Assisted living facilities continue to represent one of the largest growth opportunities for hospices in the coming year, according to industry leaders who responded to the Hospice News 2021 Outlook Survey. The prospect of growth in assisted living remains promising despite challenges accessing patients in many locations due to restrictions brought on by the coronavirus pandemic.
Assisted living facilities offer the most potential growth as settings for hospice services, according to results from the 2021 Hospice News Outlook Survey and Report sponsored by Dallas-based tech company Homecare Homebase. Of more than 160 hospice professionals, including owners, executive leaders and managers, 15% indicated that assisted living facilities would be the largest opportunity for growth in 2021. About 38% responded that these settings would offer the most potential growth over other settings such as skilled nursing facilities, hospitals and inpatient units at 32%, 15% and 7%, respectively.
Assisted living facilities rose in potential from last year’s survey findings, in which hospices also indicated that they expected to see substantial growth in this setting.
The largest opportunity for hospices in 2021 comes alongside their biggest challenges as the pandemic continues to pummel organizations’ operations and finances. As many facilities closed their doors to visitors to minimize spread of the virus, hospices faced tremendous strain accessing patients.
“The significant challenges of accessing patients as experienced in skilled facilities will continue to be roadblocks to the personal touch kind of hospice care and may decrease opportunities to increase assisted living facility referrals,” said Sharon Branham, president and CEO of Kentucky-based Appalachian Hospice Care. “Assisted living is an area of growth opportunities for hospice programs dependent upon several factors.”
One of the largest factors will be regaining access to settings such as assisted living facilities as COVID-19 vaccines continue to roll out across the country. Regaining regular access to hospice patients in assisted living or other facilities was a top concern related to COVID-19 among nearly 45% of the Hospice News survey respondents.
Other driving factors include demographic tailwinds and increased interest in assisted living among seniors. Hospice utilization among Medicare beneficiaries is greater in assisted living facilities than many other settings, including private residences, according to research published in Health Affairs.
More than 12% of Medicare beneficiary decedents in 2018 received hospice care in assisted living facilities, according to a report from the National Hospice & Palliative Care Organization. That setting saw the most expansion during 2013 and 2018, exceeding by 40% over nursing homes or inpatient hospice centers.
Building census in assisted living facilities should be a focus for hospices during 2021, according to Shelley Cartwright, CEO of Illinois-based APEX Hospice and Palliative Care. Cartwright told Hospice News that facility operators are increasingly integrating the hospice care stage into strategic planning.
Evolving health care delivery and payment models will continue to shape how hospices strategize and work with assisted living facilities. Payers and providers want to help patients remain in their homes to reduce health care costs.
“Assisted living facility operators began to recognize that hospice is a care stage for [their] residents and have included it in their strategic planning,” Cartwright said. “Together, hospices and assisted living facilities [can] recognize the unique value that hospice offers to residents. Assisted living facilities allow our hospice agency to have a healthy and stable growth with an improved length of stay. This also provides stabilization of the assisted living facility census.”