Senior Living News Wire

In the pursuit of new property development, developers today are spending much time and money in working with the communities in which they are building senior living communities—which may be a departure from ways of the past.

One New York developer made recent headlines over public benefits included in a project proposal for a memory care community in Halfmoon, New York, including a $75,000 commitment toward a picnic pavilion, bike paths and trails, highway improvements and sewer updates with a potential additional $35,000 going to the 133-unit project.

Today’s developers are working with their surrounding communities, rather than against them, to sweeten the deal for both parties and provide public benefits to show their commitment.

“Historically, senior housing developers tried to convince communities that their projects would have ‘no impact’ on the community,” says George Mesires, partner at Ungaretti & Harris LLP and co-chair of the firm’s Finance and Restructuring Practice. ”However, more and more, the best senior living developers are engaging the community leaders early to focus on the synergies that can be created when developers and communities collaborate.”

Those might include infrastructure improvements, as in the case of the Halfmoon development, or by incorporating mixed-use square footage, or even partnerships with local schools to connect students with senior residents.

It also simply spans appearance, which has proven effective in many recent cases, panelists told attendees of a SHN webinar last week.

“One of the keys for seniors housing is to make it attractive as a residential community,” said Debbie Laycock, managing director, ARA Seniors Housing citing landscaping as a simple example. But working with the community goes beyond a simple pledge; it also means communication. “Owners need to realize they need to be accessible.”

Benchmark Senior Living has working with the community is critical in its infill developments in the densely populated northeast.

“You have to incorporate [community] concerns,” said John Dragat, head of development for Benchmark. “Mitigate the impact and get people comfortable. In many cases you have to cooperate with the government and uncooperative neighbors.”

The community benefits can also provide a good platform for the senior living developer to continue working with its surrounding stakeholders on an ongoing basis.

“The goal should not be ‘how to be keep the senior living community within its own walls’ but rather ‘how do we integrate the senior living community beyond its own walls into the broader community,’” Mesires says. “…Such integration can lead to community benefits such as greater volunteerism, increased charitable giving, civic pride, and an active citizenry.”

Written by Elizabeth Ecker

LeadingAge’s Center for Aging Services Technologies (CAST) is releasing a white paper and selection matrix for senior living providers looking to implement an electronic health record (EHR) system. 

These tools are an expansion of the portfolio of free tools that CAST released last year to help long-term and post-acute care organizations plan for and identify EHR products that meet their needs.

The whitepaper outlines the detailed steps of planning, assessing and selecting an EHR system and defines the major components that these products offer. The update includes added sections on decision support systems, interoperability standards and health information exchange.

Also included in the whitepaper is a checklist of assessments to ensure the strategic planning of rolling out EHR technology aligns with the mission or goals of a provider. These include assessing one’s IT infrastructure, staff competency to identify training needs down the road, as well as the readiness of an organization in general. 

The selection matrix catalogs more than 200 major functionalities in 36 long-term and post-acute care organization EHR products, up from 22 in 2012, according to Majd Alwan, Ph.D, LeadingAge senior vice president for technology and executive director of CAST.

“EHR is a key, enabling technology for the future,” Alwan told SHN. “Having an EHR helps providers offer more accurate, timely documentation, and using the advanced features of this technology helps them increase efficiency and improve the quality of care for their residents.”

Now in its second year, the updated portfolio of CAST tools aim to allow LeadingAge members to meet the leadership required of pioneering technology solutions, according to Larry Minnix, president and CEO of LeadingAge.

“In an age where providers are looking to meet greater demand on a tighter budget, EHR’s are a great example of how technology is improving quality while reducing costs.”

As of April 2013, about $14.6 billion in meaningful use had been distributed to various healthcare professionals as incentive for EHR development, according to Robert Anthony, deputy director of the HIT Initiative Group at the Centers for Medicare & Medicaid Services Office of E-Health Standards and Services.

Written by Jason Oliva

Edward Lange Jr. has resigned as Holiday Retirement’s chief executive officer just two months after taking the position, a source within the company confirmed on Tuesday.

Lange was named the company’s CEO in April 2013, succeeding Jack Callison, Jr. He previously served as chief financial officer and chief operating officer for BRE Properties, Inc. and has more than 20 years’ experience in the residential and senior care industries. 

Kai Hsiao, Holiday’s president, has assumed the role of interim CEO, sources told SHN. 

