Senior Living Leaders: New Product Must Emerge to Fill Care Gaps

Senior living providers must adapt to increasingly blurred lines between different senior housing products in order to stay competitive and be best positioned for tomorrow’s residents, industry experts agree.

“Skilled nursing used to be long-term care — [but] no longer,” said Tom Grape, CEO of Benchmark Senior Living during the LINK LTC & Senior Living Conference on July 21 in Chicago, Ill. The east coast senior living provider offers independent living, assisted living, memory and respite/short-term care facilities, with 49 total communities in operation and two in the pipeline, according to its website.

To address a changing senior living market, providers are taking two different approaches: Some are expanding their reach into other sectors of the senior housing industry to offer what they see as a need for a continuum of care, while others are focusing on high-end versions of one product to maintain a competitive edge.


“Independent living is now playing the role of assisted living, and assisted living is now long-term care that skilled nursing used to be 20 years ago,” Grape said. “Much like assisted living emerged 25 years ago, is there a new category? With such dramatic change in the industry, it doesn’t make sense that there wouldn’t be something coming along.”

Vivage Quality Health Partners, largely a skilled nursing operator, is expanding its reach into the assisted living and home health sectors, said Jay Moskowitz, the company’s CEO. The provider is branching out because it sees offering a continuum of care as key to its long-term financial sustainability.

“When you have a resident that lives with you and then goes home, you no longer monitor that care. Maybe they miss a doctor’s appointment, or don’t take their medicine,” Moskowitz said. “Then they return to the hospital — and then the hospital [blames] the most recent facility that person received care at, even if they spent [a number] of days at home after leaving that facility.”


Vivage Quality Health Partners narrowed down three partnerships with home health agencies, and acquired two small home health agencies in its existing markets.

Patient length of stay at Vivage Quality Health Partners’ skilled nursing facilities has dropped to between 8.7 and 12 days on average, compared to an average of more than 20 days three to four years ago, Moskowitz said, noting a change in stay length reflects a changing product.

The desire to age in place, and receive care in a less clinical environment are contributing to the changes providers are seeing, said Rick Fisk, CEO of Covenant Retirement Communities. Covenant Retirement Communities operates about 900 skilled nursing beds across the country in typically smaller facilities, with the largest facility boasting 100 beds. In addition, it offers continuing care retirement communities (CCRCs), independent living, assisted living and memory support senior living communities.

“Ten years ago if you were in independent living and you couldn’t groom yourself, you would go into assisted living,” Fisk said. “Now, it’s not that way at all. [Consumers] want to receive service in the most home-like environment.”

Remington Medical Resorts, which exclusively offers skilled nursing, elevates a comfortable setting to a luxurious one, said Mark Fritz, CEO and founder of the two Texas-based short-term care facilities. The San Antonio facility has 60 beds and the second Dallas location has 90 beds.

“We wanted to be a leader and innovator in the skilled nursing industry and move into a more customer-focused operation,” Fritz said.

Unlike some providers who see expansion into a variety of senior living housing models as key, Remington Medical Resorts sees offering a more unique product as a way to stake its claim in an evolving industry.

Focusing only on short-term stays bodes well for the high-end skilled nursing provider, Fritz said.

“We tried [dealing with short- and long-term care] in my previous company,” Fritz said. “With both run under the same roof, it’s very difficult for staff to get their hands around moving someone out after 13 days versus having someone with you for a year.”

The hotel industry inspires Remington Medical Resorts’ housekeeping and culinary services, attracting a new type of resident who is put off by the idea of the more traditional skilled nursing facility.

“At the end of the day, who wants to buy skilled nursing services?” Fritz said about the brand name’s inclusion of resorts. “We felt like we would have a product people would want to buy. It’s a lot easier for aunt Ethel to say after hip surgery, ‘I’m going to this resort for rehab,’ rather than, ‘This skilled nursing facility.’”

Written by Cassandra Dowell

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