8 Robots and drones Pandemic shapes adoption 10 Trends Tech use balloons since outbreak 16 Manager’s Toolboxes Harnessing technology in 2 critical areas

A different kind of virus COVID-19 speeds provider adoption of telehealth, other types of tech Thank you to our everyday heroes.

By any measure, these are extraordinary times. We at McKnight’s hope that you, your loved ones and your business associates remain safe and well.

We’d like to express our profound gratitude to all the medical professionals, caregivers and other essential workers keeping our loved ones and communities safe during this crisis.

Our publications, webinars, e-newsletters and other oerings are here to help. We will do our level best to make them as meaningful, relevant and useful as possible.

What we know about people in this sector is that they are remarkably resilient. Many have dealt with challenging economic, regulatory and competitive times before — and have always emerged stronger for the experience.

Above all, know this: We will get through this together.

Be strong and stay safe. TECHNOLOGY: CHANGING THE FUTURE

McKnight’s Tech Awards open for entries

he 2020 McKnight’s Excellence in Technology Awards program is now Topen for nominations. Entries will be accepted through July 24. The competition features two tracks — one for senior living, and one for skilled nursing — with six categories each. “Chances are more than good that your organization is harnessing several tech tools to make life better for those you serve,” said John O’Connor, editorial director of McKnight’s Senior Living and McKnight’s Long-Term Care News, “and as long as you are already doing that, why not get rewarded for the effort?” The annual contest recognizes providers that convey how technology — simple or advanced — has improved care and opera- tions in their organizations. Categories in the senior living track include Quality, High- Tech/High-Touch, Innovator of the Year, of Activities. Entries must be submitted by of the program this year. MatrixCare is the Keep It Super Simple, Safety, and Activities. senior living and skilled nursing provider Gold sponsor for the senior living track. Categories in the skilled nursing track are organizations. For more information, visit mcknights the same, except Transitions takes the place Stanley Healthcare is the Platinum sponsor techawards.com. ■

More embracing EHRs, “This report provides the most The project relies on a “nation- ter where they are in develop- HIEs, study finds recent national description of al COVID-19 testing challenge,” ment,” the agency noted. More assisted living operators EHR use and computerized in which scientists and inven- are harnessing electronic health support for health informa- tors developing coronavirus Older adults like email, record systems and participating tion exchange among a major tests across the country will looking up weather in health information exchang- provider of community-based compete for a share of a $500 An AARP survey provides es, according to a report from long-term services and sup- million pool earmarked for insights into technology use by the Centers for Disease Control ports — residential care,” the diagnostic development. Suc- those in their 70s. and Prevention’s National Cen- authors said. cessful entrants will get paired A total of 2,607 people aged ter for Health Statistics. with manufacturers and busi- 50 or more years participated in Communities using EHRs Initiative may quicken ness leaders who can speed up the AARP’s online “2020 Tech increased to 26% from 20% COVID-19 testing production of resulting tests. and the 50+ Survey,” and 781 between 2012 and 2016, noted The National Institutes of “Shark Tank” is a television of them were aged 70 or more “Trends in Electronic Health Health has unveiled a $1.5 bil- program in which capital-seek- years. Record Use Among Residen- lion “Shark Tank-like” initiative ing entrepreneurs pitch business Sixty-two percent of those tial Care Communities.” Inves- to rapidly develop coronavirus partnerships to a panel of ve aged 70 or more years reported tigators also found that health diagnostics. The effort could investors, or “sharks.” using smartphones in 2019. Of information exchange capacity lead to the deployment of “mil- “We need all innovators, from them, 88% said they use them among communities increased lions of tests per week” by late the basement to the boardroom, daily. to 55% from 47.2% during summer or fall, the agency to come together to advance Forty percent of respondents those years. claims. diagnostic technologies, no mat- in this age group said they use