Holiday Retirement is the nation’s largest independent living provider and the third-largest senior living provider with more than 42,800 units spread across 316 properties. 

The Lake Oswego, Ore.-based company has made a few acquisitions in the past few months, including communities in McAllen and Longview, Texas and Raleigh, N.C.

Written by Alyssa Gerace

Tech companies nationwide continue developing innovative designs with a focus on senior care technology. Whether it’s a virtual reality program simulating what it’s like living with dementia, or a rollout of touch-screen apps to keep residents “in the loop” of community happenings, there is a technology to meet a variety of care needs. Read on:

1. Senior Star Takes Virtual Dementia Tour on the Road

With Senior Star at Weber Place’s Virtual Dementia Tour, users can experience the reality of what it’s like living with Alzheimer’s. 

One of the largest operating free-standing memory care communities in the state of Illinois, Senior Star at Weber is now taking its Virtual Dementia Tour (VDT) on the road. 

Through the VDT tool, the Senior Star at Weber Place team is educating caregivers, medical professionals, caseworkers and family members of the critical needs of those who are living with Alzheimer’s.

The 15-minute program uses tools and activities to depict what it’s like for someone living with a form of dementia. Participants are asked to perform tasks in an altered state whereby the VDT artificially impairs the senses affecting the ability to interpret the environment. 

Participants reacting to the impaired sensory input lead to behaviors such as wandering, talking to oneself and not following instructions—behaviors often seen in dementia. 

Lead by expert Anna Walters, director of memory care at Senior Star at Weber Place and certified to conduct the VDT, the program creates a realistic scenario utilizing a home-like environment and activities of daily living.

The program also includes a question and answer session focusing on how to cope with Alzheimer’s patients and recognize some of the early signs.

 ”We are providing the VDT for hospitals and other health care providers, businesses and civic groups,” said Michelle Franzak, executive director of Senior Star at Weber Place. “It has been very helpful in understanding this terrible disease and how to cope and care for those suffering from Alzheimer’s and other forms of dementia.”

2. Dakim BrainFitness Yields Improved Cognitive Skills

The results of a peer-reviewed clinical trial of Dakim BrainFitness, conducted by the UCLA Semel Institute, found that participants showed significant improvement in memory and language skills.

Additionally, researchers proposed that brain fitness tools such as Dakim BrainFitness may help protect individuals from cognitive decline commonly associated with aging and Alzheimer’s disease. 

The Dakim BrainFitness System is designed with a kiosk-style console that uses a touch-screen to provide a fully personalized workout that can help maintain brain fitness and slow the effects of cognitive decline. 

The program enables users to cross-train their brains to achieve peak mental functioning by touching on six essential cognitive domains. These include short-term memory; long-term memory; language; computation; visuospatial orientation; and critical thinking skills. 

Dakim BrainFitness is the only evidence-based cognition program approved by the U.S. Administration on Aging, enabling Area Agencies on Aging to use Title III, Part D funds for disease prevention and health promotion, to purchase Dakim for the seniors they serve.

The technology is used at more adult living communities than any other mental fitness program, and is now being used by healthcare professionals and rehabilitation centers in Texas, Washington, California, Kentucky and Minnesota.

3. Touchtown Apps Roll Out in Denver Retirement Community

The first wave of tablets with the new Touchtown Resident Apps is arriving at senior living communities and residents are quickly learning how to use the new technology.

Among those receiving the Touchtown tech are all 167 independent living residents at Clermont Park, a Denver retirement community. 

Touchtown Resident Apps provides a platform for seniors to stay connected through event sign-ups, daily check-ins instant messages, transportation requests, dining information and housekeeping services. The apps’ interface includes large icons and text, navigation, scrolling ability and a text-to-speech feature.

“It’s a communication tool that helps improve the quality of life for residents at senior living communities,” says Jeff Pepper, president and CEO of Touchtown. “And for organizations, Touchtown Resident Apps can be integrated with workflow or point-of-sale systems to help streamline operations.”

Touchtown offers more than 20 apps for senior living communities to choose from, each customizable on a community and individual level. Additional apps range from health and wellness resources to directories to a variety of interactive communication and information-sharing tools. 

“We’re already seeing how the apps allow for better and more personalized communication with residents,” says Jill Vitale-Aussem, executive director of Clermont Park. “It promotes interaction, gives residents an added sense of freedom, and also safety and security.”

