COVID-19 Rapid Response Network for Nursing Homes

The Institute for Healthcare Improvement, with support from John A. Hartford Foundation, offers a free COVID-19 Rapid Response Network for Nursing Homes. 

Operators and staff of nursing homes are facing enormous challenges. To help nursing homes tackle these challenges with pragmatic and real-time solutions, the Institute for Healthcare Improvement, with support from the John A. Hartford Foundation, has launched a free COVID-19 Rapid Response Network for Nursing Homes. 

The Rapid Response Network offers a daily 20-minute National Nursing Home Huddle that includes solutions that can be implemented immediately to address key challenges posed by COVID-19. Its goal is to support nursing home leadership, staff, residents, families, and communities impacted by the pandemic.

So far, these huddles have included creative ideas to help with the most pressing challenges faced by nursing home and long-term care staff and residents. Representatives from organizations such as the CDC have also participated to provide data and policy updates. Topics have included PPE, testing and screening, hospital to nursing home transfers, staff illness and absences as well as the emotional well-being of staff and residents.

Institute for Healthcare Improvement states the following as benefits of participation:

  • Immediate access to specific, pragmatic guidance on clinical and operational issues confronting the nursing home community today. Guidance will be focused and ready to implement.
  • Ability to speak with a collective voice to federal and state policy makers, regulators, health care systems, and others to help remove policy and regulatory barriers to mission-critical operational challenges.
  • Access to tools and materials to help explain the work of nursing homes and promote participation in the COVID-19 Rapid Response Network for Nursing Homes. These tools will help nursing homes communicate with local media outlets about efforts to serve and protect residents and staff.

To learn more and to sign up to participate in the free daily huddles, visit the Institute for Healthcare Improvement registration page.

Skilled Nursing Occupancy Decreases in March

Skilled Nursing Occupancy Decreases in March. Monthly Data Released from NIC’s Skilled Nursing Data Initiative for March 2020.

First Monthly Data Release from NIC’s Skilled Nursing Data Initiative

Data Ending March 2020 Shows 132-Basis Point Decline in Occupancy from February.

In response to rapid market changes caused by the COVID-19 pandemic and its impact on the skilled nursing industry, NIC has increased the data release frequency for key performance metrics. Starting now and going forward, NIC will release data from its Skilled Nursing Data Initiative on a monthly basis. NIC will post data through April 2020 by July 7, 2020. Key points from the first monthly release with data from January 2012 through March 2020 are summarized below. 

  1. The initial effects of the COVID-19 pandemic were evident on skilled nursing occupancy in March, with a 132-basis point decline from the prior month and a 53-basis point decline from year-end 2019 to 83.4% in March 2020. This pushed the occupancy rate to its lowest level since NIC began collecting the data in 2012. Larger impacts are anticipated in April when the pandemic was significantly more pervasive. Occupancy usually increases from the fourth quarter to the first quarter given the flu season and higher admissions in the winter months, but the coronavirus changed that pattern as a result of hospital transfers associated with the illness and fewer admissions related to post-acute elective surgery care needs. Furthermore, occupancy decreased year-over-year as it slipped 134 basis points from March 2019.NIC Skilled Nursing Occupancy January 2012 - March 2020
  2. Skilled mix increased 17 basis points from the fourth quarter 2019 to end March 2020 at 25.3% as Medicare and managed Medicare patient day mix increased from December 2019. However, there was a drop in both Medicare and managed Medicare from February to March 2020, falling 18 basis points and 46 basis points, respectively. These declines suggest the pressure on new post-acute admissions began in the month of March as COVID-19 started to impact skilled nursing properties. The pressure on Medicare and managed Medicare in March resulted in skilled mix decreasing 59 basis points from February to March 2020. Skilled mix also showed a decline year-over-year as it decreased 60 basis points from March 2019.SNF Patient Mix 052820
  3. Overall managed Medicare revenue mix continued to hover around 10%. Managed Medicare revenue mix initially increased as expected in the first quarter of 2020, rising from 9.9% in December to 10.4% in January to 10.8% in February 2020 before slipping 76 basis points in March as COVID-19 likely started to impact managed Medicare admission due to various factors such as suspension of elective surgeries. Managed Medicare revenue mix was down almost two percentage points from a high-water mark of 11.9% in February 2019 due to continued revenue per patient day pressure and more recently the effects of the coronavirus.   However, over the longer-term since 2012, managed Medicare revenue mix has been in an upward trend increasing from 6.8% in January 2012.SNF Revenue Mix 052820
  4. Medicaid patient day mix held relatively steady in the first quarter of 2020, increasing slightly by 9 basis points from December 2019 to 67.1% at the end of March 2020. Compared with February, Medicaid patient mix increased 66 basis points as less of the patient population was likely associated with post-acute care, i.e., Medicare and managed Medicare stays were likely down due to the numerous measures implemented to contain COVID-19. This is notable and suggests that the occupancy decrease from February to March was mainly, if not all, due to the decreases in post-acute admissions.

