AI50

Amy Goyer, author of "Juggling Life, Work and Caregiving" and is a nationally known writer, speaker and consultant specializing in caregiving and family issues. Amy serves as AARP's national family and caregiving expert, columnist, and spokesperson, and moderates AARP’s Facebook Family Caregivers Discussion Group. Her columns and caregiving YouTube series share her personal caregiving journey as well as practical, actionable tips for caregivers.

Amy is often quoted, and a recognized media authority and frequent guest on NBC’s Today show with 35 years of experience in the field of aging, she began her career as a music therapist. She is also a Certified Aging in Place Specialist. Amy’s work is the perfect fusion of her professional and personal experience.

Amy is a passionate champion for family caregivers and has been one her entire adult life, caring for her grandparents, parents, sisters and other family members and friends. Learn more about AARP resources for family caregivers at https://www.aarp.org/caregiving/. Connect with Amy at http://www.amygoyer.com/ and https://blog.aarp.org/author/amy-goyer and in Facebook, Twitter, Youtube, Instagram, Pinterest and LinkedIn.

Topics Discussed:

• How Amy's current work is the perfect fusion of her personal caregiving experience and professional experience
• Caregiving during the holidays in the middle of a pandemic
• Mental health issues for caregivers
• AARP Facebook Group and other resources for caregivers

More of Amy's Links:
LinkedIn: https://www.linkedin.com/in/amygoyer/
AARP Blogs: https://blog.aarp.org/author/amy-goyer
Company Website: https://www.aarp.org/caregiving/experts/info-2019/amy-goyer.html

Donika Schnell began her healthcare career in financing as a hospital consultant at KPMG and then in financial reporting with The University of Chicago Hospitals. She transitioned to lending to healthcare providers starting with working capital finance in lending operations and adding real estate and cash flow term loans soon after.

Donika moved into business development for Heller Financial, GE Capital and then CapitalSource building pipelines and relationships to providers and capital providers along the entire continuum of healthcare primarily in the Western half of the country. With rounded lending and industry experience, Donika was tapped to build two national healthcare lending divisions for banks before her recent focus on real estate lending at Greystone solely eyeing seniors housing, skilled nursing and hospitals.

Greystone is the number 1 HUD lender to the healthcare industry who also provides Fannie/Freddie and bridge term loan lending.  Greystone additionally owns and operates about 4,000 seniors/skilled beds.

Topics Discussed:

• Overview of the sources of capital available to providers:
  1. Equity – There is approximately $2T of pent up equity to deploy into the economy from the Private Equity sector.  Healthcare is very attractive as it has proven to be recession proof and if supporting the right sectors and operators/managers, equity investments have been solid returns.
  2. Bank Debt – Community banks willing to work with smaller providers.  Larger banks stalled with COVID first hit as they tried to assess existing portfolio risk and then what the pandemic meant overall to the industry.  Took about 90 days or so but most banks are back to lending at usually lower advance rates and perhaps asking for increased credit enhancements.  Pricing increased by 25 to 75 bps.
  3. Finance Companies – also stalled a bit when COVID first hit in March, but are back at lending at prior lending levels. Pricing increased by 50 to 100 bps.
• What does a lender look for in evaluating credit?
  1. Operator experience and track record
  2. Financial performance of the business historically. High emphasis on dealing with COVID in the business.
  3. For real estate such as skilled nursing, look to surveys and reports from CMS and especially Star Ratings and Special Focus Candidate lists.
  4. Occupancy trends.
  5. Projections/Proformas. Sources of revenue, thorough understanding of reimbursement, expenses especially any additional COVID costs such as increased staffing and PPE costs.
  6. Debt needs clearly defined.
• From a national lender’s perspective, how are the Seniors Housing and Skilled Nursing industries performing?
  1. Occupancy naturally down in ALFs and SNFs. With the drop in selective procedures, occupancy went down. Additionally, fewer discharges to SNFs after hospital stays affected occupancy. Independent living facilities have fared rather well with occupancy.
  2. Stimulus monies have helped ease the concern of working capital for providers so they can focus on caring for patients/residents and staff with needed safety measures.
  3. Have seen providers work closely with county and/or state health departments to provide for COVID only patients for care upon hospital discharge. Delicate balance to ask staff if they are committed to working in those buildings and wards – very collaborative efforts being made in communities.
  4. Future sees a high need for mental health services.
  5. Preventative services back to near pre-COVID levels such as with dentists, PCPs, ancillary services put on hold.

