COO Outlook: Expect Senior Living Occupancy Rebound, Workforce Challenges in 2021

With the senior living industry largely focused on when occupancy will start to recover, chief operating officers with provider companies are focused on rebuilding census — and feeling optimistic about the prospects for 2021. In fact, several COOs indicated that they are less worried about restoring occupancy than they are about looming workforce challenges.

With regard to occupancy, top operational executives see two emerging trends that give them hope for the future: the growing rate of vaccinations in senior living, and upticks in new sales leads at the beginning of this year signaling pent-up demand.

“If you had asked me a month ago, I would have said I am cautiously optimistic [about the rest of 2021],” Atlas Senior Living President, Co-CEO and former COO Wyman Hamilton told Senior Housing News during an interview last month. “But judging by what we saw in January with leads coming, and what we continue to see in February … I’m optimistic.”


Still, many factors could change the shape or trajectory of a potential senior housing recovery this year, such as whether Covid-19 case counts spike again or the rate of new vaccinations lags. Additionally, a battle over occupancy is about to begin, meaning the rate of recovery might differ from one community to another as the competitive environment turns cutthroat.

And staffing — perennially the biggest operational challenge in senior living — remains the source of top concern. At the outset of the pandemic, some industry leaders hoped that a silver lining of high unemployment rates might be a reduction in turnover and an uptick in applications to senior living. But hiring and retaining workers remains a sore spot for the industry, and an area that is commanding attention — and causing some concern — among COOs.

Going on the offensive

Late last year, Charter Senior Living Partner and COO Jayne Sallerson was focused on shifting the company’s sales staff from a defensive business mindset focused on preventing bad outcomes to an offensive mindset focused on executing sales. That focus continues this year as the Naperville, Illinois-based company looks to begin to rebuild occupancy lost during the pandemic.


“People are still aging, families still have to care for seniors and need help caring for seniors, and seniors that have been at home have been really severely impacted by isolation,” Sallerson told SHN. “So, as more and more people are vaccinated, I think you’re going to see [the industry] rebound quicker than people think.”

In attracting new prospects, Charter is pushing for safe face-to-face contact, when possible. The reason for that is simple: moving into a senior living community is an emotional choice that is not easily decided over Zoom or on the phone.

“The more that we can actually sit with a prospect and actually have a conversation, I believe that is going to be the key moving forward,” Sallerson said. “Our goal is not to just try to get a virtual tour, our goal is to say, ‘Hey, I’ll meet you at Starbucks, or we can meet in the lobby’ — it’s finding alternative ways to actually connect with a customer on a more intimate level.”

When Charter’s sales staff are in front of prospective residents and their families, they stress safety, security and infection control. The company’s leaders are also eager to open up communities to visitors when it’s safe to do so.

“Families want to be able to come back into the communities, and window visits are getting old,” Sallerson said. “So, we want to find ways … to allow families back into the community. I think that will make a huge difference in opening up any pent-up demand right now.”

Birmingham, Alabama-based Atlas Senior Living is focused on ways to get visitors back into its 25 communities in the Southeast.

Wyman Hamilton, who handles typical COO duties as co-CEO, believes that a recovery is already at hand for assisted living and memory care providers.

“People are already starting to see the light at the end of the tunnel, and I think some of that pent-up demand is starting to come back,” he said. “I think it’s going to be a May, June or July timeframe [for a recovery in assisted living and memory care], and I think independent living … will probably follow right behind that.”

Like Sallerson, he also believes that emphasizing safety and bringing back elements of socialization and hospitality will help attract residents and their families back into senior living communities.

“It’s not like we can just open up and go right back to normal,” Wyman Hamilton said. “But I do think that we will slowly start to see, both in the regulations and in visitations, lift slowly.”

Kendal Corp. COO Marvell Adams Jr. is also optimistic about the industry’s road ahead.

The Kennett Square, Pennsylvania-based organization — with a portfolio of 13 affiliated life plan communities across the United States — has made good progress on its vaccination efforts, and the company hasn’t seen occupancy disruption at the same scale as other providers. Reservations for Kendal’s forthcoming Enso Village community in Healdsburg, California, have already exceeded 70% despite the pandemic and the fact that construction hasn’t even started yet, Adams said.

Still, while Adams believes that occupancy has likely hit rock bottom, he isn’t ready to say the recovery is fully underway for the senior living industry. But there are actions underway that might give him more confidence, such as the looming passage of the Biden administration’s $1.9 trillion “American Rescue Plan” aid package.