    To get more trends from the latest data, please download the NIC Skilled Nursing Data Report. There is no charge for this report. The latest quarterly report will be released on June 10, 2020.

    This report provides aggregate data at the national level from a sample of skilled nursing operators with multiple properties in the United States. NIC continues to grow its database of participating operators in order to provide data at localized levels in the future. Operators who are interested in participating can complete a participation form here. NIC maintains strict confidentiality of all data it receives.

Executive Survey Insights  | Wave 7, Week Ending May 24, 2020

A NIC report providing timely insights from owners and operators on the pulse of seniors housing and skilled nursing sectors. Wave 7, week ending May 24.

A NIC report developed to provide timely insights from owners and C-suite operators and executives on the pulse of seniors housing and skilled nursing sectors.

NIC’s weekly Executive Survey of operators in seniors housing and skilled nursing is designed to deliver transparency into market fundamentals in the seniors housing and care space at a time where market conditions are rapidly changing—providing both capital providers and capital seekers with data as to how COVID-19 is impacting the space, helping leaders make informed decisions. 

This week’s sample (Wave 7) includes responses collected May 11-May 24, 2020 from owners and executives of 155 seniors housing and skilled nursing operators from across the nation. Detailed reports for each “wave” of the survey can be found on the NIC COVID-19 Resource Center webpage under Executive Survey Insights.

 

Join other operators in the sector and participate in the next wave.

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Summary of Insights and Findings

While most organizations continue to report a deceleration in move-ins in the past 30-days, in Wave 7 of the survey, the shares of organizations reporting deceleration is the lowest—across each of the care segments—since the first two waves of the survey (data collected March 24-31 and April 1-12).

Reasons cited for a deceleration in move-ins continue to primarily be slow leads conversions/sales resulting in difficulty replacing residents who have passed away or moved out; however, about 20% fewer organizations cite an organization-imposed ban on move-ins in Wave 7 compared to Wave 4, as all of the states in the country have begun to loosen social and economic restrictions. About one-half of respondents continue to cite resident or family member concerns about moving in. Others note fewer hospital referrals and elective surgeries, and general concerns about the economy.

Most organizations continue to report no change in the pace of move-outs in the past 30-days. Of those that did experience an acceleration in the pace of move-outs, reasons cited include a growing percentage of residents transferring to higher levels of care. Other respondents cited nonspecific resident deaths and hospitalizations, resident or family member concerns and normal discharges.

Fewer organizations saw a decrease in occupancy compared to earlier survey waves. Respondents with assisted living and memory care segment units report slightly higher shares of stable or improving occupancy rates from a week ago. And, just over one-third of the organizations reporting on their nursing care segments, in two consecutive waves of the survey, note occupancy rate declines from one week prior (38% and 36%)—significantly lower than in Waves 5 and 4 (67% and 62%).

The percentage of residents that were tested for COVID-19 by care segment rose with acuity level. The operator average share of residents tested by segment ranged from 2.1% for independent living, 13.5% for assisted living, 18.2% for memory care and 24.0% for nursing care. These rates of testing are higher than the previous time frame, with the exception of the independent living segment.

