Senior Housing News recognizes the seriousness of the Covid-19 pandemic, so we will be updating this bulletin to keep you apprised of the latest developments, focusing on news and information that we identify as especially pertinent to senior living. The team at SHN knows how important your work is right now; we thank you and your teams, and encourage you to reach out to us individually or at firstname.lastname@example.org with news items, topics that you believe are important for coverage, or other feedback.
Bulletin for Thursday, April 9, 2020:
Senior housing occupancy for Q1 2020 was 87.7%, which was a slight dip from 88% in the previous quarter, according to data released Thursday by the National Investment Center for Seniors Housing & Care (NIC).
Given that the U.S. Covid-19 outbreak did not take hold until mid-March, this data should be seen as a benchmark for where occupancy stood prior to the pandemic, NIC stated in a Thursday press release.
“Data from the first quarter will be an important benchmark moving forward in these unprecedented times, with occupancy and construction starts challenged by circumstances beyond anyone’s control,” said NIC COO Chuck Harry, in the release. “The industry’s first priority is to ensure that frontline caregivers are in the best possible position to address the health and safety of residents, as well as their own wellbeing and that of their families.
Occupancy for majority independent living communities came in at 89.9% for Q1 2020, which was a drop of 10 basis points from the previous quarter.
Assisted living occupancy dropped 20 basis points from the previous quarter, to 85.3%. The record low for AL, set in 2019, was 85.1%.
In an effort to determine how Covid-19 might be affecting senior housing occupancy, NIC conducted an executive survey between March 24-31. This showed that occupancy had remained stable, with two-thirds of respondents saying that occupancy rates had not changed from one month prior.
However, real estate investment trusts have been reporting a slowdown in move-ins during the second half of March. Some industry analysts have warned that occupancy could hit historically low levels due to the pandemic.
Over the last four quarters, new construction starts in NIC’s primary markets totaled 17,062 — the fewest since 2014.
“The deceleration in assisted living property construction starts foreshadows a further slowdown in new senior housing development associated with the effects of the COVID-19 pandemic,” said Beth Mace, NIC’s chief economist, in Thursday’s press release. “Many finance and capital providers are waiting for more clarity on how the pandemic will play out to understand what impact it will have on the broader economy.”
Also in the news:
— Assisted living facilities across 29 states are dealing with more than 700 confirmed cases of Covid-19, Kaiser Health News (KHN) reported Thursday, citing public health authorities and news organizations.
“Assisted living complexes, home to more than 800,000 people nationwide, have quickly become a new and dangerous theater in the coronavirus war,” reporters Laura Ungar and Jay Hancock wrote in their article, which also ran in USA Today. “Challenged by deepening financial pressures, sicker residents, limited oversight and too few employees, they now face a crisis that could force companies into bankruptcy, roil the industry and even close some facilities — putting frail seniors at greater-than-ever risk.”
— Shares in publicly traded senior housing owners and operators rallied on Thursday as stock markets surged on news of additional actions from the Federal Reserve to shore up the economy. Among the biggest gainers, Brookdale Senior Living (NYSE: BKD) was up 17.61% at market close; Ventas (NYSE: VTR) was up 12.18%; and Capital Senior Living (NYSE: CSU) was up 28.88%, although its shares still were trading below $1.00.
Over the course of the week, the S&P 500 recorded its largest one-week gain since 1974, of 12.1%. The Dow Jones Industrial Average also gained more than 12%. Markets are closed on Friday in observance of Good Friday.
— Sienna Senior Living (TSX: SIA), which operates 83 residences in the Canadian provinces of Ontario and British Columbia, withdrew its 2020 guidance in light of Covid-19. The Ontario government has allocated $243 million to support long-term care homes and $20 million to support retirement homes, while the British Columbia government has allotted $10 million for long-term care homes, Sienna noted in a press release Thursday.
“We continue to believe that Sienna’s fundamentals remain strong with a solid balance sheet and ample liquidity. At this time, the Company has approximately $215 million of liquidity and an unencumbered asset pool of approximately $540 million,” the press release stated.
— Senior living communities in California are implementing more stringent policies regarding residents re-entering after a hospital stay, the San Diego Union-Tribune reported.
Bulletin for Wednesday, April 8, 2020:
The $2 trillion CARES Act stimulus package included $100 billion in relief for health care providers. The first $30 billion is being disbursed this week, and senior living providers are not receiving any of that money.
Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced the $30 billion distribution on Tuesday evening. The money is being divided up amongst health care providers based on their Medicare revenue, and providers that depend on other sources of revenue are not part of this first wave of distribution. Verma called out nursing homes — which rely primarily on Medicaid dollars — as being among the providers that will receive money in the second wave.
However, she did not mention senior living providers that rely primarily on private-pay revenue, such as assisted living and memory care communities. Still, federal officials have indicated that senior living could be eligible for some of the $100 billion allocated health care.
“Per Ms. Verma, there will be a second round of funding where priority will be given to children’s hospitals, pediatricians, nursing homes and other providers that receive much of their funding from other sources,” Mizuho analysts observed in a note issued Wednesday. “This suggests more to come for senior housing, and a possible glimmer of hope for senior housing to receive aid given senior housing is being impacted by Covid-19 as well, and large senior housing operators likely will not qualify for the SBA loans as they often have more than 500 employees given the high touch/labor intensive nature of the business.”
Argentum and the American Seniors Housing Association (ASHA) have repeatedly pushed for $20 billion to be allocated for senior living providers, most recently in a letter to Health and Human Services Secretary Alex Azar. In that letter, they shared a third-party analysis showing that the industry could be facing a $57 billion financial hit due to Covid-19.
Meanwhile, smaller providers are trying to tap into the SBA forgivable loan program, but that has gotten off to a rocky start.
Also in the news:
— Brookdale Senior Living (NYSE: BKD) is recruiting for more than 4,500 positions, the Brentwood, Tennessee-based provider announced Wednesday.
Senior living providers across the country have been making concerted hiring efforts, faced with staffing pressures due to Covid-19. They are seeking to fill a variety of roles even as millions of other U.S. workers have been laid off, and are making efforts to recruit out-of-work hospitality and restaurant workers in particular.
The huge number of open positions at Brookdale reflects the company’s scale: With more than 740 communities nationwide, Brookdale is the largest U.S. senior living provider by a wide margin. Open positions include registered nurses, certified nursing assistants, caregivers, housekeeping, dining and other roles. The company has a newly created position of “room service attendant,” given that the company has moved to in-room dining as a social distancing measure.
“While these positions may initially be seen as a temporary solution by individuals, our hope is that these new associates will find purpose and meaning in a career with Brookdale, and awareness that this is a great opportunity to be a part of something bigger than themselves,” stated Lucy Leeming, senior vice president of talent management at Brookdale.
— Covid-19 has put telehealth front-and-center, and new survey results from SYKES show that older adults are embracing the technology. Out of about 400 respondents over the age of 55, 52% said Covid-19 has increased their willingness to try telehealth, according to unpublished data shared with Senior Housing News.
About 50% of older adult respondents said they would consider a telehealth appointment, although only about 12% have had one already. The biggest telehealth deterrent, cited by 43% of over-55 respondents, was skepticism that they could be properly diagnosed or treated via telehealth.
— More Medicare Advantage plans are offering supplemental benefits that cover services commonly provided in senior living, according to a new study from the Better Medicare Alliance and conducted by Milliman.
“The coronavirus pandemic has underscored in sobering ways the deeply personal nature of health care, particularly for seniors. As this study shows, Medicare Advantage continues to innovate with new tools to help seniors stay on the path to wellness, including benefits such as telehealth and meal delivery that can keep seniors safe at home,” said Allyson Y. Schwartz, President and CEO of the Better Medicare Alliance, in a press release.
Bulletin for Tuesday, April 7, 2020:
March 2020 move-ins were down 50% compared to March 2019 for the senior housing operating and continuing care retirement community (CCRC) portfolios of Healthpeak Properties (NYSE: PEAK).
Compared to February 2020, SHOP and CCRC move-ins were down 41% last month, the Irvine, California-based real estate investment trust reported Tuesday. Together, SHOP and the CCRC portfolio represent 27% of net operating income for the company.
As of March 31, total blended occupancy in the SHOP/CCRC portfolio was 83.4%. That was down from 83.8% on Feb. 29.
“Move-ins were in line with our expectations through mid-March,” Healthpeak stated in its April 7 Covid-19 update. “Thereafter, move-ins declined in response to COVID-19 protocols, sheltering in place, and reduced in-person tours.”
Leads for March 2020 declined by 32% compared to March 2019. However, the REIT’s month-over-month conversion ratios improved, suggesting that inquiries are coming from people with a more urgent desire or need to move.
Other REITs have also reported a slowdown in move-ins starting in mid-March, as the Covid-19 crisis escalated in the United States. Financial analysts watching the space have warned that the pandemic could lead to historically low occupancy rates. However, occupancy appears to have held up reasonably well over the last month, according to data compiled by the National Investment Center for Seniors Housing & Care (NIC).
Even as move-ins have slowed and occupancy has ticked down, REITs are also reporting fewer voluntary move-outs. Healthpeak anticipates a reduction in voluntary move-outs, although the company is not yet predicting how much Covid-19 will affect these numbers. Voluntary move-outs account for roughly a third of Healthpeak’s total move-outs.
Going forward, Healthpeak anticipates that SHOP occupancy will drop roughly 2% to 4% a month and CCRC occupancy will drop about 1% a month due to Covid-19. The REIT may consider rent deferrals for its triple-net lease operators.
Operators are also facing increased costs due to the coronavirus situation. Labor costs are likely to rise between 5% and 15% during the pandemic, Healthpeak stated. Purchases of personal protective equipment typically account for 2% of total costs but this is likely to increase by two to five times.
Currently, 22 Healthpeak communities managed by nine different operators have confirmed cases of Covid-19 among the resident population, and residents have died from the disease in 11 communities, the REIT reported.
Also in the news:
— Argentum and the American Seniors Housing Association (ASHA) have launched “Senior Living FastMatch,” a tool to help connect laid-off workers with opportunities in senior living. Powered by technology from Arena, the tool harnesses artificial intelligence to match job seekers from other industries with senior living positions available in their region. Providers can post job opportunities to FastMatch at no cost through Sept. 30, 2020.
