There are signs that Covid-19 has propelled more senior living providers to consider diversification strategies, adding new ancillary service lines as a financial and strategic play.

October 25, 2021

By: Tim Regan

The trend was already underway before the pandemic struck, but with Covid-19 eroding occupancy to historically low levels, providers have recognized the risks in tying revenue almost entirely to census.

“I … knew that 98% of our revenue comes from CCRCs, from the resident rates, so you have to think, ‘How do I continue moving forward, investing in infrastructure, investing in innovation, investing in our workforce, and growth in all the things we want to do by just relying on resident rates?’” Asbury Communities CEO Doug Leidig said earlier this year during an interview for Senior Housing News’ Changemakers series.

The pandemic added further urgency to Asbury’s quest to become a “diversified aging services organization” — and Asbury is not alone.

Publicly traded senior living provider Five Star Senior Living (Nasdaq: FVE) has for years tended to a growing rehabilitation service line dubbed Ageility. And the provider’s leadership foresees a future in which Five Star is even more diversified, in order to serve the new generation of consumers in a variety of settings.

Indeed, even as Covid-19 highlighted the need for more diverse revenue streams, the pandemic reinforced consumer preferences for at-home care, prompting even more senior living providers — including Bickford Senior Living — to consider branching out into these service lines.

The strategy is not easy to execute; many senior living providers have been successful by sticking to the business they know best. But providers that are pursuing diversification believe that by investing the necessary time and resources into creating multiple sustainable service lines, they will be positioned to serve future consumers and withstand market shocks.

“A lot of the services that we’ve been working on are about positioning ourselves for the future so that the businesses … will create revenue over time, and not just that quick-punch revenue that can sometimes fade,” Asbury’s President of Integrated Services Shaun Smith told SHN.

Data fills in the picture

Despite the rise of ancillary services in recent years, there are many senior living providers who did not create new service lines in 2020. This is unsurprising, given that providers were focused on rising to pressing pandemic challenges last year, but new data compiled by HealthTrust COO Colleen Blumenthal for an upcoming ASHA study helps fill in the picture, showing that some types of communities bucked the overall trend.

Among the 737 properties in the survey’s same-store sample that reported ancillary revenues, 59% said they did not increase ancillary revenues in 2020.

However, the surveyed assisted living communities reported a 26% increase in ancillary revenues, going from an average of $572 ancillary revenue per occupied unit in 2019 to $735 in 2021.

Combination assisted living and memory care communities saw 8% higher ancillary revenue last year, going to an average of $1,037 per occupied unit in 2020 from $958 in 2019.

And ancillary revenue for independent living communities grew 6%, increasing from an average of $270 per occupied unit in 2019 to $287 in 2020.

While certain care types grew their ancillary revenue last year, these revenues fell for others. Standalone memory care providers reported a whopping 41% less ancillary revenue in 2020, dropping to an average per occupied unit of $315 in 2020, which is down from $529 in 2019. Similarly, continuing care retirement communities saw 12% less revenue from ancillary services last year, decreasing to $3,785 in 2020 from $4,312 in 2019.

Communities with independent living, assisted living and memory care units saw about 5% less ancillary revenue in 2020, while IL/AL communities remained about flat.

Ancillary Service Strategies

While 2020 was a difficult year to embark on new ancillary service initiatives, some providers did go down that road — and their experience suggests the benefits of this strategy and suggests that other organizations may be wise to undertake similar efforts as pandemic challenges recede.

Frederick, Maryland-based Asbury affiliated with Albright Care Services at the start of 2020. The affiliation brought together Albright, a Pennsylvania organization with two retirement communities, three “LIFE” centers offering Living Independence for the Elderly services (known as PACE, or Programs of AllInclusive Care for the Elderly, in other states), a small home health line and a pharmacy service line; and Asbury, which in addition to its continuing care retirement communities (CCRC) also offered home-based services.

About three months into the affiliation, Covid-19 hit. But that didn’t deter Asbury from pursuing a new way to offer rehab services. The organization soon formed a joint venture with Flagship Rehabilitation to create Edge Therapy Solutions, an inhouse rehabilitation therapy service.

