Big senior living stories of 2022 – News – McKnight’s Senior Living

The effects of the COVID-19 pandemic on staffing and other areas of senior living continued to be felt in 2022, with many operators reporting that they expect the ramifications to continue well into 2023 or longer. But the industry saw glimmers of hope in 2022, too, with combined independent living and assisted living occupancy more than halfway down the road to recovery, increasing to 82.8% in October from a pandemic record low of 77.9% in June 2021, according to the National Investment Center for Seniors Housing & Care. 

Still, as the year ended, a “tripledemic” of coronavirus, influenza and respiratory syncytial virus, or RSV, was creating a disconnect between move-in rates and higher lead volumes, according to a NIC survey.

Here are some of the other major stories in senior living in 2022.

COVID relief hopes fade

Senior living saw its hopes of securing additional COVID relief funds fading in November when approximately 1% of Phase 4 Provider Relief Fund applications remained outstanding. The US Department of Health and Human Services’ Health Resources & Services Administration said it expected to make final determinations on the remaining Phase 4 funding application by the end of 2022 or early in 2023 and then will review funding reconsideration requests submitted by providers. All PRF payment determinations, including reconsiderations, adjustments and payouts, are expected to be completed by June 30.

Assisted living first was recognized during Phase 2 distributions, with Phase 3 distributions covering pandemic expenses from the first half of 2020. The senior living industry has received far less in relief than providers such as skilled nursing facilities, according to industry advocates.

The year is ending with half of the country’s governors, all Republicans, calling for an end COVID-19 public health emergency, which is expected to end no sooner than April.

Regulatory changes

One third of states updated their assisted living requirements between 2020 and 2022, according to the National Center for Assisted Living’s “Assisted Living State Regulatory Review,” released in September.

On the federal level, many senior living providers faced rule and regulation-related pressures, too:

• Large employer vaccine mandate. 2022 kicked off with the Supreme Court blocking the Occupational Safety and Health Administration’s vaccination-and-testing rule for large businesses, although it upheld a separate federal COVID-19 vaccination mandate geared toward healthcare workers. OSHA still vowed to “hold businesses accountable” for protecting workers from the coronavirus.
• OSHA’s National Emphasis Program for COVID-19 was set to expire in June, but the agency instead extended it “until further notice.” At the time, the agency said it planned to increase its inspections of assisted living communities and some other types of long-term care and healthcare-related employers. OSHA inspected more assisted living communities and nursing homes in the first six months of 2022 than it did for all of 2021, according to a Bloomberg Law analysis.
• In July, the Centers for Medicare & Medicaid Services released its first-ever home- and community-based services quality measure set in an effort to promote consistent quality measurement within and across state Medicaid HCBS programs. The federal government’s introduction of the measures, however, came amid “longstanding, chronic underfunding” of HCBS that has led to provider workforce shortages, senior living industry advocates — Argentum, the National Center for Assisted Living and LeadingAge — told McKnight’s Senior Living.
• Improving access via operational, policy changes. December saw the launch of a new initiative to improve access to medical and mental care in assisted living via operational and policy changes. The goal is to put into practice 43 recommendations published in October in the journal JAMA Network Open. Operators may not feel threatened by the effort because several industry players are involved.
• OSHA healthcare standard. As the year winds down, providers still are waiting for OSHA to issue a replacement for the COVID-19 healthcare emergency temporary standard that lapsed in December 2021. The original standard required assisted living communities and other healthcare settings to conduct hazard assessments and have written plans to mitigate the spread of the coronavirus; called on healthcare employers to provide some employees with N95 respirators and other personal protective equipment; and included social distancing, employee screening, and cleaning and disinfecting protocols. The agency solicited comments on a proposed final rule released in March that it said will protect assisted living and other healthcare workers from exposure to COVID-19 in the workplace. Senior living industry leaders filed their opposition to the broad requirements in the proposed final rule, calling it “overly prescriptive” and confusing, and they also testified about the proposed rule in April.
• Joint employer status. As 2023 looms, senior living providers await a new rule from the National Labor Relations Board related to “joint employer” status, with which they disagree, as well as an overtime rule from the Department of Labor.