Wave 7 Survey Demographics

    • Responses were collected May 11-May 24, 2020 from owners and executives of 155 seniors housing and skilled nursing operators from across the nation.
    • More than one half of respondents were exclusively for-profit providers (57%), about one-third (32%) were exclusively nonprofit providers, and 11% operate both for-profit and nonprofit seniors housing and care organizations.
    • Owner/operators with 1 to 10 properties comprise 58% of the sample. Operators with 11 to 25 properties make up 23% while operators with 26 properties or more make up 19% of the sample.
    • Many respondents in the sample report operating combinations of property types. Across their entire portfolios of properties, 77% of the organizations operate seniors housing properties (IL, AL, MC), 36% operate nursing care properties, and 33% operate CCRCs (aka Life Plan Communities).

Key Survey Results

Pace of Move-Ins and Move-Outs

Respondents were asked: “Considering my organization’s entire portfolio of properties, overall, the pace of move-ins and move-outs by care segment in the past 30-days has…”

    • In Wave 7 of the survey, between 65% and 59% of organizations reporting on their independent living, assisted living and memory care segments, and 75% of organizations with nursing care beds indicated that the pace of move-ins decelerated in the past 30-days.
    • The shares of organizations reporting a deceleration in move-ins in the past 30-days is the lowest, across each of the care segments, since the first two waves of the survey (data collected March 24-31 and April 1-12).
    • Approximately 40% of organizations with memory care and/or independent living segments and about one-third and one-quarter of organizations with assisted living units and/or nursing care beds saw no change or an acceleration in move-ins in the past 30-days.

wave7chart1

 

Reasons for Deceleration in Move-Ins

Respondents were asked: “The deceleration in move-ins is due to…”

    • Significantly fewer respondents in Waves 7 and 6 cited an organization-imposed ban on settling new residents into their communities than in Waves 5 and 4 (41% and 46% vs. 59% and 61%, respectively).
    • In Wave 7 of the survey, in similar proportions to the prior three waves, roughly two-thirds of respondents attribute a deceleration in move-ins to a slowdown in leads conversions/sales. Around one-half of organizations cite resident or family member concerns, and about one-quarter cite a mandatory government-imposed ban. Others cite fewer hospital referrals, elective surgeries and general concerns about the economy.

wave7chart2

 

Move-Outs

  • Between 60% and 69% of organizations reporting on their independent living, assisted living and memory care units in Wave 7 saw no change in move-outs in the past 30-days.

wave7chart3

 

Change in Occupancy by Care Segment

Respondents were asked: “Considering the entire portfolio of properties, overall, my organization’s occupancy rates by care segment are… (Most Recent Occupancy, Occupancy One Month Ago, Occupancy One Week Ago, Percent 0-100)”

    • Approximately one-half to about two-thirds (54% to 65%) of organizations reporting on their independent living, assisted living and memory care units in Wave 7 of the survey—across their respective portfolios of properties—experienced a decrease in occupancy from the prior month, however roughly one-quarter to one-third report no change (25% to 36%).
    • Notably fewer organizations with assisted living units and/or nursing care beds report a decrease in occupancy in the past month compared to Wave 4 (65% vs. 81% and 73% vs. 82%, respectively).
    • The independent living and memory care segments also saw fewer organizations reporting a decrease in occupancy rates compared to earlier waves of the survey. The share of independent living organizations reporting a decrease in occupancy in the past month fell from 68% in Wave 4 to 54% in Waves 5, 6 and 7. Additionally, fewer organizations with memory care units in Wave 7 than in Wave 5 note declining occupancy rates (59% vs. 70%).
  •  
  • wave7chart4
  •  
    • The chart below breaks out the rates of change in occupancy by care segment with greater granularity, comparing the current timeframe (Wave 7 data collected between May 11 and May 24), the middle of the pandemic (Wave 3 data collected between April 13 and April 19), and earlier in the pandemic at the start of this survey when the majority of independent living, assisted living and memory care segments had yet to report major changes in current occupancy compared to one month prior (Wave 1 data collected between March 24 and March 31).
    • As shown in the chart, near the beginning of the pandemic (Wave 1), the share of operators that reported month over month occupancy rates declines increased as the pandemic progressed into Waves 3, and most recently, Wave 7.
    • Shares of organizations reporting a decrease in occupancy in the past 30-days in Wave 7 and Wave 3 are similar for independent living, assisted living and memory care, but slightly more organizations in Wave 7 report both wider declines and improvements in occupancy for the memory care segment than in prior waves of the survey. Fewer organizations with nursing care beds in Wave 7 report significant downward changes in occupancy compared to one-month prior than in Wave 3.