Under the JV, Flagship provides two regional staffers focused on compliance and management as well as rehab directors in all nine Asbury campuses.

“The whole premise was that you can save money by having your own in-house therapists,” Smith said.

While setting up a rehab therapy joint venture in the middle of a pandemic was not an easy task, Smith said Asbury saved money amid Covid by doing so.

“We really haven’t missed a beat on the revenue side,” Smith said. “We’ve been able to keep more of that revenue because we’re not sharing it with a therapy company, and we have also been able to develop some additional services in outpatient.”

Bickford is another company that has diversified its services. In June, Bickford launched a new home care service line with HomeCare Advocacy Network (HCAN) called “Bickford Home Care,” at four of its locations — in Chicago, in the Cedar Rapid/Iowa City market, and in the Muscatine/Quad cities market. The company is also launching its own hospice service at Bickford communities in some markets.

Bickford Executive Vice President of Operations Alan Fairbanks told Senior Housing News that although diversifying revenue was not the primary driver behind the moves — instead, it was aimed more at serving older adults where they are choosing to age — it did factor into the Olathe, Kansas-based company’s decision. And he took a similar view of revenue and savings as Smith and Asbury.

“It is an additional revenue stream,” Fairbanks told SHN. “But I don’t know that I would use the word ‘diversification’ because to me … it’s vertical integration, and we’re going to be providing care and services as Bickford to our residents versus outsourcing that care and services to other providers.”

Home-based care is a service line more frequently seen in nonprofit operators, who usually have a mission to serve older adults, both those living in their communities as well as beyond their walls.

About 45% of the operators featured in the 2021 LeadingAge Ziegler 200 — which covers the 200 largest non-profit operators in the U.S. — reported offering home- and community-based services to non-residents in 2021.

Of those services, home care and home health care were most popular, with 30% and 25%, operators reporting offering those services, respectively; followed by hospice (17%) adult day care (16%), continuing care at home (10%) and PACE (7%).

However, Bickford is far from the only for-profit organizations that is active in the at-home care space and looking to expand ancillary services further.

Another operator interested in home care is Kansas City, Missouri-based Tutera Senior Living and Health Care, which has 75 communities in nine states, one third of which are senior living. Though Tutera COO Randy Bloom said the company is already diversified with a home health care business among other in-house services, it is still looking to expand into other service lines, such as hospice, pharmacy, lab services, transportation and therapy.

“There’s nothing really off the table,” Bloom told SHN.

The pace of diversification is an open question — most providers working with Scott Moody, co-founder and CEO of senior living tech provider K4Connect, are still focused primarily on occupancy recovery at this stage in 2021.

Other trends Moody sees include senior living providers expanding into tech-enabled ancillary services for non-residents such as fall-detection, home automation, check-in capabilities or remote monitoring; and capturing a portion of insurance or health care costs, such as by offering services that are paid through Medicare Advantage.

“Some people have started to play in Medicare Advantage, where if they do take better care of that person, then they have the advantage,” Moody said. “[Tech-enabled services for nonresidents], fewer people are looking at that … but we’re definitely looking at that with some active adult communities.”

>>Read the full article on Senior Housing News

 

 

Here Khoa Pham, UI/UX and Design Lead of K4Connect, explains how to design digital healthcare solutions that are accessible and easy to use for older patients.

September 29, 2021

By: Leila Hawkins

We speak to Khoa Pham at K4Connect about how to design digital healthcare solutions for older patients
K4Connect is a tech startup that develops technology solutions for older adults. Here Khoa Pham, UI/UX and Design Lead of K4Connect, explains how to design digital healthcare solutions that are accessible and easy to use for older patients.

What issues do older patients encounter with digital healthcare tools?
The first things that come to mind are accessibility and privacy. And when I say accessibility, I mean both physically and from a design standpoint. Older adults and patients have a lot to be concerned about when it comes to privacy as they are often targets of personal information and digitally-driven scams. The privacy of their data, their rights and control of usage should be easily accessible and clearly defined.