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tablet computers. Of them, 61% so-called virtual assistants said they use them daily. increasingly are used by senior Among the older adults who living and care residents either own smartphones or tablets, the on their own or as technology most popular uses were looking integrated into other systems up the weather (69%), sending used at their communities. email (67%), using the internet Now, through a partnership (56%), looking at photos (55%) with First Databank, residents and using social media (50%). and others are able to access Fifty percent of the older drug information through Alexa respondents who own smart- queries. phones or tablets said they A subset of FDB’s drug infor- use social media at least once mation, used for more than 40 a week. Inc. Photo: Amazon.com, years by healthcare profession- Amazon’s Alexa and other so-called virtual assistants increasingly are By far, the most popular types used by senior living and care residents either on their own or as technology als, now can be accessed by con- of social media used by those integrated into other systems used at their communities. sumers from any Alexa-enabled aged 70 or more years were device. Facebook (59%) and YouTube Individuals are able to ask (23%). “Older individuals who use the internet about drug interactions, side The next most popular form effects, precautions and a drug’s of social media, Instagram, was to seek health-related information class in English and Spanish. used by only 8% of the older experienced improved outcomes.” Examples of some common respondents, and 31% of people medication-related queries that Journal of Applied Gerontology authors in this age group reported not Alexa now will answer: using social media at all. In fact, Facebook and You- found that internet use among of the internet as a means of • “Alexa, what type of drug is Tube, by far, also were the most those aged 60 or more years sharing information, and given ibuprofen?” popular types of social media increased from 60.2% to 66.4% older adults’ greater need for • “Alexa, what are the side used by those in their 50s and from 2011 to 2016. health information.” effects of sertraline?” 60s who took the survey, with “When it comes to specific “Studies report that older • “Alexa, does Zoloft interact Instagram ranking in a distant sociodemographic subgroups,” individuals who use the inter- with Aleve?” third place for them as well. however, they said, “the sig- net to seek health-related infor- • “Alexa, what’s the difference Only 37% of those aged 70 nificant increases in internet mation experienced improved between Tylenol and Advil? or more years said they used use between 2011 and 2016 outcomes with respect to their social media daily to stay con- were observed among those knowledge of health issues, “People lead busy lives, and nected with friends and family who were young-old [60 to 74], health communication with voice provides a simple way to members. old-old [75 to 84], female, and medical professionals, and get helpful information about non-Hispanic whites, and those appropriate use of health ser- medications, including side Study finds ‘digital divide’ with high school graduation or vices,” they said. effects and drug interactions, with internet use above.” “In addition, numerous stud- for themselves and the people Some older adults may be miss- That is, statistically signi cant ies report other benefits for they care for,” FDB President ing out on the health and well- increases were not seen among older adults of using the inter- Bob Katter said. ness benefits that can result the “oldest-old” (aged 85 or net such as improving interper- “This information will from internet use, according to more years), men, those who had sonal interactions, promoting complement advice from their the results of a newly published not graduated from high school, better cognitive functioning, medical and pharmacy teams. study, which noted a “digital and racial/ethnic groups other and enhancing their experience Ultimately, we believe that more divide.” than white. of control and independence.” informed consumers will lead Researchers analyzed data Findings, published in the to improved medication adher- from 107,500 older adults who Journal of Applied Gerontology, Drug info now accessible ence, the reduction of adverse participated in the California are important, according to the via Alexa queries drug events and better patient Health Interview Survey and authors, “given the importance Amazon’s Alexa and other outcomes,” he added. ■

4 Technology: Changing the Future • June 2020 • www.mcknights.com • www.mcknightsseniorliving.com TECHNOLOGY: CHANGING THE FUTURE Tablets to the rescue Devices facilitate family communication when in-person visits aren’t possible

By Lois A. Bowers enior living communities and nursing facilities got Screative to keep the lines of communication open when safety guidelines were issued and shelter-in-place orders went into effect across the country this spring. No-visitor poli- cies prevented residents from interacting with loved ones, and social distancing recommenda- tions restricted in-community activities that could take place. Often, iPads and similar tab- let computers, equipped with apps such as FaceTime, Skype, Google Hangouts or Zoom, Photo: courtesy of Westminster-Canterbury on Chesapeake Bay Photo: courtesyof Westminster-Canterbury have offered a solution. Birdsong in use at Westminster-Canterbury on Chesapeake Bay. “When we had to tell families, ‘You can’t come visit your loved Families also are able to log “Older adults and their loved sure that the residents are get- ones,’ we were equipped, because into a Touchtown portal to see ones at home, even those in ting some social connection,” all of our residents are issued an videos and photos that Avanti senior living communities with said Brian Geyser, vice presi- iPad when they move in,” said has uploaded, as well as planned visitor restrictions, can use video dent of clinical innovation and Lori Alford, chief operating of - activities and meals, Alford said. chat to stay connected, giving population health. cer of The Woodlands, TX-based Residents of the nonprofit peace of mind to families,” The tablet devices are a favor- Avanti Senior Living, which has Westminster-Canterbury on Westminster-Canterbury on ite technology among residents locations across three states. Chesapeake Bay, a life plan Chesapeake Bay President and at communities, he added, Once family members signed community in Virginia Beach, CEO J. Benjamin Unkle Jr. said. “because their friend visits or up for Skype and Avanti con- VA, didn’t have to look far for a Additionally, the Birdsong family visits through the iPad.” nected them on the commu- technologic way to communicate website contains thousands of The technology serves other nity’s end, she said, “They with their friends and family curated entertainment experi- purposes, too, and Geyser instantly had access.” members. The Birdsong Tablet ences and video communica- doesn’t see use of the tablets The funny thing is, Alford touchscreen device was devel- tions tools that are being made ending when visitation poli- said, families always have had oped by Birdsong, the innova- available for free as well while cies change. the capability of speaking with tion division of the CCRC, and social distancing and sheltering- “The tablet will continue to Avanti community residents via offers video chat capabilities. in-place is occurring. be part of our programming,” an app. And residents have had The tablet is designed espe- Westport, CT-based Maple- he said. “A lot of our residents iPads since Avanti’s inception. cially for those with lim- wood Senior Living, with com- have mobility challenges, or Some people used the capabil- ited technology experience or munities in multiple states, has they may be feeling under the ity, “but that wasn’t a big deal to physical or cognitive limitations. purchased several iPads for each weather and isolated in their them, because they would rather Large, picture-based icons, large community, and video calls are apartments. So we’ll be able to come and visit their moms,” she font sizes, and a permanent scheduled via life enrichment leverage those tablets for the said. “When all of this went home button are some of the team members. “We feel it’s our future even beyond the pan- down, everybody got on it.” device’s accessibility features. duty and obligation to make demic.” ■

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Flipping the switch Operators across the senior living and care spectrum embrace telehealth

