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Senior living operators are notching improvements in the duration of resident stays as the industry has settled into a new normal in 2024.
It’s no secret that the length of stay across the senior living industry has decreased in the last four years, a trend thought to be driven by higher-acuity residents and older adults waiting longer to enter communities than they did prior to the pandemic in 2020.
That has pushed some operators, like Distinctive Living, to focus more on lower-acuity residents in an effort to increase length of stay and improve financial metrics, chief among them increasing margin and care revenue.
“You’re immediately more attractive from a pricing standpoint for low-acuity residents, and we’re repositioning several of our assets,” Distinctive Living CEO Joe Jedlowski told Senior Housing News.
Other operators including the Aspenwood Company, Chelsea Senior Living, Distinctive Living, Goodwin Living, and Watermark Retirement Communities are also drilling down on operations, increasing care services, growing lifestyle enrichment programming and repositioning communities to alter and stabilize length of stay.
Repositioning with length of stay in mind
In the last four years, senior living operators have evolved operations and care services to meet increased resident needs while preparing for the next generation of senior living customers.
Tucson, Arizona-based Watermark Retirement Communities reported an average length of stay for independent living residents of just over three years. That comes as the organization continues to deepen its lifestyle and wellness program known as Well360, according to Watermark Chief Operating Officer Karen Mlawsky.
“We’ve been working really hard the last two or three years on the programs that drive length stay and drive really that resident engagement,” Mlawsky said in an interview with SHN.
Distinctive Living revamped its care structure from four levels to ten to better capture care revenue, Jedlowski told SHN. For the remainder of 2024 and into 2025, Distinctive will center its efforts on increasing length of stay.
As it stands, the operator’s average length of stay across its stabilized portfolio is 24 months, a metric close to recent industry averages. Senior living operators in recent years have spent millions in capital expenses to reposition existing communities through independent living development or the addition of new, lower-acuity offerings.
“It’s really about knowing your market, focusing on our strategic positioning of those assets, and it’s one of our top initiatives in 2025 that we extend length of stay,” Jedlowski said.
Distinctive Living is in the process of developing cottage additions at certain properties across its portfolio and comes as the Freehold, New Jersey-based company acquired Validus Senior Living and hired a new COO this year.
The repositioning is also a digital one, Jedlowski noted.The company is reviewing its website and community listings to capture impressions of prospective residents within “the first 30 seconds” of visiting a landing page for a Distinctive property.
“The lack of new supply in a lot of markets has also been able to help us reposition some of these assets previously known as high acuity and reposition them in the right market by adding amenities and repurposing spaces,” Jedlowski added. “What we’re doing is aligning ourselves with the hospitality and lifestyle mindset.”
On the nonprofit side of the industry, many length of stay trends are similar to those reported by private-pay counterparts.
Alexandria, Virginia-based Goodwin Living recently reported length of stay in assisted living at its recently-acquired rental community as being less than or at one year, according to CEO Rob Liebreich.
Average length of stay at Goodwin’s two life plan communities – part of the organization’s original portfolio – is currently about 24 months. This comes as occupancy for the East Coast provider remains in the “mid-90s,” Liebreich told SHN.
With shorter lengths of stay, Goodwin has focused on its turnaround and refurbishment of vacated units to maintain a strong census while dealing with a shorter time that residents stay in a community.
“The speed by which we can do that work becomes really important,” Liebreich said.
Diving into higher-acuity programming, lifestyle offerings
Colorado-based Aspenwood Co.’s effort of extending length of stay started at the higher-acuity end of the continuum. The company recently launched its “Soar” memory care program that gave new programming and lifestyle offerings to residents.
Aspenwood has seen a 35% increase in length of stay in the product type from last year, according to CEO Heather Tussing. The program combines resident care services, programming, and lifestyle offerings to keep memory care residents engaged with an emphasis on socialization.
On average, across the entire Aspenwood stabilized portfolio, length of stay has increased to 27 months, an overall 15-percentage point increase from last year’s average length of stay.
Aspenwood has taken a unique approach to programming for residents by catering to certain hobbies and pastimes. A case in point was earlier this year when a resident with a passion for woodworking was paired with a maintenance staff member for crafting a carpentry project, Tussing noted.
“I think that giving people that sense of purpose and fulfillment and keeping them actively engaged in what they’re interested in has made a tremendous difference in falls and behavioral challenges,” Tussing told SHN. “We’re offering things that are actually valuable to residents, not just what looks good on a flier.”
Improving care delivery and capturing care-specific revenue starts with the resident health assessment process, and Watermark recently revamped its assessment process to better match residents to care plans while also aligning care revenue streams. At Watermark assisted living and memory care communities, length of stay this year stands at just over 18 months, a figure that has improved slowly over the past four years, Mlawsky said.
“We’ve been working to ensure that we continue on this trajectory of being able to care for residents longer,” Mlawsky said.
Alongside the effort to increase care models and revenue, Watermark has doubled-down on data analysis to help better understand where corporate support can aid in supporting communities while also in-detail tracking resident health and wellness metrics.
On the flip side, Watermark leaders are able to clearly demonstrate the need for additional resources at communities like a care coordinator position through tracking care-specific data–something that’s helped lead to greater transparency with capital providers, Mlawsky added.
At Chelsea Senior Living, President Roger Bernier told SHN the company’s average length of stay was at 24 months, a decline from 36 months and greater prior to 2020.
Across the company’s five levels of care, Bernier said Chelsea communities have witnessed residents entering at higher acuity levels than in years past, as the average age of residents at Chelsea communities increased this year to between 87 and 88 years old, Bernier added.
By increasing partnerships with care providers and having a robust nursing staff, increasing care offerings to meet higher acuity needs of residents, Chelsea has been able to stabilize its length of stay, Bernier said. With some tailwinds on hiring staff, both in operations and in health services, staffing pressures have eased the ramp-up in providing greater care to residents.
In the near term, Bernier estimated that the acuity of residents would continue to plateau, while still higher than in the past, but would allow senior living operators to adapt to the new operating playbook needed to handle greater resident needs, both in care delivery and lifestyle enrichment.
“I think it’s the new normal,” Bernier told SHN. “But I don’t think we’re going to see acuity continually rise. I think where they are now is what we’re going to see as we go forward.”
