Building Occupancy with Onsite Primary Care

Dan O'Neill

As the pandemic recedes, many senior living operators are still working to rebuild occupancy, and trying to attract health-conscious seniors and improve length of stay for residents arriving with greater needs. Despite a slight increase in 2022, senior housing occupancy remains below pre-pandemic levels. Welltower, one of the largest owners of senior housing properties, reported 78% occupancy at the end of 2022, still well below the 86-87% across its portfolio before the pandemic.

Against this backdrop, new models of onsite primary care – focused on clinical quality and the senior living environment – offer community leaders a unique amenity to attract move-ins, while extending length of stay. Today, seniors and families alike are highly attuned to the health and wellness services available in a particular community, with expectations that go far beyond dining programs and social activities. And, since today’s residents may have delayed a move during the pandemic, they often arrive with greater needs, or more concerns about how a community will support them as they age. New models of onsite primary care can help senior communities build and maintain a healthy, competitive, and high-performing community.

Today’s senior living resident

Today’s seniors often arrive in a new community a bit older, and with more chronic conditions, including hypertension, diabetes and mild cognitive impairment. A recent study in the Journal of Gerontological Social Work found that seniors are delaying their move into assisted living communities due to several factors, including worries about the quality of care. To some extent, the COVID-19 pandemic exacerbated some of these concerns, as seniors and their families worry about care management and potential isolation in a residential community.

While rising acuity may be most noticeable in assisted living and memory care buildings, the trend is also evident in independent living units. As investment surges in the independent and active living segments, many residents considering these communities and planning for a very active retirement also hope to age in place, once they have settled into a new home, and worry about being forced into a subsequent move if they need more clinical support in a few years. These resident concerns can be challenging for sales and marketing teams charged with building occupancy, and for the health and wellness staff working to keep residents healthy, happy and in the community they have chosen.

The impact of onsite primary care

Onsite primary care can help communities meet these challenges – adding a compelling amenity for health conscious seniors and their families, while improving resident satisfaction. For active and independent residents, convenient care in the home has a concierge feel (without the usual price tag), and can allow residents to avoid or postpone a move to a higher-level setting.  In assisted living and memory care properties, onsite medical care reassures families worried about their loved ones’ clinical needs, and about day-to-day challenges like complex medication regimens or the regular lab tests Mom or Dad may need to ensure their chronic conditions are well-managed. For all of these reasons, onsite primary care can help attract and retain residents across, as communities work to build and maintain occupancy across all lifestyles.

Meanwhile, when onsite care is delivered by value-based physician groups – still a relative rarity in American healthcare – evidence suggests this sort of partnership can cut ER visits and resident hospitalizations. A study published in December 2022 found that seniors who receive care from value-based primary care providers are less likely to end up going to the ER, suffer fewer hospitalizations for a range of chronic conditions, and are less likely to be readmitted to the hospital after an acute episode.  Elderly patients tend to deteriorate sharply in the hospital, so even small reductions in hospitalization or re-admission can have significant effects on the likelihood that a resident returns to the community, and on overall length of stay in a senior living setting. And, since each resident hospitalization can consume at least five hours of senior living staff time, the presence of a value-based onsite primary care provider can ease workloads for the community’s nursing staff. The impact of this model can be profound with healthier residents, longer length of stay, and less strain on the community’s own care team.

Finding the right partner for onsite care

Senior living operators or community leaders can look for a few elements when searching for an onsite care partner to help build occupancy:

  • Expertise in senior living. Senior living residents and communities have unique needs and operating cadences. The average medical practice or community clinic may see plenty of healthy kids and young adults, and is geared toward a steady stream of patients who drive to their offices and wait in the reception area. They are also often unfamiliar with the compliance requirements of a licensed residential care property. Just as you would seek out a cardiologist to treat a heart condition, it is wise to find a clinical partner who specializes in senior living.
  • Responsiveness and accessibility. As we age, small issues escalate more quickly. Missed medications or too many medications can cause a fall or a spike in blood pressure, leading to an ER visit or even a stroke. Senior living operates around the clock, and when your residents have a concern or a worrying symptom, you need to be able to get in touch with their primary care provider. Not for an appointment next week, but now. A high-quality onsite care provider will have the infrastructure and systems to respond and intervene quickly.
  • Value-based model. Even in 2023, the vast majority of physician groups operate under a fee-for-service. Their revenue depends on the pace and volume of patient visits, which leads to lots of drive-by visits and little attention to clinical outcomes. Talk to potential partners about quality. How do they measure their own clinical results? Are their diabetic and hypertensive patients well-managed? Achieving good clinical outcomes is difficult, but value-based primary care providers are deeply invested in measuring and managing quality, and focused on avoiding ER send-outs and hospitalizations - aligning their work with residents’ goals and your success as a community.
  • Staff support for growth and resident care. Your sales and marketing team is working hard to attract new move-ins, and the care staff is working around the clock to keep residents safe and healthy. Once you have found a responsive, value-based primary care provider, how will they support the community relations team when they are working to support a senior who is ready to make the move? How do they integrate the onsite care program into your community’s operations? Will the primary care provider round with your care team, to check in on residents, solve problems and help build staff knowledge? Successful onsite care is a team sport, and the right healthcare partner will fit into the community, supporting your staff as they build occupancy and care for residents.

What our partners are saying about Pine Park Health

“Since partnering with Pine Park Health, we have received amazing feedback from new residents and tour attendees. In just the first month, we had two new move-ins and one couple retained because of the Pine Park care offering. With the challenges in the healthcare industry and long wait times for basic appointments, residents are excited about the consistency and quality of care. The Pine Park staff is also friendly, approachable, and motivated to provide the best care to the patients in my community.” - Megan M., Director of Sales, Tuscany at McCormick Ranch, MBK Senior Living

"When it comes to addressing patients' needs and providing quality care, the Pine Park Health team is thorough. It’s easy to get in touch with providers - they are accessible and responsive, resolve issues quickly, and are here every week to care for residents. Pine Park is a true partner in our community." - Joann N., Nurse at Pacifica Senior Living

If you’re interested in learning more about Pine Park Health and our community partnerships, please visit our Communities page.

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