The senior housing industry is gradually embracing technology but still struggles to keep up with the pace of new advancements, as well as the costs involved with implementing technology.
Still, forward-thinking providers are making significant technology investments that are bearing fruit. When asked to name the single tech implementation that has made the biggest positive impact over the last three to five years, executives at Revera, Asbury Communities and Carlton Senior Living chose to highlight different types of systems that all had one commonality: They improved the day-to-day experience of their workforces.
These three providers are of different sizes and represent both the nonprofit and for-profit worlds. They described the challenges in selecting and implementing new tech but also the payoff, as they now have enhanced capabilities to tackle the intense labor challenges besetting senior living.
Improving front line worker engagement
When Asbury Communities looked to improve its associate engagement and communications between the C-Suite and front line staff, it turned to its associates for inspiration, CEO Doug Leidig told SHN.
“We had engagement, but it was not as uniform as I would have liked,” he said. “It was hard for us to relay messaging and our culture in terms of listening to those closest to the process [of serving residents]. It’s really important to listen to them as they are the ones who have the biggest influence on the quality of life of our residents, creating and instituting a new culture and for recruitment of new workers,” he said.
Leidig also recognized that Asbury needed to be more innovative. The Frederick, Maryland-based nonprofit provider, which has a portfolio of eight communities following a recent affiliation, doubled its technology expenditures in 2019. But one of its most important tech launches was an associate app, which allows management to directly communicate with front-line staff, Program Director Jason Brennan told SHN.
The idea came during a “spark tank” presentation at one of Asbury’s LDI conferences at its annual leadership development institute. Modeled after the television show Shark Tank, Spark Tank is an opportunity for front-line employees to pitch ideas to senior Asbury executives which hold the potential for improving operations and workforce culture.
The executives loved the associate app concept, and partnered with redeapp, a mobile workforce communication platform, to develop it. The concept was chosen because 59% of Asbury’s associates lacked access to desktop computers and email.
“We chose this as it had the biggest opportunity to move away from being a top-down culture,” Leidig said
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Asbury and redeapp focused on ease of use for the app, centering on a “three-tap rule” for associates to download, set up and start using the app. Rollout was on a community-by-community approach starting at its campus in Solomons, Maryland, and associates were not mandated to participate in the launch. This allowed Asbury to tweak issues with the app and streamline the training process to make associates comfortable with the software.
Asbury was satisfied with the initial results. Of its 2,400 associates, 1,300 — 61% — downloaded the app. Additionally, over 308,000 messages were sent and received through the app, and the open rate for messages is 20% higher through the app over standard email.
Having bought into the concept, associates have taken the lead in adding tweaks to its use, Leidig told SHN. Managers are now using the app to schedule open shifts, associates are able to log in sick days, days lost to inclement weather, and personal time off, and the usage rates continue to climb.
Associates used the app to participate in the annual Great Place to Work Survey. More than 86% of Asbury’s associates participated in the survey, and 41% more employees filled out the survey through the app than via email in 2018. Finally, the app in an increase in Asbury’s Going the Extra Mile [GEM] employee recognition citations. Of 1,400 Gems this year, 20% went through the app, double what was expected, Brennan told SHN
“Using this helps us become the employer of choice in our markets. From a retention and recruitment standpoint, it also allows for more resident facing time,” he said.
Reducing resident falls
Resident falls are one of the most common issues providers face. The impact a fall can have on a resident and/or family — such as chronic pain, change in condition and the need for higher level of care — makes it crucial to work on preventative solutions. Resident falls also accounted for nearly 40% of the spike in senior living-related liability insurance claims, according to a 2018 report from CNA, a Chicago-based commercial property and casualty insurance company.
Three years ago, Concord, California-based Carlton Senior Living piloted a launch of SafelyYou, a platform combining video surveillance and AI technology to identify falls in memory care without the use of wearables, Carlton Vice President, Clinical Operations Marco Santos told SHN.