“Hospitality, restaurant, and retail workers are particularly impacted by the current crisis, and Argentum has been working with the American Hotel & Lodging Association to help connect these workers with senior living,” stated Argentum President and CEO James Balda. “They bring skills and experience that are a strong fit for many senior living positions, such as concierges, dining professionals, and housekeepers. This talent-matching tool provides the technology and opportunity to quickly help workers and providers connect in this emergency.”
Also, OnShift has created an expanded toolkit to help providers with recruiting and hiring efforts.
— KARE, a “digital labor marketplace app,” is expanding into new markets and has added features in response to the Covid-19 pandemic. The startup also revealed that its backers include a who’s-who of industry leaders, including NIC founder Bob Kramer.
The app connects caregiver “Heroes” to work unfilled shifts in senior living and care communities, offering providers a better rate than a typical staffing agency while giving workers more autonomy and ready access to income. The app launched in October 2019 in Houston and Austin and now is rolling out to other Texas markets, including Dallas/Fort Worth and San Antonio. Atlanta, Georgia is on tap for next month.
“Because of the desperate need for caregivers in this time of crisis, we are grateful that KARE is able to quickly help senior care communities quickly find staff to care for their residents,” stated Bridget Kaselak, chief growth officer for KARE, in a press release. “And because of the concerns about health care workers contributing to the spread of the virus, we have tweaked our technology to help alleviate that concern in ways that a traditional staffing agency can’t in order to be compliant with state or local restrictions.”
Specifically, no caregiver will be able to check in for a shift without reading and acknowledging the particular infection control procedures at that location, KARE CEO Charles Turner told SHN. In addition, a “switch” has been added for areas in which staff movement between different facilities has been restricted. When the switch is flipped, caregivers in that area will be assigned to a particular facility and will be unable to work in any others, and all local communities will be notified.
In addition to Kramer, KARE is backed by organizations including Bridge Real Estate Group, and leaders with providers such as Frontier Management, Seasons Living, Caraday Healthcare, Principal Senior Living, Benton House, Sodalis Senior Living and others.
— A high school in Chicago has dedicated its 3-D printers to making face masks for senior living providers, starting with Silver Birch.
— MyndVR, a company that specializes in providing virtual reality technology to senior living and care providers, will be giving away a free VR headset and one-year content subscription to communities in all 50 states. The program is meant to help reduce social isolation related to Covid-19.
Bulletin for Monday, April 6, 2020:
The Department of Health and Human Services (HHS) should confirm that senior living providers have been granted certain legal protections during the Covid-19 pandemic, Argentum and the American Seniors Housing Association (ASHA) said in an April 3 letter to HHS Secretary Alex Azar.
On March 17, HHS published a declaration under the Public Readiness and Emergency Preparedness (PREP) Act. The declaration provides liability immunity — except in cases of “willful misconduct” — to “certain individuals and entities” related to their undertaking “critical countermeasures” to fight the Covid-19 pandemic.
“For senior living communities to respond to Covid-19 in a way that best serves the interests of the elderly adults residing in their communities, the protection from liability provided to Covered Persons by the PREP Act should apply to senior living communities and their employees,” the letter to Azar stated. “We urge the Secretary to confirm this interpretation in an expedited manner to remove current and anticipated barriers to care for the nation’s elderly adults.”
Such a confirmation would provide confidence that senior living providers have liability protection related to such services as administering drugs to residents with Covid-19. If HHS determines that senior living providers are not covered under the declaration as it currently exists, Argentum and ASHA are urging the agency to amend the declaration.
Also in the news:
— Strategic Student Housing & Senior Housing Trust (SSSHT), a public, non-traded real estate investment trust sponsored by SmartStop Asset Management, has stopped selling shares to the public due to changing market conditions caused by Covid-19, CoStar reported Monday.
SmartStop has about $1.9 billion of real estate assets in its portfolio, including 117 self-storage facilities in the U.S. and in Toronto, and saw an opportunity in senior housing.
“Like self-storage 15 years ago, student and senior asset classes are a little bit below the radar,” John Strockis, president and chief investment officer for SSSHT, told Senior Housing News in October 2019. “We really want to parallel what we did with self-storage 15 years ago … acquire them, understand them, brand them.”
As of October, SSSHT had acquired four senior living properties, operated by Integral Senior Living (ISL) and MBK Senior Living. At that time, the firm was raising additional equity and contemplating a brand name for its senior housing portfolio.
— Hospitals have encountered problems in discharging patients to certain post-acute facilities, including both skilled nursing facilities and those providing “lower-level care,” according to a Government Accountability Office (GAO) report.
“One hospital reported a case in which a post-acute-care facility refused to take a patient unless the hospital sent them a week’s worth of masks for the patient and for the staff who would care for the patient, even though the patient was not positive for Covid-19,” the report stated. “Delays in receiving test results contributed to delays in transferring patients to these lower level facilities and in freeing beds in the hospitals for incoming Covid-19 patients.”
Not all senior living communities are hesitant to accept hospital patients. Some providers, such as Phoenix Senior Living, are working with local health systems to proactively manage capacity by taking on lower-acuity patients.
— Due in part to lower valuations for senior housing, the Green Street Commercial Property Price Index fell 1.3% in March. The index is a time series of unleveraged U.S. commercial property values that reflects pricing for commercial property transactions — including some that have not yet closed — across a range of asset types. The March decline is attributable primarily to lower valuations for lodging, malls and senior housing, due to Covid-19 concerns, according to a Green Street press release.
“The property markets are in an adjustment period; it’s going to take some time for buyers and sellers to figure out what a new fair price is,” said Peter Rothemund, managing director at Green Street Advisors. “Most everybody acknowledges pricing will be lower, but the question is how much. There is no one right answer. Prices of some property types should hold up relatively well, while those most affected could see 30% declines.”
— Bloom Senior Living and Assured Assisted Living have joined the ranks of providers that are offering Covid-19 tests. Family-owned and operated Bloom has partnered with Alabama-based Assurance Scientific Laboratories to perform tests for residents and associates at all of the company’s locations. Bloom is based in Birmingham, Mississippi, and operates nine communities across Indiana, Ohio, South Carolina, Louisiana and Florida.
Assured Assisted Living operates 10 memory care communities in and around Denver and Castle Rock, Colorado. The company is working with Centennial State Lab to begin testing all incoming residents for Covid-19 starting this week. Potential residents will be tested in their own homes as part of an initial care assessment. Individuals needing immediate placement will go to a specialty care home for a period of quarantine.
“When we receive negative test results we can move residents in immediately and provide peace of mind to our current families and staff,” said Francis LeGasse, in a Monday press release. “We are 100% committed to providing the safest environment possible while still helping those who need care and want to transition to an assisted living environment with memory support.”
— In brighter news during the pandemic, residents at The Enclave at Round Rock — a Spectrum Retirement Communities building in Austin, Texas — held a virtual bingo night with a special host: Oscar-winning actor Matthew McConaughey.
“Last September, the residents and team members at The Enclave posted a video on social media requesting McConaughey to join them for bingo,” CBS affiliate KEYE reported. “Amid the Covid-19 pandemic, McConaughey had the time and ability to answer this call.”
Bulletin for Saturday, April 4, and Sunday, April 5:
Welltower (NYSE:WELL) has reportedly backed off a years-long bid to buy a London-based firm with more than 200 care homes in the United Kingdom.
The Toledo, Ohio-based real estate investment trust (REIT) was previously interested in acquiring Barchester Healthcare for a sale price of at least £2.5 billion, or roughly $3.1 billion. But the company has now dropped its bid, according to a new report in The Sunday Times.
It wasn’t immediately clear why Welltower dropped its bid now, and the REIT declined to comment when reached by Senior Housing News Saturday. But the company has focused its fire in recent weeks on slowing the spread of Covid-19 as its properties. As of April 1, Covid-19 had affected 116 residents in 45 of Welltower’s communities across the United States. Occupancy for Welltower’s senior housing operating portfolio (SHOP) was 85.4% as of March 27, a decrease compared to the 85.6% occupancy rate the company reported on March 13, 2020.
Meanwhile, Welltower is bulking up on its supplies of personal protective equipment (PPE). The company last Wednesday said it had procured or was working to procure 400,000 pairs of gloves, 250,000 facemasks, and 120,000 isolation gowns in addition to hand sanitizer, disinfectants and no-touch thermometers. The REIT plans to distribute the supplies from a newly established center in Dallas.
Welltower wasn’t the only U.S. senior housing company interested in buying the U.K. nursing home company. U.S. investment bank JP Morgan has also shopped the company around to a lineup of different potential buyers, including Chicago-based Ventas (NYSE: VTR) and Seattle-based investment firm Columbia Pacific Advisors.
Australian investment bank Macquarie then took the lead in the bidding process, but ultimately dropped out of the process last year over uncertainty regarding the Brexit process, the Sunday Times reported.
SHN wasn’t able to reach a representative for either Ventas or Columbia Pacific as of Sunday afternoon.
Also in the news:
— If move-ins grind to a halt due to Covid-19, senior housing occupancy could be cut in half, falling below the 70% mark, BMO Capital Markets Analyst John Kim told Bloomberg. (Editor’s Note: Senior Housing News spoke with Kim about his projections Monday morning. Click here to learn more.)
Last Tuesday, on an earnings call for Capital Senior Living (NYSE: CSU), Barclays Managing Director Steven Valiquette noted that a 2,500 basis point decline in occupancy is being floated among the investment community as a potential Covid-19 scenario. Capital CEO Kim Lody and COO Brandon Ribar said they do not see any indications so far of such a dramatic decline.
And occupancy appears to have remained stable in the early weeks of the U.S. Covid-19 outbreak. Occupancy did not change or increased over the last month, according to three-quarters of senior housing executives who responded to a National Investment Center for Seniors Housing & Care survey conducted between March 24 and March 31.