Donika's Links:
LinkedIn: https://www.linkedin.com/in/donikaschnell/
Twitter: https://twitter.com/dschnell1968

Susan Ryan, Senior Director of The Green House Project, is a leader in the strategic development of  innovative thinking and cultural paradigm shifts. With international speaking and project management  experience, she has served as an integral part of The Green House Project for over 12 years and has led  the team through key transitions. In the quest for quality long-term care environments that are  accessible and affordable to all, Susan has sought to leverage lessons learned from research conducted  on the Green House model to develop protocols and metrics to ensure growth and sustainability. 

A social entrepreneur with a passion for improving quality of life for elders and those working closest to  them, she offers a unique combination of skills in Nursing, Gerontology, Alzheimer’s and Dementia, and  strategic marketing.

Susan has a background in nursing, with over 30 years of experience serving elders in a variety of  settings across the continuum of care. She has been featured as a speaker many times at LeadingAge,  The Pioneer Network and other high-profile conferences.

Topics Discussed:

• Describe the Green House Project and how it differs from a traditional nursing home?
• How have the Green House homes fared during the pandemic?
• Where are Green House homes located?
• Do Green House homes support people living with dementia, and if so, what makes their approach different from others?
• Why did you choose to have affordability the main tenet of the Green House Project?
• What are some of these biggest challenges you’ve had to lead the Green House Project through during your 12+ years with the Project?
• How have Green House homes fared during the pandemic?
• What lessons has the Green House Project learned from the pandemic that you will carry with you into a post-COVID world?

Susan's LinkedIn Profile: https://www.linkedin.com/in/susanryan2018/

Sara Kyle, Founder and Principal for LE3 Solutions
Sara Kyle, Ph.D. has spent the last 12 years researching, designing, writing, and implementing resident well-being programs across the continuum of care. From leading and overseeing programming across 108 skilled nursing, assisted living and memory care communities to overseeing the charge for Holiday Retirement to transform their resident program in 260 communities, Sara thrives in challenging settings. She is relentless when it comes to urging individual point solutions to integrate and share resident data in one location. While best intentions and knowledge at the corporate level craft well-suited programs, the most effective programs originate from research and collaboration with residents, staff, families, and future prospects.

When staff and residents are involved in creating a program or approach; interest, adoption and sustainability are remarkably higher. Successful programming is not just about a satisfaction score, rather quality of life beyond the basics of food, shelter and an expected level of care. If data collection is aimed to note participation of categorized activities, this is only one piece of the puzzle behind effectively measuring engagement.

Sara is widely known and respected in the industry. She presents at national conferences, pens articles in notable publications, and serves on various advisory boards.

Furthermore, she is fervent and highly skilled at building morale, delivering education, and bridging the gap between the executive team, community management staff and front line workers when it comes to who is responsible for resident programming.

Sara's Links:
LinkedIn: https://www.linkedin.com/in/sara-kyle-phd-0972504/
LE3 Solutions: https://www.le3solutions.com/

Kelly Stranburg, Principal at LE3 Solutions
Kelly Stranburg, M.Ed., CEP, CSCS, CDP has worked with aging adults for over 20 years, with 12 of those specific to the senior living industry. Over the years Kelly has supported over 30 CCRCs and many AL/MCs. Her most successful roles have been positions she has created from the ground up which has enabled her to analyze, identify needs and gaps, and create and implement solutions for the greater good of the residents which in turns supports the operators.

In a time of increasing competition for senior living communities, comprehensive wellness programs can help organizations remain financially fit by enhancing resident health and happiness and strengthening staff satisfaction. In addition, the need to simply connect with others, as we have seen to be of even greater importance during the pandemic, can be facilitated in safe and effective manners via an effective wellness program.

Kelly is the creator of award-winning Argentum Best of the Best Wellness Program for 2010, 2011, and 2012. She has been a featured columnist in the Journal on Active Aging and a selected speaker at national senior living and active aging conferences.

Kelly's Links:
LinkedIn: https://www.linkedin.com/in/kelly-stranburg-m-ed-cep-cscs-cdp-457b204b/
LE3 Solutions: https://www.le3solutions.com/

Topics discussed:

• Discuss how the pandemic has elevated the value of resident engagement and the criticalness of connecting with family and friends
• Discuss why the pandemic has allowed residents a greater voice in what is offered and how moving forward it should continue to be embraced
• How has the pandemic shifted the approach to activities?
• Other trends and solutions which extend longevity

Rhian Horgan is the Founder and CEO of Silvur, a fintech app dedicated to helping baby boomers navigate their next act. Her parent company Kindur was named to the 2020 Forbes Fintech 50 and has been featured in the NY Times, Forbes, Inc Magazine, CNBC, Crains, Yahoo Finance and Business Insider.  Prior to founding the company, Rhian was a Managing Director at JP Morgan Asset Management.  Born and raised in England and Ireland, Rhian lives in New York City with her husband and two young children.