“I still think that there are pieces of our economy right now that are tenuous, particularly around whether we get some inflation … or if rates go up,” Adams said. “So, I want to see that bill get passed, and all the particulars that are in it.”

For Charlottesville, Virginia-based Commonwealth Senior Living, 2021 is already looking like a better year than 2020, according to COO Michelle Hamilton. She is seeing promising signs in the rate of new leads at the provider’s 33 communities, and she believes it will take at least three to five months to make up ground lost during the pandemic with a wider recovery lasting into 2022.

“I think there’s going to be pent-up demand there that we’re going to be able to tap into,” Michelle Hamilton told SHN. “I’m optimistic … that the residents are going to be there, that occupancy is going to rebound and that we’re going to be okay.”

Arrow Senior Living, a St. Louis-based provider with 26 communities in Missouri and Ohio and a handful more on the way in both states, is viewing the rest of the year with cautious optimism. Like the rest of the industry, Arrow’s new leads plummeted at the outset of the Covid-19 pandemic. By last summer, the company was seeing about 75% of the leads it normally would during that time period. And now, that number is hovering around 90%, according to COO Amanda Tweten.

“In terms of lead generation and getting active again with our lead base, I think we’re feeling really comfortable,” Tweten told SHN.

Staffing, competition loom large

All the COOs who spoke with SHN are more optimistic than at any time since the pandemic began last year, but they also see challenges ahead that could complicate or even derail forward momentum.

Staffing — which has for years been a thorn in the side of executive directors and hiring managers — will again be a headache in 2021 and beyond. Commonwealth COO Hamilton believes it may be an even larger challenge than regaining occupancy as pent-up demand returns to the industry.

“Probably the bigger issue that I think about long-term is making sure that we have frontline caregivers, and that we have our management staff in place,” she said.

Registered nurses and frontline caregivers are still among the hardest senior living roles to fill in the face of stiff competition from hospitals or other health care organizations, she added.

Commonwealth is currently targeting recent graduates from high schools and colleges for recruitment into the industry. The company also has an executive-director-in-training program, and is working with state and national senior living industry associations on ways to hire and train fresh talent.

The senior living industry is also competing for workers with staffing agencies that offer higher hourly wages, and that creates a cycle where short-staffed providers are forced to turn to the very same agencies for help down the road, according to Sallerson.

“It’s making sure that employee engagement is well and alive — what does your onboarding look like? What does your employee appreciation look like?” Sallerson said. “[If we fail at that,] then we will constantly be battling with the staffing agencies.”

Staffing has also been a “huge challenge” for Atlas in recent months, according to Co-CEO Hamilton. That is a challenge that is exacerbated by the low rate of vaccinations among employees.

“I’m cautiously optimistic that we’re going to start to see those numbers of people who accept the vaccine go up,” he said. “And then that will certainly help our staffing issues that we’ve had in the last four or five months.”

Arrow Senior Living is even changing its staffing model in response to industry hiring pressures, going from a dynamic schedule that changes week to week to one where certain positions work fixed days each week.

“In the buildings that buy into this and understand it, we’re seeing very stable staffing schedules with little to no turnover,” Tweten said. “For those people that need a flexible work style to only work when they want to work, then that’s great, let’s create a really interesting PRN pool that can utilize people at two or three different communities.”

Pricing and competition is another challenge that may complicate a wider recovery, as the pandemic has meant that communities across the U.S. are effectively in lease-up at the same time and competing for the same pool of residents. This could lead to a rise in the rate of discounts or concessions as providers try to fill units as quickly as possible.

NIC Executive Survey Insights

Already, Sallerson is seeing some aggressive pricing in the markets where Charter operates. In response, the company’s sales teams are focused on differentiating the operator not on price, but on service and trust.

“When you don’t have a great sales discovery process or a connection with the customer, the customer has nothing to compare except pricing. They just think everyone is providing the same service,” Sallerson said. “So, we have to work harder and smarter than everybody else to connect better with this customer.”

At Kendal, Adams is not as concerned about discounting and concessions, as he believes margins are already compressed across the industry, leaving little room for deep rent discounts. But he does believe the practice can be a valuable tool if used in moderation, and that it will be useful in the effort to regain occupancy.

“If we had [large providers] dramatically reduce rates in some of their markets. I’d be surprised,” Adams said. “But I’d also pop some popcorn and look and see how it goes.”

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