But analysts are gaming out worst-case scenarios and responding to sharp drops in the market caps of publicly traded owners and operators. Senior housing REITS are essentially “uninvestable” given current uncertainties, Jeffries analyst Jonathan Petersen told Bloomberg.
— March move-ins were down 30% compared to January and February averages for New Senior (NYSE: SNR). The New York City-based real estate investment trust has a portfolio of 102 independent living communities in management contracts and one asset in a triple-net lease, with Holiday Retirement its primary operating partner.
Move-ins began to decline in mid-March as the U.S. Covid-19 outbreak escalated, putting the brakes on physical tours and new move-ins, the REIT reported on Friday in an updated presentation on how the pandemic is affecting its portfolio.
There is some good news as well, in the form of fewer move-outs. April move-out notices are 20% lower versus the comparable March metric. And tour volume increased in the final week of March due to the rollout of virtual tours.
As of April 2, eight communities managed by three different operators had confirmed Covid-19 cases, affecting 18 residents and one employee. More than 120 residents and staff members have been tested for Covid-19. So far, 84% of tests have come back negative, but New Senior expects confirmed cases to increase as testing becomes “more widely and easily available.”
“We would like to again thank and commend all of our operators and the staff at our communities, who continue to serve our residents with exceptional care and purpose, in spite of the ongoing crisis,” the REIT’s presentation stated.
— Juniper Communities and LTC Properties (NYSE: LTC) have launched Virtual Connections, a hub of free digital resources for senior living providers and residents. The website SLvirtual.com includes hundreds of activities, games, exercise videos, live webcams of zoos and aquariums and other digital resources to aid in resident engagement and entertainment while social distancing is in effect.
“As aging adults are isolated around the world and in our senior care communities, we wanted to be able to provide relief for those working in the communities and entertainment to help make these days a little brighter for residents and staff,” Lynne Katzmann, president of Juniper Communities, said in a press release. “Virtual Connections is a way to give back to our industry and show encouragement to those working tirelessly to serve seniors while honoring social distancing policies.”
In addition to working with Juniper to launch SLvirtual, LTC has started an online forum for its operating partners and other trusted industry partners.
“During these challenging times, we seek creative ways to help our partners and the industry as a whole,” Wendy Simpson, CEO and President, LTC Properties said.
— Industry associations ASHA and Argentum pushed back against an April 5 Wall Street Journal article.
“Assisted-living facilities, a booming but lightly regulated industry that houses roughly a million elderly patients in Florida and across the nation, are ill-prepared for the novel coronavirus, some health authorities say,” the article began.
The industry groups took issue with the idea that assisted living communities are less prepared than other settings for Covid-19, and pointed out the systemic challenges related to a lack of supplies and testing.
“As with most every other operator across myriad industries, if assisted living had access to quick-acting testing kits and PPE, we could further protect our vulnerable population and continue to keep most of our residents out of the hospital, allowing our health care system to focus on those with life threatening conditions,” the associations stated. “The fact of the matter is that assisted living residents are much safer living in our communities than they would be living by themselves with the physical and cognitive impairments that characterize most of those we care for.”
— A Place for Mom is launching a new ad campaign in light of Covid-19. “As the national healthcare system becomes increasingly burdened, APFM has received a myriad of inquiries from families facing pressing and difficult decisions,” the company stated in a press release. “They need access to the latest information available and support as they seek to keep their loved ones safe amid quarantines and expedited hospital discharges.”
A Place for Mom also is adding its voice in calling for more Covid-19 tests, supplies and other resources for senior living providers. A recent APFM survey found that more than 90% of the 17,000 senior living communities in its network are accepting move-ins, and about 450 of their community partners is capable of doing Covid-19 testing on site.
— Carlsbad, California-based Integral Senior Living (ISL) and the independent living brand the company created, Solstice Senior Living, plan to hire 300 new associates for a range of positions.
“We know that there are a lot of displaced workers out there right now, and we want to do our part to help by offering employment opportunities to those who have lost their jobs,” said Collette Gray, president and CEO of ISL and Solstice, in a press release issued Friday. “The health and well-being of our residents is our top priority, and our associates are at the heart of caring for our country’s most vulnerable population. Because of Covid-19, we’re in need of passionate, hardworking people more than ever.”
ISL manages independent living, assisted living and memory care communities across 20 states and is one of the 20 largest operators nationally.
Many other senior living providers — including Avamere and Solera — are making an aggressive hiring push, as they have elevated labor needs due to Covid-19 at a time when many other industries have experienced mass layoffs.
— Funding has exploded for tech startups that could address challenges related to Covid-19.
“In particular, telemedicine startups saw a 1818% YoY increase in funding. And mental health, an otherwise underfunded health sector, saw a 65% increase in funding, suggesting the pandemic could shine a light on previously overlooked areas for health innovation,” StartUp Health stated in an email on Friday, drawing on its Q1 Insight report.
Senior housing providers are among those driving the strong demand for these types of tech solutions.
Bulletin for Thursday, April 2, 2020:
Juniper Communities today began offering Covid-19 tests to all of its residents and employees as a preventative measure to stop the spread of the disease.
The Bloomfield, New Jersey-based senior living provider procured the nasal swab tests through private/commercial vendors using CDC-qualified reagents and operating under the FDA’s Emergency Use Authorization.
The lack of tests has been a major pain point in the national response to the coronavirus pandemic, and has hampered senior living providers in their efforts to create strategic mitigation efforts. As for how Juniper was able to secure tests, CEO Lynne Katzmann has a simple answer: cold calling labs.
“We smiled and dialed until we found someone we could work with,” she told Senior Housing News.
Testing has now become more widely available than in the early days of the U.S. outbreak, and Juniper is not the only provider to make tests available to residents and staff. Atlas Senior Living may have been the first to do so, announcing its partnership with a testing lab on March 22.
Juniper is not taking tests away from other medical providers or hospitals, the company stated in a press release on Thursday.
Ramping up testing is necessary, as Juniper needs actionable data in its plan to prevent the spread of Covid-19, according to Katzmann. Based on the results of the tests, the company will be able to take several actions, including:
— Confirm symptomatic individuals for isolation
— Identify asymptomatic individuals for segregation
— Change staffing patterns to limit cross-contamination
Juniper is going through a “rigorous stratification process,” which will be further accelerated by the testing, in which residents who test positive for Covid-19 but are healthy enough to stay in the senior living setting receive care in particular parts of buildings, from dedicated staff members fully equipped with protective equipment, Katzmann told SHN. While the availability of PPE has been a tremendous concern for senior living providers, Juniper’s inventory is adequate and being distributed via three central stockpile locations, she added.
Although she declined to share the cost of testing, Katzmann said it is not expensive, particularly when considered in light of the enormous costs that can be avoided through better Covid-19 detection.
The tests are not accurate in every single case, but Juniper believes that accuracy in the 70% to 80% range will be a major step forward in how the company can respond to the pandemic. Initially, test results will take a few days, but Katzmann hopes that more rapid tests will become available soon.
“We’ve successfully cared for residents through natural disasters such as Hurricane
Irma without loss of life. This is the greatest challenge we have ever faced,” she stated in Thursday’s press release. “Full testing is clearly the correct next step.”
Also in the news:
— The $2 trillion CARES Act contains a provision that could help infuse more cash into the senior living industry — but there are new questions regarding whether the program will be ready by the time it officially launches.
The provision, known as paycheck protection program (PPP), is meant to help small businesses retain their workforce with forgivable loans. Companies harmed by Covid-19 as early as Feb. 15 and with 500 or fewer workers can apply for up to a $10 million Small Business Administration (SBA) 7(a) loan under the program to be used for payroll and some other expenses, including mortgage payments and utilities. The only catch for loan forgiveness is that the businesses must keep or quickly rehire their employees while maintaining salary levels throughout the pandemic’s duration.
But now there are questions as to whether the government-backed loan program will launch April 3 as originally planned. Specifically, lenders say Friday’s deadline is unrealistic and the program is fraught with unworkable guidelines and requirements, according to an April 2 story on Politico. These issues may delay the program’s implementation by weeks or more.
—- Diversified Healthcare Trust’s (Nasdaq: DHC) board of trustees has reduced the company’s regular quarterly cash dividend on its common shares for the first quarter to $0.01 per share, a move they expect will conserve about $33.3 million per quarter this year.
The dividend will be paid to the company’s shareholders on April 13 and distributed on or about May 21, the company said.
Diversified Healthcare Trust also deferred some previously planned capital investments that are expected to save up to $150 million in 2020. The company said it will later this year reevaluate all of the capital projects it deferred.
And although the company closed on the sale of four assets for approximately $56 million since the fourth quarter of 2019, it expects the pace of sales will slow considerably in the future.
The moves were made in response to the operating challenges and uncertainty of the Covid-19 pandemic. The company reported 41 confirmed cases of Covid-19 in its managed and leased properties, including 31 residents and tenants and 10 employees across 23 properties, primarily in its SHOP portfolio.
“We continue to carefully monitor developments related to the virus and support our senior living manager, Five Star Senior Living, and tenants following recommendations provided by the CDC and federal, state and local regulatory authorities,” Diversified Healthcare Trust President and COO Jennifer Francis said in a statement. “From a financial perspective, we believe we are taking all of the appropriate steps to preserve capital, maintain liquidity, and meet our debt obligations during this crisis.”
— The senior living and long-term care industries’ top associations on Thursday released a joint statement calling for more actions to protect frontline caregivers during the Covid-19 pandemic.
The leaders of ASHA, LeadingAge, NIC, Argentum, ASHA/NCAL all co-signed a statement emphasizing there is more to do to protect frontline health care workers caring for people affected by Covid-19 IN senior housing and skilled nursing communities across the U.S.
Specifically, the industry leaders called for the prioritization of testing for frontline caregivers, an increased availability of personal protective equipment (PPE) and more creative solutions to help meet workers’ personal and family obligations.
— Humana Inc. (NYSE: HUM) has announced it’s implementing more streamlined claims processing to get reimbursement payments to providers as quickly as possible and help ease their financial concerns as the Covid-19 pandemic rages on.
