What Will Your Continuum Look Like in 5 Years?

Insights | October 01, 2018 | by Stephen Maag

Is your current continuum of services and supports up to the task of serving future consumers? Steve Maag offers advice on how to find out.

Eaton Senior Communities, a LeadingAge member in Lakewood, CO, recently closed its 66-unit assisted living community after more than 3 decades of operation.

There were a lot of reasons behind the decision. Chief among them was Eaton’s remarkable success in another, related area of senior living.

Eaton has spent the last 10 years developing a housing plus services model in its affordable housing community, located on the same campus as its assisted living community. The model revolves around an onsite team, consisting of a wellness nurse and a service coordinator, which assesses residents’ health and well-being, helps residents set realistic health goals, and then works with local community-based partners to coordinate a host of services designed to help residents meet those goals.

President and CEO David Smart says that Eaton has been able to save “tons of money” for the health care system by helping its housing residents remain in their own apartments and avoid moves to higher levels of care, including assisted living, skilled nursing, and hospitals. Eaton is now working with a university researcher to document those positive outcomes.

Success Brings Change

The success of the housing plus services model has been good for Eaton’s housing residents. But that success had an unintended consequence for Eaton’s assisted living community.

As the housing community’s service program became more robust, Eaton’s management team noticed that housing residents had fewer reasons to move to assisted living. Why move, after all, when you can access the services you need right in your own home?

That observation got Eaton’s board and management team thinking. With more residents staying in their apartments for longer, was an assisted living community the best use of Eaton’s resources?

It took 4-5 years of careful study before Eaton decided to close and renovate its assisted living building so it could offer 64 new independent apartments that will serve middle-income seniors who don’t qualify for housing subsidies but can’t afford a life plan community. Those residents will have access to Eaton’s full menu of onsite services, most of which are provided by community partners at no cost to Eaton.

A Lesson for Other Providers

Let’s be clear. This isn’t a story about the pros and cons of housing plus services models or of assisted living communities. It also doesn’t mean our life plan community members should look at changing how they deliver services.

Rather, it’s a story about the positive outcomes that can result when an organization’s board and management team make deliberate decisions about the role they want to play in the aging services landscape.

In a nutshell, Eaton found a good model that works for its housing residents, and decided to increase its capacity to offer that model to more older adults.

I’m not suggesting that other providers step away from assisted living as Eaton did.

But I am urging those providers to have similar discussions about what they do best, where they want to focus their energies and resources, how they can best serve their residents and the larger community, and how they might work with partners to meet the needs of their local market.

Certainly, not every provider will decide to restructure. And that’s not a bad thing. It’s powerfully validating to recommit to your existing service lines after a thorough and thoughtful look at both your organization’s strengths and the market’s service gaps.

Big Change Calls for Big Questions

Consumers are looking to us for a variety of targeted services that meet their unique health, social, and financial needs.

I’m not sure the current continuum is up to the task.

Consumers of the future are not necessarily going to accept the standard menu of services that we’ve traditionally offered them. Plus, we’re already seeing signs that consumers, like the residents at Eaton Senior Communities, aren’t necessarily interested in following that continuum like a straight path that starts in independent housing and inevitably leads to assisted living, and then to nursing. The ability of individuals to age in place, increasingly supported by technology, will also have a profound effect on our traditional notion of a continuum of care.

Our field is changing too. Providers are trying to find their own way through an evolving health care landscape that is increasingly dominated by managed care and value-based payments, and that offers myriad new opportunities for partnerships with acute-care providers.

Taking time now to ask big questions could help you prepare for and adapt to these changes—and emerge in a stronger position 5 years from now. For example, try asking yourself:

  • How should we provide services to residents who need higher levels of care?
  • Should we focus on helping older adults age in place?
  • What do our life plan communities need to do to remain strong?
  • What role, if any, should we play in the post-acute care market?
  • Should we continue offering the same amount of skilled nursing or assisted living services? Or should we look at new ways to meet the needs of individuals who have traditionally resided in assisted living or skilled nursing?
  • What is our core expertise? Should we build on that and expand services, or partner with other providers who can help us serve our residents?

Don’t expect quick or easy answers to these and other questions. But be open to where the discussions may take you. In short, focus on creating your best vision for how you fit into the future of aging services. You can iron out the details later.