Ingleside spent almost $500 million in recent years updating and expanding its communities and offerings, but Covid-19 is prompting the senior living provider to further reinvent itself.
The pandemic is driving a larger investment in technology and a reexamination of the continuum of care. It is also likely to drive more consolidation among senior living nonprofits, according to Lynn O’Connor, Ingleside’s President and CEO. Ingleside’s senior housing portfolio includes three life plan communities in the Washington, D.C. area, and the organization also offers other service lines and a real estate development and property management company.
“We see Covid-19 as an accelerator for mergers, acquisitions, partnerships, innovation, changing what we do in older adult services in so many ways,” O’Connor said during an appearance on the Senior Housing News podcast, Transform.
In preparation for the future, Ingleside is also ramping up the amount of money it spends on technology. Currently, the organization invests 3% of its annual budget on technology — and the provider has made it a goal to grow that investment to as much as 10% in the future, O’Connor said.
On the challenges of dealing with Covid-19:
We’ve never seen anything like this before. We have board members who are physicians, and we’re listening to the CDC, CMS, local jurisdictions as well as our colleagues. This is new territory for us.
Communication is really essential in all of this, and building trust — for our residents, for our board, for our bondholders and for our donors — so that we can continue to move Ingleside into the future, and thrive in perpetuity even though Covid has had a definite impact. We’re seeing our staff and our residents come together in ways we have never even thought of.
Residents are having social hour with each other, leaving bottles of wine outside their apartment doors and still continuing socialization. I’ve heard from residents that they’re so glad that they’re living in our Ingleside communities because of all the great work that our staff has done.
We’ve had some challenging times, too. On March 13, we made a very difficult decision to stop move-ins, and we did that so that we could build trust. Our residents’ and our staff’s health and safety is paramount in everything we do. Margin is, as well, but we needed to take a breather to figure out how to do this safely. So, we stopped move-ins until we figured that out, and now we’ve started doing move-ins again.
We’re focused on mission and on margin as well as strategy, so absolutely, the revenue top-line has been impacted — not only just because of move-ins, but because our donors, our foundation, has been impacted. The president and CEO of our Westminster Ingleside Foundation said that donations and philanthropy is a contact sport, just like sales. And it’s very hard to have the same impact when you’re meeting by Zoom as if you’re meeting face-to-face. So, our foundation has been impacted.
Our Westminster Ingleside Group, known as “WING”, is a real estate development and property management company. And it has been impacted because we had some potential business arrangements for real estate development that are on hold. And of course, in our life plan communities, when we stopped move-ins, we have seen an impact in our revenue.
And, because of the Covid expenses, we’ve seen an impact in our expenses, in many ways, such as in personnel as well as all the supplies that an organization needs to safely serve our residents and our staff. So, it’s been a challenging time.
We feel fortunate and blessed that we were able to receive almost $5.3 million from the Payroll Protection Program, which has been a huge impact for us in taking care of some of the Covid expenses. That has helped all of our six not-for-profits.
We spent about $500 million on new projects, and our Centers for Healthy Living were a very key part of that. Ingleside at King Farm’s Center for Healthy Living opened last year with great success, and the residents and staff were so thrilled to have those new spaces and new programs. The energy was palpable.
But Covid-19 has impacted that. We had to shut down a lot of those services, such as the fitness center, the salon and the congregate education — although the education is now going through Zoom, and we’ve taken some things outside and with social distancing.
Ingleside at Rock Creek’s Center for Healthy Living was supposed to open this year, and unfortunately before it opened, Covid-19 impacted us. We also have a project at Westminster at Lake Ridge for a Center for Healthy Living there, and although we put that on hold, it’s now resumed. We’re moving forward intentionally with everything we do to ensure that our staff and residents are safe as we look at reopening those spaces.
On whether Covid-19 will drive more affiliations, mergers and acquisitions among nonprofits:
We see Covid-19 as an accelerator for mergers, acquisitions, partnerships, innovation, changing what we do in older adult services in so many ways.
