Participating in the NIC 2020 Fall Conference panel on “What does senior living look like in the COVID Era?” are moderator Bob Kramer, left, Michael Grust and James Lydiard.

One of the biggest ways COVID-19 will drive change in the senior housing industry is healthcare delivery, according to Nexus Insights founder and President Bob Kramer.

COVID-19 has introduced a fear of traditional healthcare delivery settings, especially among older adults, Kramer said Tuesday as he moderated a panel during the first day of the 2020 National Investment Center for Seniors Housing & Care Fall Conference, which went virtual this year due to the pandemic. Collectively, senior living settings, he said, are emerging as a key player in the healthcare continuum, with a major objective being to keep residents out of the hospital. And whereas health and healthcare need to be an essential focus for senior living providers, “You don’t have to do it all yourself,” Kramer told operators.

The session moderated by the co-founder, former president and CEO, and current strategic adviser to NIC, “What does senior living look like in the COVID era: The new role of health and healthcare,” opened the door to pointed discussion.

Panelist Michael Grust, president and CEO of Senior Resource Group, which operates 32 senior living communities in seven states, said his California-based company always has been focused on healthcare and hospitality and experience, but COVID-19 still turned its system upside down.

“Our business model has always been to deliver on a promise of not just a quality experience, but quality care,” Grust said. Overnight, he added, “our business model had become one of protecting residents and, frankly, putting them in a position where they could ultimately be in an environment where they felt safe.”

COVID-19 has created a convergence of healthcare and housing, said James Lydiard, staff vice president at CareMore Health, a California-based integrated health plan and care delivery company for Medicare and Medicaid beneficiaries. Although some operators see more healthcare as better healthcare, Lydiard said that COVID-19 showed that “the right amount of healthcare is the right healthcare.”

CareMore, which has partnered with SRG for a decade, provides a medical complement to the hospitality and wellness model in senior living, offering individualized care plans for residents, Lydiard said. Residents sign up through a health plan affiliate, a Medicare Advantage partner or through Medicaid.

Lydiard said CareMore brings to the partnership data and communication platforms, remote patient monitoring, technology platforms, population health tools, electronic health records and other tools to align with existing community programs to help them exceed their health and wellness goals.

“The COVID pandemic has really just emphasized the flexibility that we have,” Lydiard said.

Grust said the partnership is a no-brainer and a game-changer, marrying SRG’s “commitment to care and quality and protective prevention” to CareMore’s service delivery.

“Giving people a reason to leave their home and move into a communal setting, we have to deliver something that does create and be a catalyst for quality of life,” Grust said. “Keeping people healthier longer makes a difference on not just length of stay, but their quality of life during their duration of living in one of our communities.”

Wellness ‘elixir’

Activating, educating and engaging residents, Grust said, is what wellness is about in the senior living setting. 

“Engagement is a powerful elixir for residents feeling a part of something bigger, giving them a sense of purpose. You have to give them an opportunity to engage in life the way they want to live it, but giving them a sense of purpose and connection is truly what our unique selling proposition is,” Grust said. “The benefits of senior living are far more than having a great dining experience and playing Bingo. We’ve evolved.”

The senior living industry is at a “nexus point” and needs to deliver more than activities of daily living and hospitality, he said.

“Through COVID, more than ever, the ability to deliver on all of these things and be the catalyst for quality of life is truly going to make the difference in our industry moving forward, Grust said, “because that is what is going to compel people to leave their homes.”

Science fights off COVID-19 successfully

In a separate session, Fee Stubblefield, the founder and CEO of The Springs Living, said that surface testing helped prevent an outbreak of COVID-19 in communities of the McMinnville, OR-based provider of independent living, assisted living and memory care services. The company’s program was highlighted in an NIC meeting operator spotlight session called “Using science to fight COVID-19.” 

In the early days of the pandemic, Stubblefield said, long-term care facilities were faced with constantly changing guidelines and protocols. Science, he said, did not yet know what was going on. So Stubblefield said he decided to “throw everything at this.”

One thing that stuck, he said, was surface testing, which became another tool to detect and defeat the virus.

The Springs Living participated in a three-week pilot study with the University of Oregon and Enviral Tech, a Eugene, OR-based biotechnology company. The senior living communities allowed surface-testing kits to be used to check for evidence of COVID-19 even after a commercial cleaning company had cleaned and disinfected buildings.

Stubblefield said the buildings had known exposures to COVID-19, but no one was showing symptoms. Still, evidence of the virus was detected on surfaces such as keyboard and computers, but also in air ducts.

“Surface testing led us to the fact that this virus not only spread through moist droplets and human contact, but it spread through the air,” he said. “It was a great revelation for us.”

Knowing that COVID-19 had come into a building allowed staff at those buildings to enhance their cleaning and disinfecting protocols, ask more people to isolate and create a more controlled environment. The move, he said, bought those communities days in preventing a coronavirus outbreak.

“The cost of surface testing is a fraction of the cost of an outbreak,” Stubblefield said. “Besides the direct benefits of keeping our communities safe, our experience has been in the confidence it gives our residents in what we’re doing.”

That confidence, he said, has led to the pent-up demand for move-ins that comes with the knowledge that the community offers a safe and healthy environment.

“COVID changed the way senior housing providers must operate,” Stubblefield said. “Organizations will need to embrace the reality that you cannot deliver great care without delivering a safe environment.”