Green House Blog

Innovations and Trends in Elder Care

Lisa McCracken, Ziegler

In the first of our four-part “Making the Business Case for Culture Change” series, Lisa McCracken, Director of Senior Living Research & Development at Ziegler shares an overview of key trends and innovations in elder care. Ziegler is one of the nation’s leading underwriters in financing for not-for-profit senior living providers and works with merger and acquisition activity in the private sector. As the Director of Senior Living Research & Development, Lisa conducts market research and trend analysis and contributes to educational articles and white papers on key industry topics.

Rising demographic changes are driving evolution and innovation in senior living organizations. Specifically, there are two key stakeholder groups providers need to target when thinking about their market audience, the baby boomers and millennials. As roughly 10,000 baby boomers turn 65 each day, the aging services spectrum enters a large period of scale. We now see a trend in non-traditional healthcare players entering the industry as they discover their unique role in solutions around aging, from technology to transportation. Senior living providers will need to adapt and evolve to meet the new preferences and characteristics of the baby boomer generation to connect with the new older adult. Specifically, Lisa discusses language changes, wellness initiatives, resident engagement and support services, and community life. As a major part of the workforce of the future, millennials have new values regarding recruitment, retention, and employee engagement. Lisa encourages providers to be “thinking smart” about attracting millennials into our field, particularly when competing with other industries. Four out of the six top projected in-demand occupations fall in our field, creating a growing number of professional opportunities for this rising workforce (Personal Care Aide, Registered Nurse, Home Health Aide, and Certified Nursing Assistant). Lisa shares labor challenges many organizations face and presents best practices to overcome workforce barriers to attract and retain great talent.

How is senior living changing and growing? There are significant differences between not-for-profit and for-profit growth and development. In the not-for-profit sector, organizations are focused on expanding and renovating current communities rather than building new locations to adapt to the changing demographic. Not-for-profit providers are also focused on repositioning their skilled nursing neighborhoods away from the institutional model and reinvesting in real home environments, such as The Green House model to support organizational culture change and provide elder-centered care. In the for-profit sector, Ziegler is seeing a growing number of new communities, particularly in the Assisted Living and Memory Care space across the country. However, in both sectors, there is a growing number of sponsorship transitions and mergers and acquisitions because of several factors, including the increased complexity of healthcare reform and organizational leadership turnover.

In our dynamic environment, Lisa provides an overview of the pressures many providers are facing, particularly in the post-acute rehab space. Decreased length of stay, higher acuity levels, narrowing hospital networks, and an increasing number of treatment plans that skip skilled care entirely place high pressures on skilled nursing providers as occupancy trends decline. Lastly, as we look toward the future, we see new technology entrepreneurs continue to emerge providing innovative solutions that are paving the future of resident care, organizational staffing, caregiver communication, and family engagement.

To listen to the full webinar, please register to receive the recording:

Leadership and Vision

If you are reading this blog post, three things are clear: You are an innovative leader, who values elders, and you have a definite vision for a better tomorrow.

So, I begin with the most important message: Thank you.
From a leadership perspective, you are driven by governing values, have a clear image of a positive future and have the foundation to take action and be effective.

As leaders in our community, we know 10,000 of our friends, family members and neighbors will turn age 65 every day for the next 19 years! What a blessing it is to be able to tap the energy, insight and expertise of Boomers as they become our elders! And what a challenge it will be to adapt care in terms of financing, engagement and wellness.

My life experience in the public, private, and not-for-profit sectors, working with our treasured elders, has helped me to identify several attributes of effective leaders that will be essential to our professional success going forward.

In creating communities of care inside and outside of centers, effective leaders will recognize the importance of and study effective techniques in communication and negotiation that puts people first, places shared interest over individual position, and separates a person from the problem or challenge with which they are identified.

These concepts of negotiation come from the hallmark text, Getting to Yes by Harvard scholars Roger Fisher and William Ury. For leaders working in a public/private intersecting space with features of home, hospital and community, and with varied voices of community members, families, staff teams, funders and regulators, negotiation is most certainly a necessary core competency for success.

Leaders know the importance of identifying crucial conversations as the intersection between opposing opinions, strong emotions and high stakes – as outlined by the authors Kerry Patterson, Joseph Grenny, Ron McLillan and Al Switzler in their powerful book of the same title. In the early pages of Crucial Conversations, the authors begin by offering important and powerful tools of dialogue – shared meaning, active listening, and starting from, instead of avoiding, the heart and emotion – to identify, and successfully navigate crucial conversations.

Today and tomorrow, effective leaders engaged in realizing the opportunities and overcoming the challenges of an aging America will study and work to not avoid crucial conversations with community members, families, employees, teams, and regulators (to name just a few in our broad circle of influence).

As Jack Welch and his wife Suzy point out in their book Winning, effective leaders recognize that “before you are a leader, success is about growing yourself. When you become a leader, success is about growing others.” Effective leaders in aging America recognize it is critical to learn from and nurture leaders in care, to grow leaders on staff and community teams, and to recognize the positive influence we can all have on other leaders in the broadest sense of community.

As leaders in our important work of helping elders to be as engaged, well, healthy and safe as they want and are able, we have a tremendous opportunity in our professional communities to envision and make the business case for sustainable care enterprises, whether for- or not-for-profit.

Effective leaders negotiate by putting people first, recognize and have crucial conversations, help others to grow as leaders and focus on all that connects us instead of that which separates us.

Steve McAlilly of Tupelo, Mississippi is this sort of effective, passionate and powerfully impacting leader. Steve can be counted among a handful of gifted leaders in our community of, for- and not-for-profit, large and small, government, private and philanthropic businesses, associations and scholars, who are working to guide us to a better tomorrow.

Our elder community is expanding exponentially. Green House homes have made a tremendous difference in the lives of real people. As long as we all put people first and recognize the various tangible and intrinsic values in caring, there is room for, and value in, various models of care and community.

About Joe:
Joseph DeMattos, Jr., is the CEO of the Health Facilities Association of Maryland (HFAM), Maryland’s oldest and largest nationally affiliated provider association representing skilled nursing, transitional, rehabilitative and long term care providers. Prior to joining HFAM DeMattos worked in the leadership of AARP in Hawai’i, in its national office in Washington DC., and in Maryland.

DeMattos holds Masters Degree in Government from Johns Hopkins University and is an Adjunct Professor of Leadership at the University of Maryland Baltimore County Erickson School for the Management of Aging Studies. He has over 30 years of professional experience in labor, government, the private sector, and in association management with a focus on health care policy. He can be reached at