With eight months of a Biden presidency in the books, James Balda isn’t as concerned about an imminent risk of increased federal regulation of the senior living industry as he was shortly after the November election.
“It seems not to be a priority at this point in time to take a look at any kind of wholesale regulation of the industry,” the Argentum president and CEO said, adding, however, that he is “not a believer that there’ll be a single event that would ultimately regulate assisted living across the board.”
“If anything, I think it would be incremental and over time that it would happen,” Balda said, pointing to infection control and staffing issues as possible initial areas where federal regulation would be attempted, regardless of whether a provider is reimbursed through private or government funds.
“And that’s why we’ve got to stay vigilant,” he told McKnight’s Senior Living in an exclusive interview at the association’s recently concluded Senior Living Executive Conference in Phoenix.
“Regulation of the industry at the state level is appropriate” due to the varying nature of senior living communities and the residents who live there, he added.
‘We can hold ourselves accountable’
Although the pandemic paused an industry discussion about ways to ensure quality as a means to possibly avoid federal regulation, Balda said those conversations among associations need to take place at some point.
“Whether it’s standards, whether it’s guidelines, whether it’s best practices, there does need to be some effort to ultimately self-regulate our industry so that when we’re talking to policymakers, whether it’s elected officials or regulators, we can hold ourselves accountable to something,” he said. “Otherwise, the issue of federal regulation, I think, becomes much more pronounced.”
“There does need to be some effort to ultimately self-regulate our industry so that when we’re talking to policymakers … we can hold ourselves accountable to something.”
Areas of self-regulation most relevant for policymakers, and the issues representing the highest risk for residents, Balda said, include emergency preparedness and planning, infection prevention and control, and memory care. “That’s where we continue to focus our thinking and our efforts,” he said, adding, “Infection prevention and control is certainly top of mind as we continue through the COVID-19 pandemic.”
‘Higher visibility’ now
After a year and a half of advocating for Provider Relief Fund monies and priority consideration for COVID-19 vaccinations with elected officials and regulators, the senior living industry has “higher visibility” among policymakers and members of the lay media, Balda said. “I still think it is conflated a bit with skilled nursing facilities,” however, he added. “And so I think for us, we need to continue to educate stakeholders about the distinctions between senior living and skilled nursing facilities.”
“We need to continue to educate stakeholders about the distinctions between senior living and skilled nursing facilities.”
To handle such matters, Argentum has doubled its government and public affairs staff and attracted 700 people to its Argentum Advocates program, begun in April.
Beyond the federal government, the association plans to up its game at the state level as well, Balda said.
“Our state partners do a great job,” he said. “I think the role for Argentum moving forward is ultimately identifying some of those issues at a national level that we can ultimately affect change on at the state level, and working with our state partners and our members to do that.” COVID-19-related protections against provider lawsuits is an example of an area where Argentum and its state partner organizations have seen success, Balda added.
‘A good solution’
The prospects for the senior living industry “continue to be positive,” the CEO said.
“If anything, I think this [pandemic] has shown that we are a good solution to providing care for seniors that need help and assistance with activities of daily living,” Balda said. “Those that move into our communities know it. Their families know it. It’s just everybody else doesn’t seem to know it, and I think that’s going to change over time.”
“If anything, I think this [pandemic] has shown that we are a good solution to providing care for seniors that need help and assistance with activities of daily living.”
The push to enable older adults to age in place is evident from a policy perspective, he said. In fact, the leader told those attending the conference’s opening session that “the most significant domestic policy debate in a generation” may be over “how to care for America’s seniors.”
Sometimes a move to a senior living community and then aging in place there, rather than remaining in a private residence, is in an older adult’s best interest, Balda told McKnight’s Senior Living.
“I hear countless stories of when residents move into our communities, their lives change for the better. They’re blossoming because of socialization, because of nutrition, because of the activities and the wellness programs,” he said. “I think what we need to do as an industry is better educate potential residents and families about the benefits of being in our communities. At the end of the day, though, I think once people move into our communities, they understand it; they get it.”
Policymakers need to understand the benefits of senior living, too, Balda said.
“I mean, how much are we actually saving Medicaid as a private-pay model? How much are we saving Medicare because we’re keeping people healthier longer, because of the nutrition and the socialization and the physical activity?” he said. “We need to do a better job of quantifying that and qualifying that and sharing that with policymakers.”
On the workforce front, Balda said, there is reason for hope that a solution to recruitment challenges is on the horizon, Balda said.
“The next generation of workers in our country … they seem to have more of a mission-driven attitude toward life,” he said. “I don’t know if that resonates across that entire generation, but if it does, I think that could bode well for us as an industry, because it’s about doing well doing well by doing good.”