Topics Discussed:

• How retirement has changed over the last 20 years, but industry has not evolved to meet those needs
• The role of technology in supporting Baby Boomers - Are they participating online and do they use tech?
• How inclusive UX can support underserved customers
• The intersection of health and wealth in America - In retirement, health is a financial issue
• Outlook under a new President

Rhian's LinkedIn: https://www.linkedin.com/in/rhianhorgan/

Christine Weber Craik brings over 20 years of experience working in the design industry, specifically in senior living, multifamily and geriatric healthcare design. She strives to create environments in which others can healthfully and happily live their best lives. She has received her Registered Professional membership with the ASID, IDC (IDIBC) and IIDA, and she is a Board Certified Healthcare Interior Designer with the AAHID and serves on the board of the non-profit German-Canadian Benevolent Society, whose mission is to provide quality care and support for seniors in British Columbia.

Christine is a guest lecturer for Senior Living Design at the British Columbia Institute of Technology for the Bachelor of Interior Design Program, and a volunteer Mentor and Award Juror for the IDIBC and the IIDA. Christine is a member of the BC Care Providers Association, the International Council on Active Aging and the Canadian Association on Gerontology.

Christine brings a depth of knowledge and experience having worked on complex projects in the senior living and wellness sector, including luxury independent living. assisted living, memory and dementia care, complex care and geriatric behavioral health environments in the United States and Canada.

Topics Discussed:

• How does the design of senior living environments differ from the design of other spaces?
  • Designing for senior living must first emphasize the humanity of the individuals living there
  • It is more than just a pretty residence - It must support, encourage, engage, and welcome every care giver and care receiver
  • It must feel safe, emotionally and physically - meaning it must be not just safe in terms of life safety, but it must feel safe i.e. recognizable and relatable, cozy, supportive
• Christine's design philosophy she created based on her experience, called "Sensory Design"
  • What are the main directives of Sensory Design? The idea that recreating spatial and sensory relationships that are familiar increases the health, well-being and happiness of our residents because their minds and bodies are intrinsically connected to the spaces in which they live
  • Familiarity = decrease in anxiety = increase in positive health outcomes = better quality of life
  • Deciding to move from the comfort of your home into a Modern Elders or Senior Living community is an emotional one
  • Recognition is essential for comfort in any space, especially for Boomers whom are smart consumers; they know what they want and expect excellence - Providing that high level of excellence, going beyond just surface appointments and “bling”,  involves design thinking that is outside the box
• Senior Living should be seen as a reward, not a consolation - How does the shape and character of Kasian’s design philosophy deliver?
  • Threading sensory design through all senior living work starts with a deep understanding of the end users
  • Responsive senior living communities offer exactly what your users want and need, not just what is trendy
  • What works in New York will not work as well in Phoenix; Likewise, what works in Scottsdale will not work as well in Tempe – two suburbs of Phoenix
  • Design should start with a lot of research, interviews, focus group discussions and study of existing communities, preferably, one-on-one interviews
  • Understanding begins with relationships, meeting people, hearing their stories, understanding their vision for what their dream senior living community looks and feels like

Christine's LinkedIn: https://www.linkedin.com/in/christine-weber-craik/

Glen Roebuck has served as a leader in senior health care and post-acute care for over 32 years. His career has spanned a wide range of positions with growing responsibility. He holds an MBA and Certificate in Leadership from the University of Iowa, and undergraduate degree from The College of Wooster. Mr. Roebuck has been a licensed Nursing Home Administrator in three states, and served as a regional director of senior care operations in numerous states throughout the Midwest and Mountain West. He has also served in strategic leadership roles, including operational guidance, business development and consultation, in environments ranging from single ownership models to large, statewide and national health care systems.