From making reservations at the community restaurant or signing up for an exercise class, residents will be able to say “There’s an app for that.”

4. State Healthcare Association Streamlines Wellness Tech for Seniors

Linked Senior, Inc. and the Health Care Association of New Jersey (HCANJ) have announced a partnership to provide technology to enhance the quality of life for residents of New Jersey nursing homes and assisted living communities. 

The agreement will allow member facilities of HCANJ to purchase Linked Senior programming, specifically designed for seniors, at a reduced rate.

Linked Senior Inc. uses technology to support programming & wellness, opens communities to the world while helping management improve resident and family satisfaction, productivity and efficiencies. 

The system also includes a touch screen kiosk and content tailored for seniors with features including games, puzzles, custom slideshows, brain fitness and educational content. 

“Linked Senior’s approach will allow the individuals who reside in our long term care facilities the opportunity to enjoy programs tailored to their varied levels of health and abilities,” said Paul R. Langevin, president of HCANJ. “The methodology employed in their product will enhance out members’ ability to provide a more person-centered experience for all their residents.”

Headquartered in Washington, D.C., Linked Senior Inc. is a leading provider of resident engagement solutions to the senior housing market.

5. Health System’s Technology Solution Reduces SNF Length of Stay

Virginia-based Centra Health has selected HealthMEDX to provide technology to manage patient care across all post-acute care settings, as well as enable the exchange of patient information across Centra Health’s entire acute-care continuum, including hospitals, physician offices, pharmacies and labs. 

Through Centra’s cardiac program, where a specially-trained cardiac nurse manages care for cardiac patients in SNFs using specialized care pathways, Centra has reduced patient length of stay from 4.52 days in 2006 to 3.85 days in 2012. 

Based on this success, Centra is developing similar programs for orthopedics and piloting Emergency Room Diversion Protocols to keep patients out of the ER. 

“With HealthMEDX’s long-term post-acute care EMR and connectivity platform, we will be able to enhance the quality of care across all settings and continue our evolution as a technology leader,” said John Paul Jones, M.D., chief medical information officer of Centra Health.

HealthMEDX is the only vendor that provides an integrated, person-centric system that includes a full electronic medical record and comprehensive billing system with integrated CRM. 

The product, known as Vision, supports the entree post-acute care continuum, including rehab, home care, hospice and long-term care for independent living, assisted living and skilled nursing. 

The HealthMEDX Exchange platform, with its system as a software design, allows post-acute care providers to connect with hospitals, physicians and payers to address readmission management and facilitate coordination across the care continuum.

6. Social Tech Teaches Seniors about Preventative Health

Preventative health has a whole new meaning at the East Boston Neighborhood Health Center (EBNHC) for people ages 55 and older. 

Through its Program for All-Inclusive Care for the Elderly (PACE), members have the opportunity to become computer savvy through ConnectedLiving, a Quincy, Massachusetts-based company.

ConnectedLiving has developed a web-based social platform designed specifically for the senior living industry, servicing all segments of the market, including private pay and affordable senior living communities.

The partnership with PACE includes an additional focus on preventative health information, further encouraging seniors to learn about technology in a stimulating and social way. 

“What’s different about this relationship is not only teaching computer and Internet skills to members through exciting topics of interest, but to use ConnectedLiving in the future for preventative health education,” said Anna Hall, vice president of ConnectedLiving University. “Empowering seniors to be informed has proven value to their overall well-being.”

Recently, the company launched its ConnectedLiving University with online tools and resources for seniors and senior living communities that promote lifelong learning.

The ConnectedLiving Network, from which the University program is accessed, is a cloud-based social network tailored for seniors. The platform includes an easy-to-navigate interface providing secure Internet access, email, photos, a library, games and video chat.

In addition to online content for seniors, the program also provides extensive training for senior living community staff. The training curriculum was developed with an understanding of the needs of older adults and their caregivers. 

Written by Jason Oliva

Siena PSD, a partnership between Siena Senior Living and Pacific Summit Development, marked new progress on its 20-project, approximately $360 million pipeline of senior living communities after obtaining entitlements for an eighth site in mid-June.

The pairing combines real estate development veterans with some relative newcomers to the senior housing industry who are planning to build about 2,064 units of mostly assisted living and memory care with some independent living in the next couple years. The size of the communities generally ranges between about 75-125 units each at an average construction cost of $18 million.

