Value-based care is still a big driver in how senior living operators are meeting future challenges.

That’s according to a recent survey by the American Seniors Housing Association (ASHA) and tech firm August Health. The survey includes responses from 68 senior living clinical leaders between July 15 and August 15 of this year. Nearly a third of respondents said their respective organizations cared for between 1,001 and 2,500 residents.

About one-third of respondents, 31%, said they have no value-based care plans, while 29% are actively operating with a value-based system in place.Another 31% are evaluating opportunities to join a value-based care system.

“My sense is that a growing number of companies with multiple properties are dipping their toes in. For example, they might be piloting value-based care at one or two properties. If you are serving assisted living residents, there are myriad reasons to be thinking about value-based care opportunities,” wrote ASHA President Dave Schless in the survey.

Coinciding with this shift to value-based care, operators are exploring new technologies to track resident changes in condition and acuity. But 87% reported still having conversations with a clinical team at shift change or department meetings to note a change in condition. Sixty-two percent of respondents said they used electronic health record (EHR) systems to trigger re-assessments of resident acuity.

“Verbal discussion is not reliable as it typically only highlights the concerns for that period of time,” said Shadoworee Betts, Chief Operating Officer at Senior Star, in the survey. “What about the residents no one is discussing? I would love to see more movement toward the use of analytics to identify residents that need immediate interventions.”

Staffing challenges lead to changes in emphasis

Senior living providers and their clinical teams are changing staffing models to adapt to challenges in operations.

When asked about what’s changed regarding staffing models in recent years, 50% of respondents said they had expanded the role of medication technicians, followed by 28% adding more nursing staff to combat rising acuity and 16% adding more administrative staff.

“Positioning med techs as universal workers and allowing them to take on caregiving or clinical support roles, while also adding more licensed nurses, allows operators to more effectively respond to rising acuity within communities,” said Josh Allen, Principal at Allen Flores Consulting, who was quoted as part of the survey.

Staffing remained a significant challenge for clinical leaders, with 65% reporting hiring or retaining staff as the biggest challenge, followed by improving quality of staff (57%) and addressing rising resident acuity (41%).

Clinical leaders are also in need of more specific data to forecast where staffing issues will come next, with top data points reviewed regularly include incident reports, reasons for move-outs, high-risk resident reports and community acuity levels.

The biggest medication-related challenges faced by senior living teams include med pass staffing and operations (63%) followed by polypharmacy, or the use of multiple prescription drugs to treat one condition, at 53%. That is followed by errors made in medication administration at 34%.

“We have found success when we take a proactive approach to partner with pharmacists who specialize in the senior population. They are able to offer a thorough medication review at the time of move-in, which helps to mitigate the risks associated with polypharmacy and improve resident care outcomes,” said Jennifer Sato, who is the vice president of health services for Oakmont Senior Living, in the survey.

Senior living falls have long been an important area for operators to focus on to improve resident acuity, and operators are now using more tools to prevent falls, with 26% having fall management programs, 22% using physical therapy referrals, 21% conducting root cause analyses of falls and 13% using sensors or camera technologies.