LANCASTER, Pa. (AP) — At the height of the COVID-19 pandemic, residents of Landis Homes would line a roadway into the Lititz campus on Friday afternoons, cheering on the retirement community’s workers with signs and noisemakers as they left or arrived for work.
When the campus resident council suggested a more permanent show of appreciation, Landis Homes residents donated over $10,000 toward a Garden of Gratitude, a new park on two-thirds of an acre featuring walkways, greenery and a gazebo offering views of surrounding farmland.
Not every retirement community has such a tangible symbol of gratitude, but many share the sentiment.
“The pandemic has brought out an appreciation of how good we had it before and has been a reminder of how important community and family are,” says Jonathan Hollinger, CEO of Pleasant View Communities.
While local senior living communities have faced many physical and financial challenges over the past year, they also see many positives that point to a promising future.
“Coming into the pandemic, continuing care retirement communities in general were enjoying high occupancy and financial stability,” says Lisa McCracken, a Lancaster County resident and director of senior living research and development for Ziegler, a Chicago-based investment-banking firm.
“We entered this pandemic on really solid footing,” she says.
But COVID-19 has taken its toll.
First quarter 2021 statistics from the National Investment Center for Seniors Housing & Care show senior living occupancy nationally at a new 15-year low.
CCRCs show an overall occupancy of 84.3%, a 7.2% drop from the same period last year.
Within those CCRCs, however, the independent living segment has fared the best, with an occupancy rate of 88.6%. While the skilled nursing segments of CCRCs fared the worst at 76.5%, their occupancy was still nearly 3% higher than skilled nursing facilities that are not part of a CCRC.
“Nursing homes were impacted way worse than retirement communities,” McCracken says. “If you take a look at all the residential options — CCRC held up the best of any of them.”
The fact that skilled nursing fared worse during the pandemic is not surprising, she says, given that even under normal circumstances they tend to have the frailest residents and a higher turnover. Adding to the challenge was the reduction in short-stay residents — those requiring a temporary stint for rehab after a hospital stay or surgery. Fear of COVID-19 prompted more hospital discharges straight to intensive home care, while the temporary halt in elective surgeries further reduced referrals.
Locally, at Fairmount Homes, residential apartments and cottages remained full, but personal care and health care occupancy took a hit, notes Mitchell Hanna, director of marketing.
“We had some family members take their loved ones home to care for them there because of visitation limitations on our campus,” he says.
Adds Nicole Michael, corporate director of sales and marketing for Moravian Manor Communities, “Why would you admit your loved one into long-term care if you are unable to visit?”
In some cases, the reduced occupancy was by choice. Amy Kenn, community director for Luthercare, writes in an email that Luther Acres halted new admissions in its skilled nursing health care center to keep numbers down and residents safe. The same was true at Masonic Village, says admissions supervisor Jeanie Hummer.
“With COVID-19 precautions in place, and to protect our current residents, we have not had as many move-ins from the local community to our personal care, nursing and memory support areas, resulting in lost revenue,” Hummer says, noting occupancy is down 15%. She anticipates those levels will improve once they can reopen to the public and increase their marketing efforts.
Reversing those occupancy numbers, however, isn’t the only issue. Communities also have to deal with a national health care staffing crisis, Kenn writes. The staffing shortage has affected many CCRCs in Lancaster County.
“We have many great jobs available right now,” writes Christina Gallagher, director of marketing for Homestead Village, in an email. “The pay and benefits have never been better; but they remain unfilled.”
Hands-on LPN and CNA classes have been rare over the past year, reducing the supply of available new employees, says Michael, of Moravian Manor. Burnout is another factor. “Wearing N-95 masks, gowns and protection for extended periods of time is exhausting,” she says.
In addition to the physical health issues of the pandemic, the resulting isolation has had severe mental health ramifications for both residents and team members, says Hollinger, of Pleasant View. There are financial ramifications as well, not only from lower occupancy but also from additional costs for all of that personal protective and screening equipment.
