CHI Living CEO: We Aim to Reshape the Senior Living Paradigm, Pursuing Hub-and-Spoke Model

Catholic Health Initiative (CHI) Living Communities continues on its recovery journey, as the organization looks to reshape the longstanding senior living model. 

CHI Living Communities CEO Prentice Lipsey said the organization has spent the last 12 months normalizing operations from the turbulence of the Covid-19 pandemic and focusing on regaining historical occupancy figures.

“In 2023, we knew that this was on us to get back to what we operationally do best,” Lipsey told SHN. “There’s no one giving handouts. We have to get back to our historical rates.”


With occupancy creeping back up over 82% in early 2024, Lipsey said more work remains. Margins for the nonprofit provider are “positive” due to the range of services offered at CHI Living Community locations as occupancy improves. But in order to fully recover from the doldrums of 2020, Lipsey estimates it will take another two years before pre-pandemic metrics are reached.

“We’re getting close to the historic margins that we like to see and we’ve figured out our path to recover, and we have an opportunity to get our workforce solidified and back to 87% occupancy across the board,” Lipsey said.

The Centerville, Ohio-based nonprofit senior living provider operates 12 communities in seven states and is part of the CommonSpirit health system.


2024 about ‘continued alignment’ of services, engagement

Senior living operators have taken different paths in recouping lost performance metrics in the last two years, with some focusing on refining services and product offerings with lifestyle and wellness in mind.

In 2024, Lipsey said, CHI Living is focused on aligning its service offerings to meet the needs of its residents, with goals to evaluate service improvements across the portfolio.

What that looks like may be helping residents age in place, while also developing “proactive care” focused on engagement, wellness visits, care navigation and improving CHI Living’s digital footprint to better capture demand.

“When we are talking about putting our resources to use, for me, that looks like aligning with internal growth, to identify opportunities to have more of a relationship with our own health agencies,” Lipsey said.

That could be leveraging CommonSpirit’s existing physician and clinician business and to support health care partners in the area, improving care of CHI Living residents as they seek health care outside of the community.

“We want to follow our residents through the aging process and the goal is to help people age in place, not so much … going through the continuum of two decades ago but [improving] the experience so that they feel safety, engagements and that we are putting technology to use so we can build greater connections,” Lipsey said.

But in order to maintain strong relationships with residents and the swath of physicians that provide care, Lipsey said the organization must figure out how to find efficiencies—and that starts in an obvious place: connecting with prospective residents and their families.

In the years ahead, Lipsey said, he envisions a “hub and spoke” model for service delivery to residents, with larger communities serving as “hubs” with service lines running from the location to support the surrounding area as “spokes.”

This “hub and spoke” concept appears to be top of mind for other nonprofit senior living providers, with California-based Eskaton CEO Sheri Peifer charting a similar growth trajectory.

What that looks like in future development for CHI Living could be a clubhouse as a “centralized area” with all branches of service associated with resident care present to successfully allow residents to age in place. That comes as more seniors value independence and remaining at lower acuity care settings, even as acuity levels rise across senior living settings overall.

“We’re going to be forced to let people live independently, but we have to have a line of sight on them, and there’s a lot of different technologies out there that are allowing us to engage with residents differently,” Lipsey said.

From wearable devices to integrated devices into senior living residences, Lipsey said technology will help improve how CHI Living staff engage with residents, thanks to nuanced health updates that inform care planning.

“I see us being successful in making people feel like we’re connected while truly doing our best to maintain their well-being,” Lipsey said.

To support these changes in how care is delivered to residents, Lipsey noted that the organization completed an internal review and is renovating and repurposing existing community spaces, while also realigning services already offered at CHI Living Communities including home health, behavioral health and beyond.

“If we can identify how resources can overlap, that’s when we are truly reshaping the paradigm of health care and senior care of the future,” Lipsey said.

‘Leading the way’ to ‘educate the entire system’

As providers tackle challenges of increasing health care needs of residents, senior living organizations that are part of broader health systems attempt to take advantage of additional resources. Being part of the CommonSpirit health system, Lipsey said, there’s a vast opportunity to leverage broader resources.

“We’re leading the way to educate the entire system on what it means to be age-friendly, and we have an interest in making sure that we find those areas of integration,” Lipsey said.

From skilled nursing working more closely with assisted living and memory care to bringing closer ties among adult daycare and home health, Lipsey said opportunity remains to improve services.

“It’s our job to figure out how we help a senior navigate this complex medical system,” Lipsey said.

But the “recipe for success” for a full recovery lies in one area: improving staffing, from recruitment to retention. While reducing agency 20% compared to last year, Lipsey said CHI Living’s largest challenge came in identifying candidates that are mission-driven.

“Our focus is on strengthening our culture back to our basic, grassroots mission,” he said.

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