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Confidential ©MatrixCare 2017Factors Influencing the Evolution of Assisted Living and Senior Living Factors Influencing the Evolution of Assisted Living and Senior Living

Factors Influencing the Evolution of Assisted and Senior Living

Denise Wassenaar, RN, MS

VP Clinical and Regulatory Affairs and Chief Clinical Officer

Confidential ©MatrixCare 2017Factors Influencing the Evolution of Assisted Living and Senior Living

• Software solution for:

• Skilled Nursing

• Life Plan Communities

• Assisted Living

• Home Care

• Marketing, Meal Tracker and Point of Sales Solutions

• Serve over 11,000 Facility-based Care Settings and 1,600 Home Health & Home Care Agencies

• Largest EHR provider in United States


• Review the historical progression of Assisted Living

• Discuss the impact of market forces, healthcare initiatives, population trends affecting Assisted and Senior Living

• Explore the impact of technology on Assisted and Senior Living

• Discuss the value standardized assessments

Talking Points


Review the historical progression of Assisted Living


• 24% received assistance with 3+ ADLs (bathing, dressing, locomotion)

• 81 % need assistance with medications

• 34% with moderate to severe cognitive impairment

• Retention:

• 31% would discharge a resident who used a w/c.

• 55% would not retain a resident with dementia

• 72% would not retain a resident who needed nursing care > 14 days

AL Resident Profile and AL setting (1993)

• 38% Need assistance with 3+ ADLs

• 87 % need assistance with bathing

• 81 % need assistance with medications

• 42% with diagnosis of Alzheimer’s

Resident Profile (2012)

Assisted Living Resident Profile


External Forces

•Healthcare Reform

•ACO’s

•Hospital Readmission Penalties

•Consumer demand “Aging in Place”

• Increase in Hospice Services

•↑ State Regulations

Internal Forces: Changing AL Resident Profile

•# Chronic conditions

•↑ assistance with ADLs

•↑ Prevalence of Dementia

•↑ in needed nursing services

•↑ Frailty of the population

ACUITY

Changing Acuity


Discuss the market forces, healthcare initiatives, population trends affecting Assisted and Senior Living


1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050

US 8.3 9.2 9.8 11.3 12.5 12.4 13.1 16.6 20.2 21.2 21.5

Germany 9.6 11.5 13.6 15.6 15 16.3 20.8 23.1 28.2 31.8 32.7

Italy 8.1 9.5 11.1 13.4 14.9 18.3 20.3 22.8 26.8 31.7 33

0

5

10

15

20

25

30

35

Growing Population of Older People in the U.S., Germany and Italy% of population age 65 or older

US Germany Italy

Statistics: Population


Population


Transition of Volume Value Based Care

• Priorities

• Reduce harm

• Engagement

• Effective communication and coordination

• Effective prevention and treatment practices

• Promote best practices

• Make quality care more affordable

Technology Adoption

• Increasing adoption of technology

• Reasons include:

• Safety

• Reduces treatment issues and medication errors

• Drives revenue capture

• Increases efficiency

• Demand for Data

• Influences wellness

Emergence of Alternative Payment Models

• Healthcare reform is influencing:

• Changes to the spectrum of care

• Transition to a medical model

• The need for exchange of healthcare information

• A focus on quality and outcomes, especially hospital admissions

Trends Impacting the Eldercare Continuum


Explore The Impact Of Technology On Senior Living


Nana Technology

• A term coined in 2004 by Andrew Carl, a professor at the University of George Mason.

• Definition: • A technology that

is intended to improve the quality of life for the elderly and is particularly being utilized by the baby boomers.


• Location: San Francisco, CA

• Founders:

• CEO: Adrian Anou, A former Alphabet Executive

• Ilya Abyzov, an Uber Executive

• Erik Frey, Leader of artificial intelligence at Google

• Rob Sebastian, Leader of product strategy for several GoogleX moonshot projects

• Financial Backers:

• Eric Schmidt, Alphabet Executive Chairman

• Marc Benioff, CEO salesforce

• Aaron Levie, Box CEO

• Joe Lonsdale, Palantir Technologies co-founder

• John Doerr, venture capitalist

• Physicians:

• Stanford Hospitals

• Sutter Health

• Kaiser Permanente

Doctors Office of the Future: Forward


Physician Care: The Future


Personal Emergency Response Offerings

Open voice communication, allowing the elderly to speak directly with a caregiver or operator; GPS and Wi-Fi tracking to accurately locate the wearer, even indoors or heavily built up areas.

Telehealth

• Remote monitoring, consultation, prescribing

• As life expectancy rises along with the effects of chronic diseases and lifestyle, telehealth approaches and smart ways to deliver care more cost-effectively will prevail

Senior Technology: Aging in Place at Home


Labor Realities

• Labor Needs:• It is estimated that by 2030, 3.5

million additional health care professionals and direct-care workers will be needed.

Labor Shortages

Source:


Follow nurses and record data

Robotic Nurses

Lifting

Robotic Nursing

Med reminders, socialization

Robotic Nursing

Labor Technology Solutions


Riba II


Robot Receptionist


Pill Reminders

Reminder Rosie 25 Alarm Clock with Large Display

and Voice Reminders

MedCenter System

MedFolio Wireless Pillbox

Pharmacy/Med Reminder system

• https://www.medminder.com/medminder-pharmacy/

Medication Management

https://www.medminder.com/medminder-pharmacy/


Medication Management


Memory Care

Dementia Friendly Clocks

Motion Sensors Wearable Sensors

Smart Soles


Discuss how the use of standardized assessments can be used to manage wellness and prevention


Gather Standardized Assessment Information

Identify Risk

Develop and Evaluate Wellness Programs Depending on the Needs of the Community

How Does Your Assessment Process Translate Into Wellness?


Documentation Consistency

Trending

Data = InformationCommunication

Program Development

Why Standardized Assessments?


Area of Assessment Suggested Tool Rationale

Monitoring of chronic conditions • Nursing clinical assessment • Manage high risk chronic disease through clinical interventions

IADLS and ADLS • Lawton and Katz • Identify service needs and track changes over time

Cognition • St. Louis University Mental Status (SLUMS)

• Functional Assessment Staging of Alzheimer’s Disease. (FAST)©

• Memory support programs• Manage wandering and

elopement• Trend changes over time

Depression • Geriatric Depression Scale • Undetected depression could result in decline in ADLs and socialization

Types of Assessments


Area of Assessment Suggested Tool Rationale

Mobility and Gait • Timed Up and Go (TUG) • Identify fall risk• Design and implement fall

management programs

Nutrition • Nutrition risk screening (NRS) 2002

• Identify nutritional risk

Medication Assessment • Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE™)

• Determine ability to mangemedications

• Identify polypharmacy

Types of Assessment


Future in Aging Services

Increase use of sensors

Alternative uses for Ride Sharing

Solutions

Home Care to Address Aging in Place at Home

Continued focus on Wellness

EHR: data collection; trending;

interoperability

Future Trends

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