By Kim Marselas his spring’s ght to keep older adults healthy in the Tface of the coronavirus pushed many healthcare pro- viders and senior living and care communities into the willing arms of telehealth. Previously, cash-strapped operators or many embracing a hospitality model argued there’d been little incentive to roll out robust virtual services that could address therapy needs, help residents manage chronic conditions or get a diagnosis for a new condition without leaving home. Even those who had telehealth capabilities weren’t necessar- ily using the tools to their full extent just a few months ago. Images Plus Photos: John Fedele/Getty Six Avanti Senior Living com- Increasing consumer demand and rapidly improving capabilities will ensure that telehealth fi nally becomes a permanent component of the aging services portfolio. munities in Arizona, Louisiana and Texas each had rounding nursing providers, whose use nursing home and discharge vis- conducted by Ziegler and physicians, a medical concierge of telehealth had largely been its. Although CMS couched the LeadingAge found that almost suite with exam room, and an limited to rural locations. changes as temporary, experts 20% of the nation’s 200 largest existing telehealth portal as part But then the Centers for say regulatory and payer chang- nonpro t providers were using of a new Avanti Health service. Medicare & Medicaid Services es, increasing consumer demand telehealth or remote patient That existing infrastructure, stripped away several barriers to and rapidly improving capabili- monitoring, whereas only 16.5% including signal repeaters to Medicare telehealth coverage in ties will ensure that telehealth had more active telecare or ensure dependable wireless mid-March, and many private finally becomes a permanent behavioral monitoring services. coverage, made it easier for insurers followed. The govern- component of the aging services But a late-March survey con- the luxury assisted living and ment relaxed Health Insurance portfolio. ducted by Trinity Life Sciences memory care provider to limit Portability and Accountability found 46% of healthcare provid- the number of therapists and Act enforcement so physicians Not a choice ers across settings and special- clinicians entering once visitors could use cell phones and other “People that have seen it as a ties are using more telehealth were restricted. devices to discuss resident and choice will be left behind,” said than before COVID-19, with “We didn’t want any Tom, patient health and allowed more Lisa McCracken, who tracks specialties such as cardiology Dick or Harry in our buildings.  exibility for healthcare provid- technology use as director of and psychiatry experiencing an That’s why we’re still COVID- ers to reduce cost-sharing for senior living research and devel- extra spike in popularity. free,” Chief Operating Of cer telehealth visits. opment for investment banking And COVID-19’s isolation Lori Alford said. By late March, CMS was pay- rm Ziegler. “That’s the reality requirements have highlighted Avanti and its peers had a ing for more than 80 new tele- of it.” visibility gaps in independent headstart on many skilled health services, including initial As of late 2018, a joint study living and assisted living. As an

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example, McCracken said that and cut their risk of COVID-19 a resident who tends to stay in infection, Alford said. That fac- his or her own unit might go tor may be important for senior undetected for a long period of living communities, which don’t time after falling. Voice-activat- stand to benefit from revised ed technology could allow that CMS payment rules the way resident to call for help, and skilled nursing facilities do. remote monitoring would give Regardless of how they bill for providers insights that speed it, providers almost certainly response times. will have to meet increased con- sumer demand for on-site health No longer Big Brother services now that residents and McCracken expects that tele- families are accustomed to it, health use will remain elevated McCracken said. as the power of such solutions Her sentiment is echoed by becomes more obvious. Bob Kramer, founder of the Where once such tools might National Investment Center for have been viewed as the work of Seniors Housing & Care, who Big Brother, residents now may recently launched Nexus Insights

shift their view on sharing data to rethink aging services in light Living Photo: Avanti Senior — both with their facility and of the pandemic’s effects. A resident of Augusta Pines at Avanti Living in Spring, TX, assisted their family members who can’t “Telehealth and telemedi- by a nurse, has a telehealth visit. get in to visit or reach nurses cine have overnight become during busy periods. the accepted ... practice in tions, broadband connectivity proliferating almost as quickly as Families, hospitals and pay- healthcare, and that has huge and telehealth devices. The FCC the use of virtual appointments. ers, she noted, also are watching implications for seniors hous- also has launched the broader, Amwell said use of its nursing how facilities have managed to ing,” Kramer said. “If we think long-term Connected Care Pilot home solution increased 350% care for residents at home dur- we’re going to continue to have Program, which makes avail- nationwide so far this year. It ing incidents that previously our overnight shift basically, for able another $100 million to launched a new app in April. might have precipitated an healthcare, use paramedics and help defray costs of providing Medici, already serving 20,000, emergency department visit. the ER, we won’t survive. Fami- telehealth services to patients reported a 1,800% increase in At Avanti, the HIPAA-compli- lies will not tolerate that.” at home or in mobile locations. provider registration in April. ant portal allows residents to log He predicts that payers, espe- Telehealth providers are Those who don’t receive fed- in and schedule visits monitored cially those running managed racing to launch new applica- eral funding or direct reim- by the operator’s national medi- Medicare plans, won’t accept tions, and software providers bursement still should like the cal director. Nurses join resi- hospital visits in the way they are helping long-term care return that comes from adding dents for their appointments, traditionally have, further providers integrate platforms or re ning services, McCracken equipped with iPads, e-stetho- speeding the use of telehealth. with existing devices, electronic said. Offsetting savings may be scopes and e-blood pressure records and health information found in reduced transportation cuffs. Such visits have helped Never more choices exchanges. Holiday Retirement for off-site care or less need for the communities assess whether For operators that aren’t neces- added telehealth access at all personal protective equipment. a resident might have COVID- sarily reimbursed for all of their 261 of its communities. Others Even as implementation 19, examine potential pressure telehealth services, the question have coverage in some locations, affects the bottom line, wounds and determine whether of investment remains. such as Wisconsin-based Heri- McCracken said it will be dif- an emergency department trip In late March, the Federal tage Senior Living’s use of Dic- cult to deny telehealth’s neces- was needed following a fall. Communications Commission tum Health’s cart systems in ve sity. “It shouldn’t be [viewed] Although it’s not a replace- chairman approved $200 mil- communities. as an expense,” she said. “The ment for a hospital in a true lion in congressionally appropri- To be sure, providers never expense of losing prospective emergency, virtual care has ated funds to support healthcare have had more choices about residents or staff not wanting reduced the number of Avanti providers’ COVID-19-related what services to use. The num- to come work for you — there’s residents going to local hospitals purchase of telecommunica- ber of telehealth platforms is a cost to that, too.” ■

