How Five Star is Taking Senior Living Wellness to the Next Level

As senior living aims to be taken more seriously across an evolving health care landscape, today’s providers recognize that it’s all about measuring outcomes.

Five Star Senior Living (NYSE: FVE) is taking a new approach to that measurement not through the usual channels, but by re-envisioning its wellness program across hundreds of communities.

The fourth largest senior living provider’s new Lifestyle 360 program, launched in the first quarter of 2015, aims to create “a happier, healthier, more well-rounded lifestyle for [its] residents.”


Implemented at each of the provider’s more than 220 communities nationwide, Lifestyle 360 targets the five dimensions of wellness — intellectual, social, physical, emotional and spiritual — and will collect data that could serve as a catalyst for health care partnerships in the future, says Brenda Abbott-Shultz, Five Star’s director of resident programming and creator of Lifestyle 360.

By offering evidence-based programming, Five Star will be able to track a resident’s participation in certain activities and measure that against the health outcomes they aim to achieve.

For example, under the emotional dimension of wellness, how do creative art therapies help residents reminisce? Or how does a regular exercise program decrease a resident’s chances of falling? The answers to these questions will come from data collected on residents’ participation in the different dimensions.


And for Five Star, it’s a new approach to prove itself as a major player in the shifting health care landscape — and it could mean positioning itself as a preferred provider down the road.

“It’s a completely different take altogether — no one thinks about activities as being a player in any of this,” Abbott-Shultz says. “We’re saying, not only are we a player but we are going to make a major difference in the outcomes of our residents. It’s not just about clinical care. We have a part to play in that whole [wellness] process — and I think that’s something no one is thinking about.”

Integrating Science in Senior Living

Last year, Abbott-Shultz embarked on a journey to find a better way to enhance Five Star residents’ overall experience.

“Much like how the celebrity chef program enhanced our dining experience, we wanted to take a good hard look at our programming brand and what we offer residents,” she says.

And with a background in nursing, it was easy for Abbott-Shultz to approach the task methodically — and to find the metrics behind the programming.

“Programming in senior living has been mostly focused on engaging the residents, [figuring out] how to get them involved in activities, busy during the day and fulfilled,” she says. “But I don’t think there’s been a lot of focus placed on the benefits our residents will derive from participating in these programs. With nursing, it’s all about the clinical outcomes — we don’t have that in programming.”

As part of the new Lifestyle 360 rollout, Five Star created Signature Programs, which highlight a different dimension each month. This month, the emtional dimension is featured through the provider's “Honoring the Hands of Time” program. Photo courtesy of Five Star.
As part of the new Lifestyle 360 rollout, Five Star created Signature Programs, which highlight a different dimension each month. This month, the emtional dimension is featured through the provider’s “Honoring the Hands of Time” program. All photos courtesy of Five Star.

The five dimensions of wellness now serve as the foundation of Lifestyle 360, but Abbott-Shultz also integrated elements of Maslow’s hierarchy of needs, a theory that people are motivated to achieve certain goals, and the end goal is achieving “self-actualization,” meaning self-fulfillment and purpose.

Making the Cut

After developing the foundation for Lifestyle 360, Five Star conducted a comprehensive review of its existing programs, keeping the activities that fit into the five dimensions and cutting the rest.

“We probably kept about 60% of them, and out of that 60% some of them needed some tweaking,” Abbott-Shultz says. “My gut check was: Is there research out there to support the benefits of this program? If there wasn’t, we cut it.”

Each Five Star community is now required to offer a certain number of programs to fulfill the dimensions: They must offer seven physical programs a week; seven social; seven intellectual; five emotional and three spiritual.

If residents aren’t attending the activities, then the communities need to switch up the programs they’re offering in that particular dimension.

Additionally, as part of the new Lifestyle 360 rollout, the operator created Five Star Signature Programs, which highlight a different dimension each month. For the month of May, the emotional dimension of wellness is featured through the “Honoring the Hands of Time” program, in which communities take professional black-and-white photos of residents’ hands and frame them with a note describing “what these hands have done.”

The Signature Programs will rotate and highlight a different dimension each month.

Measuring Outcomes

It’s not all just fun and games for Five Star. Ultimately, Lifestyle 360 aims to do more than just provide activities for residents.

“When we design a program, we specifically ask, ‘What dimension does this program cover?’ and ‘What are the outcomes or benefits our residents will experience by participating in this program?’” Abbott-Shultz says.

A similar initiative was recently launched by the American Senior Housing Association (ASHA) in partnership with NeuroVigil, a company that merges neuroscience with non-invasive wireless brain recording technology.

As part of the initiative, NeuroVigil will monitor the aging brain and collect massive amounts of data from residents to determine whether senior living communities — and their programs — are benefiting them.

But through Five Star’s Lifestyle 360, the provider will conduct a comprehensive assessment on residents to ensure that they are each getting the individualized programming they need. By tracking their participation in the five dimensions, the provider will be able to calculate which dimension a resident is stronger or weaker in and readjust the programming schedule accordingly.

“Say a resident is physically weak. We can offer more physical programs as part of their wellness plan,” Abbott-Shultz says. “If they’re spiritually strong, maybe we could include more physical programs than spiritual because that’s what the resident needs.”

And when these activities are measured and tied to scientific research backing their benefits, Five Star will be able to see — and track — the therapeutic benefits of Lifestyle 360.

For instance, if a resident is participating in more emotional programming, is Five Star seeing a reduction in that resident’s use of psychotropic medications?

“We measure what matters. If this matters to us — which the outcomes do — we have to measure it and we have to do something with it,” Abbott-Shultz says.

And that’s where the operational benefits come in.

Increasing Referrals, Partnerships

Eventually, Five Star hopes the Lifestyle 360 program will serve as a marketing tool to increase move-ins and as a catalyst to jump-start partnerships.

According to Chief Operating Officer Scott Herzig, resident referrals are Five Star’s best lead source, as they convert at 25%, have the highest length of stay, and the lowest cost of sale, he said during the company’s first quarter earnings call with analysts.

“Referrals were up 13% and resident referral move-ins were up a robust 31% year over year. Today, resident referrals account for nearly 25% of our total business, up from 20% a year ago, and reflective of our overall resident satisfaction,” he said.

But Abbott-Shultz hopes Lifestyle 360 will contribute to even more resident referrals.

“We hope our residents will remain with us longer and that friends and families will refer so we’ll see those rates go up,” she says. “Just as important, we’re hoping our resident and family satisfaction scores related to programming will increase and we’re hoping to see that people will want to move in because we have this unique therapeutic approach to programming.”

She also notes that Lifestyle 360 will serve as a marketing tool for new resident move-ins.

“When we can market our outcomes, we can demonstrate more than the competition that these are the benefits of living with us,” she says.

As for using the data to develop relationships with universities and health systems, Five Star hopes to do that too.

“Once we get our quantitative ducks in a row, it will make those discussions a lot easier and more fruitful,” Abbott-Shultz says.

Written by Emily Study

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