The company also said it’s expanding its policy of suspending prior authorization and referral requirements. The company is now requesting notification within 24 hours of inpatient and outpatient care. The move is applicable for all providers, regardless of network affiliation, for patient care related to Covid-19; and applicable for in-network provider for patient care not directly related to Covid-19. The move will allow for easier transfer of hospital patients to alternative sites of care, including senior care communities.
The policies are applicable for covered plan benefits under individual and group Humana Medicare Advantage, Medicaid and employer-sponsored plans.
— Compass Senior Living is paying its employees extra this month to show appreciation for their efforts amid the Covid-19 pandemic.
The Eugene, Oregon-based provider is paying all of its team members a bonus equal to 10% of earned wages for the month of April. The bonus applies all wages earned, including regular and overtime hours.
Compass said it will pay out the bonus on May 8.
Bulletin for Wednesday, April 1, 2020:
Welltower (NYSE: WELL) reported Wednesday that 116 of its residents in 45 of its communities were affected by Covid-19. The Toledo, Ohio-based REIT has also made headway on procuring PPE and is opening a new distribution center in Dallas.
Occupancy for the company’s senior housing operating portfolio (SHOP) was 85.4% as of March 27, a decrease compared to the 85.6% occupancy rate the company reported on March 13, 2020, and the 85.8% rate it reported on February 28.
Looking forward, Welltower expects more declines due to the limitation of tours at many of its communities and restrictions on resident move-ins. The portfolio’s operating expenses also rose in recent weeks, as the Toledo, Ohio-based real estate investment trust (REIT) has seen an increase in labor costs as well as an uptick in costs related to personal protective equipment (PPE) and medical supplies.
But Welltower said it’s making good progress on amassing a stockpile of PPE for use by its operators’ workers.
On Wednesday, the company said it had already procured or is working to procure 400,000 pairs of gloves, 250,000 facemasks, and 120,000 isolation gowns. The company also reported stocking up on hand sanitizer, disinfectants and no-touch thermometers. The REIT will distribute these supplies from a newly established center in Dallas. There, the company will receive bulk orders from suppliers and group purchasing organizations, along with new supply chains.
Welltower has also bulked up on Covid-19 testing kits, and has begun building new relationships with regional and national lab providers for testing capabilities. And, through an existing relationship with the University of California San Francisco’s (UCSF) Clinical Innovation Center, the REIT has connected its operating partners with experts who can provide guidance on interfacility transfers, staff screening and safety, and testing protocols.
“Amongst a host of other initiatives, we have provided resources designed to support telemedicine solutions to avoid subjecting residents to unnecessary risk of infection and to triage in-place residents,” the REIT wrote in a business update Wednesday. “Welltower is committed to further engagement with parties across the health care sector to explore any and all solutions which will benefit our operating partners.”
Also in the news:
— Brookdale Senior Living (NYSE: BKD) announced Wednesday that it completed three financing transactions totaling $208.5 million. The deals allow the Brentwood, Tennessee-based operator to refinance the majority of its near-term debt maturities, as well as partially fund recent acquisitions.
On March 31, Brookdale received $149.3 million in mortgage financing from Capital One. The refinancing took the form of ten-year nonrecourse fixed and variable rate loans of $76.2 million and $73.1 million, respectively, resulting in proceeds of $13 million.
The operator also completed a $30 million refinancing package with BBVA USA, and a $29.2 million package from Berkadia under the Fannie Mae DUS program. The collateral used to secure these loans were communities acquired from National Health Investors (NYSE: NHI) and Healthpeak Properties (NYSE: PEAK).
— Georgia Governor Brian Kemp announced the deployment of 100 National Guardsmen to assisted living facilities and nursing homes across the state to help contain the spread of the coronavirus, according to the Atlanta Journal-Constitution. The move comes as Kemp is preparing a shelter-in-place order for the state.
The Georgia Health Care Association estimates more than 30 facilities across the state with residents who have tested positive for the virus. The Guardsmen will be used to audit sanitation methods, train staff on stricter infectious disease control protocols and clean facilities.
The Georgia Department of Public Health reports 4,638 confirmed cases of COVID-19. Of those, 139 have died.
— Juniper Communities and the American Seniors Housing Association (ASHA) have partnered with Music Theatre International to launch “Send in the Gowns,” an initiative encouraging the public to gather or make personal protective equipment (PPE) and donate them to local senior housing communities across the country.
The initiative is specifically geared toward theater groups and costumers that would have access to materials and manpower to make facemasks, gowns and face shields for front line staff responding to the coronavirus pandemic. But anyone can participate.
Juniper and Music Theatre International have an existing relationship. The Bloomfield, New Jersey-based operator was among the first to pilot Music Theatre International’s “Broadway Senior” program, which gives seniors the opportunity to star in Broadway plays adapted especially for them.
“These costumes may not be glamorous, but they’re necessary to keep our residents and those who care for them safe during COVID-19,” Juniper CEO Lynne Katzmann said in a statement announcing the initiative.
The initiative comes as Department of Homeland Security officials told the Washington Post that the country’s emergency stockpile of PPE is critically low and close to being exhausted, despite assurances from the Trump administration that plenty of stock remains available.
Bulletin for Tuesday, March 31, 2020:
Atria Senior Living CEO John Moore says he is pleased with how the company is responding to the Covid-19 crisis.
“I couldn’t be prouder of how everybody at Atria is rising to the occasion,” Moore said in an interview with Louisville Business First (subscription). “We have resources and talent aimed at supporting all the communities everywhere. It’s going to sound overly simplistic, but I think, as a company we’re reacting smartly and working together. I’m confident that this is going to make us better at what we do.”
Louisville, Kentucky-based Atria is one of the largest senior living providers in the United States, operating more than 200 communities across the U.S. and Canada. Its Atria Willow Wood community in Fort Lauderdale has been particularly hard hit by the coronavirus, with six deaths, according to media reports. Florida Gov. Ron DeSantis criticized Atria for not going far enough in screening staff; in a statement, Atria said those comments from the governor were “inaccurate and unproductive.”
Moore did not tell Louisville Business First how many Atria residents have been diagnosed with or died due to Covid-19, but said that a “handful of communities” have confirmed cases.
“We’re worrying about it (the coronavirus) everywhere,” Moore told Louisville Business First. “We’re tracking anyone anywhere with symptoms.”
Also in the news:
— Hunt Valley, Maryland-based Omega Healthcare Investors (NYSE: OHI) has identified 57 confirmed Covid-19 cases across its portfolio, with 28 facilities impacted — all but one of those are skilled nursing facilities. Like other real estate investment trusts, Omega noted that its operators are experiencing cost increases. Some increases are related to labor — including overtime and bonus pay — as well as a “significant increase” in the cost and usage of personal protective equipment and supplies. The REIT has taken steps to shore up its liquidity and expects to update its earnings guidance when it releases Q1 2020 results.
— Fitch maintained a BBB- rating and negative outlook for Sabra Health Care REIT (Nasdaq: SBRA). The ratings agency looked favorably upon the REIT’s decision to reduce its upcoming quarterly dividend, made to provide additional liquidity in the face of coronavirus-related uncertainties and challenges.
— Nursing facility care is becoming harder for seniors to access due to Covid-19, according to Dr. Alexander Sasha Rackman, a geriatric medicine physician and assistant professor of medicine at Rush University Medical Center in Chicago. Older adults living at home are beginning to suffer from a lack of home health care services, as these providers curtail visits to prevent the spread of Covid-19, Rackman wrote in The Hill.
— California has postponed activities related to its Master Plan for Aging as the state responds to Covid-19.
Bulletin for Monday, March 30, 2020:
With senior living providers under financial pressure due to Covid-19, one of the largest ownership groups in the country — Chicago-based real estate investment trust Ventas (NYSE: VTR) — has established a rent deferral program for operators in triple-net leases. This group represents about 20% of Ventas’ portfolio by net operating income.
“Under the program, certain senior housing care providers who are Ventas tenants can defer 25% of their April 2020 payment obligation until the earlier of October 1, 2020 or receipt of government assistance,” the REIT stated in a document filed with the SEC on Monday. “All amounts deferred are required to be used for operating expenses to care for seniors at Ventas communities.”
Total April deferrals could be in the $3 million to $9 million range, Ventas estimates. The REIT collected “substantially all” of its March rent.
Government assistance for senior living operators could be coming through the recently signed $2 trillion stimulus package, which included $100 billion for health care providers. The package also included $500 billion in additional business assistance loans, some of which could flow to senior living providers as well.
Average occupancy in Ventas’ senior housing operating portfolio, which accounts for about 30% of the REITs’ overall NOI, has not been materially affected but trended lower in the second half of March, the company noted in Monday’s SEC filing.
“In addition, inquiries and tours have begun to decrease materially and move-ins have begun to slow,” the document states. “While there is not yet a clear trend, move-outs may become elevated as a result of the pandemic. Finally, operating costs have begun to rise as operators take actions to protect caregivers and residents and increase screening and infection control efforts. Each of these trends accelerated in the second half of March, and may accelerate further as the pandemic continues.”
Out of approximately 70,000 residents in its senior housing operating and triple-net portfolio, about 70 have so far received a positive Covid-19 diagnosis, while 25 staff members have been diagnosed. In all, 33 communities in Ventas’ portfolio have had a positive Covid-19 diagnosis.
The pandemic has put senior housing-focused REITs on a wild stock market ride, with their market caps drastically falling and then recovering somewhat last week as the overall market rebounded. Shares in Ventas were down 5.26% at the end of the trading day on Monday. The firm’s CEO, Debbie Cafaro, appeared on the CNBC show “Mad Money” last week and reassured investors of the company’s “solid and stable” financial position.
Also in the news:
— Executive officers with Dallas-based Capital Senior Living (NYSE: CSU) will not receive an increase in their base salaries for 2020, in light of “current economic conditions.” In addition, the CSU board’s compensation committee has enacted a temporary suspension on equity awards for all directors and officers of the company.
The compensation committee approved retention awards for Capital’s named executive officers and certain other executive officers, equal to 100% of current base salary, with 50% of the award contingent on continuous employment through Sept. 15, 2020, and the remainder contingent on continuous employment through March 15, 2021. Certain performance bonuses are also available to some of the executive officers.