www.mcknightsseniorliving.com • www.mcknights.com • June 2020 • Technology: Changing the Future 7 TECHNOLOGY: CHANGING THE FUTURE Robots and drones Pandemic shapes use of technology for older adults

By Kimberly Bonvissuto interaction, they do help resi- obots and drones are just dents feel more connected by two types of technology allowing more frequent video Rbeing called into service chats with families, physicians in senior living and care to and the internal teams. The address challenges presented robots also deliver packages to by the COVID-19 pandemic. residents’ rooms, and residents Shelter-in-place, social dis- are learning how to train them tancing and no-visitor orders to do certain tasks, such as pick- have senior living communi- ing up items from the dining ties looking for new options room. to keep residents engaged and “While the robots provide a connected. real functionality to normaliz- Connecticut-based Maple- ing daily life with strict social wood Senior Living found a distancing and social isolation creative way to support its resi- rules, the real bene t that we dents while maintaining their were hoping for and are seeing overall health and wellness by is their ability to lift the spirits of

introducing robot “friends” to Photos: Maplewood the residents,” Herlet said. “We its 15 communities in ve states. see our residents dance to the The Temi personal robots, music Temi plays, laugh along powered by technology from with its jokes, follow Temi-led Massachusetts-based Con- hallway exercise sessions, and nected Living, come with utilize the video chat function pre-con gured tablets, Alexa- to see family members who are enabled skills, a TV channel temporarily not able to visit.” with programming designed for According to Connected seniors, and a smartphone app “They’re cute. They’re entertaining. The residents love them,” Maplewood Living, the virtual learning to help seniors stay connected Senior Living’s Brian Geyser said of the robot “friends” in the communities. and engagement opportuni- with their families. clinical innovation and popula- tions. They’re just nice to have ties offered include live stream Maplewood originally tion health at Maplewood, said around.” religious services, entertain- planned to launch the Temi the company was looking into Temi interacts with residents ment, education, and art and robots as a unique feature at robotics, knowing it would via autonomous navigation, music therapy, including live Inspir Carnegie Hill, a soon- play a role in senior living in including 3-D mapping, navi- concerts, lectures and virtual to-be-opened, luxury mod- the future. With the COVID- gation, user detection and track- tours of museums and art gal- ern senior living residence in 19 pandemic, he said it was an ing, obstacle avoidance and path leries. The devices also can Manhattan, said Shane Herlet, opportunity to “pull the trigger” planning; dynamic video, audio offer programming to reduce Maplewood’s chief operating on a program to help residents and arti cial intelligence. The stress and anxiety, including of cer. The robots initially were cope with social distancing. Temi robots cruise around the guided meditation and yoga. going to be rolled out primar- “They’re cute. They’re enter- community interacting with Independent programming to ily for individualized education taining. The residents love residents and have become part keep residents engaged in their and entertainment, then phased them,” Geyser said. “They of the fabric of each community rooms or apartments includes into programming at suburban have kind of personalities. They now, Geyser said. reading materials, crossword Maplewood communities. tell jokes and they’ll give the Herlet said that although the puzzles, Sudoku, online trivia Brian Geyser, vice president of weather and they’ll ask ques- robots don’t replace human and gaming resources.

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The robots also can connect residents with telehealth ser- vices. “Temi allows us to safely check temperatures at the door, set up family and doctor social or health visits, and interact with unlimited engagement content,” said Connected Liv- ing co-founder and CEO Sarah Hoit. “We know that people who are actively engaged lead better lives, plain and simple. While we already rely heavily on tech- Photos: UPS nology to keep our residents engaged, the outbreak of the coronavirus has inspired us to nd creative new ways to do so, while keeping residents safe,” Maplewood President and CEO Gregory D. Smith said.