Most of the county’s retirement communities are nonprofit, and many rely on fundraisers. Fairmount Homes canceled or scaled back many of its regular fundraising events, including a book sale, sandwich sale, Heritage Days and a benefit auction, Hanna says.
To address the fundraising issue, United Zion Retirement Community held its first-ever online auction and virtual gala in late April to benefit its Heart of the Home campaign to build a new chapel, notes Megan Weiss, director of marketing and development.
The bright spots
A virtual fundraiser is just one of the ways local retirement communities have adapted to the pandemic over the past year. CCRCs have gotten creative in their delivery of programs and services out of necessity, but many say some changes have been so successful they will likely become permanent. Here are just a few:
“Video has become one of the key ways we communicate internally, and while that medium has been steadily growing, during quarantine it became the primary way we engaged our residents,” writes Tara Ober, vice president of communications and resident life for Brethren Village, which has both a YouTube channel and an internal TV network.
President and CEO John Snader used those mediums to broadcast regular COVID-19 updates. They’ve also been vehicles for everything from worship to exercise. “Daily Dose of Wellness,” a 30-minute fitness program geared to all levels, is particularly popular and will continue to air on Brethren Village’s TV network even when the pandemic is over.
Landis Homes added a new closed-circuit TV channel that broadcasts live concerts, exercise instruction and lectures, says Sarah Short, director of residency planning. Woodcrest Villa also turned to its in-house TV channel to provide fitness programs, entertainment, news and updates, writes Connie Buckwalter, director of marketing for Mennonite Home Communities, in an email.
“Residents loved them all — especially ‘The J&J Show’ — a weekly news update program featuring our director of residential living, Jennifer Bicher, and social worker Jessica Perry,” Buckwalter says. “The show has turned out to be a ‘must watch’ now for many of the residents!”
Online programming at Willow Valley Communities includes fitness videos, cooking demos, classes, lectures and performances, notes Maureen Leader, public relations and communications manager. It’s also become an effective marketing tool, along with video tours of the campus and residences.
“As prospective residents visit and subsequently move to Willow Valley Communities from nearby and across the country, we have observed that many enjoy viewing an online video tour of our campus or other virtual experience before coming for an in-person visit,” she says.
The great outdoors
Landis Homes residents are spending more time outdoors exploring the campus walking and biking trails, woods, wetland and park areas, Short says. For safety reasons, the community also brought some of its exercise classes and other programs outdoors, a move that has been so popular it likely will continue in the future.
Stacy Schroder, director of wellness and prevention at Masonic Village, notes that while the pandemic created the need for Zoom-based personal training, wellness coaching and support groups, it also inspired the staff at the Baird Wellness Center to develop more outdoor programming, like cornhole, kickball, biking and walking groups.
Masonic Village also started bringing food trucks to campus every Wednesday to give residents a chance to socialize outdoors. The community plans to continue the Wednesday tradition through October.
To give residents the live performances they were missing, Garden Spot Village introduced wagon concerts. Performers rode in a wagon pulled by a tractor that made stops at eight outdoor locations on the New Holland campus over the course of two hours. Residents could safely gather and physically distance at each of the locations while enjoying a mini-outdoor concert, explains Juanita Fox, director of media experience and storytelling.
“We invited a number of local performers from Servant Stage, Fulton Theatre and even local high school and college students,” Fox writes in an email. “The performances were amazing and life-giving for everyone who participated.”
Fairmount Homes similarly held concerts on wagons in areas where residents could listen from their windows and balconies.
Fox says Garden Spot Village plans to continue the concerts this summer.
Garden Spot Communities
A number of communities report that residents who were previously fearful of or resistant to using technology are now comfortable using platforms such as Zoom, Skype and FaceTime to communicate with family and friends.
“It’s a wonderful way to connect residents with their out-of-town family members and loved ones, and we will continue to utilize technology for this purpose,” says Kenn, of Luther Acres.