Pacific Summit Development, founded in 1987, is led by partners Randall Driscoll and William Thurston, both of whom have extensive real estate and development experience through their backgrounds with the Downey Savings and Loan’s real estate development program.

Don and Andrew Pitarre are the co-principals of Siena Senior Living, LP, which formed in 2008 and sold its first planned and developed assisted living community, located in Longmont, Colo., to Ventas (NYSE:VTR) in March 2012.

“We always wanted to get into assisted living, but it’s hard to do unless you’ve got a track record,” says Don Pitarre, who says his company forged ahead “in spite of” the Great Recession. “So we paired up [with PSD]. They’ve got the strength to help bring a lot of projects to the market, and we’ve been on a tear this year getting properties and going through entitlements. We specialize in getting entitlements done.”

At this point there are about 20 projects in Siena PSD’s pipeline that will be developed in the next 18 months. As of June 15, eight are slated to have completed the entitlement process, with six more expected to obtain entitlements by early fall and the rest by the end of the year, according to Siena PSD’s project pipeline schedule.

Project locations include Fairfield, Ventura, Santa Barbara, San Ramon, Carmichael, Citrus Heights, Nipomo, and San Diego, Calif. Eight more projects are located in Texas, in McKinney, Temple, Waxahatchie, Austin, Houston, and San Antonio, and two more in Scottsdale, Ariz.

Once projects are entitled, Siena PSD generally breaks ground within 60 days. The developer has relationships with nearly 10 sale-leaseback senior living operators, and works with REITs both directly and through those operator partnerships, says Pitarre, although he declined to name any operator or REIT partners. Siena PSD uses architect Irwin Associates for all its projects and ProMatura Group for market studies.

REITs and private equity funds have been “very active” with development financing, and that’s where around half of the Siena PSD projects will get 100% of their financing, Pitarre estimates.

“The mindset is changing with the REITs—they’re running out of Class A properties to acquire. The only way to get that Class A property is to build it yourself,” he says, echoing sentiments voiced by Sabra Health Care REIT executives during an investor presentation at REITweek 2013. “The Class As are getting few and far in between, and to get into assisted living and memory care you have to do more and more development.”

The rest of the projects will be conventional 50/50 ownership-financed deals, he says, noting that banks are getting more active—a trend expected to continue throughout 2013.

For Siena PSD projects done with bank debt or some other form of financing in addition to REIT capital, the developer retains ownership generally until the property is stabilized with occupancy between 91-93%.

“We prefer pre-arranged [deals] with the REITs. What we’ll do is bring a lease-back operator in to work with us that guarantees a lease with the REIT, which makes them feel comfortable to fund 100% of the development,” says Pitarre.

Memory care is a key component of many of Siena PSD’s projects, and Pitarre views the sector as a growing, unmet market that will become an “acute” need. While there’s always concern about overbuilding in any segment, he says, developers just need to do their market research homework.

Moving forward, Siena PSD plans to keep its projects mostly west of the Mississippi River, with sights set toward eventually targeting the active adult market in California and Texas.

“You’re seeing home prices rise now, and seniors are going to be able to sell their homes and either purchase a 55+ home or an active adult rental,” Pitarre says. “The market studies we’re relying on indicate the active rental market has the most potential for growth, so we’re trying to get into places that match up with that interest.”

Written by Alyssa Gerace

Seattle-based Merrill Gardens announced on Monday the hiring of Tana Gall as president and Jason Childers as senior vice president, effective immediately. Both Gall and Childers were formerly the president and senior vice president, respectively, of Leisure Care, also based in Seattle.

Merrill Gardens’ former president Bill Pettit has moved on to lead R.D. Merrill Company, the parent company of Merrill Gardens and Pillar Properties, which owns and operates apartment residences in Washington state.

Prior to joining Merrill Gardens, Gall worked at Leisure Care for 19 years. Childers was with the company for 11 years. As of Monday, only Dan Madsen, Leisure Care’s CEO, is listed as the company’s leadership. Senior Housing News has not heard back from Leisure Care regarding new leadership as of press time. 

Merrill Gardens owns and operates 56 retirement communities in nine states and is celebrating its 20th year of operations in 2013.