— The Centers for Medicare & Medicaid Services (CMS) has further expanded telehealth flexibilities in response to Covid-19. The agency is now allowing more than 80 additional services to be furnished via telehealth. Providers can evaluate beneficiaries via audio only, bill for telehealth visits at in-person rates, and can utilize telehealth for emergency department visits, initial nursing facility and discharge visits, home visits and therapy services furnished by a clinician allowed to provide telehealth. Telehealth also can be used to fulfill many face-to-face visit requirements in home health, hospice and inpatient rehabilitation facilities.
— The Alzheimer’s Association — in conjunction with several senior living providers including industry giants such as Brookdale and LCS — issued an emergency preparedness guide with best practices in dementia care during Covid-19. The document covers topics such as preventing illness and ways to observe and respond to dementia-related behaviors. Many of these best practices hold true at any time, not just in emergency situations, but the guide may be especially helpful for those who are called on to provide dementia care specifically during the pandemic.
“Maintaining operations in long-term and community-based care settings with the expected staffing shortages during any pandemic, epidemic or disaster can be very challenging,” the document states. “During this time, non-clinical staff may be needed to assist with care.”
— Some family members are taking their loved ones out of senior living communities due to Covid-19, but the decision is a hard one and sometimes results in a discharge, CNN reported: “Another concern in bringing someone home: Some facilities are telling residents that if they leave, even temporarily, they can’t return. That happened to a family in western New York, according to Roxanne Sorensen, a geriatric care manager with Elder Care Solutions of WNY. When this family took their elderly parents out of an assisted living facility for a brief ‘stay-with-us’ respite, they were told the parents had been discharged and had to be placed on a waiting list before they could return.”
Bulletin for the weekend of March 28 and March 29:
Senior living providers are considered “health care providers” and therefore are exempt from certain requirements of the Families First Coronavirus Response Act (FFCRA) related to providing paid leave for employees during the Covid-19 outbreak.
President Trump signed the FFCRA on March 18. The act stated that employers with fewer than 500 employees had obligations to offer 10 days of paid sick leave and up to 12 days of paid leave for employees who needed to care for children due to school closures, if certain criteria were met. However, exemptions were available to health care providers; senior living industry groups Argentum and the American Seniors Housing Association (ASHA) pushed for the Department of Labor to clarify the definition of “health care provider” and to include senior living under that definition.
The DOL clarified the definition of “health care provider” in a Q&A document issued Saturday.
“For the purposes of employees who may be exempted from paid sick leave or expanded family and medical leave by their employer under the FFCRA, a health care provider is anyone employed at any doctor’s office, hospital, health care center, clinic, post-secondary educational institution offering health care instruction, medical school, local health department or agency, nursing facility, retirement facility, nursing home, home health care provider, any facility that performs laboratory or medical testing, pharmacy, or any similar institution, employer, or entity,” the document states.
Senior living was not the only health care industry to raise concerns over the FFCRA. For instance, some home health industry voices also warned that the child care-related requirements could be financially unsustainable and winnow the ranks of workers at a time when they are needed on the frontlines of caregiving. Argentum and ASHA joined with home health and home care industry groups to make their case in a March 23 letter to U.S. Secretary of Labor Eugene Scalia.
“We are gravely concerned, based on prior experience, that absent an exemption from the requirements … we will lack an available workforce able to deliver much needed home health and residential care,” that letter stated.
Many senior living providers are offering paid sick leave and child care benefits to employees in some form. Wilsonville, Oregon-based Avamere, for instance, is offering full pay for any employee who has to miss work due to a Covid-19 quarantine, and is providing up to $50 a day in child care reimbursement.
Also in the news:
— Policies that require nursing homes or assisted living communities to accept “surge” patients from hospitals to free up beds for Covid-19 patients are “short-sighted” and could end up making the problem worse, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) and AMDA the Society for Post-Acute and Long-Term Care Medicine warned in a letter issued Sunday.
The groups specifically cited an order in New York state under which nursing homes are cannot deny admission or readmission based “solely” on a confirmed or suspected Covid-19 diagnosis.
“The question all state officials must consider is whether the risk of introducing a virus with an estimated 30% or higher mortality rate into a nursing home or assisted living community outweighs the risk of hospitals being overcrowded,” the letter states. “Regrettably, this is a difficult decision that many officials will be facing now or in the near future.”
Even more than nursing homes, assisted living communities and CCRCs are not equipped to handle “medically complex surge-related discharges,” the letter noted.
— Debt and equity providers are signaling that they will commit to deploying capital until the pandemic subsides and a clearer picture of the economic landscape emerges, according to a state of the market report from Chicago-based lender, Helios Healthcare Advisors.
Lenders are still moving forward with completing previously committed transactions and will focus on existing clients in the short-term.
“Some sophisticated conventional lenders, specialty finance and non-bank lenders who hold large portfolios of healthcare and healthcare real estate loans still open to new business and intend to ‘cherry pick’ best opportunities, however pricing, advance rates, and credit standards are becoming more conservative,” the report notes.
Helios’ analysis echoes observations from panelists during a Thursday webinar on the market landscape hosted by the National Investment Center for Seniors Housing & Care (NIC). The panelists on that webinar warned of “peak volatility” for the industry, but that senior housing is a more stable real estate product than other commercial sectors, and its need-based, recession-resilient components open it up to available sources of liquidity.
— The House of Representatives passed the $2 trillion coronavirus stimulus package on Friday and President Trump signed it, but it was not without some drama.
The House was set to pass the package in a voice vote Friday morning until Rep. Thomas Massie (R – Kentucky) held up the move in favor of a recorded vote.
Massie’s move forced scores of lawmakers on both sides of the aisle scrambling to return the capital, and he was roundly criticized by members of both parties and President Trump, who signed the bill into law.
Senior living providers dealing with mounting expenses responding to the outbreak will be able to apply for relief through a $100 billion public health and social services emergency fund and a $500 billion stabilization fund. The package also includes tax relief measures that can benefit operators.
— Echoing other senior living executives, Notre Dame Health System President and CEO Wayne Plaisance said that personal protective equipment (PPE) is in short supply and “not available at any price.” The Notre Dame system includes three senior housing and care communities in the New Orleans area, one of which — Chateau de Notre Dame — has been identified as a coronavirus cluster by the Louisiana Department of Health.
— An associate at a Brookdale Senior Living community in West Lake Hills, Texas has tested positive for Covid-19, according to KXAN-TV.
The associate has been placed in quarantine and will not be allowed to return to work until testing negative for the virus. Residents, family members and fellow staff have been informed of the situation, and Brookdale is monitoring residents and working with local public health officials to monitor the community for further signs of an outbreak, Brookdale spokeswoman Heather Hunter told the station.
Many of the nation’s largest senior living providers — including Atria Senior Living, Sunrise Senior Living and Five Star Senior Living — are now responding to positive diagnoses of Covid-19 either among residents, staff or both.
— As bans on non-essential visitors stretch into another week, family members of senior living residents are becoming increasingly “agonized” over the forced separation from loved ones, and are particularly fearful of residents “dying alone,” the Minneapolis Star-Tribune reported. (Providers such as Brookdale Senior Living have been explicit in stating that visitors will be allows in buildings during end-of-life situations.) Minnesota also passed a $300 million Covid-19 aid package, and Department of Health Infectious Disease Director Kris Ehresmann said that a particular focus is on congregate senior living settings.
Bulletin for Thursday, March 26, 2020:
Covid-19 threatens every senior living and care community across the country, but not all of them face the same level of risk. An interactive map tool has been developed out of the Massachusetts Institute of Technology (MIT) that assigns a risk score to nursing homes around the country by ZIP code, and also identifies the number of assisted living beds in those areas.
The tool is a product of the MIT-based Covid-19 Policy Alliance, headed up by two professors at the Sloan School of Business, Simon Johnson and Retsef Levi. Johnson formerly was chief economist at the International Monetary Fund and Levi spent more than a decade in the intelligence wing of the Israeli Defense Forces.
“This is a war, and in order to win a war you need coordination and intelligence,” Levi told Senior Housing News, referring to the fight against Covid-19.
The Covid-19 Policy Alliance was formed to improve intelligence and coordination capabilities, and within days the effort involved a team of about 80 people, including many students from across various MIT programs. Interest in their work is steadily growing, and in fact the interactive tool may be temporarily unavailable as they migrate it to a more robust platform to manage the growing demand. The tool should be up and running within a day or two, Levi said.
Drawing on publicly available information from the Centers for Medicare & Medicaid Services (CMS), the Alliance’s map tool assigns a risk score to senior housing and care facilities based in part on past track records of infection control and safety, according to Alida Lujan, a member of the Alliance’s data analytics team and a student in Sloan’s executive MBA program.
By hovering over the map, users can see how many nursing home, assisted living and long-term care hospital beds are in a given county, and what the nursing home risk score for that county is.
Because comparable infection control data is not available for assisted living, no comparable risk score has been generated for those communities, Lujan told Senior Housing News. The Alliance scraped the web to generate information about the number of assisted living beds in a given ZIP code, grabbing data from government sources as well as senior living referral websites. The Alliance is interested in partnering with the industry to gather more data and beef up the assisted living component of the tool.
The tool still could be helpful for assisted living providers as they will want to be aware of the risk score for nursing homes in their county. If a nursing home has a Covid-19 outbreak, that would have ripple effects through the continuum of care for that locality, Lujan noted.
The intention is not to single out particular facilities for criticism or censure, Johnson stressed to Senior Housing News. Rather, it is meant to be useful in driving a more data-driven response to Covid-19.
“Our aim is to be helpful,” he said.
The team has laid out steps that they believe should be taken to mitigate the risk of serious Covid-19 outbreaks within these settings that are full of people who are particularly vulnerable to the virus. Levi laid out these steps in a presentation posted to YouTube. They are:
- State-wide, mandated shelter in place orders for all senior living facilities to ensure no site exposure to anyone with unconfirmed or positive Covid-19 status
- Aggressive allocation of resources to test and screen all residents, workers and vendors who enter a facility, including those who are asymptomatic for Covid-19
- Creation of appropriate state support systems for infection control and clinical expertise to be provided via telehealth
- Ensure critical supply of medicines and personal protective equipment (PPE)
These steps would improve on the current status quo, in which screening and testing is too sparse and haphazard, and “suggestions and guidelines” do not go far enough in ensuring that all facilities are practicing necessary infection control procedures, Levi said.