wave7chart5

    • Regarding the change in occupancy from one week ago, respondents with independent living units consistently report the fewest declines in occupancy from one week earlier while nursing care, assisted living and memory care have been generally consistent with around 36% of respondents reporting decelerations in occupancy from the prior week for the last two waves; these are all below Wave 4 percentages, however.
    • Most organizations with independent living, assisted living and memory care segment units note no change (51% to 70%); however, slightly higher shares of organizations with assisted living and memory care segment units report no change or an increase in occupancy from one week ago.
    • Just over one-third of the organizations reporting on their nursing care segments in Waves 7 and 6 of the survey note occupancy rate declines from one week prior (38% and 36%)—significantly lower than in Waves 5 and 4 (67% and 62%). Greater shares report no change or an increase from the week prior in Waves 7 and 6.

wave7chart6 

Incidence of COVID-19 Among Survey Respondents

Data was collected between May 11 and May 24 (Wave 7) and April 27 and May 10, 2020 (Waves 5 and 6 combined).

Answering on behalf of their organizations, seniors housing and care owners and executives provided the COVID-19 incidence data shown below. The data represents a subsample of the total respondents that answered the COVID-19 questions fully, is self-reported and non-validated, and should not be considered a statistical representation of COVID-19 incidence in seniors housing and care, in general.

wave7chart7

 

    • Considering the Wave 7 subsample of survey respondents, the percentage of residents that were tested for COVID-19 by care segment rose with acuity level. The operator average percent of residents tested by segment ranged from about 2.1% for independent living, 13.5% for assisted living, 18.2% for memory care and 24.0% for nursing care. These rates of testing are higher than the previous time frame, with the exception of the independent living segment.

NIC wishes to thank survey respondents for their valuable input and continuing support for this effort to bring clarity and transparency into market fundamentals in the seniors housing and care space at a time where trends are rapidly changing. Your support helps provide both capital providers and capital seekers with data as to how COVID-19 is impacting the space, helping leaders make informed decisions. 

If you are an owner or C-suite executive of seniors housing and care properties and have not received an email invitation but would like to participate in the current Executive Survey, please click here for the current online questionnaire.

 

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NIC MAP Releases the First Intra-Quarterly Data Set

NIC has launched initiatives to provide seniors housing data on an accelerated timetable, and announces the release of NIC MAP® Intra-Quarterly Data.

The COVID-19 pandemic has created an urgency for insights on data and trends in the seniors housing and care sector. NIC has long held that transparency, accuracy, and timeliness are key factors for well-informed decision-making.In response to the quickly developing situation presented by COVID-19, therefore, NIC has launched a number of initiatives to provide relevant data on an accelerated timetable, including last week’s release of NIC MAP® Intra-Quarterly Data.

The NIC MAP Data Service team, working with diligence and passion, has produced a new monthly time series. The April data, released May 19, marks the inauguration of the new NIC MAP Intra-Quarterly Data series. 

Monthly Reporting of NIC MAP Data

With the launch of Intra-Quarterly Data, the NIC MAP Data Service will now report three-month rolling time series data on a monthly basis. The data represents performance for the three most recent months, labeled as the final month for the reported period. The rolling period for April 2020 covers February, March, and April 2020. This first data release includes 13 months of three-month rolling data on stabilized occupancy for both seniors housing and nursing care properties. The data series begins in April 2019 and is reported for the Primary Markets, Secondary Markets, and other aggregated geographic levels. 