“Tana and Jason’s expertise will be critical as we build the platform for our operating systems for the future,” said Pettit in a statement. ”They will be leading the way as we transform the company through technology and innovate new ways to best serve our senior population. We are very fortunate to have them join our team and I look forward to the opportunities their continued partnership will provide to Merrill Gardens.”

Written by Alyssa Gerace

The Department of Health and Human Services has made updates to its National Plan to Address Alzheimer’s Disease including its take on the vulnerability of older Americans who live in care facilities. 

Due to the particular vulnerability of people with Alzheimer’s disease who live in care facilities, HHS stated, the department will increase its attention to this population via the studies currently available. This will include an “in-depth analysis” that has implications for those providing care in assisted living communities. 

…”This will include an in-depth analysis of the National Survey of Residential Care Facilities to better understand the level of cognitive impairment among residents and the types of services provided in assisted living facilities,” HHS writes. “The results of these studies will be used to identify areas that the National Plan should address in future years.”

While reports of elder financial abuse are currently fielded by state Adult Protective Services, not all of these programs cover residents of long-term care communities, HHS says. State funding allows states to survey Medicare and Medicaid-certified nursing facilities, while state licensing agencies may investigate other types of care communities, including assisted living. 

The changes to the plan come as part of an effort to better protect those who are receiving long term care. 

“Congress must see to it that the necessary resources are committed to accelerate and prioritize the government’s efforts on Alzheimer’s,” said Harry Johns, President and CEO of the Alzheimer’s Association and member of the Advisory Council to the Plan. “Without these new resources, efforts in Alzheimer’s research, care and support will continue to be hampered to the determent of millions of families and the economic well-being of the nation.”

In the early iterations of the plan, assisted living was not included as a care setting, which prompted a campaign by the Assisted Living Federation of America (ALFA) to introduce it to the plan. ALFA submitted comments last year to HHS toward the initiative. 

Written by Elizabeth Ecker

State lawmakers are urging elderly citizens to use life insurance as a way to pay for long-term care, reports The Wall Street Journal. 

The strategy aims to provide seniors and their family members with financial resources to pay for immediate care needs through life settlements, a practice in which policyholders sell their life insurance policies at a discount in the secondary market and the buyer takes over premiums and collects the death benefit.

Proposed legislation is pending in at least eight states, including Texas, New York, California, Florida, Kentucky, Louisiana, Maine and New Jersey. 

The states hope life settlements will stop seniors from dropping their life-insurance policies in order to qualify for Medicaid. To ward off policy owners from spending down their settlements, the proposed bills require that money go straight into an irrevocable bank account used solely to pay for long-term care.

There is nothing to prevent life-insurance owners from selling their policies to pay for long-term care, but legislators hope the new laws will help to publicize, as well as regulate, the strategy.

A drawback to these settlements, notes WSJ, is that the company buying the policy retains a “sizable chunk” of its value, which can amount to 45% of the policy’s death benefit, depending on a holder’s age and health.

Families find that selling a life-insurance policy can still help them meet immediate care needs for family members, even though they are losing a percentage of the policy upon selling.

Read The Wall Street Journal article.

Written by Jason Oliva

The Department of Housing and Urban Development (HUD) recently released finalized guidance clarifying its position on the role of housing in accomplishing the goals of Olmstead, the landmark Supreme Court decision giving people with disabilities the right to have multiple housing options.  

Olmstead‘s objective is to help people with disabilities lead normal, integrated and independent lives. For some, this may mean living in a community setting where they can also receive supportive services if necessary, rather than a nursing home or some other institutional setting.

There has been a lot of cross-agency collaboration between the Department of Justice, the Department of Health & Human Services, and HUD to clarify and implement Olmstead, notes Michelle Norris, senior vice president of acquisitions and development at National Church Residences (NCR), which provides affordable housing to a variety of populations including the elderly and disabled. 

The ruling has implications for senior housing, especially for providers of HUD-assisted supportive housing. A significant number of disabled people are also elderly, Norris says, and because of the aging in place trend, that’s not expected to change.

“People are living in [their homes] longer and living longer,” she says, adding that the average age of people living in NCR housing is now 75. “As people head into their 80s, they generally have more limitations, chronic illness, and disabilities. We are going to see both sets, the elderly and those with disabilities, in our buildings.” 

While there have been increased efforts across the country to give more choices to disabled individuals who are institutionalized or housed in settings that are considered segregated, there has still be a lot of confusion about how housing providers should follow Olmstead, according to the HUD guidance. 

