As the nursing home space faces a crossroads, with the pandemic exposing many flaws in the long-term care system and exacerbating existing workforce and funding constraints, leaders are calling for a reimagined skilled nursing facility.
Notably, SNF executives are placing greater importance on community, along with customized, coordinated and person-centered care for more ideal – and viable – senior living communities in the future, according to a report from the Center for Innovation (CFI). The nonprofit was formed in November of last year, and is made up of leadership from the Green House Project and Pioneer Network.
CFI leaders said their vision counters a “stark decision” the sector faces. They can either stick with the status quo and fail to provide for the next generation of seniors, or pioneer breaking the cycle. But breaking out of a decades-old rut will mean creating something truly new and different.
To that end, CFI convened a group of nursing home leaders to discuss the future of senior living earlier this year, for a discussion moderated by Scott Townsley, professor and longtime senior care visionary with the University of Maryland, Baltimore County.
The executives suggested moving away from today’s typical nursing home model – and where it’s usually located – and incorporating more technology and AI at SNFs.
“The groups of [long-term care] leaders had a wide variety of ideas for the physical locations where services could be provided, indicating a desire to move away from the one-size-fits-most world of nursing homes, assisted living communities, and memory care centers,” CFI said in its report.
Airbnb-style rental models, all-age community centers and accommodative housing rentals with in-home supports were discussed as alternatives to the more traditional, institutional building.
“The places where [seniors] receive care should look as diverse as the places where people of all ages live,” CFI authors said in the report.
Similar to physical location was the idea of linking nursing home care with community – “segregating [seniors] into age-specific communities have long since passed,” authors said.
Human connection at the core of care delivery means residents stay connected with religious, professional and cultural associations. And, residents pursuing hobbies, learning new skills and hosting friends and family shouldn’t have to do so away from the surrounding community in which they live.
Ultimately, CFI hopes its report inspires leaders and advocates to think differently about nursing home reform and improvement, CFI Director of Communications and Marketing Alex Spanko told Skilled Nursing News in an email.
“Way too often, the issues are presented in an adversarial framework – nursing home operators fear home health agencies taking away market share, assisted living providers increase their higher-acuity services to woo people away from nursing homes,” Spanko said.
An adversarial mindset is often coupled with a tendency to focus on individual settings and problems, he added. Attempting to change public perception of nursing homes without “substantially changing anything about them,” or debating staffing standards when there are dozens of other metrics equally important for resident care are both examples of trying to solve a problem without a multi-faceted approach, he said.
Townsley challenged attendees to create a new system from scratch, unbound by current reality, according to the report.
“To provide inspiration, attendees were encouraged to think completely outside of the current [senior care] framework, armed with the knowledge that most great innovations come from outside of any given industry,” authors said.
CFI used the photography and hotel industries as examples, with Kodak being forced by competitors to adopt digital photography despite having the opportunity to lead, and Airbnb shaking up the lodging industry with an innovative new model.
Applied to the nursing home industry, the CFI report noted that the U.S. is grappling with a care crisis leaders have seen coming for decades, as the population ages and health care workforce dwindles.
“Nothing so far should come as a surprise to anyone who’s worked in [senior care] at any point in the last 20 years – or even anyone who’s just attended a single LTC conference since the year 2000. This white paper argues that that lack of surprise is the root of the problem,” authors wrote.
Challenges are well known, but the industry cannot imagine a future for itself that doesn’t look siloed by its past or present, according to the report. Providers are “extremely reluctant” to look beyond what exists and take cues from other industries.