The NIC MAP Intra-Quarterly Data will be delivered as an Excel file for NIC MAP clients and will also be featured in NIC’s Intra-Quarterly Snapshot, a new monthly publication offering highlights from the data. The Intra-Quarterly Snapshot, available for download on NIC.org, includes key takeaways on the reported time series data, visual representations, and statistics for the past 13 rolling three-month periods, plus three economic indicators to provide some perspective on the current economic conditions. 

Note that the publishing of the Intra-Quarterly Data and Intra-Quarterly Snapshot report will occur on the third Tuesday of each month. 

April 2020 Intra-Quarterly Data Key Takeaways 

In April 2020, following the onset of the COVID-19 pandemic, stabilized occupancy for both seniors housing and nursing care properties dropped significantly. Nursing care properties experienced the largest decline, falling 220 basis points from the prior month to 84.7% for the rolling period of February-March-April 2020 in the NIC MAP Primary Markets. The seniors housing stabilized occupancy rate fell a lesser 110 basis points over the prior month to 88.7% for the NIC MAP Primary Markets. Prior to April, both the seniors housing and skilled nursing stabilized occupancy rates had been relatively stable. 

The impact of COVID-19 was clearly reflected in the rolling period of April 2020, with a greater toll seen in skilled nursing than in seniors housing. Specifically, the drop in stabilized occupancy for both skilled nursing and seniors housing is indicative of the effects of the pandemic on existing properties without the effects of competition of new properties on market conditions.  In addition, some of the sharp decline in skilled nursing occupancy was likely driven by fewer hospitals discharging patients to post-acute care settings for rehabilitative therapy as hospitals defer elective surgeries due to the pandemic.

More to Come

Going forward, NIC will continue to expand the NIC MAP Intra-Quarterly Data set and report on additional metrics, geographies, and data subsets in the third quarter of 2020.

In the meantime, NIC will continue to respond to the pandemic by doing what we do best − delivering data, analytics, and connections – to continue to provide transparency to the sector. Details can be found on our COVID-19 Resource Center which puts new data initiatives, as well as COVID-19-relevant commentaries, regulatory updates, and popular webinar details all in one place.

NIC would like to recognize those directly impacted by the COVID-19 pandemic and those on the frontline keeping residents of seniors housing and skilled nursing communities safe. We understand that seniors housing and skilled nursing operators are bearing tremendous burdens, and applaud their efforts to protect and serve their residents.

Leadership Huddle: Adjusting, Innovating, and Earning Trust

NIC’s Leadership Huddle webinar on May 21. Beth was joined by Mercedes Kerr, who provided her insights on these topics.

In the fifth installment of NIC’s “Leadership Huddle” webinar series, held Thursday, May 21, NIC Chief Economist Beth Mace and Belmont Village Senior Living President, Mercedes Kerr discussed the impact of COVID-19 on senior living. The discussion drew over a thousand registrations. Mace’s presentation of “The NIC Bluebook: Five Ways COVID-19 Could Affect Senior Living,” gave the huddle it’s title.

The presentation kicked off with Mace’s thoughts on the severity, breadth, and duration of the pandemic. Mace pointed to the “astounding” pace of the virus’ spread across the globe, growing by over 2 million new cases in the past month, to a May 19, 2020 total, provided by the John’s Hopkins Coronavirus Resource Center, of 4,823,479 confirmed cases globally, and 1,508,957 in the U.S. As Mace commented, “the pandemic is here, it’s widespread, and it’s affecting all of us.” While the number of newly confirmed cases each day is flattening, Mace summarized the latest data by saying, “there are still enormous numbers of people that are at risk in this pandemic, and that are being affected by it.”

Describing the measures her organization has put in place to combat COVID-19, Kerr observed that, “We are continuing to learn about this disease and how it manifests.” Belmont Village Senior Living has 31 communities in seven states and Mexico City, with its largest concentration in California, with approximately 4,000 residents in total.

