Despite advances in LGBTQ+ non-discrimination policies, senior living communities and other long-term care providers still have some work to do, according to a new report.
The Human Rights Campaign Foundation and SAGE released the 2023 Long Term Care Equality Index Wednesday. The LEI 2023 represents the first validated survey of LGBTQ+ inclusion in long-term care and senior housing communities using a first-of-its-kind benchmarking tool.
Modeled after the Healthcare Equality Index, the LEI measures benchmarks of LGBTQ+ inclusion in the areas of non-discrimination and staff training, resident services and support, employee benefits and policies, and resident and community engagement.
The report included 200 US senior living community participants in 34 states. Participants represent 23,000 residents and 17,000 employees in assisted living communities, memory care communities, continuing care retirement / life plan communities, independent living communities, affordable senior housing properties, skilled nursing facilities and hospice programs.
The index revealed that 90% of participant communities had updated their resident and employee nondiscrimination policies to include protections based on both sexual orientation and gender identity, compared with only 18% in 2021.
In addition, 84% of participants now meet staff training requirements by having 80% or more of key executives either complete the LEI executive briefing training module or by requiring training provided by SAGECare as part of their credential.
A majority of participants indicated that they have resident admission materials using inclusive language when collecting a person’s chosen name (89%) and partner relationships (83%), and more than half collect data on sexual orientation (55%) and gender identity (54%).
Approximately 75% of participating communities earned the “higher performer” or “leader” designation, indicating that their actions went beyond the basics, according to the HRCF and SAGE.
The high performers and leaders
In the LEI 2023, 13 senior housing and long-term care communities achieved the LGBTQ+ Long-term Care Quality Leader designation for making significant progress in their “inclusion journey” and demonstrating that employees have access to a transgender-inclusive health insurance plan. Another 137 communities earned the high-performer designation for having a solid foundation of key nondiscrimination policies and adopting best practices in the areas of resident services and supports, employee benefits and policies, and resident and community engagement.
United Church Homes — which operates life plan and affordable senior housing communities as well as skilled nursing facilities across 14 states — had several communities profiled as leaders, high performers and participants for being “unapologetically inclusive.”
UCH Administrator Jeremy Lemon said that participating in the LEI gives the company the opportunity to gauge how well it is “walking the talk.” The provider said it has seen an increase in the number of employees attracted to the company due to its policies.
Edenwald, a life plan community in Towson, MD, also was profiled as a high performer. The CCRC said that participation in the LEI is important because it affirms the provider’s “unwavering commitment to embrace every individual for who they are, regardless of sexual orientation or gender identity.”
Edenwald President Mark Beggs said in a video released with the report that he wants everyone to feel as if they can be themselves. He called participation in the LEI “business smart” and said that following the policies has contributed to successful staff recruitment.
“We, through the pandemic, through the Great Recession, have been fully staffed here,” Beggs said. “We have no issue recruiting for any position we have open, because people want to come here because of the culture.”
Still some work to do
Although progress has been made, the research found that communities still need more work in some areas, including collecting data on preferred pronouns (11%), implementing abuse and neglect policies (5%) for residents, and having policies that outline procedures to eliminate bias and insensitivity (7%).
Tari Hanneman, HRC health and aging program director, told McKnight’s Senior Living that HRC and SAGE initially focused on ensuring that operators were adopting foundational policies in the first set of criteria, including equal visitation and nondiscrimination in employment. It is understandable that resident services and support and community engagement are lagging, she said, because those efforts take more time.
“Part of it is just participating in the LEI and learning about them and seeing best practices other communities are employing and how they can do it,” Hanneman said. “Some of these things they haven’t really thought of before the LEI provides them with templates and a roadmap.”
Growing aging population prompted action
HRC and SAGE started the LEI after an AARP study found that 76% of LGBTQ+ older adults were concerned about having adequate social supports to rely on as they age, and 73% didn’t have access to LGBTQ+-specific services. In addition, 70% of LGBTQ+ older adults said they were concerned they would have to hide their identity in an assisted living community or nursing home.
In today’s politically charged environment, Hanneman said, members of the LGBTQ+ community are “under attack everywhere,” which takes a toll on people, including on residents who may be afraid to reveal their identity.
“It makes the work of the LEI even more important when communities are putting in place non-discrimination policies and different practices to help residents or potential residents know they’re welcome and they can live there and be safe,” she said.