Drone delivery service launched Meanwhile, in Florida, resi- dents of The Villages, one of the country’s largest retirement In the new medication delivery program, deliveries are dropped autonomously by a drone near The Villages retire- communities, began receiv- ment community from a nearby CVS Pharmacy, then a UPS ground vehicle completes the delivery. ing prescription deliveries via eries from two additional CVS temperature-sensitive medica- pickup, this drone delivery drones in May, UPS announced. pharmacies in the area, UPS tions. The Federal Aviation service provides an innovative Deliveries are dropped auton- said. The ultimate goal of the Administration approved the method to reach some of our omously by drone at a location program is to make deliveries program under its Part 107 rules customers.” near the Sumter County, FL, directly, with the drone lower- for small unmanned aircraft “to CVS is the first retail part- retirement community from a ing packages by winch, accord- operate through the pandemic ner using drone delivery with nearby CVS pharmacy. A UPS ing to the company. and explore ongoing needs after UPSFF, although UPSFF and ground vehicle completes the “Our drone delivery service that period.” Matternet have been working delivery to the doorsteps of the will help CVS provide safe and The service follows a similar with the University of California community’s 135,000 residents. ef cient deliveries of medicines pilot program from UPSFF San Diego Health System and The service involves UPS to this large retirement com- and CVS to a North Carolina WakeMed Hospital in Raleigh, subsidiary UPS Flight For- munity, enabling residents to retirement community resident NC, where they have completed ward, established in 2019, and receive medications without in November. more than 3,700 flights since CVS Health Corp. subsidiary leaving their homes,” Scott “Now more than ever, it’s launching service there in CVS Pharmacy, using the Price, UPS chief strategy and important that our customers March 2019. M2 drone system developed transformation of cer, said in have access to their prescrip- UPSFF and Matternet are by UPS partner Matternet, a a statement. tions,” Jon Roberts, CVS Health now testing service in Virginia California-based aerial deliv- The drone service program executive vice president and with the U.S. government and ery company. supports social-distancing dur- chief operating officer, said partners to determine how The first flights have been ing the COVID-19 pandemic in a statement. “In addition to drones can assist medical pro- less than a half mile, but the and is meant to provide faster, our in-store pickup, free deliv- fessionals in the fight against potential exists to expand deliv- same-day delivery of time- or ery services and drive-through COVID-19. ■

www.mcknightsseniorliving.com • www.mcknights.com • June 2020 • Technology: Changing the Future 9 TECHNOLOGY: CHANGING THE FUTURE Tech use balloons in shrinking COVID-19 world Devices and virtual care capabilities have become more than accessories

By Kimberly Marselas survey, with almost half of all ablets, telehealth and other participating providers report- technology have long been ing use of some kind of tool Tpart of the model of care at offering connectedness via a The Allure Group, a network of mobile device or television. six New York City skilled nurs- But, Alwan acknowledged, ing facilities. the coronavirus and the social Therapy robotics, remote distancing requirements it has monitoring and social engage- necessitated undoubtedly have ment platforms were available to changed the habits of providers most of the chain’s 1,400 clients, and residents. though many shied away from “The foot in the door we’re various technology because they seeing is the social connected- simply weren’t accustomed to it. ness aspect, but the develop- But since the COVID-19 ers are starting to layer in and outbreak arrived in the United exploit the platform for addi- States, devices and virtual care tional needs-based aspects, capabilities have become more what I call the ‘wants-based than accessories. As is the case services,’” Alwan said. with many healthcare provid- If a community already has ers and senior living operators, given its residents tablets, devel- Allure expects more — and opers are jumping at the chance more powerful — technology to equip that same device with tools to remain a permanent and medication reminders or com- Photos: The Allure Group Photos: The Allure robust part of its business model A resident uses an in-room tablet equipped with PadInMotion at The Allure munity-wide messages or enable long for the foreseeable future. Group in hard-hit New York City. it with remote vitals-tracking “While this pandemic has services. been uniquely dif cult for all There also has been a spike in healthcare and eldercare facili- interest in voice command and ties, having cutting-edge tech- “Having cutting-edge technology voice interaction tools because nology in place has helped us in place has helped us weather of their intuitive user interfaces, weather this most challenging Alwan said. Such devices can time to the best of our abili- this most challenging time.” help with in-room needs such ties,” said Joel Landau, Allure’s Joel Landau, Allure founder and chairman as food ordering or connecting founder and chairman. “If the with a concierge to schedule a crisis encourages a wider-spread services providers. LeadingAge compared with previous years. telehealth visit. adoption of life-saving technol- and senior-focused investment Only the use of telehealth, If resident devices have cam- ogy, it’s certainly a silver lining bank Ziegler team up for an telemonitoring and medica- eras and secure access, then in an otherwise catastrophic annual survey of the nation’s tion monitoring tools had grown providers even can repurpose event.” 200 largest nonpro t aging ser- signi cantly between 2013 and them for remote physician or Majd Alwan, Ph.D., Leading- vices providers that pinpoints 2018. therapy visits — and from there, Age executive director for the technology trends. providers are able to incorporate Center for Aging Services Tech- The 2019 report found tech- Engagement growing nurses’ notes and diagnoses into nologies, or CAST, tracks tech- nology adoption rates were Social engagement tools have their electronic medical records. nology adoption among aging stagnant in many categories only just entered the tracking In 2018, about 75% of all LZ

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200 technology survey partici- pants used EMRs — many of them on the senior living side.