The Covid-19 Policy Alliance is working long days to improve the existing interactive map tools, create new resources, and advocate to government officials about the senior living industry’s needs, Johnson said. In fact, members of the Alliance are meeting with senior government officials on Friday to share the information that the Alliance has gathered and the group’s policy proposals.
The lack of PPE has emerged as a particular pain point for senior living providers, with Ohio Living CEO Larry Gumina writing this week of his “anger and frustration” at the shortage of these supplies. Johnson is aware of this situation, and said the Alliance is working actively on bringing in more PPE to senior housing and care communities, including by working in concert with corporate partners and resources.
“We’re working with people in the industry to help bring whatever reinforcements of material they tell us we need,” he said.
In addition to the interactive map focused on nursing homes and assisted living communities, the Covid-19 Policy Alliance has created a map that evaluates risk for individual counties across the country. From the coronavirus crisis in Italy, it is clear that locations with a sizable population of older adults are at risk of becoming Covid-19 hotspots, where the local health system can be overwhelmed by serious cases.
The interactive map from MIT assesses a county’s risk by looking at its percentage of residents older than 65 years, and the incidence of diabetes, obesity and hypertension. These comorbidities increase the likelihood that a person who catches Covid-19 will need serious medical intervention such as hospitalization.
Based on this information, the researchers believe that testing could and should be prioritized for high-risk areas, social distancing should be aggressively enforced there, and hospital capacity should be evaluated.
USA Today on Friday ran a story examining counties with large senior populations, noting the unique and serious risks posed by Covid-19 in these locales. The newspaper’s analysis found that in 11% of all U.S. counties, at least 25% of the population is 65 or older. “Texas leads the nation with 27 of those 341 elderly-heavy counties, followed by Nebraska, Michigan, Montana, Florida and North Carolina,” the article stated.
Florida’s leadership has come under criticism for not doing enough to enforce social distancing, with large spring break crowds gathered on beaches in recent weeks. On Wednesday, Florida Gov. Ron DeSantis did ask all seniors in the Sunshine State to shelter in place in their homes.
Also in the news:
— UnitedHealth has validated self-adminstered Covid-19 tests and is rolling them out in Seattle, an early epicenter of the U.S. coronavirus outbreak, with a Kirkland nursing home being a hotspot.
— 3.3 million people filed unemployment claims last week, in the biggest jump in claims in U.S. history. The senior living industry is actively trying to recruit many of these laid-off workers.
— The Covid-19 outbreak has begun to affect older adults’ perceptions of senior living, according to survey results from product review and recommendation website The Senior List. But the good news is that people who reside in senior living communities or have family in a community have a much more positive perception.
Of 715 survey respondents, only 4% of people who do not live in senior housing said that they believe these facilities provide excellent care and/or healthy environments. But that number went up to 37% among respondents in senior living, with 34% saying that senior living facilities provide good care and/or healthy environments.
The survey zeroed in on a serious outbreak of Covid-19 at a Washington state nursing home. Forty-three percent of respondents said their perspective of senior living has been negatively affected by this situation, but 14% said that they now have a more positive opinion of senior living than previously.
In reporting on these findings, The Senior List team noted: “One explanation for this is that the reports on seniors living alone who are struggling to get necessities during this time are leading people to believe seniors are better off being cared for in a facility.”
Overall, the findings suggest that Covid-19 has so far not improved people’s perception of senior living, but it also has not done extreme damage.
“While the news so far has been focused on the vulnerabilities of those in senior living, there is potential for the industry to recover lost public trust,” The Senior List report noted.
— Linked Senior has launched a campaign called #ActivitiesStrong to support resident engagement despite limitations on normal activities due to Covid-19. The company has made a tip sheet and other resources available and is making its technology available for free for 90 days.
— Seniorly, a company that has been likened to the Airbnb of senior living, has enlisted Broadway and Hollywood performers to take part in a free daily show, Curtain Up!, to be broadcast via YouTube. Among those slated to perform are Bethany Joy Lenz, known for her performance on TV’s One Tree Hill; Aaron Lazar of the hit musical Dear Evan Hansen; and Will Roland, who performed in the musical Be More Chill, as well as Dear Evan Hansen. New York City-based nonprofit Sing For Your Seniors has partnered with Seniorly on this project. Curtain Up! airs at 4pm ET on weekdays.
“I realized the other night while singing my kids to sleep that there must be so many people out there in need of comfort,” Lazar said. “I remember visiting my great grandfather in the nursing home when I was a little kid. Singing for seniors is so important, now more than ever.”
Bulletin for Wednesday, March 25, 2020:
After coming to an initial agreement in the early morning hours, Senate lawmakers continued to wrangle over a $2 trillion stimulus package on Wednesday, but ultimately passed it unanimously. As they face heightened expenses related to Covid-19, senior living providers will be able to apply for relief through a $100 billion public health and social services emergency fund and a $500 billion stabilization fund, leaders with industry groups Argentum and the American Seniors Housing Association (ASHA) said.
“In this latest package, lawmakers set aside $100 billion in grants for providers to prevent, prepare for, and respond to Covid-19, and reimburse eligible health care providers for lost revenues directly attributed to coronavirus,” Argentum President and CEO James Balda explained in a statement. “The bill also provides for $500 billion in liquidity through loans, loan guarantees, and other investments, that would be available to eligible businesses including senior living providers.”
The stimulus package also includes tax relief measures that could aid senior living providers.
ASHA and Argentum led an advocacy effort in recent days aimed at getting $20 billion of the stimulus packaged earmarked specifically for senior living. No specific allocations for the industry were made in the final bill, but the trade associations said that they are pleased that the final bill boosted the health care fund to $100 billion and that senior living providers will be have the opportunity to receive financial support. They plan to continue to push for senior living interests in a potential fourth round of stimulus.
“We were very proud of the way our collective memberships stepped up their advocacy efforts these last two weeks,” ASHA President David Schless stated. “They called and wrote to their congressional representatives and staffs, in many cases more than once, asking for much needed government financial relief to offset the costs associated with COVID-19 preparedness and response. These resources are a good start to helping our members meet this unprecedented challenge as they and their employees continue to serve our vulnerable seniors.”
The stimulus package is expected to be quickly taken up the House of Representatives, where there is a plan to bring it to a voice vote on Friday.
Also in the news on Wednesday:
— While merger and acquisition activity remained steady in the early days of the U.S. coronavirus outbreak, one large deal has now been scrapped and another has been postponed. Irvine, California-based Sabra Health Care REIT (Nasdaq: SBRA) was pursuing a previously announced $150 million acquisition that has now been postponed. Seattle-based investment and development firm Columbia Pacific Advisors’ $175.4 million sale of a Canadian senior housing portfolio will not proceed due to Covid-19 uncertainty.
— Ohio Living CEO Larry Gumina issued an impassioned public call for more personal protective equipment for senior living providers, writing that he is “frustrated and angry” at the situation. Hospitals in Ohio are reportedly “flush” with PPE, while clinicians and caregivers in senior living must “get to the end of the line” and are wearing re-used masks and gowns.
“We, aging service providers, are caring for the most vulnerable members of our society, 24/7, and we are last on the prioritization of PPE,” Gumina wrote. “ … My hope is that in the days and years ahead, we’ll be able to learn from this misplaced hierarchy of value and the aging service segment of our health care delivery system will be equally prioritized.”
— Westlake Village, California-based LTC Properties (NYSE: LTC) terminated its previously authorized stock repurchase program. As of March 25, 2020, LTC had purchased 615,827 shares at an average price of $29.25 per share, including commissions, for a total investment of approximately $18 million, the REIT announced.
“LTC’s Board has made the strategic decision to terminate the repurchase plan,” LTC President and CEO Wendy Simpson stated. “We believe that the course for LTC now is to further increase our liquidity and help maintain our strong and flexible balance sheet. With a rising level of uncertainty in all aspects of corporate life, we believe it is prudent to enhance our already high level of conservatism. Additionally, increased financial flexibility and liquidity will allow LTC to complete and compete for accretive transactions when this crisis passes.”
— Sabra lowered its quarterly dividend to $0.30 per share for the dividend expected to be declared in May 2020.
“Preservation of capital is important in times of uncertainty,” Sabra CEO Rick Matros stated. “Retaining a greater portion of our cash flows from operations will help us better manage our leverage as we expect to face disruption in our revenue stream during the pendency of the COVID-19 pandemic. Our operators are diligently and skillfully managing through the pandemic, and we are pleased with how they have been handling these unprecedented challenges.”
The reduction is expected to generate about $30 million of cash savings per quarter, which will likely be used to manage leverage and fund operations.
— Mary Sue Patchett has been named Executive Vice President – Strategic Operations at Brookdale Senior Living (NYSE: BKD). Previously her title was Executive Vice President – Community Operations. She will continue to lead the Covid-19 emergency response command center in her new role, which will also encompass the provider’s ssenior living portfolio segmentation initiative, integrated health care strategy, strategic accounts relationships, innovation efforts and sustainability initiatives. She is reporting to Cindy Kent, the company’s president of senior living.
— Chicago craft distillery Koval has turned to producing hand sanitizer, which it is donating to senior living communities and other health care providers.
Bulletin for Tuesday, March 24, 2020:
Tuesday brought some relief to publicly traded senior housing owners and operators, whose share prices were buoyed as part of a larger market rally. Investors seemed hopeful that Congress would soon move forward with a $2 trillion stimulus; news came early Wednesday morning that the Senate and White House had reached a deal on the package. Senior living associations have been pushing to get a $20 billion allocation for the industry. Meanwhile, updates came Tuesday from two of the public senior housing companies — real estate investment trusts Ventas (NYSE: VTR) and Healthpeak (NYSE: PEAK). Ventas CEO Debra Cafaro appeared on CNBC, while Healthpeak issued information on its Covid-19 exposure. Read on for details:
— Ventas (NYSE: VTR) CEO Debra Cafaro appeared on CNBC’s “Mad Money with Jim Cramer” on Tuesday and made a case for why investors should still consider the Chicago-based health care REIT a buy. Cafaro cited Ventas’ “very experienced” management team and their ability to weather previous downturns and economic cycles.
