Senior Living Referral Streams Thaw, But Some Return Faster Than Others

Referral streams that were frozen at the outset of the pandemic are starting to thaw as pent-up demand returns to the industry.

Data from senior living sales and technology companies Sherpa and Enquire, along with firsthand accounts from senior living providers, tell the story that many referral sources are returning to life across the industry as vaccinations increase and communities start to ease certain restrictions.

But in some cases, the referral sources that are driving the most leads and move-ins today have shifted from where they were before the pandemic.


And providers have worked to develop deeper relationships with referral sources and have come up with new ways to reach them.

“We have seen an increase in professional referrals, especially over the past quarter,” MBK Senior Living Vice President of Sales and Marketing Christy Van Der Westhuizen told Senior Housing News. “A big push for us was getting to know our professional referral sources, especially the healthcare sector, much better during the pandemic.”

Signs of a spring thaw

At the outset of the pandemic, referral streams all but dried up as Covid-19 case counts rose and lockdowns went in place. But roughly a year later, conditions are improving across the industry.


That is evident in data from Sherpa, a St. Louis-based firm offering a senior living sales enablement platform, providing methodology, CRM technology and sales analytics; and Enquire, which provides customer relationship management, marketing automation and contact center solutions to the senior living industry.

Sherpa’s data, which includes metrics from 729 communities across the U.S., shows:

— General sales volume is up 22% in March compared to January and February of this year; and up 27% in March compared to October 2020

— Overall sales leads were still down 22% between October 2020, and March 2021, compared to the same months in 2019 and 2020.

Sherpa’s data also showed that leads from professional referral sources — such as hospitals and physicians’ offices — are again on the upswing, and nearing pre-pandemic levels.

In March, leads from professional referral sources were up 16% over January and February, and 22% over October 2020.

Professional referral volume between October 2020, and March 2021 is now within about 1% of the volume seen during the same months in 2019 and 2020.

Resident referrals have picked up slightly in March compared to previous months, but are still lagging 35% behind where they were between October 2019 and March 2020..

Event-generated leads were also down 55% in the same period, but conversions have also doubled, going from from 7% to 14%, according to Sherpa’s data.

Referral sources in Sherpa’s data broke down thusly: 30% from lead aggregators; 40% digital/website; 8% from professional referral sources; 6% from resident/family; and the remaining 16% were from advertising, direct mail, signage and other similar channels.

Enquire’s data tells a similar story.

Lead volume for Enquire’s clients in March of this year was 25% to 35% higher than March 2020, with 1Q21 lead volume averages in line with those seen in the first quarter of 2019.

And inquiries, which don’t always turn into leads or move-ins, are already nearing pre-pandemic levels.

Consumer confidence in the industry is driving these trends, according to Erin Hayes, co-founder and chief revenue officer at Enquire.

“January and February [2020] were our best months on record, our highest for average inquiries per month across the board,” Hayes told SHN. “March is ticking up toward there.”

Referrals from professional sources are also rebounding, according to the data. Independent living communities averaged just over 3 professional referrals per month in 2019, but dipped to an average of about 2 last year. This year, that average sits at 2.5 per month.

Assisted living providers are averaging about 4 professional referrals in 2021 so far, a gain from an average of the average of 3.5 in 2019 and 2.5 in 2020. Communities offering both assisted living and memory care saw an average of about 3.5 professional referrals in March, on average. That is below the nearly 4 professional referrals those communities saw in 2019, but more than the 3 average monthly professional referrals those communities saw in 2020.

“I do see a lot of organizations making more of an effort to cultivate relationships with those professional referrals — more so than they have in the past,” Hayes said.

Leading indicators

Zooming in from the 30,000 foot view, providers on the ground are relaying many of the same trends.

Chicago-based Vi, which has 10 high-end CCRCs, also saw an uptick in leads this year, according to David Egeland, vice president of sales and marketing. Year-to-date, Vi’s overall leads are still 15% to 20% below what the provider saw in 2019. But in March and April those trends looked much closer to 2019 levels.

In particular, the company saw a sizable increase in its paid lead sources, a broad category that includes direct mail, e-mail, website traffic, social media and third-party placement services. Vi’s paid leads this year are currently 25% to 30% higher than 2020 levels, and slightly above 2019 levels.

“Leads started to come back — both paid and non-paid — but definitely paid came back at a stronger pace,” Egeland told SHN.

The company’s non-paid leads, such as referrals from friends and family, professionals or financial planners, are still lagging about 20% to 25% behind 2019 levels, but are up over 2020 levels. Those referrals typically make up a third of the company’s total leads but represent nearly half of its move-ins, making it a crucial target for improvement.

To rebuild that source of leads, Vi has engaged in what Egeland refers to as “old-school resident referral drives.” That helped the company hold its roughly 90% occupancy rate in 2021.

“We printed up a card … and gave it to our residents and said, give us five referrals, and when one of your friends comes in, we’ll give them a box of macaroons and you’ll get a box of homemade macaroons, or you’ll get a picnic kit,” Egeland said. “For March, when we had this big push and a sales contest for referrals, we saw that the numbers came back very strongly, close to 2019 levels.”

Vi also plans to resume limited in-person events in May. In the meantime, the company’s digital leads are trending 35% to 40% higher than in 2019. Some of that has to do with the fact that Vi upgraded its website and improved the digital experience for leads last year.

“Those leads are very efficient for us, as we’re not sending them an expensive direct mail piece,” Egeland said.

Beyond ‘muffin marketing’

Irvine, California-based-based MBK, which operates a portfolio of 33 communities, is observing similarly positive trends.

“Our leads were cut in half in April of 2020,” Van Der Westhuizen said. “[In] March of 2021, it’s almost back to pre pandemic levels.”

Specifically, the company saw its average monthly lead volume drop to around 800 monthly leads in April, 2020. But by March of this year, leads were back to an average of about 1,400 or 1,450 per month.

When the pandemic hit, MBK strove to deepen its relationship with non-paid professional referral sources, such as doctor’s offices, skilled nursing facilities, hospitals or home health care agencies. One tool that worked particularly well for achieving that goal were virtual events, such as virtual trivia with prizes or handbag bingo, in which the prizes are handbags.

“If we really want to get to know these professional referral sources personally and make a relationship, it can’t be the muffin marketing of days gone by where we drop a dozen muffins off at the doctor’s office and keep our fingers crossed that they call us,” Van Der Westhuizen said.

It’s an observation made by other providers in recent months as well. Atlanta-based Thrive Senior Living even created a coffee truck as a way to connect with referral sources in the health care community of Montvale, New Jersey.

MBK also applied a creative approach to cultivating prospective residents and held remote events such as virtual happy hours, bingo games or sushi-making classes. One MBK community in Colorado Springs, Colorado, even held culinary classes over Zoom and delivered prospects fresh ingredients to cook with beforehand.

While Van Der Westhuizen believes the days of hundreds of prospective residents flocking to an in-person event are gone, that doesn’t mean in-person events are going away entirely. For instance, MBK plans to hold a scaled-down in-person event at one of its recently renovated communities in May.

“I think the success of an event, whether it’s virtual or in person, will be in how many people you really connected with,” Van Der Westhuizen said “And I think in a smaller, intimate setting, you can genuinely get to know people much better.”

Looking ahead, Van Der Westhuizen is encouraged by the company’s momentum and believes that it will continue as pent-up demand returns to the industry in 2021.

“There are people who need a safer and more engaged place to live, and they’ve been putting it off so long,” Van Der Westhuizen said. “So I think [leads from] referral sources are going to see the same uptick that we are seeing in our communities. I think they will continue to grow.”

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