“[T]here is a great need for affordable, integrated housing opportunities where individuals with disabilities are able to live and interact with individuals without disabilities, while receiving the health care and long-term services and supports they need,” HUD says.

NCR’s action plan is to continue providing supportive housing for populations including seniors, the disabled, and the homeless, and to keep working with states that are providing funding for supportive housing and make sure they understand Olmstead policy.

The agency is exploring how it can fund additional integrated housing units with long-term healthcare and supportive services along with the funding it already provides for single-site supportive housing that already houses and supports individuals with disabilities. 

“HUD is taking this opportunity to advise housing providers, as they manage their portfolios of housing and develop new housing to meet the needs of individuals with disabilities, to consider the particular housing needs in their individual communities and in their state,” the guidance reads.

Through the finalized guidance, HUD is trying to help states understand their position from both a housing and supportive services perspective. 

“HUD and HHS have been going state by state educating people on the parameters [of Olmstead],” Norris says. “There’s room within this guidance; it’s not very, very strict, saying ‘you must do this, you can’t do that.’ It’s more balanced.”

Some independent living providers see opportunity in Olmstead and how it is enforced.

“We believe ILCs [independent living centers] can play a crucial role in the implementation of managed care,” said Liz Pazdral, California’s Independent Living Council Executive Director, in a statement.  ”ILCs have established and effective relationships with community-based organizations and can help managed care plans contain costs by assisting individuals living with disabilities to live independently in their homes rather than in institutions.”

California is transitioning to a managed care model for its dual eligible population, with an emphasis on home- and community-based services. Through the state’s Coordinated Care Initiative and Medicaid system, independent living  centers can work with managed care plans to expand access to HCBS services. This is accomplished by including those services in a benefit package for dual eligibles, says the California State Independent Living Council, and contracting with managed care organizations to deliver the services in a community setting.

“In the past, ILCs have never had to demonstrate to health plans the benefit of the services we provide and how those services can effect positive outcomes such as reducing re-hospitalization or providing in-home support services that keep individuals out of emergency rooms,” said Todd Teixeira, Silicon Valley Independent Living Center’s director of programs. “Given the role we can play in keeping costs down while providing quality services, it will be critical for ILCs to collect data and track outcomes that demonstrate our value to the managed care plans.”

Access the finalized HUD guidance.

Written by Alyssa Gerace

Following the housing bubble and subsequent burst, the senior housing industry is facing an ongoing phase of consolidation, with many, many more deals on the way that will come in response to the post-boom era.

For many non-profit organizations, it means consolidation ahead, but perhaps not in the traditional form. Many will opt to affiliate with larger groups or other single-standing properties in order to boost financial stability or for other, newer, reasons, say those who assist communities in maintaining their economic position in the market.

“We’re seeing a gradual consolidation phase,” says Dan Hermann, senior managing director and head of Investment Banking for Ziegler. “For the leading not for profit sponsors, many are multi-facility systems that have been desiring to grow and have recognized that growth through affiliation is as logical and rational as growth through development.”

The agreements that have already taken place are paving the way for more, Ziegler says, as companies face certain challenges following the downturn in the market.

“Usually they need two to three factors,” Hermann says. “Those might be aging physical plant, declining occupancy or financial distress.”

For two Kansas-based CCRCs, Kidron Bethel Village in North Newton, Kansas and Schowalter Villa in Cedar Hesston, located six miles apart from one another, joining together took the two from being competitors to enjoying many operational efficiencies under the new partnership.

“As non-profits we always viewed the people close to each other as colleagues but also as competition,” says James Krehbiel, president and CEO of Bluestem Communities. “We were two organizations that drew from the very same marketplace.”

Today they are one operator: Bluestem Senior Living. Yet three years ago, the operators were only talking about the efficiencies available if they were to join together as one.

Both were strong in quality and functioning, but with uncertainty and Medicare reimbursement cuts, a conversation began among the two communities.

“We saw what we needed to do with specialization,” Krehbiel says. “Why not be proactive and look at the possibilities of: here are two organizations six miles apart. What about becoming one non profit? Would there be advantages?”

After 18 months of conversations among board members, the communities entered a phase of consulting with stakeholders and beginning to broach the topic with them.

Ultimately, they looked at the potential partnership as coming to terms in several areas: the mission, financial impact, specialization opportunities and additional efficiencies. They agreed the efficiencies they would gain through a partnership would benefit both communities financially, and across the board. 