“We have an incredible balance sheet and a lot of strength and stability at Ventas. We’re using all the strength that we have and our great operating partners to ensure that [we all] come out of this unprecedented pandemic in the best possible position.”
— National Investment Center for Seniors Housing & Care (NIC) Chief Economist Beth Burnham Mace shared her thoughts on the pandemic and its impact on the long-term care industry. She also announced that NIC is launching a new monthly “Executive Survey” to gather timely information about move-ins and move-outs, changes in occupancy rates, staffing considerations and construction delivery pipelines.
NIC is championing initiatives to give front line workers the support they need and deserve, including:
- Government authorities giving staff priority access to personal protective equipment (PPE)
- Immediate, no-hassle access to Covid-19 testing
- Emergency access to day care, for workers with children
Mace also identified six areas of impact: residents and health care workers; operations; transactions and pricing; economic impacts; financial markets; and construction.
Covid-19 is the type of “unexpected shock” to the economy that Mace warned about to SHN in January, and while it is affecting the industry across the board, there are opportunities for innovation such as expanding telehealth and perhaps even opening ghost kitchens to serve residents who are isolated in their rooms.
“Collectively, let’s help provide support, solutions, encouragement and assistance for those on the frontlines in our industry and for those behind the scenes in management and decision-making roles,” Mace wrote.
— Healthpeak Properties (NYSE: PEAK) on Tuesday released a report sharing its perspectives and observations of the Covid-19 outbreak on its portfolio. So far, people in seven Healthpeak-owned SHOP properties have tested positive for Covid-19 — six of those are operated by Atria Senior Living or Sunrise Senior Living. Five residents at two communities have died, and more positive cases and deaths are expected as the crisis worsens. Protocols enacted to contain the spread of the virus include multiple daily temperature checks of residents and employees, limiting entry to essential medical workers, eliminating group activities and outings, and when necessary, isolation of residents in their suites.
The REIT’s operating partners are experiencing significant cost increases responding to the pandemic, notably in staffing and supply costs. Operators are also offering wage premiums to hourly workers to ensure staffing needs are met. And actions are being taken to address shortages in personal protective equipment (PPE).
Previously scheduled move-ins are still happening, albeit with enhanced safety protocols including 14-day quarantines. Tours of communities have declined as operators have secured buildings to only essential personnel, and virtual tours are being offered. As a result, Healthpeak expects an occupancy decline in the coming weeks due to the reduction in tours and normal move-out activity.
— Wall Street’s rollercoaster ride of late ended trading Tuesday on a high amid hopes for a government aid bill. The Dow Jones closed trading up 11.4%, or 2,113 points. That is the biggest point gain on record and the biggest percentage gain in 27 years.
The S&P 500 and Nasdaq composite rose 9.4% and 8.1%, respectively. The S&P gain was its biggest since 2008.
The “Big 3” health care REITs stock prices responded positively to the news, as well. Welltower (NYSE: WELL) ended trading Tuesday up 4.32%, to $45.37 per share. Ventas traded nearly 12% higher and closed trading at $25.70 per share, and Healthpeak Properties (NYSE: PEAK) closed trading up 6.1%, to $21.16 per share.
Among publicly traded operators, Brookdale Senior Living (NYSE: BKD) stock rose nearly $41% to close Tuesday at $3.13 per share. Five Star Senior Living (NYSE: FVE) stock traded 15.6% higher, to close at $2.75 per share. National Health Investors (NYSE: NHI) closed trading Tuesday 16.21% higher, or $42.80 per share.
Bulletin for Monday, March 23, 2020:
In the midst of Covid-19, taking all steps to protect the health and wellbeing of senior living residents and staff is of paramount importance — but owners and operators are also carefully watching the bottom line. Expenses are on the rise and and move-ins may slow down. The good news is that occupancy has held firm in the early going, according to newly released data. Meanwhile, owners and operators continue to take steps to maintain liquidity.
— Welltower (NYSE: WELL) has secured a $1 billion, 2-year unsecured loan. As of March 20, 2020, the Toledo, Ohio-based REIT had $338 million of cash and cash equivalents and approximately $1.5 billion of available borrowing capacity under its unsecured revolving credit facility. Welltower is continuing to close on previously announced dispositions and has forward sale agreements for 6.8 million shares of common stock under its ATM program.
“While we maintain unwavering confidence in our balance sheet, we believe it is prudent to take further steps to enhance our liquidity profile given current capital market conditions and the uncertain impact of the COVID-19 pandemic,” CFO Tim McHugh stated. “We believe today’s announcement is a testament to our operating platform and capital allocation discipline and will enable us to continue executing on our strategy amidst a volatile macroeconomic backdrop.”
— Two confirmed cases of Covid-19 had been identified in the portfolio of New Senior (NYSE: SNR) as of March 20, the New York City-based REIT reported Monday. The company expects more cases to be identified as testing increases. Independent living giant Holiday Retirement is New Senior’s largest operating partner, managing 98 communities. New Senior shared several protocols that Holiday has implemented, including rolling out MeMD telehealth service to all residents. No material occupancy deterioration has occurred yet as a result of the coronavirus situation, although the REIT does expect some declines in leasing activity.
— Omega Healthcare Investors (NYSE: OHI) has drawn $300 million under its $1.25 billion revolving credit facility and is suspending its dividend reinvestment and common stock purchase plan. The board of the Hunt Valley, Maryland-based REIT authorized the repurchase of up to $200 million of Omega’s outstanding common stock over the next 12 months, funded using cash flow from operations, balance sheet cash, planned asset sales, and/or borrowings under Omega’s revolving credit facility.
“Our responsibility is to both preserve and prudently allocate capital and, with the impact of COVID-19 continuing to rapidly evolve, we are seeking to protect our liquidity while having the opportunity to judiciously capitalize on any material mispricing in our equity,” CEO Taylor Pickett stated. “While we have not seen any material change in the financial performance of our operators, by drawing down on a portion of our credit facility, we are bolstering our liquidity to weather a potential significant and prolonged impact to our business and are better positioned to creatively support our operators if necessary.”
— As the Covid-19 pandemic expanded last week, senior housing occupancy remained steady, with some providers seeing increased move-ins, according to survey data from Activated Insights, the senior care group of Great Place to Work.
Nearly 80% of operators saw no significant uptick in move-outs last week, while 21% reported increased occupancy. Some of the move-ins were pre-scheduled, but some are being motivated by the recognition that senior living communities are safer places for older adults to be, due to rigorous infection control procedures.
“The data reflect how quickly senior housing operators have adapted lessons learned in Washington state to protect our nation’s vulnerable elders and frontline staff by upholding the highest standards of care,” said Robert Kramer, Founder and Strategic Advisor at the National Investment Center for Seniors Housing & Care (NIC). “The results from this survey are especially timely since the investment community has been starved for data in this time of uncertainty.”
The survey represented 1,078 buildings and 100,899 units, and was conducted via phone on March 18-March 19.
— As federal lawmakers continued tense negotiations over a nearly $2 trillion stimulus plan, industry associations Argentum and ASHA sent a letter to Senate and House appropriators urging that the Public Health and Social Services Emergency Fund be increased to $100 billion, and that 20% should be reserved for senior living providers.
— The commercial real estate financing market is “on the brink of collapse,” requiring swift and sweeping action, according to Colony Capital (NYSE: CLNY) Chairman and outgoing CEO Tom Barrack. He outlined the steps that he believes would ward off calamity, including $500 billion in funds to inject liquidity into the financial system, and a “time-out” to avert “rushed and widespread margin calls” and other actions that would precipitate a domino effect. As of Dec. 31, 2019, Colony’s consolidated healthcare portfolio included 154 senior housing properties.
— In an effort to alleviate isolation and loneliness among senior living residents during the Covid-19 outbreak, Argentum has launched a Facebook group called Sharing for Seniors: “The call to action for this group is to help reduce the feeling of isolation for these older adults and use this space to share positive messages of connection, inspiration, hope, and appreciation, to brighten their days. Post a photo, video, message, song, dance, or artwork (get creative!), that our network of senior living companies and communities can share with their residents and families.”
— The federal government is releasing a new nursing home survey tool, taking a stricter approach to infection control by applying lessons from the Covid-19 outbreak at a Kirkland, Washington, skilled nursing facility.
To better understand and report on Covid-19, we here at SHN want to hear how providers are responding. Please take this 2-minute survey, and you’ll have a chance to win a $100 Visa gift card.
Bulletin for the weekend of March 21 & 22, 2020:
With senior living providers under enormous financial strain as a result of being on the frontlines of the Covid-19 pandemic, industry associations are pushing for $20 billion to be earmarked for the sector in the nearly $2 trillion “Stimulus 3.0” package being hammered out on Capitol Hill.
After a weekend of negotiations, the Senate failed on Sunday to advance the Coronavirus Aid, Relief & Economic Security (CARES) Act through a key procedural vote. Democratic lawmakers argue that the bill — which includes $500 billion for distressed companies — is too favorable to large corporations. Negotiations were continuing Sunday night, with President Donald Trump expressing optimism that an agreement could be reached.
Argentum and the American Seniors Housing Association (ASHA) over the weekend urged members to reach out to legislators to explain why the $20 billion in financial support is critical for the senior living industry and the nation as a whole.
“While the senior living industry continues to work diligently on the front lines of the pandemic, the financial stress cannot be overstated,” ASHA President David Schless said in a statement provided to Senior Housing News. “It is imperative that seniors housing communities across the nation receive immediate financial support that will allow them to continue to serve and protect the residents and staff. While Congress is looking to bail out cruise lines and airlines, they need to prioritize the seniors who are disproportionately impacted by the virus and the frontline staff and caregivers who are working diligently to keep our seniors from this terrible virus.”
Argentum President and CEO James Balda emphasized the same points and noted that tax incentives are being requested in addition to the billions in relief.
