Despite staffing issues, interest in HCBS remains strong among senior living providers

Despite staffing issues, interest in HCBS remains strong among senior living providers

Over the past year, home and community service offerings have held relatively steady or fallen among most of the largest nonprofit senior living providers.

Although senior living providers generally remain committed to these services, they have been difficult to manage due to a variety of factors, including staffing issues.

This and other takeaways are according to the LZ 200, an annual report by LeadingAge and Ziegler Healthcare Investment Banking that examines the nation’s 200 largest nonprofit senior living multi-site, multi-site government-subsidized housing and unique campuses.

Of these senior living providers, 42% offered some form of home and community care. This could include home health care, domiciliary care, adult day care, Continuing Home Care (CCaH) programs, and All-Inclusive Care for the Elderly (PACE) programs.

“Overall engagement with HCBS has generally been stable in recent years – even with the impact of COVID,” Lisa McCracken, director of seniors research at Zeigler, told Home Health Care News in an email. . “However, we know that staffing pressures have absolutely impacted the ability to grow these platforms.”

Staffing pressures have forced healthcare providers at all levels to reconsider launching new service lines or investing in existing ones, but “the figures show relatively stable commitment within the LZ 200 to home care and home health,” Katy Barnett, the director of home care and palliative care operations and policy at LeadingAge, also told HHCN in an email.

LeadingAge, based in Washington, DC, is an advocacy group made up of nonprofit organizations that serve the aging population. Meanwhile, Chicago-based Ziegler is a private investment bank specializing in home health care and senior living facilities, among other areas.

Top providers in this year’s LZ 200 included Trinity Health Senior Communities, Presbyterian Villages of Michigan, St. Paul Senior Services, Holland Home, Concordia Lutheran Ministries and Brio Senior Living Services.

While there are slight drops and rises in the figure above, these can also be attributed to year-over-year variances in respondents.

For example, CCaH – which has grown in popularity in recent years – has dropped from 10% to 8% among providers. But that’s probably not a sign of a larger trend. In fact, it’s probably the opposite trend that’s happening.

“The composition of the LZ 200 varies slightly from year to year depending on who moves and who merges,” McCracken said. “I would say – even beyond CCaH within the LZ 200 – that we continue to see a commitment to this model within the nonprofit sector.”

In fact, LeadingAge has seen more nonprofits launch CCaH over the past year — and heard from others considering launching the program — according to Dee Pekhrun, director of community services and policy at Plan de life at LeadingAge.

At the other end, the adult daytime model is still struggling. After severe COVID-19 issues starting in early 2020, many suppliers had to start from scratch as the pandemic finally subsided.

“Adult day providers are still navigating a number of unclear regulations around reopening gathering places,” Barnett said. “That, coupled with reimbursement rates for these services from a Medicaid perspective — a major issue — may make it difficult for some providers to justify keeping these service lines open.”

When it comes to home health care, experts at LeadingAge and Ziegler doubted that an uncertain pricing environment would lead to fewer providers offering services.

However, staffing can always be a challenge in home healthcare, which makes joint ventures popular in the space. Almost 35% of organizations in the LZ 200 are engaged in a formal joint venture with another provider, health system or home care or home care agency. This is up from the 29% who were in such a partnership in 2021.

McCracken also mentioned that there are vendors who can turn to technology in order to solve some of the staffing issues they have faced.

“I think noting the role of technology in this space is important,” she said. “It can help reach people to a greater extent than possible in the past. It can also help with some of the staffing challenges. Technology and home services really create some of the best platforms out there. .

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