Close-up senior Asian woman hand with her caregiver helping hands, Caregiver visit at home. Home health care and nursing home concept.
(Credit: Artit_Wongpradu / Getty Images)

The social aspects of senior living remain one of the industry’s main selling points, but a focus on clinical care and helping residents age in place longer is emerging, and it can be a differentiator for operators, some experts say.

One of the positive outcomes from the COVID-19 pandemic was that it put assisted living on the map, according to Pat Banta, regional director of health services in New York and New Jersey for Chelsea Senior Living. Banta was part of a panel discussing healthcare integration in senior living — and how it can be a differentiator for communities — during last week’s Argentum 2023 Senior Living Executive Conference in New Orleans.

The healthcare system was not very familiar with senior living until the pandemic occurred, Banta said, but hospitals were overwhelmed and looking for someplace to send older adults who no longer needed skilled care but still needed help, particularly with behavioral health.

The pandemic, however, Banta said, also brought assisted living to the front of regulators’ minds.

“Before, we were just an unknown industry. They didn’t know what we did,” she said.

Assisted living helped advance wellness programs during the pandemic to provide onsite services for frail, older adults, Banta said, adding that assisted living communities are the new nursing home, nursing homes are the new community hospitals and hospitals are “research centers where you go when you need surgery.”

Assisted living communities, the panelists said, increasingly are offering resident-controlled scheduling and personalized living arrangements, and new providers are entering the market to help older adults age in place as long as possible. Innovative operators, they said, are focusing on mental health, wellness and the social determinants of health; rather than physical needs, their aging-in-place solutions focus on addressing social isolation and emotional support.

Senior living steps up during pandemic

Cascade Senior Living Services became one of the innovative operators during the pandemic, panelist CEO and founder Chad Solvie said. Washington state is fairly progressive and “working really hard to get rid of nursing homes,” closing more than 20 nursing homes in the past five years, he added. Instead, he said, the state is looking to deliver care in more cost effective and less regulated settings.

When the pandemic spurred a housing and addiction crisis that overwhelmed hospitals, the state solicited ideas from everyone, Solvie said. Cascade Senior Living Services stepped up with the idea that much behavioral healthcare offered in nursing homes could be offered in assisted living given the proper training and care models. 

Four years ago, Cascade Senior Living Services launched a pilot program that ultimately became the new state model now rolling out across Washington to care for older adults with the dual diagnoses of behavioral health issues and Alzheimer’s disease. Assisted living communities, Solvie explained, worked directly with hospital emergency departments to create medical respite programs for discharges.

“We are the nursing home — they come to us for a while, and then we place them in adult family homes or somewhere else in the community,” he said, adding that the model consolidated providers and brought services to campuses to lessen the need for care coordination, while providing better overall care. “That trend is continuing,” he added.

Education is key to success

Success, Banta said, depends on having the right partners in place in the community, having access to resources and educating staff, particularly on assessments, including those for geriatric depression and substance abuse screenings. 

Both Chelsea Senior Living and Cascade Senior Living Services partnered with Optum, a Minnesota-based healthcare services provider and subsidiary of UnitedHealth Group, to coordinate care and provide onsite health services and benefits.

“It takes a lot of training to get in a comfort zone to have interactive dialogue and conversational assessments to drill down and see what’s going on with a resident,” Banta said, adding that using rehabilitation, speech and occupational therapists, as well as psychology services, is a blended care function. “The more hands on deck the better, because it’s more eyes on those residents,” she said.

Success decreases fragmentation and increases collaboration for the benefit of residents, Banta said.