” Baier

Less than 1% of residents at the country’s largest senior living operator have tested positive for COVID-19 as of April 30, but the disease has affected occupancy rates, according to comments Wednesday from Brookdale Senior Living executives during the company’s first-quarter earnings call.

President and CEO Lucinda “Cindy” Baier said Brookdale was early in undertaking some precautions to prevent or contain COVID-19. 

Move-ins and visits — including virtual visits — declined significantly in March as the pandemic spread, she said. In April, occupancy dropped to 80%. Baier expects occupancy challenges to continue in May but ultimately sees metrics improving because “this is a needs-based business, and those needs will continue.”

Steven E. Swain, executive vice president and chief financial officer, said Brookdale spent $10 million in the first quarter on the company’s COVID-19 response, including personal protective equipment, medical equipment, and cleaning and disposable dining supplies, enhanced cleaning and environmental sanitation costs, and increased labor expenses. 

“Since these expenses were only for a partial quarter and incremental labor costs were not significant in the first quarter, we expect COVID-related expenses to be significantly higher in the second quarter,” he said. “In addition, we are in the process of testing substantially all of our community residents and associates.”

Baier said Brookdale executives are using their influence to call on policymakers to prioritize the senior living industry in supplying resources necessary in the fight against COVID-19.

She said she joined with industry trade organizations to address Congress, the Trump administration and state officials to request help for the senior living industry in providing the resources to “make progress in addressing the needs of this critically essential service industry.”

“Our industry does not have a loud enough voice in Washington, D.C., who understands the industry to inform policymakers regarding the senior living industry and its vitally important role in protecting this vulnerable population,” the CEO said. “Industrywide, about 1 million seniors live in independent living, assisted living and memory care settings.”

Many overlooked senior living’s role on the front lines as being part of the healthcare continuum, and others incorrectly grouped predominantly private-pay senior housing with government-supported nursing homes, Baier said.

“Our industry’s two largest trade associations, several influential members of the industry and I, as the leader of the largest senior living operator in the U.S., have spent an enormous amount of time advocating for the industry,” she said. “We have requested priority access to testing kits, PPE and prioritized government financial relief, among other topics.”

Baier said Brookdale is not confident that the incremental costs of fighting COVID-19 will be passed on to residents, who largely are on fixed incomes. That is why, she said, she is aggressively reaching out to Congress for help. 

Government assistance in long-term care mainly has been in the home health, hospice and skilled nursing areas because aid can be calculated relatively easily based on Medicare and Medicaid revenues. Because senior living predominantly is a private-pay business, she said, the government has not determined a way to help, although the industry has requested that relief to operators be based on the number of full-time equivalent employees. 

“I think that recognizes the more intense nature of assisted living or memory care than independent living, so there’s a bigger impact for the COVID-19 response,” Baier said. “Until the government decides how it wants to handle it — Health and Human Services in particular — we just won’t know if we’re going to get support, and if we do get support, how it will ultimately be determined.”

Brookdale did receive $29.5 million under the Coronavirus Aid, Relief, and Economic Security Act of 2020 (CARES Act) for its home health and skilled nursing businesses, but Baier said she is not sure that Brookdale will get to keep all of the funds received.

“Even once you get the money, there is no guarantee you get to keep all of it,” Baier said, adding that Medicare Accelerated Advance Payment program and payroll tax deferral program dollars will have to be repaid. 

Brookdale has used its resources to lead the industry in fighting a global health crisis, Baier said, adding that she believes the company was the first senior living operator to launch a website dedicated to COVID-19 updates and best practices. 

“We shared links with our peers, reporters and the public. It was important to share our knowledge and ideas with anyone interested, especially small senior housing operators that may not have the resources we have,” she said, adding that its COVID command center and clinical leaders were panelists on Argentum’s first webinar for best practices in battling COVID-19.

Brookdale also significantly increased its social media engagement as the pandemic spread and saw likes, comments and shares on content triple historic averages. Facebook, Baier said, took notice and informed Brookdale it was being used as an example of a best practice in the COVID-19 response.

“We are confident our early reason and communications have helped reduce the spread of the virus and ultimately saved lives,” she said.

Baier said she supports the federal government’s recommendation that the senior housing and care industry should be in the final wave of the three-phase approach for reopening the economy. Once testing is widely available, she said, communities could open again as older adults are more inclined to move in because they know they won’t be isolated from loved ones.

Looking to the future, Baier said Brookdale’s early actions in fighting the pandemic relative to the industry, and its position as an industry leader, will place it in a good position to recover. The sales team is already feeling more optimistic, she said.