Healthcare Perspectives

Healthcare Perspectives


Trends in Senior Living: 5 Challenges Your Facility Will Face in 2019 and Beyond

May 14, 2019
By: Barbara Bell

Managing a senior care facility presents a combination of challenges for everyone on staff, and the challenges are only set to ramp up in the coming years. Not only are lifespans getting longer in many cases, but also the United States is about to face the realities of the 1945-1961 baby boom, a time when more than 65 million children were born.

With those individuals born during this time ranging in age from 59-75, there are approximately 67 million people over the age of 60 who currently need or will need care. This care ranges from community or assisted living to in-home care or nursing homes. Another 65 million Americans will turn 65 in the next two decades, so even though there is a massive opportunity for your business, there will also be immense strain and pressure to keep up with demand.

At Wipfli, we work with many businesses in the Senior Care industry and understand the many challenges you face — whether day-to-day or in the long term — and today, we would like to explore some of the trends you should be on the lookout for not just in 2019 but also over the next decade and beyond.

The Impending Baby Boomer “Boom”

As mentioned above, the senior population is about to experience a baby boomer retirement boom, a time in which the population of elderly Americans experiences a rapid uptick. By 2050, the Center for Housing Policy expects that there will be 88 million Americans over the age of 65. While this will mean that you will have more residents, questions arise, namely, “how many,” “when” and “where?”

First, with the rise of in-home care, some families are moving away from the traditional facilities to keep elderly individuals in their homes for longer. Added to this, with continued advancements in healthcare, some may not need care as early as in years past.

Finally, retirees are choosing new places to live, based partially on cost of living, cost of healthcare and taxes, meaning that even if Florida and Arizona continue to be “retirement destinations” and a safe bet for expansion, states like Iowa, South Dakota and Virginia have potential to draw more people over the age of 65 in coming years, according to Motley Fool.

The Challenge: Knowing When to Grow

For senior care facilities and other entities working with the aging population, planning for this boom in the elderly population will require intuition and strategic planning — expand too early and lose money from low occupancy rates; expand too late and fall behind your competition. Strategic planning will require your facility to track both internal and external trends so that you can make smarter decisions on where to build your next facility, when to break ground and how many rooms it should have.

More Facilities Need More Staff

With an expanding population of elderly individuals, there will be an increasing demand for staff. Whether it’s your activities staff, nursing team or finance department, your organization isn’t the only one expanding, and you can expect the competition for staff to ramp up.

The Challenge: Retaining Care and Back Office Staff

For senior care facilities, this will possibly be one of the biggest challenges to hit over the next decade. Nearly every front- and back-office role in your facility is facing a talent crisis. Pair this with intense levels of competition for staff and increasing expectations from workers, and it becomes harder and harder to retain and recruit the right people. In this, you can’t afford to have disgruntled staff.

Maintaining your “employer brand” will be a necessity. Providing ample benefits, staff-friendly schedules and competitive pay can help you keep nurses and others in charge of care happy and productive. But for your back office staff, you may need to look towards making their job easier. Automation and integration could reduce headaches for those in finance, billing and the like, reducing their stress and improving their work. Additionally, this automation can give your staff more time to focus on strategic decision making, helping your facility to grow without “growing pains.”

Reputation and Quality of Care

Increased demand, increased competition and staffing challenges combine to create an additional strain on your ability to provide quality care. Turn on the television any night and you will see advertisements from personal injury attorneys willing to take on a nursing home abuse, neglect or negligence case. Look online and you can find negative reviews and investigations into many senior care facilities. Maintaining your reputation is often a challenge.

The Challenge: Upholding Your Reputation

For families, putting a loved one in a senior care facility is by no means an easy decision, and it’s a decision only made more complex if you have even one scandal or lawsuit against you. To address this, you need to ensure that your staff is committed to high-quality care. Scheduling needs to be planned and hours need to be tracked to minimize the likelihood that an overworked staff member makes a mistake. This requires visibility and control over policies, procedures and technology to mitigate staffing mishaps.

Payor and Regulatory Oversight Challenges

The families of your residents aren’t the only external parties who care about quality of care and reputation — the organizations paying the bills do as well. Whether the oversight comes from private insurance payors, Medicare, Medicaid or other regulatory bodies, your ability to get paid relies on providing reliable, quality care for your residents.

The Challenge: Moving Beyond “Heads in Beds”

As both federal and state governments look to scale back spending and regulators push a model of reimbursement that ties spending to quality, nursing homes face newfound pressure to survive amid ever-evolving challenges. From standards in the ACA pushing toward outcome-based care to decreasing reimbursement rates and potential to repeal the ACA and set caps on Medicare and Medicaid spending, providing outcome-based care is necessary if you hope to continue to receive payment.

Technology and Security

In accordance with new healthcare legislation, medical providers either have moved or are in process of moving to electronic health records. Additionally, the use of diagnostic devices is becoming increasingly common to connect to remote networks for digital data input. As a facility, you maintain the medical and billing records of seniors, often doing so without the same cybersecurity budget as a hospital network. This makes you a prime target for hackers.

The Challenge: Keeping Data Secure

It doesn’t matter if a company operates five communities or more than 100 communities. A lack of industry-wide best practices, along with the growing sophistication of cyber threats in an increasingly digital world, puts a target on the back of any company that collects and stores sensitive data, cybersecurity experts agree.

Protecting health data, payment information and your business’ financial information — three of the most highly valued and targeted data stores — requires planning and a commitment to technological advancement. Knowing this, many senior care facilities are turning to the cloud to protect sensitive data, a topic we will discuss further in coming weeks.

The Overarching Challenge: Taking Control of Finances

With so much pressure on senior living facilities, your ability to control financial decisions may be the most challenging. As mentioned throughout the article, decreasing reimbursement rates, increasing demand and competition, and ongoing staffing concerns have made it harder to make strategic decisions.

Knowing when to grow, having the right information to secure financing when you need to grow and even being able to consolidate your information across two, ten or fifty communities presents a wide range of challenges for today’s senior care facility.

Over the coming weeks, we will continue to dig into the challenges your organization faces, answering the following questions:

  • How do you get better visibility into finances when you increase your number of locations?
  • How can the cloud help your organization stave off the onslaught of threats from hackers?
  • How can an integrated solution for senior living organizations save time and money while increasing back-office staff satisfaction?
  • What are your options when looking to bring your finance staff into the cloud, and how do you make an informed decision?

At Wipfli, our specialized team of health care professionals thoroughly understands the pressures placed on your leadership team. You’re facing challenges with increasing your market share through partner alignment, embracing new payment structures and leveraging advancements in technology to gain insight into real time analytics, and we can help. Get to know more about our services for senior living providers and our technology solutions for health care businesses. If you are ready to learn more, contact us for more information.


Barbara Bell, CPA, CMA
View Profile
Healthcare Perspectives blog
Subscribe to Healthcare Perspectives