Residents are also increasingly using technology to communicate with medical facilities and physicians, says Mark Eyer, director of retirement living at Masonic Village. “There is a comfort level now with virtual meetings, and while we believe residents will still prefer face-to-face get-togethers, it’s good to have this as an option.”
Health and safety measures
From improved infection-control practices to new airflow systems, local retirement communities put measures in place that will last beyond the COVID-19 pandemic.
An Accushield kiosk at Luther Acres’ health care center screens temperatures of team members and visitors and includes a check-in/check-out system and health questionnaire, Kenn notes. It will continue to be an effective tool during flu season or future outbreaks, she says.
Among the many steps Fairmount Homes took to prevent infection, one of the most significant had benefits beyond the community’s borders.
“Most importantly, we gained the knowledge of how to convert a wing of our rehab center into an isolation wing,” Mitchell Hanna writes.
In late March 2020, Fairmount converted a hallway of its rehab center into a secure isolation area designed to treat not only its own residents who tested positive, but also patients from area hospitals and other nursing and personal care facilities. Along with specially trained staff, they equipped the wing with negative pressure to prevent cross-contamination.
In a span of 11 months, Fairmount Homes treated 122 patients in its isolation wing, Hanna says.
United Zion made some changes in 2019 that turned out to be fortuitous over the past year, Weiss says. They included a conversion to all private rooms and a neighborhood model, where a small cluster of rooms has its own gathering space and kitchen/dining space. The community also completed planned renovations to its Lexington Restaurant in 2020, allowing for more spacing between tables and separate areas for personal care and residential living.
“Private rooms and being able to easily close areas helps slow and reduce the spread of infections,” Weiss says. “Although we didn’t have a pandemic in mind when we developed these plans, these last five years of renovations are key to being ready in the future for another pandemic.”
Looking to the future
Some local retirement communities note that the pandemic seemed to reinforce a common public perception that CCRCs are much the same as traditional nursing homes. Leader, of Willow Valley, anticipates that stigma will fade as prospective residents visit their campus.
“We have found that residents and prospective residents have concluded that community living is truly safe living,” Leader says. “In addition to relief from isolation and loneliness, support services like meal/grocery delivery, 24-hour nursing care (and) engaging online programming provided our residents, as well as their families, with relief and comfort that was much appreciated.”
Ober reports that Brethren Village has seen an increase in requests for information and campus tours, a sign that seniors aren’t shying away from retirement living. For their part, CCRCs are continuing with expansion and renovation projects and other initiatives to make themselves even more attractive to potential residents.
“We’re hard at work shaping the future of the community and strengthening our offerings to current and future residents. We’re re-envisioning health care services and increasing resident choice through infrastructure, care and service enhancements,” writes Dave Shenk, president and CEO of Tel Hai Retirement Community, in an email. “We know the value, freedom, and flexibility found in a continuing care community is — and will remain — extremely attractive to seniors looking to secure their financial future while accessing the full continuum of care, amenities and related services.”
Buckwalter, of Mennonite Home Communities, is already seeing that sentiment in action.
“We are absolutely thrilled with the level of interest we have been experiencing in our community,” she writes. “The housing market has made it a great time for people to get the most value from their home sale and then move to a retirement community like ours.”
That robust housing market was also a reason for the strength of CCRCs before the pandemic, says McCracken, the director of senior research for Ziegler.
While aging in place has become a popular option, it is not always practical for everyone. That may turn out to be particularly true for the baby boomer generation, McCracken says — and particularly beneficial to senior living communities that can offer residents both an active, independent lifestyle and a continuum of care that includes assisted living, memory support and skilled nursing, should they ever need it.
“Baby boomers are a much more chronically ill population than people in older generations,” she says.
Boomers are also more likely to be divorced, leaving them without a spouse as a caregiver. And before you suggest a son or daughter for that caregiver role, consider this, McCracken says: The percentage of boomers without children is higher than any other generation.
The caregiver ratio — the number of people available to provide care to those who need it — is dropping dramatically, she adds.
“We’re in a period of reflection and reexamining and redefining,” McCracken says. “It’s important to know what lies ahead of us.”