Median occupancy in senior living has not varied dramatically from two months ago, specialty investment bank Ziegler found in its latest CFO Hotline survey on the effects of COVID-19.

The highest occupancy rate (92%) in late August / early September was reported for independent living, compared with 88% for memory care, 86% for assisted living and 78% for skilled nursing. Compared with results of the last survey, in late June / early July, independent living occupancy has dropped 1%, memory care occupancy is unchanged, assisted living occupancy has fallen 2%, and skilled nursing occupancy has increased 1%.

Independent living demand has “stayed strong,” respondents said, noting a “definite softness” in demand for assisted living and skilled nursing, however.

The report included responses from 230 providers, largely not-for-profit organizations, received between Aug. 24 and Sept. 4. Respondents primarily worked at senior living and life plan communities, also known as continuing care retirement communities.

Approximately 70% of respondents said they are not offering any type of entrance-fee or monthly fee discounts in response to COVID-19 pressures. Those that are offering incentives said they most commonly provide assistance with moving costs (31%), followed by deferred payment of entry fees (24%).

On the revenue side, the largest proportion of respondents (36%) reported seeing decreases in monthly revenue between 6% and 10%, with 40% indicating a monthly revenue decrease of 5% or less. The providers reporting the greatest monthly decreases also reported lower median assisted living (80%) and skilled nursing (70%) occupancy.

And although respondents wrote favorably of government funding, some expressed concerns that relief fund payments to date “mask the longer-term impacts of COVID-19,” including continued testing, increased infection control training, additional costs for personal protective equipment, and census pressures on assisted living, personal care homes and skilled nursing Those effects, one respondent said, need to be factored into considerations for 2021, but relief payments likely not be available then.

When asked about growth mindset, no across-the-board decreases in overall growth plans were noted, although the one area that dipped substantially was unit expansions (55% in late August compared with 64% in early March). Plans for new community development and affiliations or acquisitions remained fairly consistent from six months ago, whereas growth plans for home- and community-based services platforms grew significantly from six months ago (28% in late August compared with 14% in early March), which Ziegler said may be a function of the increased demand for at-home care during the pandemic.

When asked about future plans due to pandemic pressures, 20% of respondents said they most likely may explore exiting the skilled nursing business, whereas 12% said they would consider exploring affiliating with another organization. Only 2% said they were going to explore third-party management.

The survey also explored employee turnover and sales and marketing tactics.

Looking at staffing during the pandemic, responses were fairly evenly split between providers reporting little to no change in staff turnover (49%) and those reporting an increase in staff turnover (42%). Approximately 10% indicated that staff turnover has decreased since the onset of the pandemic. 

Comments related to effects on staffing pointed to an increased use of agency workers, bonus/hazard pay, isolation units, infection control and ongoing testing. Respondents also stated that staff stress and burnout is a major issue.