Our strategic plan for several years now has focused on not just recruiting, developing and retaining excellent staff, but also on partnerships, and on expanding our mission and impacting older adults in different ways. I can’t get too deep into it because we have signed non-disclosure agreements, but we’re working with several other innovative nonprofits on some things right now. And I think that will continue.
We’ve been continuing to evolve in the 114 years that we’ve been around. When I arrived in August of 2010, we were three separate life plan communities doing things totally separately. Our board wanted to create a supporting organization, which we did, and that’s Ingleside. In 2011, we received our 501(c)(3) status. We took those three separate entities and we have consolidated them in an affiliation, if you will, to provide back-of-the-house services in sales, marketing, technology, human resources, finance, board, governance, strategy so that we would have efficiencies of scale.
Now, we’re continuing to take what we’ve learned and what we’re doing, and continuing to improve it, as well as to share it with other outside not-for-profits who may or may not want to partake in those efficiencies and that opportunity, because we’ve seen great outcomes from this affiliation.
On how Ingleside uses technology during Covid-19:
We invest about 3% a year, with Chief Information Officer Dusanka Delovska-Trajkova leading that effort.
Alexa has been a really big part of what we’ve been doing. It’s helped with people who are hearing impaired and have trouble with keyboards. But it’s very interesting: We haven’t really seen an uptick in the utilization of Alexa. What we’re really seeing an uptick in is, we’ve added additional TV channels so that residents are able to receive communication via technology through their television.
We’re also seeing Zoom utilization all throughout the organization. Our residents are using Zoom with meetings, staff are using Zoom, our board members are using Zoom, and that’s how we’ve been communicating with our Ingleside leadership team. We really haven’t stopped doing what we’re doing. We’ve just been doing it differently, and using technology as a tool to continue to connect.
We’ve gone from investing 1% in technology annually to 3%. It’s a really important tool for us. It provides efficiencies, and it really helps us with data.
Technology changes in a picosecond, and to keep up, you have to continue to invest in new technologies. Also, security in technology is critically important to us. We use technology in everything — documentation in skilled nursing, that’s HIPAA protected. Our Zoom is HIPAA protected. As those technologies evolve and change, we have to continue to reinvest in upgrades, invest in security, to ensure that hackers don’t get into our system.
That’s a really big initiative, and those things are also expensive. So, we spend a lot in audit and compliance and technology, and reinvesting so that we’re continuing to evolve as the technology does. We wish that we could spend more to bring in new technologies. Dusanka has done a stellar job in keeping us informed, and she continues to grow and evolve in her space and her profession. So that she allows us to know what’s available and how much it’s going to cost so that we can see our return on investment.
On whether Covid-19 is changing how Ingleside thinks about the care continuum:
We still see a place for a continuum of services, which is IL, AL, memory support AL and skilled nursing. That said, Covid-19 has impacted memory support assisted living. Skilled nursing was impacted even before the pandemic, and it has been impacted even more so with Covid-19.
Our biggest competitor has always been people living at home. That’s why, in 2015, Ingleside created Ingleside at Home to provide services to our residents and to the outside community in their home. We still see a market for life plan communities. That said, we also see a great desire for people continuing to live at home. So, we’re continuing to think through how we provide those services so that they are still desirable and provide value to people.
Some of our residents are saying they are so glad that they’re here at Ingleside, even though it’s different than what they thought it would be. It’s because they feel safe, they feel cared for, they feel loved. So, when people understand life plan communities, there’s still a desire and a value to be part of that community setting. Our residents got together and donated $100 to each of our staff members out of gratitude for all that they are doing.
So, we still see a place for life plan communities. Our issues now are: How do we reinvent ourselves? How do we deal with the outside private-duty and home and community-based services? Where is skilled nursing in all of this and how will it be provided? Will it be provided to people in their apartments through home health? Will it still be provided in an inpatient or in-residence setting like we have now?
This is my 40th year anniversary in older adult services, and I’ve seen things evolve and change, and they will continue to evolve and change. Larry Minix, the prior CEO of LeadingAge, used to say that there will be two types of organizations: the excellent and the non-existent. So, Ingleside is committed to be excellent and innovative so that we will thrive in perpetuity, and that’s why we’re reexamining all that we’re doing in our services and programs.