In researching fall reduction platforms, Carlton found other options were still somewhat limited and are typically based on either an auditory alarm or a form of wearable. SafelyYou, by contrast, stood out. In addition to the video and AI components, an occupational therapist reviews the footage and consults with the community manager to craft an appropriate care plan for the resident.
“Having support from an occupational therapist really empowered our team to have a new proactive approach in identifying potential fall risks in our residents’ apartments,” Santos said.
Carlton deployed the software in its 11 communities, which is home to more than 200 memory care residents, 89% of which participate in the service. To date, the provider has seen a 31% reduction in falls and slashed emergency medical services calls by 61%. Furthermore, SafelyYou was able to identify instances where residents are on the floor but did not necessarily fall.
“Instead they self-lowered themselves to the floor; something that prior to SafelyYou, would most likely result in an ER visit,” Santos said.
The platform has ancillary benefits, as well. Carlton saw a reduction in ER visits which saves residents and their families money, not to mention the trauma of having to wait in an emergency room for hours. EMS responders are also able to assess the falls more accurately with the use of video footage.
From a financial perspective, as an early adopter of SafelyYou, Carlton was able to forgo installation costs, and was able to tweak the type of surveillance hardware it used as the program expanded across the portfolio. The provider initially used wireless cameras, discovered some issues with WiFi strength, and switched to wired cameras as SafelyYou expanded to other communities.
“The beauty of it is that this system does not require any additional labor. The part of utilizing SafelyYou that takes the most time from our team is implementing changes to assist in the prevention of a fall depending on the cause. It’s time well spent from our perspective,” Santos said.
A fully integrated HR platform invoicing app
Revera owns and/or operates 500 communities in the U.S., Canada and the U.K., under a variety of banners. The Mississauga, Ontario-based company’s Canadian platform includes 175 sites across the country, employing over 20,000 people, which can be difficult to manage efficiently, Chief Information Officer Steve Paraskevopoulos told SHN.
One particular challenge Revera faced: outdated tools handling payroll, financial processes involving invoicing, and HR processes such as hiring. The firm was researching a new payroll system that could handle the complexities of its Canadian platform; Revera is a highly unionized organization in Canada with over 220 collective bargaining agreements, for example.
“We needed a tool that we could configure and be effective,” Paraskevopoulos said.
After diligent research, Revera adopted Workday, a cloud-based enterprise resource planning tool, and found the platform provided additional benefits. In addition to streamlining the payroll planning, Workday could be integrated with its HR systems. This allowed the company to manage the life cycle of an employee much better. Workday’s finance application, meanwhile, drove further efficiencies in Revera’s invoice processing.
What Revera learned about Workday’s backend technology was interesting, but what drove the value of the platform home for the company was its impact on the end user: its employees.
“Our goal was to make [Workday] efficient for them to do what might be looked at as administrative or management tasks. If we can save hours a day on very critical management roles on the site, then those are hours that will be spent working with our residents,” Paraskevolpoulos said.
Revera also wanted to make the case to potential hires that it was providing the most progressive platform for them to manage their information and workflows around: booking vacations, submitting expenses, training and applying for open positions.
“We wanted to make sure we had a fully automated process from end to end,” he said.
Revera spent 15 months working on Workday before launching it across its Canadian platform in September. There have been initial growing pains, given the size of its Canadian workforce. Around 12.5% of its employees are what Paraskevolpoulos called heavy users in upper management.
So far, Revera is satisfied with its initial results, and the feedback it has received from users has centered on the pace of the changes in processes. Leadership is convinced, however, in Workday and as the rollout progresses, Revera is already looking at deploying new features to Workday and ways to use the data the app collects to help its communities find operational efficiencies.
“This not only positions us well with our current employee base, but the introduction of this technology, the governance associated with that and the tools that are becoming expected by potential candidates, has positioned Revera as a leader in our sector,” he said.