The ability to use the internet and having access to the tools to get there is also an accessibility consideration for older adults. The majority of digital healthcare tools presume these capabilities and while older adult internet usage is rising, there is still a significant portion of this demographic reported to not be connected to the internet.

How they access the internet must also be taken into consideration. For example, those without personal devices using public computers at the library or community center introduces a whole host of privacy concerns. Along with these prerequisites to gain access to these tools, there can be a financial barrier to entry. We serve seniors across the entire socioeconomic spectrum, including those who may not be able to afford a couple hundred dollars for a laptop.

Are there specific issues with the design of digital healthcare tools?
There are a number of common issues that tend to break down in value when the physical impairments of those 65+ get more specific. For example, practices such as color contrast, font sizes and one-size-fits all accessibility are less impactful for an older adult with severe visual impairment like macular degeneration.

There is also the burden of having to understand technology and complicated medical terminology being placed on the individual who’s trying to self-serve. Is it truly easy for an 82-year-old to set up their own Zoom call to discuss their Haemoglobin A1C? Do they know what that means? These are the types of questions we’re constantly asking ourselves at K4Connect to ensure we are designing technology as true advocates for older adult users.

What are the most important things to take into account when designing healthcare solutions for older patients?
Empathy, always. Ultimately the goal is empathy for each individual’s unique circumstances. We begin, at least, with empathy that “older patients” means more than everyone 65+ having all the same problems.

There are those with vision issues, others that have mobility impairments, those with memory loss, those who have a lot of money in retirement, those who are on state-supported care, those who are close to family, those who are far from family, those who are veterans, those who are widows, and those who combinations of everything above and more. There isn’t a one size fits all solution. You can certainly start broadly, but to reach people that need it most, some specialization needs to be considered.

What is K4Connect’s approach?
We acknowledge that there are many stakeholders in this industry. There are the older adults, their friends and family, the community’s staff, the operators, the technology and health partners and the best solution involves serving all of them well. We want to create an ecosystem that centers around the older adult.

>> Interested in more? Read the full piece in Healthcare Global.

“Our expansion into multimodal experiences with the enterprise managed Echo Show device is an exciting part of the next frontier of voice innovation.”

September 22, 2021

By: Eric Hall Schwartz

Tech solutions for seniors developer K4Connect will integrate its software for assisted living communities with the Amazon Echo Show smart display for release later this year. The K4Community Alexa skill takes advantage of new Alexa Management APIs released by Amazon, allowing for multimodal software experiences.

MULTIMODAL LIVING

The new Echo Show skill developed by K4Connect augments the existing platform with new tools for communication and engagement through an assisted living center’s own software. The skill offers secure video calling, smart home controls, and entertainment designed for residents like games and music. Information about the local community, like events and menus that can also be accessed through Alexa and the information, can be set to display on rotation in the form of digital cards when the device is not in use.

“We are thrilled to expand our voice offering to include our multimodal skill. We were among the first to deploy Amazon Alexa across senior living communities and recognized early on that the natural interface of voice would empower older adults to live more independent and comfortable lives,” K4Connect CEO Scott Moody said. “Now, to combine both voice and touch into a single device, we’re able to serve even more residents using K4Community in ways that suits them best.”

SENIOR VOICES

Voice assistants and devices supporting them have grown enormously in popularity with older people during the COVID-19 pandemic, and subsequent quarantines set up at many assisted living communities. The new skill builds on the partnership between K4Connect, and the non-profit North Carolina Assisted Living Association (NCALA) that saw more than 1,400 Amazon Echo Show 8 smart displays installed in around 1,200 North Carolina assisted living communities early on this year. The success of those devices in boosting resident morale and keeping them connected with family and friends led K4Connect to explore more ways of using their software to help homes maintain their residents’ mental and physical well-being.

>> Read the full story on Voicebot.ai 

“Our expansion into multimodal experiences with the enterprise managed Echo Show device is an exciting part of the next frontier of voice innovation.”

September 17, 2021

By: Jason Parker

K4Connect is set to release an enterprise-managed integration with the Amazon Echo Show.

