senior living

Nursing home avoidance continues for both investors and care recipients. You might have read about investors cutting back on nursing home investment within ‘healthcare’ REITS.  CMS and Medicare are reimbursing less for ever-shorter nursing home stays, ending their multi-year ‘billion dollar pie eating’ wave of investment.  Note that the biggest chains of skilled nursing facilities (SNFs) like Signature Health Care (which has a web URL signaling LTC -- LongTerm Care) Revolution) – what might that revolution be?  Consider the consumer’s first encounter with the industries for health care, long-term care (LTC), skilled nursing facility (SNF), nursing home, or post-acute facility. This terminology morass mirrors the reimbursement patterns of government agencies, which, in turn, drive investment language, behavior and labeling.

It's been a busy week that reflects growing interest in aging and new technologies. Just after the third annual Louisville Innovation Summit, some of the attendees and/or exhibitors dashed to San Francisco for the Aging 2.0 Optimize event. The founders, Stephen Johnston and Katy Fike, launched Aging 2.0 in 2012 'to pick up the pace of innovation that benefits older adults.' The program includes the Generator Ventures fund, an 'Academy' to cultivate classes annual classes of startups, distributed worldwide events, and competitions that feature finalists who participate in pitch competitions. Their flagship and well-attended Optimize event concluded today in San Francisco – with five of the exhibiting/pitching startups featured below. Information is from their websites or press materials: 

Who expects that most seniors will move to assisted living? Not that many. Our clues: # 1) one of the long-time thought leader consultants in senior housing, Ryan Frederick, is now involved in multi-generational housing development.  Or Clue # 2) Occupancy is unchanged in senior housing – still at 89% for the past three years. And don’t you just love the phrase 'inventory has outpaced absorption'? Or the next big challenge for senior housing – serving the middle class? And the profile of the resident in assisted living?  Clue # 3) The typical resident is an 87-year-old woman who remains for an average of 22 months.   Clue # 4) The net worth for folks aged 75+, presumably the feeder group for assisted living, inclusive of home equity, is $155,714.

Finding new findings is slowing down in these last days of August.  First we learn that older people are happier. Whew. And we also learn that seniors don’t seem to take to digital health tools, according to a JAMA-published National Health and Aging Trends Study, a project out of the school of public health at Johns Hopkins University. “Notably, the seniors in the NHATS were willing to get on a computer to respond to this annual, in-home, computer-assisted, longitudinal nationally representative survey of community-dwelling Medicare beneficiaries 65 years and older.” Okay – hence it must be valid.  Says study author Dr. Levine: "Little is known about how this population actually uses technology." Well, actually quite a bit is known -- and published during the study years of 2011 – 2014.  For one, consider the 2011 Linkage survey of individuals age 65-100.  Then there are the numerous surveys from Pew, for example, this one from 2014 on older adults and technology adoption.  Or from Nielsen.  

Nursing home avoidance – the home care wave fits the profile.  So we know that tech-enabled home care has received several infusions of cash lately.  Whether this is an anomaly -- once new-age firms realize that home care consists of difficult and backbreaking labor – or signals a trend, remains to be seen.  The apparent bloom of the home care business opportunity appears to be the inverse of the business gloom in senior housing, as noted in these Chapter 11 filings. These businesses are failing at the same time as nursing home bed capacity is anticipated to become constrained.   As AARP has endlessly repeated, 90% of older adults want to remain in their own homes. Or maybe it is 87%.  But regardless of intent, most will stay because they can’t afford anything else.