“We did not anticipate how much intersection there was of how we do it here and there and figuring out solutions together, from maintenance and grounds meeting to say how do we do grounds better, to chaplains communicating on how to do spiritual life better,” Krehbiel says. “We did not anticipate it to the degree it did.”

Like Bluestem, Ziegler sees much more opportunity on the horizon for mutually beneficial partnerships between communities. Rather than seeking options to refinance or become acquired, there are other options available, and they will be used increasingly, says Rebecca Neth Townsend, senior vice president, investment banking, for Ziegler. In some cases they are spanning multiple denominations.

“They tend to be careful when they step into sponsorship transition,” Townsend says. “But the concept of ‘I’m a not for profit and we’re going to extend to another not for profit’ seems to play well as a less threatening approach.”

With many conversations currently under way spanning geographic regions as well as community types and specialties, Ziegler expects the market to see many more partnerships among those communities that have weathered the economic storm but are looking to improve and remain competitive.

“We’re seeing a gradual consolidation phase,” Townsend says. “Not for profit senior living tends to be  slower to react to initiatives with risk associated.” 

Written by Elizabeth Ecker  

Researchers at Carnegie Mellon University (CMU) have developed a method for tracking the locations of multiple individuals within an indoor setting that has implications not only for healthcare, but broader security also.

Using a network of video cameras, CMU researchers were able to follow the movements of 13 people within a senior care facility, even though individuals sometimes slipped out of camera view.

Researchers used multiple cues to identify individuals from the video feed, such as apparel color, person detection, movement trajectory and even facial recognition. 

Multi-camera, multi-object tracking has been an active field of research for a decade, but automated techniques have only focused on well-controlled lab environments. 

Carnegie Mellon’s team, by contrast, proved their technique with actual residents and employees in a nursing facility—with camera views compromised by long hallways, doorways, people mingling in the hallways, variations in lighting and too few cameras to provide comprehensive, overlapping views.

The algorithm developed by CMU significantly improved on two leading algorithms in multi-camera, multi-object tracking. It located individuals within one meter of their actual position 88% of the time, compared with 35% and 56% for the other algorithms. 

The technology has drawn comparisons to the fictional Marauder’s Map used by popular book and movie series Harry Potter, which upon viewing and with a hint of magic, reveals the location of people moving about nearby.

While no magic was necessary to create the video monitoring tech, researches developed their tracking technique as part of an effort to monitor the health of individuals in senior care settings. 

“We thought it would be easy, but it turned out to be incredibly challenging,” said Alexander Hauptmann, principal systems scientist in the Computer Sciences Department (CSD) of CMU.

Something as simple as tracking based on color of clothing proved difficult, for instance, because the same color apparel can appear different to cameras in different locations, depending on variations in lighting. Additionally, a camera’s view of an individuals can often be blocked by other people passing in hallways or even by a piece of furniture. 

This is where face detection helped in re-identifying individuals on different cameras.

Yi Yang, a CSD post-doctoral researcher, noticed that faces can be recognized in less than 10% of the video frames. So, researchers developed mathematical models that enabled them to combine information, such as appearance, facial recognition and motion trajectories. 

Further work will be necessary to extend the technique during longer periods of time and enable real-time monitoring, CMU researchers agree, especially as they look for additional ways to use video to monitor resident activity while preserving privacy. 

“The goal is not to be Big Brother, but to alert the caregivers of subtle changes in activity levels or behaviors that indicate a change of health status,” Hauptmann said.

Written by Jason Oliva

Are you looking for a new senior housing job? Check out the Senior Housing News jobs board to view openings for sales and marketing directors, assisted living administrator, executive director, and much more. 

Are you a senior living company or organization looking for new talent? Post a job on Senior Housing News Jobs Online.