The middle market, active adult, DEIB and caregiving

The senior living industry tackled some big topics in 2022 and saw researchers and the government express an interest as well:

• A new analysis released in September by NORC at the University of Chicago — an update to the NIC-funded “Forgotten Middle” study from 2019 — found that more than 11 million older adults will not be able to afford assisted living by 2033, and they likely won’t qualify for Medicaid to pay their long-term care needs either.
• Also in September, NIC defined “active adult” as rental properties that “are age-eligible, market rate, multifamily properties that are lifestyle focused; general operations do not provide meals.” The aim of the effort is to unify thinking and help potential investors interested in this increasingly hot area.
• The federal government’s national caregiver strategy, also released in September, focused on relatives of senior living residents among others. But the new strategy also called for efforts to address professional caregiver education, training and compensation; to establish a pipeline of workers for long-term care; and to reform the long-term services and supports financing system — all areas of great interest to providers.
• In a first for the industry, the Senior Living DEIB Coalition — a partnership including Argentum, the American Seniors Housing Association and NIC — in November released the results of a survey summarizing data on efforts to address DEIB. It found that the senior living industry has some work to do to advance diversity, equity, inclusion and belonging but that the industry is in an enviable position to draw from its people-focused mission. The coalition, which was announced in January, also released a DEIB toolkit to inform stakeholders about resources to help them craft their own DEIB plans.

Ch-ch-ch-ch-changes

McKnight’s Senior Living readers’ most-read story of 2022 detailed Woonsocket, RI-based CVS Health’s plans to sell its long-term care pharmacy business, Cincinnati-based Omnicare, because it is “no longer a strategic asset.” The business reported a $2.5 billion loss in the third quarter, affected by the pandemic, but at one point, CVS saw assisted living as an important growth area.

Some other notable change-related news:

• Brookdale Senior Living, the country’s largest senior living company, in November marked 13 consecutive months of occupancy growth as rumors swirled that the company was exploring a potential sale. Meanwhile, Brookdale announced that it had refinanced $220 million in debt and began a public offering of 2.5 million tangible equity units. President and CEO Cindy Baier also discussed her new book, “Heroes Work Here: An Extraordinary Story of Courage, Resilience, and Hope from the Front Lines of COVID-19.”
• Five Star Senior Living. Five Star Senior Living had a busy year, with the company announcing a new name, AlerisLife, and plans to diversify its offerings to include active adult management, home care and concierge services in January; the resignation of President and CEO Katie Potter in May, with Chief Financial Officer Jeff Leer being named her interim and then permanent successor; plans to reduce costs by approximately $14 million and invest approximately $4 million under recommendations made by a consulting firm in August; and potential stock market delisting in November.
• Sonida Senior Living President and CEO Kim Lody announced in August that she would be leaving the company in September, with Chief Operating Officer Brandon M. Ribar succeeding her per the company’s succession plan. She had been in the leadership role since January 2019. After some rocky financial times, in 2022 the former Capital Senior Living made its first acquisition in almost five years and also experienced five consecutive quarters of occupancy and revenue growth.
• Welltower in November said it planned to move 147 skilled nursing facilities operated by ProMedica Senior Care into a joint venture between the Toledo, OH-based real estate investment trust and Integra Health. ProMedica will continue to operate 58 private-pay senior living communities under a lease backed by the existing guaranty, Welltower said. ProMedica said that the facilities all are Arden Courts memory care communities within its real estate joint venture with Welltower.
• Good Sam, Ebenezer parents to merge. In November, the parent companies of two of the largest not-for-profit senior living and care organizations in the country announced their intention to merge. Sioux Falls, SD-based Sanford Health, which includes the Evangelical Lutheran Good Samaritan Society, and Minneapolis-based Fairview Health Services, which includes Ebenezer Senior Living, Minnesota’s largest senior living operator, announced a plan to combine to create a new health system.
• The Walt Disney Company in February announced plans to introduce Storyliving by Disney master-planned communities that include 55+ housing.

Suspected senior living serial killer sentenced

In a dark chapter of 2022, suspected senior living serial killer Billy Chemirmir was sentenced in two capital murder trials for the deaths of two older women.

In April, he received a sentence of life in prison without the possibility of parole for the slaying of Lu Thi Harris, who was 81 when she was found deceased in her Dallas home in 2018. Then, in October, he was sentenced to life in prison for the 2018 death of Mary Brooks, who was 87 when she was found deceased in her condominium.