The organization began by meeting Centers for Disease Control and Prevention (CDC) recommendations in early March, but quickly realized that would not be enough. Kerr described an “evolution” of actions, including voluntarily banning new admissions, restricting access to properties, using new processes and technologies to screen staff, restricting meal service, and modifying social engagement activities. Belmont is also using technology, such as Zoom and other connectivity apps, to help keep residents safely in touch with family and loved ones. They are also investing in telehealth technologies to enable the delivery of healthcare to residents without having to transport them to a hospital or doctor’s office.

For Belmont’s memory care residents, the organization has made further adjustments, including restricting dining into shifts, so smaller groups can visit the dining room at the same time, and training staff on how best to communicate with cognitively impaired residents while wearing a mask and PPE – a challenge particular to memory care.

Mace’s presentation on the economy was titled, “The Economy: A Storm Ahead.” The pre-COVID-19 economy was enjoying the longest expansion on record, and the lowest unemployment rate in 50 years. Now, Mace noted, “This is the third time in two decades that all job-growth of the previous cycle has been eliminated. We’re back at the same level of jobs as back in February, 2010, and August of 2003, and December of 1999.” The unemployment rate is now at its highest rate since before World War II. Now at 14.%, Mace said that the rate is “projected to possibly go to 20% when we get the new data from May.” She pointed out that in the nine weeks since the pandemic hit the U.S., 38 million people have filed for unemployment insurance.

Visualized in a chart tracking quarterly U.S. Gross Domestic Product since 1968, a “Severe shock to the economy” is clear to see, as GDP is projected to drop at an annualized rate of 25%-40% in the second quarter of 2020. “We’re in the thick of it,” Mace said. Most economists, according to Mace, believe we’re seeing the worst of the economic impact now, and that it will soon begin to show signs of improvement. However, “It largely depends on whether we have a second wave, and how well we’re able to get testing, PPE and tracing, and if we can get a vaccine.”

A number of these economic factors are impacting the seniors housing and care industry. Data reported in Senior Housing News reveals that the sector’s labor costs are rising in the pandemic. Labor costs are 8% higher for properties unaffected by COVID-19. In communities that have tested positive for the virus, these costs are 18% higher. Costs are driven by “appreciation pay,” or “hazard pay,” for frontline care givers, hiring temp staff, providing childcare stipends, and similar labor-related costs. Other COVID-related costs include acquiring PPE and testing kits, building sanitation costs, and higher insurance costs.

Kerr added that paid leave, or, “quarantine pay,” is another category adding significant cost, as operators keep COVID-positive staff out of their properties. She also observed that finding PPE can be very challenging – and often the costs vary significantly. She said that the cost of a full isolation kit, which is used when caring for COVID-10 positive residents, is averaging $45 a day. She added that COVID-specific costs quickly multiply in communities in which residents have tested positive for COVID-19, averaging about three times the additional cost for COVID-free communities.

Some of those costs will remain, even after COVID-19, but some will be reduced as supply chains are streamlined and society adjusts to a new normal. “The silver lining is that the deeper we are into this…the more efficient we are becoming,” said Kerr, who expects to reduce costs through better planning and preparation.

NIC Executive Survey Insights indicate that higher acuity properties are seeing large declines in move-in rates. The most recent “wave” of data, from May 3, reflects that 84% of skilled nursing respondents reported declining occupancy rates over the previous 30 days, with assisted living reporting 74%, and independent living 71%.

Belmont Village has seen a drop in move-in rates, too, due largely to banning new residents, but has begun to allow move-ins in select locations. Kerr also noted that there are prospective residents waiting to move in, “there are a lot of people who have been waiting to move in because they do have special needs and would like to be cared for in a suitable environment.” The company now offers virtual tours, which Kerr says have been very well received, and is instituting new protocols, such as isolating move-ins to ensure they are COVID-free, and minimizing foot traffic through new move-in procedures.

