- October 1, 2021: Vol. 8, Number 9

5 Questions: Senior living and the need to invest in people

by Mike Consol with Randy Bufford

What’s ahead for senior housing and care? Randy Bufford has some thoughts on the topic, as he recently expressed to the National Investment Center for Seniors Housing & Care (NIC). As founder and chairman of Trilogy Health Services, Bufford is one of the thought leaders who will be attending the 2021 NIC Fall Conference in Houston, the NIC’s first in-person convening of leaders in senior housing and care since the pandemic began.

Bufford identified five senior living trends to watch.

Labor shortages are dogging many U.S. industries. What is the situation in the labor-intensive senior care business?

This is the most difficult labor market I’ve ever seen in my 39 years in the industry. We need to invest in people. Great staffing leads to great customer service. We need to focus on retention. That means a holistic approach, including training programs and apprenticeships to create career paths; a servant leader culture that demonstrates the company cares about them; and frequent, strategic wage increases. We have 127 communities and have been gradually raising employee wages every quarter. We are looking to boost the pay of the lowest-paid workers. Caregiver positions today pay $15 an hour and up. Make those investments wisely and the industry should be able to solve these staffing challenges.

You recently made the switch to all private units. What motivated that move?

A few years ago we switched our prototype design to all private rooms. The pandemic only highlighted the need for greater infection control, which is easier to achieve with private rooms. Dual-occupancy units in skilled nursing should be changed.

What kind of technology advances are you seeing in the industry?

Telehealth is likely here to stay. Remote visits got a big boost when Medicare expanded coverage of telehealth services during the pandemic. Many expect the coverage to continue when the health emergency ends — a net plus for the industry. Also, monitoring devices will continue to be refined to help improve resident health and reduce labor costs.

What has the spread of COVID-19 taught senior care operators about infection control?

The pandemic highlighted the need for new approaches. We launched The SHIELD program as a comprehensive view of infection control, applying the latest disinfection and cleaning tools. The communities are also equipped with a UV light system that destroys 99.99 percent of surface and airborne pathogens. We are continuing to experiment with special ventilation and filtration products to determine whether they can help limit the spread of viruses. We’ve learned a lot of tough lessons during the pandemic, but they’re good lessons.

Investments in quality come at a price. How can the senior care market keep its facilities and services affordable while making necessary expenditures?

Overall, I’m bullish on the industry as the number of seniors who need help continues to grow. But the rising older population, especially among those seeking an affordable housing option, is colliding with the labor shortage. One possible solution is engaging families in caregiving, since they already provide a lot of care services at home. The idea would be to move those relationships to a senior living community where the family would help provide care in return for a reduced cost of services. The operators that win will be those that innovate in their approach to find ways to provide better care, more efficiently.


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