“As an industry, we are facing a financial strain that left unaided, will significantly impact the nation’s ability to respond to the Covid-19 crisis and undermine the ability to provide long-term care services and supports to the nation’s seniors for years to come,” he said in a statement to SHN. “We are seeking $20 billion in relief and asking Congress to include ALL senior living communities and employees in their forthcoming stimulus bill. Specifically, we are asking for sufficient financial resources to ensure communities can continue to operate, as well as tax incentives to engage in activities related to Covid-19 prevention and mitigation.”
Speaker of the House Nancy Pelosi on Sunday indicated that the House of Representatives would create its own, separate stimulus package. Argentum plans to push for the $20 billion in senior living aid to be included in any House bill, Argentum COO Maribeth Bersani said in an email to SHN.
Already, senior living providers are running out of supplies, incurring additional labor-related costs, and spending money related to expanded infection control, the associations noted in a March 19 letter to Congressional leaders and U.S. Treasury Secretary Steven Mnuchin.
Stock futures fell on the news that the bill had not advanced through the Senate vote Sunday night, with the Dow Jones Industrial Average futures dropping 800 points.
Publicly traded senior living operators and owners have seen their market capitalization plummet during recent stock market shocks related to Covid-19. For example, shares in Brentwood, Tennessee-based Brookdale Senior Living (NSYE: BKD) have fallen from $8.39 on Feb. 19 to $1.88 as trading ended last Friday.
CDC’s Covid-19 Guidance for Senior Living Communities
The U.S. Centers for Disease Control & Prevention (CDC) has issued interim guidance on how retirement communities and independent living communities can prevent the spread of Covid-19. The guidance can be found on a CDC website last reviewed March 20, and includes many steps that senior living communities across the United States are already taking, including canceling all non-essential group activities and public events; cleaning/disinfecting all common areas and shared facilities; and maintaining social distancing.
Other recommendations include establishing a “buddy system” for residents, to ensure regular check-ins and back-up caregiving in the event a primary caretaker becomes ill.
Should Covid-19 be diagnosed in a senior living setting, an operator should coordinate with local health officials; communicate with residents, workers, volunteers and visitors; as residents to self-monitor for 14 days; and clean and disinfect thoroughly.
Click here to access separate guidance for long-term care facilities and nursing homes. Click here to access a preparedness checklist for long-term care facilities and nursing homes; the CDC notes that lower-acuity senior living settings may want to adjust this checklist to meet their own “needs and circumstances.”
Meanwhile, a new CDC report shows the vast majority of U.S. Covid-19 deaths between February 12 and March 16 were among people 65 years of age or older. In fact, 8 out of every 10 Covid-19 deaths in the U.S. during that period belonged to that age cohort.
Atlas Senior Living To Begin Testing in Communities
Atlas Senior Living might be the first senior living provider in the U.S. to offer its own Covid-19 testing to residents.
The Birmingham, Alabama-based company has partnered with Assurance Scientific Laboratories to provide Covid-19 test kits to all of its 24 retirement communities in Alabama, Florida, Georgia, Kentucky, South Carolina and Tennessee. The test kits are slated to be available starting during the week of March 23.
Tech Providers Offering Free Products, Services
As the Covid-19 crisis deepens across the country and within senior living, technology companies are making certain products and services available free of charge. The number of tech companies doing so is growing quickly, but a partial list includes:
— Digital health solutions firm VitalTec, which is offering free telehealth access for patients and physicians on its namesake platform through a partnership with Concord Health Partners. The move is aimed at accomplishing social distancing, which the CDC and other authorities say will be vitally important in stopping the spread of Covid-19.
— Status Solutions is making the web version of its CATIE communications solution free of charge for senior living communities.
— Eversound is launching new live-streamed, interactive programming to senior living communities, as a way to increase resident engagement through virtual connections with cultural institutions and subject-matter experts. The company is offering free access to more than 100 recordings of past interactive events, through April 30.
— CareAcademy is offering a free Covid-19 certification class, covering best practices for direct care workers.
— Relias is offering free access to training courses and “how-to” materials related to Covid-19.
— GreatCall is offering 24/7 access to registered nurses via its Urgent Care service free of charge to customers during the outbreak.
Here’s what else you need for know for March 22, 2020:
- As senior living communities ban non-essential visitors and change operational procedures, that could be creating care gaps for residents, STAT reported. ““I would bet there are residents who are going without getting their teeth brushed, because the staff is trying to implement measures to save their lives,” Lisa Sweet, chief clinical officer of the National Association of Health Care Assistants, told the publication.
- Not all Covid-19 news is dire; examples abound of people going above and beyond in the midst of the pandemic. Family members of residents are writing messages in brightly colored chalk on the sidewalk outside the Heritage at Sagewood in Grand Island, Nebraska. And Gayle King, a 76-year-old resident at Ohio Living Westminster-Thurber, is working hard to make sure that other residents continue to have some socialization.
Bulletin for Thursday, March 19, 2020:
Each day brings news of more senior living residents and staff members diagnosed with Covid-19. Some of the nation’s largest providers, including Atria Senior Living and Five Star Senior Living, as well as major regional players such as Benchmark, are now responding to these situations. Meanwhile, Cindy Baier — CEO of Brookdale Senior Living (NYSE: BKD), the nation’s largest provider — appeared in a video message to provide an update on the company’s latest policies. The company is restricting all visitors to buildings, except in end-of-life situations or pursuant to guidance of public health officials.
— Among the latest reports of new Covid-19 cases in senior living: five residents of Atria Burlingame in California; a resident of The Kensington in Falls Church, Virginia; five residents of Camellia at Deerwood in Jacksonville, Florida; a staff member at Church Creek, a community located in Arlington Heights, Illinois, operated by Five Star Senior Living; six people at Laurel Manor Care Center, operated by Volunteers of America, in Colorado Springs, Colorado. A resident of Bonaventure of Tri-Cities in Richland, Washington, who died last Saturday was subsequently diagnosed as having had Covid-19. A man who resided at Benchmark Senior Living at Ridgefield Crossings also passed away after being hospitalized and diagnosed with Covid-19.
The following statement from Atria CEO John Moore was provided to Senior Housing News on Thursday:
“As you can imagine, we’re very busy. People are stepping up and doing great things. I couldn’t be more proud of how our team is facing these challenges.
There is and will be so much more to say about how we are learning to both keep our residents safe and also find ways to allow our residents to have community, engagement and continued connection to family and friends in a mostly quarantined environment.”
— “In light of the changing guidelines, Brookdale is tightening up our current policies and protocols. At this time, we are restricting all visitors and non-essential health care personnel to our communities. There is an exception for certain compassionate care situations, such as the end of life, or pursuant to the guidance of public health officials,” Brookdale CEO Cindy Baier said in an updated video message posted Thursday.
— Only 33 people in Florida retirement haven The Villages have been tested for Covid-19, and the state’s large population of seniors could be at particular risk, The New York Times reported.
— Family members of residents understand the need for visitor restrictions at senior living communities, but they are struggling with emotional fallout as a result of being separated from loved ones during the pandemic, according to a story in the San Diego Union Tribune.
— Cleveland, Tennessee-based Legacy Senior Living canceled its leadership retreat and funneled the funds into Covid-19 response at the community level. The company has installed “immunity boost” stations at all of its 14 communities, featuring healthy food and vitamin-infused hydration. “We believe these proactive wellness efforts can give residents a positive outlook, a sense of calm and perhaps even a stronger immune system,” said Bryan Cook, co-founder and president of Legacy Senior Living.
Bulletin for Wednesday, March 18, 2020:
- “Limitations in effective infection control and prevention and staff members working in multiple facilities contributed to intra- and interfacility spread.” Read the whole CDC report on how Covid-19 spread through long-term care settings in Washington.
- National Health Investors (NYSE: NHI) has updated its website to segment its portfolio by coronavirus testing and diagnosis status. So far, no active cases have been reported in communities owned by the Murfreesboro, Tennessee-based REIT.
- The New York Times reports on social isolation among seniors as a result of Covid-19.
- Older adults living at home face a “host of challenges,” Kaiser Health News reported.
- “Our experienced staff remains onsite and has implemented additional quarantine protocols,” Atria Senior Living stated, as the large Louisville, Kentucky-based provider responded to a Covid-19 outbreak at a Fort Lauderdale community.
Bulletin for Tuesday, March 17, 2020:
- Ventas drew $2.75B from revolving line of credit, withdrew 2020 guidance.
- Welltower announced two Covid-19 diagnoses in its senior housing portfolio; CEO Tom DeRosa touted senior living as a key setting for keeping coronavirus patients out of hospitals to maintain bed availability.
- Brookdale has drawn on its full revolving line of credit, stopped its share repurchasing program and halted some capex projects as expenses have grown due to Covid-19.
- The first cases of coronavirus in senior living in the state of Georgia were reported, involving three residents and an employee of a Phoenix Senior Living building.
- CMS updated guidance for PACE programs.
Bulletin for Monday, March 16, 2020:
- Two more senior living communities in Kirkland, Washington, have reported cases of Covid-19. A Life Care Centers community here was hit in the early days of the U.S. outbreak and has lost more than two-dozen residents to the virus.
- The Dow plummeted nearly 3,000 points on Monday after plunging late last week. Senior housing related stocks continued to be affected, with the “Big 3” REITs all down more than 20% and Brookdale Senior Living (NYSE: BKD) trading down nearly 36% at the close.
- Irvine, California-based Healthpeak (NYSE: PEAK) — one of the Big 3 REITs — issued a Covid-19 update. The company expects a deterioration in performance relative to expectations at least for the next few months.
- Industry associations Argentum and ASHA urged Congress to exempt senior living providers from certain provisions of the Families First Coronavirus Response Act that they argued would “decimate” providers’ workforces.
- Personal care aides are among the workers most at-risk from Covid-19, according to a New York Times analysis.
- Covid-19 infections continue to spread among health care professionals generally, with workers in five states testing positive over the weekend.
- Testing for an experimental coronavirus vaccine got underway Monday, with the first volunteer receiving the shot in Seattle.