‘At an inflection point’ Alwan expects the urgency of the current situation will turn some users into permanent adopters. “We’re at an in ection point,” he said. “I don’t see this going back to ‘normal.’ It will be sim- ilar to what’s happening with telework and online trainings.” Usually, technology begets more technology, Alwan added. Don’t necessarily expect pro- viders that start spending money on telehealth services or engagement suites to cut back elsewhere in their technology Photos: Ziegler, LeadingAge Photos: Ziegler, budgets. Lisa McCracken, Ziegler director of senior living research and development, and Majd Alwan, Ph.D., executive In fact, many will have to director of LeadingAge Center for Aging Services Technologies. spend more to keep the ser- vices they’re implementing reluctant seniors to use more advantage during this time,” now dependable and accessible. technology. McCracken said. There likely will be more pro- For instance, Allure’s year-old “We’re at an Both she and Alwan expect vider investments in network Samsung tablets are equipped in ection point. that future LZ 200 surveys bandwidth, internet speed, with PadInMotion, which can will reflect increased adop- blanket WiFi and related com- power anything from food I don’t see this tion, although the urgency of ponents, Alwan predicted. ordering to telemedicine solu- going back this year’s crisis will make select “Clearly, the virtual realm and tions. categories spike. Other catego- technology medium has just “While they initially provided to ‘normal.’ ” ries, such as the already highly exploded during COVID-19,” residents with entertainment Majd Alwan, Ph.D. popular EHR, likely will con- added Lisa McCracken, direc- and stress relief, they are now tinue steadily chugging upward. tor of senior living research and helping them stay in touch with For every new technology development for Ziegler. “Yes, their loved ones over audio and adopted, of course, providers it’s out of necessity. But people video chats,” Landau said. tion through telehealth. get more data about residents, are also adapting really well and User rates have “skyrocketed,” their families and staff mem-  nding they may never go back. he adds. Vendors innovate in new bers. And savvy providers likely ...We have advanced more in the Allure staff members also ways also will invest in tech that can last two months than in the last added a “call tree” app that Providers and their employees put that information to work. several years.” allows representatives to offer aren’t the only ones becoming Landau said that having his families hotline access for video more nimble. Vendors also have Coming from CAST staff members trained to use conference scheduling or con- innovated in ways unthought of Later this year, CAST will technology pre-COVID-19 dition updates and rolled out just a year or two ago. launch a new selection service helped with increased use dur- Vis-a-Vis, a service for virtual “The companies that are for data analytics tools that pro- ing the crisis. But restrictions on doctor visits post-discharge. able to do a quick pivot and duce business intelligence, and visitors — and shifts in how the Patients are given a small, add on services remotely [with Alwan expects the category to federal government covers tele- handheld device to take home no need for in-person installa- show up on the 2021 LZ 200 health — also have encouraged and help manage their transi- tion], they’ve been at a strategic data. ■

www.mcknightsseniorliving.com • www.mcknights.com • June 2020 • Technology: Changing the Future 11

TECHNOLOGY: CHANGING THE FUTURE 4 costs associated with tech adoption

By Jared Darlington a light bulb, but now, that light nnovative senior living and bulb may be a greater cost and care organizations and lead- may need to be integrated into Iers are using technology to the smart lighting system. improve the care and service experience for residents, fami- • Operational costs lies and staff members. Operational costs must be Before embarking on a new addressed in many aspects, from technology within your com- the beginning of any new proj- munities or facilities, conduct ect. What are the actual costs a deep dive into the benefits associated with additional staff for both your residents and members and training to use organization, from a resident the new technology? Will this experience and operational technology require additional, standpoint, and compare the specialized IT staff members, potential outcome with the or does the technology provider costs. Does this technology offer support from a technical address current issues within standpoint at an included or your organization by increasing Images Plus Photo: Supoj Buranaprapapong/Moment/Getty additional cost? Determine the costs and benefi ts before undertaking any projects. your quality of care, and are you As an organization, you will prepared to continue to invest in need to determine the cost/ technology in the future? bene ts before undertaking any Five years ago, new technology Before embarking on a new technology project for your communities. in our sector may have consisted within your facilities, conduct a deep Understanding these points in of electronic medical records, all phases of implementation point-of-care systems and com- dive into the bene ts for your residents can help any organization maxi- munity internet access. Now, and organization. mize the bene ts and minimize these technologies are expected. the cost while providing the The next generation of new best possible experience for technology consists of resident Capital costs include costs of of your  eet of devices that may the residents and family mem- monitoring, wearable devices equipment for your commu- need to be replaced. bers. ■ and telemedicine/telehealth, nities/homes that your staff among other types. may use (such as tablets and • Subscription costs The cost of adding new tech- mobile devices), upgrades to the Subscription costs could include nology to your organization structure of your homes (secu- monthly internet costs required should be viewed according to rity, fall-monitoring systems, to run new technology and costs upfront equipment expense, smart-enabled lighting) and associated with software plat- monthly subscription/main- costs for wearable devices for forms that can consist of addi- tenance costs and operational your residents. Leasing offers tional use costs for telemedicine. cost concerning staff time. As bene ts over ownership, from an organization, you will need both a cost and future upgrade • Maintenance costs to identify what costs you can standpoint. Maintenance costs include absorb and whether your pric- Also, as devices become small- anything associated with the ing model allows costs to be er, the chances for devices to go upkeep of your technology. A passed on to residents. missing (via theft or misplace- good example is smart lighting. The author is the founder and ment) become greater. Consider In the past, your maintenance CEO of Symmes Township, OH- • Capital costs factoring in a certain percentage staff simply may have replaced based Cornucopia Family Homes.

14 Technology: Changing the Future • June 2020 • www.mcknights.com • www.mcknightsseniorliving.com TECHNOLOGY: CHANGING THE FUTURE 2 steps to help with cyberattacks, data breaches