Kerr, whose twenty-year career in seniors h

ousing and care includes time working on the capital provider side, both with Welltower, Inc, and HCP, also commented on the availability and cost of capital. Mace reviewed the current situation: Lenders are “on pause” until the picture becomes clearer, its difficult to evaluate and price risk, we’re seeing limited originations and capacity for new ground-up development, and the approach to lending and borrowing has become more conservative.

Underwriting assumptions are also more conservative today. Mace discussed longer lease up times, near-term rent and NOI growth impairment, compromised margins, rising costs of borrowing, and uncertainty in cap rate movement. She also described today’s reality regardingtransaction volumes as being limited and having extended timelines. Capital providers are focusing on their existing portfolios, private markets still haven’t followed the rapid repricing seen in public markets, but likely will do so, and bid/ask disparities are widening. With many government offices closed, the pandemic is also impacting the ability to get inspections and paperwork completed.

Asked how Belmont is responding to these trends, Kerr said that the company is moving ahead with development projects already in the works. “It’s probably a relationship type of market and by that I mean transactions with repeat providers, where there’s a great deal of experience already, or projects we have done together,” she explained. “I’m not suggesting the flood gates are open, by any stretch, but we have been…continuing as planned and securing debt…we have continued down the path without interruption.”

On the possibility of rate cuts, Kerr said, “Given everything we’ve talked about up to this point, the absolutely extraordinary effort that has to go into what we are doing, I don’t anticipate that this is an environment for rate cuts…this is not a period for discounting.” Echoing comments from earlier Leadership Huddles, Kerr also suggested that the market would see fewer new entrants as a result of the pandemic. “I think you will see less of the type of development that we might have seen in the past…new entrants to the market, people who are ‘dipping their toe in.’ I don’t think this is a time to try something new.”

Speaking about the rapid pace of regulatory change, Kerr addressed how difficult it has been to remain in compliance. “It’s a real herculean effort to keep up with the changes in requirements,” she said, describing getting multiple different sets of guidance from different governing bodies, “You’re getting some sort of executive order from a governor’s office, versus something that is coming out of your local department of health.”

Mace briefly presented key demographic data, pointing out that baby boomers won’t even begin to arrive in seniors housing until 2028, when the first of the generation will turn 82. She also presented recent findings on the importance of lifestyle and social determinants on health outcomes, and asked Kerr about the evolving trend of merging healthcare into the seniors housing environment.

“It’s something we should all be very aware of; what role do we play in this continuum of care?” Kerr said. She described Belmont’s partnerships with academic and medical research institutions, such as USC Davis school of gerontology, Baptist Health, Vanderbilt, and others. “There’s a long list of those kinds of connections because we understand that we have the opportunity to impact wellness,” she said. Speaking about the new prevalence of telemedicine and how COVID-19 has inspired numerous innovations in delivery of healthcare and wellness, Kerr indicated many of the innovations would remain even after the pandemic. She said, “We represent where people live and these providers want to, in many cases, meet their consumer, their patient, where they live, which in our case, is in senior housing communities.”

The last portion of the webinar was devoted to answering questions from attendees, who can submit questions online. NIC Chief Operating Officer Chuck Harry collected a variety of questions from the audience, including several on testing. Responding to questions on testing, Kerr said, “We could have three sessions like this on testing and would not be done. There’s new information about it just about every day. Part of the conundrum has been that supplies have not been broadly available. They certainly haven’t been available in equal measure for every operator…we’re not looking at an evenly distributed opportunity to test.”

Another question, referencing the amount of messaging coming out of the nightly news, asked whether operators were seeing changes in consumer sentiment. In response, Kerr, described the effort her organization put into communications, establishing, “a very clear, transparent, and frequent communication with our staff, residents, and their loved ones. Nothing can replace that.” Commenting on the possibility of long-term damage, she went on, “I don’t know that there’s some sort of permanent damage; on the contrary, because people who are close to us understand the specifics, rather than just being guided by the headlines. But time will tell, Chuck. We’ll hopefully be doing this right and will earn that trust.”

Beth Mace-2-1Mercedes Kerr