In his current role, Mr. Roebuck serves as Executive Director Home, Outpatient and Senior Services for Genesis Health System, based in the Quad Cities region of Iowa and Illinois. He has operational responsibility for community and inpatient hospice services, a large home health care agency, palliative care services, 18 physical therapy clinics, specialty clinics, occupational health, home medical equipment and retail pharmacy. In addition, Mr. Roebuck has implemented an outreach program placing Genesis Nurse Practitioners within high volume post-acute care sites, dramatically affecting quality metrics and readmissions. He also maintains regular communication with senior health care facilities throughout the Genesis service area, addressing health system throughput, interoperability of EMR systems, and opportunities for improved collaboration to achieve Triple Aim performance within the community. In addition, he is actively engaged in the oversight and post-acute engagement of the Genesis ACO.

Through community partnerships and collaborations, Mr. Roebuck has developed the Genesis Senior Services partnership, a collaborative between Genesis and community service partners,  providing access to trusted, proven providers committed to excellence and a shared vision to serve the Quad Cities older adult community.

Mr. Roebuck has published numerous professional articles on topics such as the successful leadership of skilled centers during challenging economic conditions, as well as preparation for health care reform and participation in Accountable Care Organizations. Mr. Roebuck speaks locally and nationally on a variety of topics on post-acute care and health system integration. Glen resides in Davenport, IA with his wife Diane. They have two adult children.

Topics Discussed:

• Can you provide us an update on the state of the virus in your area and its impact on the senior living industry over the past months?
• What makes the current state of long-term care so tenuous?
• What are some things owners and operators need to do to keep the lights on and survive in the future, in a post-COVID world?
• What changes need to be made to make long-term care services viable in the future?
• For older adults in general, how has the pandemic changed what they need and want out of the various care models?
• Can you share about what this is and how it’s making an impact on our seniors?
• What is the importance of strong leadership in the senior living industry?
• Do you think there’s anything different about the importance of leadership in senior living vs. leadership in other sectors?

Glen's Links:

LinkedIn: https://www.linkedin.com/in/glenroebuck/
Genesis Health System: https://www.genesishealth.com/
Twitter: https://twitter.com/GlenatHDG

Joe Germain is a proven senior living executive, who has worked his way through the ranks in the industry by being a true relationship architect. Starting as a consultant, Joe has helped many operators turn properties and community's around by developing operational and sales strategies that have lead to successful outcomes.

Joe has worked with many operators ranging from operational and sales roles. Most recently, he serves as the Regional Director of Sales and Marketing for Civitas Senior Living. Joe leads a team of 9 communities. 8 that are in Florida, and the newest edition in Flagstaff Arizona.

Topics:

• The People Investment in senior living. (taking care of those that work for you)
• The redefining of senior living sales culture post COVID-19 (People, census, profit)
• How incentives play a vital role in 2021 census
• Being a young leader in senior living

Joe's LinkedIn: https://www.linkedin.com/in/jgermain1/

Ravi Bala is an AgeTech Evangelist and a startup mentor in AgeTech and Remote Monitoring. He is a Co-Founder and former Board Member at HealthSignals, LLC, a leader in technology solutions for better senior living. An innovator and an expert in mobile health, conversational AI and digital strategy, he has a successful track record of creating and managing teams of independent thinkers. He has a tenacious dedication to compassion and dignity in the workplace. He is a teacher, a mentor, and a coach at heart and works with many startup ventures as an advisor.

He is currently Chair of the Capital for Good and board member for Girls First Fund – a global effort to end child marriage.  He was a Board Member of the Startup Corps and a member of the Drexel University AgeWell Collaboratory. He has taught courses in Digital Strategy in multiple MBA programs in Philadelphia. His latest passion is changing the model of eldercare with the aid of Conversational AI, Robotics and Passive Monitoring.
 
TOPICS:

• What do you envision for the future of the older adult experience?
• What are some of the most promising technologies emerging for Aging at Home
• General trends in healthcare and their impact on Eldercare / Aging at Home
• What do you see as the biggest issue with eldercare today?
• What promising care models do you see emerging in eldercare?

Ravi's LinkedIn Page: https://www.linkedin.com/in/ravibala/

Cliff Ewing and I talked about an important part of elder care that is often left out of the conversation – heating, ventilation, and air conditioning, or HVAC. During his seven years in the HVAC industry, he’s worked on projects in multifamily settings, healthcare settings, and emergency room settings. We talk about the impact COVID is having on his work and how it is making HVAC more important than ever for our immunocompromised aging population. Finally, we discuss the benefits of improved air quality and the unfortunate obstacles that prevent some long-term care facilities from implementing better HVAC practices.

Cliff's LinkedIn Profile: https://www.linkedin.com/in/cliff-ewing/