By Bradford P. Meisel, Esq., and Diane D. Reynolds, Esq. he healthcare sector, including long-term care, Thas become a primary target of cyberattacks and data breaches. Data breach incidents increased by 424% between 2017 and 2018, according to a 2019 report by cybersecurity rm 4iQ. Cybersecurity research firm Protenus found that 285 healthcare data breaches affect- ing more than 31 million patient

records occurred between Janu- Mulvaney & Carpenter Deutsch, Photos: McElroy, ary and June of 2019. Diane D. Reynolds, Esq., and Bradford P. Meisel, Esq. Such incidents include ran- somware attacks, in which tration, financial institutions in healthcare law, including malware prevents a provider and credit reporting agencies HIPAA compliance. This rm from accessing its computer to process death records, and Long-term care can retain and supervise tech- system unless it pays a hacker because grieving family mem- facilities can face nology experts and professionals a requested amount of crypto- bers are unlikely to check their to evaluate your cybersecurity currency, and data breaches in recently deceased loved ones’ serious risks, develop and institute inci- which hackers obtain residents’ credit, ghosting often can go consequences dent-prevention measures and and patients’ personally identi - undetected for weeks or even best practices, and ensure com- able information. months. in the event pliance with HIPAA and any Many such incidents have dis- In 2018, cybersecurity of a data breach other applicable federal, state rupted and compromised resi- researchers observed hackers on and international data security dent and patient care, including the dark web selling large collec- or cyberattack. and breach noti cation laws. in long-term care. Moreover, the tions of recently deceased older Second, purchase cybersecu- number of deaths that occur in adults’ medical records that rity insurance to cover liability long-term care facilities make potentially had been obtained Long-term care facilities can in the event of a data breach and such facilities desirable targets during cyberattacks on pro- face serious consequences in the business interruption and reme- for cyber criminals. viders. These records contain event of a data breach or cyber- diation costs that are incurred Hackers have begun to obtain names, Social Security numbers, attack if they are found to have as a result of such an incident. ■ and use the personal informa- phone numbers, addresses, violated the Health Insurance tion of recently deceased indi- dates of birth and insurance Portability and Accountability viduals in a practice known as information. Therefore, long- Act. Fines for HIPAA violations Diane D. Reynolds, Esq., is a “ghosting.” According to the term care facilities that pos- can total as much as $1.5 million partner at McElroy, Deutsch, AARP, identity thieves annually sess personally identifying and per entity per violation. Mulvaney & Carpenter, LLP, use the identities of more than identi able information about who heads the firm’s cyberse- 700,000 deceased Americans recently deceased residents and What’s next curity, data protection, and pri- to “open credit card accounts” patients can be inviting targets So what steps can a facility take? vacy practice. Bradford P. Meisel, or obtain services. Because it for hackers seeking to sell vast First, retain an interdisciplin- Esq., is an associate at McElroy, can take up to six months for collections of data for use in ary team of professionals headed Deutsch, Mulvaney & Carpenter, the Social Security Adminis- large-scale ghosting schemes. by a law rm with experience LLP.

www.mcknightsseniorliving.com • www.mcknights.com • June 2020 • Technology: Changing the Future 15 MANAGER’S TOOLBOX: TELEHEALTH Telehealth innovations are on the horizon The new model can be a ’weave of services that support and protect the patient’

By John Hall Residents and patients are seen elehealth has come quite a when they need to be seen. long way since rst being mentioned in an 1879 Lan- when companies assign clini- Tcet article that brie y hinted at cians to specific facilities, so the futuristic concept of using a people and their care provid- telephone to avoid costly physi- ers are able to bond. cian of ce visits for relatively Innovations on the horizon, trivial matters. Now a pair of Chess and Eisenberg say, include health industry professionals predictive analytics in treatment think telehealth can be taken regimens, which offer an addi- to new frontiers in what they tional proactive measure to help call an entirely new category. avoid trips to the hospital; live It’s “a weave of services that patient monitoring; a Quality support and protect the patient, Assurance and Performance resident and the facility,” says Improvement playbook to help David Chess, M.D., founder, facilities minimize medication Photo: warodom changyencham/Moment/Getty Images Plus changyencham/Moment/Getty Photo: warodom CEO and chief medical offi- use and drive best practices; and cer of TapestryHealth. The person needs to go to the hos- tor in the new model is the abil- tools to help clinicians, MDS company recently changed its pital or can be safely cared for ity to have a specialist network nurses and facility staff accu- name from TapestryCare to in the facility by a nurse. in each geographic area in which rately capture diagnoses. ■ reflect a service consisting of The new model they advocate, the telehealth company operates. primary care physicians who not however, integrates a network “These are highly renowned only evaluate but treat nursing of general practitioners and specialists that most facilities home residents while doing specialists around freestand- and their patients would never Three Tips everything from prescribing ing telehealth hardware inside have access to,” he adds. Contact the telehealh ser- medication and ordering lab each nursing facility, Chess says. In the case of TapestryHealth, vice immediately whenever tests to hands-on wound care. In addition to making daily the hardware involved is a pro- 1 help is needed. The tech- Ideally, Chess says, tele- virtual rounds in each client prietary platform designed to nology always is secondary health should be “a platform nursing facility, for instance, bring instant remote consulta- to the people behind the screen. for patient-centric holistic clinicians review each resident’s tion with one-button technol- “We have created a savant group of clinicians experienced in caring medicine” that integrates care or patient’s records while work- ogy in the privacy of a resident’s for people in skilled nursing facili- “around the patient.” ing with facility staff to create room. On-board diagnostic ties but also genetically driven to Traditional telehealth, accord- care plans and keep local doc- equipment, as well as a high- treat people as if they are family,” ing to Chess and his business tors and families informed. de nition camera system, allows Chess says. “Our job is to enable partner, Mordy Eisenberg, co- Such integration of 24/7 on- and clinicians, with the assistance of these great clinicians to provide founder and chief operating offsite clinicians with remote facility caregivers, to conduct their care as e ortlessly and of cer, often is a stop-gap prod- evaluations is essential to reduc- extreme close-up examinations, e ciently as possible.” uct through which a random ing or eliminating rehospitaliza- le photos of the exam as part of physician sees a patient remotely tions, Eisenberg says. the individual’s medical record, Practice early report- and determines whether that Another important differentia- and make accurate assessments ing. Early detection of a change in condition is before treatment. 2 paramount. “Along with EXCLUSIVE TELEHEALTH SPONSOR “Nursing home residents are remote monitoring, this will save seen when they need to be seen, lives,” Chess says. without having to face the stress of leaving their facility ‘home’ Keep the remote care unit when they are already compro- close at hand. Facilities mised,” Chess says. 3 need to make it easy for WWW.TAPESTRYTELEHEALTH.COM Ideally, Chess and Eisenberg nurses to access it. believe, residents are best served