• Business Office Manager for Senior Housing (Houston, Texas) Tarantino Properties
• Assisted Living Administrator (Fort Smith, Ariz.) Brookfield Assisted Living
• Marketing Director (Westhampton, N.Y.) Westhampton Senior Living, Inc.
• Sales Director (Waterbury, Conn.) Benchmark Senior Living
• Director of Resident Programs (Austin, Tex.) Senior Lifestyle Corp.
• Executive Director (Austin, Tex.) Senior Lifestyle Corp.
• Memory Care Specialist (Chicago, Ill.) Senior Lifestyle Corp.
• Director, Sales & Marketing (Scottsdale, Ariz.) Senior Lifestyle Corp.
• Digital and Print Advertising, Outside Sales (Fort Lauderdale, Fla.)  Dominion Enterprises/www.SeniorOutlook.com
  Director of Senior Housing (St. Paul, Minn.) Great Lakes Management Co. 
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Policymakers are looking toward a revised payment system for post-acute care services as a way to change healthcare delivery from a “fee for service” model to more coordinated, accountable care, but there’s risk inherent in bundled payment models.

Under the traditional fee for service Medicare model, the program pays widely varying rates for beneficiaries depending on what post-acute care setting they are in—skilled nursing facilities, home health, inpatient rehabilitation hospitals, or long-term care hospitals—even if they’re getting the same or similar care.

“Bundled payments have the potential to improve care coordination and quality of services, rationalize service use, and lower potentially avoidable readmissions,” says the Medicare Payment Advisory Commission (MedPAC) in its June report to Congress.

In 2011, at the recommendation of MedPAC, the Centers for Medicare & Medicaid Services (CMS) launched a Bundled Payments for Care Improvement Initiative to test different bundle designs, where one benchmark price across multiple providers would cover all services given, no matter the post-acute care setting, during a defined time period following a hospitalization or other “triggering” event.

The CMS pilot found that there are advantages and disadvantages to possible approaches of bundled payments, MedPAC continues.

“Each decision involves trade-offs between increasing the opportunities for care coordination and requiring providers to accept risk for care beyond what they furnish,” says the report.

Despite the risk, bundled payments would give providers—especially those not ready to assume even greater risks associated with other payment reform models such as accountable care organizations—a way to gain experience in care coordination across a spectrum of providers and settings, according to MedPAC.

Bundled payments for post-acute care services could serve as a gateway to larger healthcare delivery system reforms, says MedPAC, which plans to continue looking into how best to proceed with payment reform in the next year.

Read the June report.

Written by Alyssa Gerace

Nursing homes are losing employees while residential care facilities and the home health industry are gaining them, suggests the May jobs report released by the Bureau of Labor Statistics. 

Thousands of healthcare workers joined the home healthcare sector in May 2013, in contrast to the hospital and nursing home sectors which saw thousands of jobs depart. 

Overall healthcare employment increased by 11,000 jobs in May 2013 including the 6,900 added to the home health care sector, according to the BLS.

The nursing and residential care facilities sector together gained 1,300 jobs between April and May 2013 despite a loss of 2,700 jobs when looking just at nursing care facilities during that same time period.

This suggests the growth in the combined sector (which includes additional related jobs) comes more from residential care than from nursing homes. 

The combined number of employees in nursing and residential care facility sector edged upwards from 3.19 million last May to 3.21 million one year later.

Home healthcare has seen even larger growth, as employees in this sector grew almost 7% from around 1.19 million in May 2012 to 1.27 million by May 2013.

Despite the substantial number of jobs added to the health care industry in May, it’s actually a sharp decline from the prior year, when job growth averaged 24,000 a month, the report noted. 

Check out the May jobs report.

Written by Alyssa Gerace

Nursing homes are losing employees while residential care facilities and the home health industry are gaining them, suggests the May jobs report released by the Bureau of Labor Statistics. 

Thousands of healthcare workers joined the home healthcare sector in May 2013, in contrast to the hospital and nursing home sectors which saw thousands of jobs depart. 

Overall healthcare employment increased by 11,000 jobs in May 2013 including the 6,900 added to the home health care sector, according to the BLS.

The nursing and residential care facilities sector together gained 1,300 jobs between April and May 2013 despite a loss of 2,700 jobs when looking just at nursing care facilities during that same time period.

This suggests the growth in the combined sector (which includes additional related jobs) comes more from residential care than from nursing homes. 

The combined number of employees in nursing and residential care facility sector edged upwards from 3.19 million last May to 3.21 million one year later.

Home healthcare has seen even larger growth, as employees in this sector grew almost 7% from around 1.19 million in May 2012 to 1.27 million by May 2013.

Despite the substantial number of jobs added to the health care industry in May, it’s actually a sharp decline from the prior year, when job growth averaged 24,000 a month, the report noted. 

Check out the May jobs report.

Written by Alyssa Gerace