In-home Care Demand Prompts Senior Living Nonprofits To Expand Services Beyond Their Walls 

Demand for in-home care and a need to expand missions are two primary reasons senior living nonprofits are expanding into home- and community-based services, according to a new Ziegler survey.

The survey, part of Ziegler’s CFO Hotline series and released Thursday, includes responses from around 200 organizations, most of which were single-site not-for-profit life plan communities.

Respondents cited a growing demand for services in the home (79.7%), expansion of their missions (70.7%) and complementing existing service lines (69.9%) as their top reasons for expanding home- and community-based services. More than half (54.5%) indicated revenue diversification as a top reason why they expanded into such service lines.

Fewer than two-thirds of respondents (61.3%) said they currently offer home- or community-based services. Top service lines included home care (68.6%), home health (43%) hospice (32%), continuing care at home (21.9%) and adult daycare (11.7%). Just 5.5% of operators said they offered home- and community-based services through Program of All-Inclusive Care for the Elderly (PACE) centers, while 18% said they did it another way.

The vast majority of respondents, 86.3%, said they used their own nursing staff to provide home- and community-based services.

Among those that don’t offer it already, 68% said they had no plans to add home- and community-based service lines in the future, while 13.7% plan to add them in the next two years and 14.7% plan to add them in a time frame greater than two years.

Fewer than half of the respondents, 46.8%, indicated they have been offering home- and community-based services for 10 or fewer years. A little more than one-third (34.4%) have offered it for 15 years or more. A majority of responding operators, 85.5% and 71.8%, respectively; said they offered the services on site and in older adults’ homes.

More than two-thirds of respondents, 69%, said home- and community-based services brought in $10 million or less annually. Only 8.6% reported that it brought in $50 million or more.

Respondents also indicated a variety of advantages to offering home- and community-based services, with 16 respondents all noting it helped expand or compliment their mission.

Offering home- and community-based services can help operators more easily transition residents into senior living due to “trust built between staff and family” prior to move-in, wrote one respondent.

Such services also give operators “better insight into the ongoing conditions and needs of certain segments of our independent living resident population [and] provides a way to gauge when it is time to move to the next level of care,” the respondent wrote.

Staffing is one challenge to offering home- and community-based services given that most respondents use their own staff to provide them. Additional disadvantages include financial burdens, low reimbursement, complexities of starting to offer the services and slower transitions to higher levels of care.

“Lack of staffing has impacted the volume of services we are able to provide,” one respondent wrote.

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