16 Technology: Changing the Future • June 2020 • www.mcknights.com • www.mcknightsseniorliving.com Introducing the latest game changer in skilled nursing facilities:

If you’re like most facilities, you don’t have real-time 24/7 coverage. In an urgent care situation, you call the doctor and wait for a call-back. You may have an overnight service that uses a simple video tablet for overnight assessments, but you and your patients need a whole lot more than that. Older, vulnerable patients need to be seen at all hours of the day and night. They can be difficult to deal with or have behavioral issues, or need the care of a specialist which you don’t have on staff and may not have easy access to, if at all.

We’ve solved all that by assigning a board-certified clinician to your facility with a support team available 24/7. We work on-site or remotely and our network of specialists represent multiple medical specialties, those most often needed in nursing homes. Tapestry’s clinicians integrate seamlessly with your staff and local doctors, we keep families informed and EMR systems up to date and accurate.

TapestryHealth helps improve QMs, CMS ratings, census and reimbursements. When we say we improve lives, we mean YOURS - patients, families, staffs, administrators and owners.

Join us. Become one of the hundreds of TapestryHealth facilities that are improving care, increasing profitability, and changing the face of healthcare.

To learn more, visit our website at www.TapestryHealth.net or call us at (203) 666-8145 MANAGER’S TOOLBOX: PROPERTY MANAGEMENT AI and predictive analytics are coming For its mitigation capabilities, facility maintenance is more important than ever in the COVID-19 era

By John Hall Computerized maintenance acility management in management systems can save senior living and care work and money. often has been unfairly ciency and avoided repair costs. Foverlooked when everything Those CMMS providers with works, Dan Roberge believes. an edge typically rank high in That all changed when the customer service and customiza- coronavirus hit. tion options, he adds. The recent outbreak of COVID-19 and its dispropor- Future innovations tionate effect on residents and Facility managers can look for- their caregivers have awoken ward to a plethora of improve- the public to the importance of ments, many of which will be a well-maintained facility, says shaped as databases mature. Roberge, president and CEO of Artificial intelligence also Maintenance Care. “From pan- could play a more prominent demic preparedness to imple- role in future systems by pre- menting quarantine measures dicting better solutions and and performing sanitization work processes for more indus- tasks, facility maintenance plays Images Plus Photo: FG Trade/E+/Getty tries. They’ll also empower a more-important-than-ever healing environments for senior progress-tracking. I see a large future systems to dispatch role in mitigating the effects of members of society to enjoy potential in streamlining work maintenance staff according to the virus outbreak on people’s around-the-clock professional processes and task management, changing variables such as loca- health and safety,” he says. care in a community of peers.” which can improve buildings’ tion, task urgency and weather. “I believe that the changes we Client communities often tell overall quality, functionality, Near-future improvements are seeing right now will leave Roberge they never will go back safety standards and asset value.” will include 3-D virtual spac- an impact on the way our society to paper documentation and es, voice assistant support and approaches senior care and pan- spreadsheets after switching The switch to CMMS seamless program integration. ■ demic preparedness in general,” to cloud-based computerized CMMS systems can vary widely he adds. “And I certainly hope maintenance management sys- in adaptability, ef ciency and it will be for the better.” tems (CMMS), which can save customizability. “Most of them Facilities are more than just work and money. will do the basics, but some businesses, Roberge says. They “It’s an upward spiral of mutu- facilities require veritable trea- Three Tips are places where healthcare ally reinforcing supply and sure chests of functionality to Invest in a computerized professionals, administrators, demand, and I believe that users yield the expected bene ts,” he maintenance manage- housekeepers, cooks, custodi- will keep reaping the bene ts of says. Roberge advises manag- 1 ment system (CMMS). ans, physiotherapists, volunteers, current and future technological ers to choose systems based on Build a habit: No matter family members and people in progress,” he says. “A lot of work their community’s priorities and how you use the CMMS numerous other roles “come time in facilities gets lost because to not be intimidated by such 2 of your choice, it’s most together to create safe and of a lack of coordination and futuristic tools as voice-assisted powerful if you fully com- implementation. mit to using it. Especially during “Don’t make cost the deciding COVID-19 and quarantine, com- EXCLUSIVE PROPERTY MANAGEMENT SPONSOR factor,” he cautions. “Mainte- munication features and remote nance software starts at about progress tracking options have the same price point as an aver- proven to be invaluable. age monthly mobile phone con- Binders of paper snip- tract and goes up to about the pets and report sheets price of monthly car insurance.” 3 have their place, but it’s WWW.MAINTENANCECARE.COM Because of this, CMMS pays for not in maintenance. itself many times over in effi-

18 Technology: Changing the Future • June 2020 • www.mcknights.com • www.mcknightsseniorliving.com