How is research helping to define the future of senior living? Lisa McCracken, the new head of research and analytics for the National Investment Center for Seniors Housing & Care, recently spent a few minutes with McKnight’s Senior Living to answer that question, as well as to discuss how the field has changed and what excites her moving into 2024. An abbreviated version of this interview appeared in the December issue of the print magazine.
Q: How did you first become interested in the area of long-term care?
A: Probably similar to a lot of other folks, it was a little accidental. My background and training is actually in clinical psychology, but I had always been involved in research and initially aspired to be a professor in academia. Instead, I went into clinical work for a few years, and I still had a hand in the research side of things. But after several years of doing that, I joined Holleran, a research consulting firm in the industry. That’s really what opened up the doors to me to this whole world that I did not even know existed. I loved it from day one.
Q: What appeals to you about working in the industry? Why do you stay?
A: Hands down, it’s just the work that’s being done, and that’s across the spectrum. I’ve always appreciated the work that is being done and the trust that people put in you. It’s good work; it’s fulfilling work, and I like to feel that the work I’ve done the past 23 years with information and data and insights really just helps organizations and individuals to do all of that better.
Q: What are some of the ways that you’ve seen the industry change over time?
A: When I look back, even just in the past five to 10 years, things have definitely changed. You can look back and see where, first of all, there’s more choices for older adults these days and, frankly, even living in your home. We’ve seen a lot more technology support that has enabled some of the aging in place. And whether they need some support services or not, that variety of support is available in more settings. Some of that has had to do with the changing consumer, too.
The other thing that we’ve seen a greater focus on is this focus on living your best life and wellness — the prevention type of activities. We have shifted to, this is the place where you maybe go to retire, maybe slow down a little bit, to where you can come here and live your best life, and how can we enable that?
That’s part of what I’ve seen as the value proposition — what can we provide in this housing setting? The senior living setting is going to be much better than what you can have in your own home prior to moving in. Those are things that I think about.
On the hospitality side of things, the bar has been raised a good bit there, with a number of different things — dining options, housing options and settings.
Obviously, we think about labor and those dynamics that have changed in recent years. We’ve always had committed, wonderful people, but I think the focus on them and the importance of the staff as an equal customer to the older adult has really advanced a good bit in recent years. Those are things I look back on, and think we’re in a better place.
There are more choices for individuals as they age. I think their ability to do it in a way that’s self-directed by them is greater. And I’m proud of the sector for advancing in that regard. We’ve still got a ways to go, but I think that we’re more on top of some of the consumer preferences and wants and using some of the technologies and advancements to do all of that better.
Q: How have you seen the consumer change over time, and is senior living rising quickly enough to answer those needs?
A: If you think back to 23 years ago and all of the web-based review systems and information at your fingertips to inform the customer, whether it’s the older adult or whether it’s their family, you can see more reviews. You also can see more employee reviews of what is this place like to work here. I think that sort of transparency, whether it’s provided by you or your constituents, puts us in a place to all be doing a better job and continuing with quality improvements.
We know that the active adult segment continues to grow, so I do think that the industry is responding and trying to give more choices and options depending on where people are.
But at the end of the day, we know the majority of people still want to age in their own home. So where do we find that balance?
The one area that has been very big and where we still have a lot of work to do is with the group in the middle. I think we could all argue here that having more low-income housing is as well. I feel like we’ve made progress. We have more today than we did even five years ago, but that cohort is so big. We’ve got to crack that nut as a sector, but it’s not easy. It’s tied to the economic conditions, and it’s tied to construction costs and a lot of different financing mechanisms.
Q: Talk about your new role as head of research and analytics at NIC. How does that compare with what you were doing at Holleran and Ziegler?
A: When I sit back and I think about it, it’s actually a blend of my 13 years.
When I was at Holleran, it was very heavily focused on a lot of resident satisfaction, family member satisfaction, staff engagement.
At Ziegler, I really covered a lot of the macro industry trends — how was the industry behaving and growing, and everything from technology to labor to consumer types of areas to home- and community-based services, but also with capital.
At NIC, it’s really the gamut of all of that, which I appreciate. I also feel it’s a significantly large platform in terms of audience. NIC is an organization that is very well respected, and we have the ability to really impact the sector in some pretty meaningful ways.
We’re also doing what we call sponsored research, and I’m really excited about these in particular. We had a recent announcement of a $3 million grant to the Milken Institute for the Center for the Future of Aging Innovation Collaborative. It’s exciting that a group is going to demonstrate leadership and do some consumer research. There is a lot to come out of that group.
We are continuing our work and released information around frailty of individuals living on their own in the greater community versus within a seniors housing community. We’ve got some really exciting research coming out around longevity that is being led by researchers from NORC at the University of Chicago, and continuing work on the middle market with four potential models of how to finance and scale those middle-market seniors housing and care projects. And then there’s a great research study coming out from the Harvard Joint Center for Housing Studies focusing on affordability.
So I feel like what I’m doing right now is the next step in my career and really a blend of the past 23 years, both with Ziegler and Holleran.
Q: With your depth of experience, where do you think the senior living field is headed into the future? What trends are you seeing?
A: I think there will be a focus on wellness and prevention. Some of those technologies, like AI, and where you can start to predict everything from workforce-related things — where is this person at, and are they at risk of leaving, or who’s going to be the right fit for a new hire, to predicting potential falls.
I think about greater integration. I still think we can function in our silos a little bit — whether it’s the tech companies or the operators or the hospitals and health systems — I think we are seeing more of some of these value-based care partnerships and initiatives. How do we provide housing and support services where it’s needed for the whole person and not just manage certain aspects? I think we need to be more innovative when we think about what we offer. At the end of the day, for people who reside in our communities, we have a unique opportunity to make a pretty significant impact above and beyond just the day-to-day services that we’re providing, and keep them healthier for longer.
What we all intuitively have known for many years is that these settings can really make a difference in terms of some longevity, frailty and potential outcomes. So we’re excited to see some of that research unfold in 2024. And what does that mean for other sectors as it relates to payers like Medicare Advantage plans and CMS? Does that put a different perspective on how they view the industry and the benefits from a quality-of-life and longevity and outcomes standpoint?
A lot is underway. One of the things that attracted me to NIC and to take this position was, in the past year, the board and leadership put out a new strategic plan with five focus areas. I think they are really forward-thinking — age tech, the ongoing commitment to the middle market, partnering for health and innovative whole-person models, value-based care, active adult. I feel like we’re having some really great conversations and movement forward with that. To move forward — the strategic plan and how our team supports that from a research analytics and thought leadership standpoint — that’s what excites me when I look at the year ahead.