The company announced the news in a statement earlier this week.

“We have a close working relationship with the Amazon Smart Properties team that focuses on Alexa innovation which puts us at the forefront of voice-first technology for older adults,” said F. Scott Moody, founder and CEO of K4Connect in an interview with WRAL TechWire. “Our expansion into multimodal experiences with the enterprise managed Echo Show device is an exciting part of the next frontier of voice innovation.”

That expansion will come at a time when ‘voice-first technology’ is being increasingly adopted by older and aging adults, the company said in its statement.

“Senior living has seen the benefits of voice assistants for some years now and the adoption of this technology is growing rapidly,” said Moody. “In fact, in a recently released data report we conducted of our senior living community residents and staff, 25% of communities implemented Amazon Alexa during the pandemic to overcome challenges of lockdown and quarantine. We also saw a 34% increase in overall resident usage of voice across thousands of deployed devices to access content and information and to communicate with others.”

Earlier this year, the company worked with Amazon and the North Carolina Assisted Living Association to deliver and install 1,400 Echo Show devices to senior living communities in the state of North Carolina, the company reported.

According to the company, features added will include two-way secure video calling, smart home controls, entertainment media, and amenities.

“The older adult population is growing and even outpacing the younger population,” said Moody. “Senior living currently only accounts for around 3% of older adults in some form of senior housing with the other 97% largely consisting of those aging at home with home or family caregivers.”

>> Read the full story on WRAL Techwire here

“Here’s how tech startups can be a positive force for good in the financial lives of so many residents in the Carolinas.”

September 13, 2021

By: Joshira Maduro

Editor’s note: Joshira Maduro is a research analyst at LendingTree in Charlotte. Startup Spotlight is part of WRAL TechWire’s Startup Monday lineup which also includes updates to our exclusive Startup Guide, our list of regional tech meetups, a review of last week’s headlines, and weekly calendars of events for the Triangle, the state, and a look ahead to next month.

When you hear the words “tech startup,” you might naturally think of traditional tech hubs such as San Francisco, New York City or even Austin, Texas. But tech is booming in North Carolina, employing thousands of people and helping to raise the financial fitness level of many local families.

This growing industry has the potential to create an increasing number of jobs and help local professionals upskill in order to meet the increasing demand for specialized jobs. Here’s how tech startups can be a positive force for good in the financial lives of so many residents in the Carolinas.

CONNECTING COMMUNITIES
Sometimes, creating more financially sound communities is core to what tech companies do — sometimes it’s a bonus. For K4Connect, establishing stronger links between seniors, friends and family and professional caregivers is their main mission. This just so happens to be an excellent tool for combating senior financial abuse.

Elder financial abuse costs Americans $2.6 billion to $36.5 billion annually. That’s a huge range, and part of why it’s so hard to get accurate numbers on senior financial abuse is the lack of reporting, whether due to shame on the elder’s part or simply not knowing how or having the awareness that the abuse is occuring.

K4Connect’s suite of communication tools makes it easy for seniors in long-term care to connect with their families and caregivers. “Any time you’re communicating with your family more, you’re talking about what’s going on in their lives, the more you can make sure that no one’s being taken advantage of; that there’s not someone preying on them in a way that can be detrimental,” said Cindy Phillips, managing partner and chief of staff at K4Connect.

This connection can also help residents become more aware of ongoing scams targeted at seniors. “Our platform allows that information to get shared more quickly in a community. Any time you hear about a scam that is hitting our community, we would want to put the word out.”

Since seniors are often at risk of financial abuse when procuring services — home repairs, grocery delivery, ride sharing — the company is also developing a new feature that will aggregate services in one marketplace. Thoroughly vetting services, and creating a solution where seniors only have to input their financial information once, can help reduce financial risks.

“As we grow, we’re thinking, ‘How do we protect people and give them peace of mind?’” said Phillips.

Many tech companies might already be developing the tools to build financially fit communities without realizing it. You don’t have to be a fintech start up to help with finances. K4Connect proves that all companies that touch consumers can play a role in developing financial literacy.

>> Read the full story on WRAL Techwire