Dallas County prosecutors said they would drop 11 capital murder cases against Chemirmir there. Prosecutors in a neighboring county had not indicated whether they planned to try Chemirmir on nine other murder cases to which he is suspected of being linked.

Altogether, Chemirmir is thought to be linked to at least 24 deaths — mostly of female residents of senior living communities — that took place in Texas between April 2016 and March 2018. Authorities said he posed as a healthcare or maintenance worker to gain access to residences and then smothered the older adults before stealing their valuables. Many of the deaths were attributed to natural causes until one woman survived and helped police with their investigation.

Some senior living communities where Chemirmir’s suspected victims lived have faced wrongful death lawsuits criticizing their handling of security and communication matters. A bipartisan group of Texas lawmakers previously introduced several bills in response to the series of suspected murders thought to be tied to Chemirmir.

Recognition and rankings grow

Successful marketing can set senior living operators apart from their competitors, and 2022 certainly gave companies some things to brag about:

• US News and World Report “Best Senior Living.” Senior living communities joined nursing homes, hospitals, colleges and other businesses evaluated and profiled by US News and World Report in 2022 with the May launching of a new “Best Senior Living” initiative; 1,247 senior living communities operated by more than 80 companies received recognition based on the results of consumer satisfaction surveys of residents and/or their family members or appointed representatives.

• McKnight’s Pinnacle Awards. McKnight’s Senior Living and its sister media brands, McKnight’s Long-Term Care News and McKnight’s Home Care, also launched a new awards program in 2022. Thirty Pinnacle Award winners — veterans who have set new standards, driven change and inspired others — were announced Dec. 13. Formal recognition will come March 7 in Chicago. (Tickets to the in-person event are available at mcknightspinnacleawards.com.)

• McKnight’s Women of Distinction awards. The fourth annual McKnight’s Women of Distinction awards lauded 54 women in senior living, skilled nursing and home care in May at an in-person celebration. (The regular deadline for submitting nominations for the 2023 awards program is Jan. 5. Nominations also may be submitted Jan. 6 to Jan. 10 with an increased entry fee. Read more here.)

• McKnight’s Tech Awards. McKnight’s bestowed 12 awards on senior living providers during the annual McKnight’s Excellence in Technology Awards. Awards in senior living, skilled nursing and home care tracks were announced during an October online event that also included educational webinars. Winners, finalists and program sponsors also were recognized in observances at the AHCA/NCAL Convention & Expo in Nashville, TN, and at a reception coinciding with the LeadingAge Annual Meeting & Expo in Denver.

Several other programs recognized operators and individuals:

• Fortune Best Workplaces. In September, Fortune announced its Best Workplaces for Aging Services lists for 2022, the fifth round of such lists the media outlet published in partnership with people analytics firm Great Place to Work and Activated Insights, the senior care affiliate of Great Place to Work. Once again this year, Baltimore-based Brightview Senior Living topped the list for large-sized companies. New to the top spot on the list of small-to-medium-sized companies (10 to 999 employees) is Skokie, IL-based Legacy Healthcare. Brightview also would for the second time be the only senior living company named to Fortune/Great Place to Work’s Best Workplaces for Women list and would be named to People’s Companies that Care list for the second consecutive year.

• ASHA largest owner and operator lists. Brookdale and Welltower retained their top spots on the ASHA 50 lists of the largest senior living operators and owners, respectively, which the American Seniors Housing Association announced in August.

• LeadingAge Ziegler 200. Wellesley Hills, MA-based National Senior Campuses (now known as National Senior Communities) retained the top spot on the LeadingAge Ziegler 200 list of largest not-for-profit multi-site senior living and care providers, announced in October, for the seventh straight year. The company oversees the development and operation of communities by Erickson Senior Living.

• JD Power study. Brookdale Senior Living and Enlivant tied for having the highest overall satisfaction scores among assisted living and memory care providers in the JD Power 2022 U.S. Senior Living Satisfaction Study, the results of which were released in November. Life Care Services ranked highest in independent living resident overall satisfaction for a fourth consecutive year.

• Caring Stars. Also in November, 329 senior living and care communities in 39 states were recognized as “Caring Stars of 2023” by Caring, the review and referral website. Atria once again topped the list, as it had the previous year.

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