The future of senior living and health care will be more closely linked, as technology continues to evolve and further support providers’ efforts in caring for the next generation of older adults.
“The barrier has always been, in my opinion, technological integration,” Inspirit Senior Living COO Jonathan Barbieri said during the most recent episode of the Senior Housing News Transform podcast.
But now, Inspirit and other senior living providers are able to track individual resident health data and respond more quickly to the needs of ancillary health care systems. For example, when a resident is discharged from the hospital and placed in assisted living, operators have the ability to personalize care plans and life enrichment offerings.
By integrating more technology into senior living operations, specifically systems supporting artificial intelligence, Barbieri sees an opportunity for the industry to better serve older adults. This means giving staff more time with residents and families.
Inspirit Senior Living is tackling new growth opportunities this year with an eye on becoming a super regional provider. The company manages over 36 communities in 11 states, and Barbieri said an annual 20% growth rate is possible as the company adds new communities under management.
“I see us growing at a pace that will change each year, and it will be driven not by a rigid design forced upon a group, but by a constant evaluation of what we can do well, and perhaps more importantly, what we can do better than someone else,” Barbieri said.
Listen to the full episode of Transform here.
Editor’s note: The following podcast transcript has been edited for length and clarity.
On becoming a super regional senior living provider:
Our initial design was actually not to be a super regional provider; it was to be the most capable provider, the most adept provider, the most flexible provider, knowing that the baby boomers coming ashore were a little different than the seniors that had come before them, their expectations, their wants, desires. As we continued to embark on that journey, we realized that resources were paramount, economies of scale in an environment where inflation and other pressures outpace a senior’s ability to save or produce additional revenue—and so both of those situations prompted us to seek growth. That growth is something that has enabled us to provide more options, more resources, and hopefully a better value at the end of the day, and so that’s our core reason to grow.
There’s always that innate drive to serve more people; there’s always that belief that something we’re doing is just a little bit better and therefore it is a responsibility to offer that to more people. We’ve been really very fortunate. We have a lot of incredible team members that really do view themselves as partners in this journey and so whereas in other companies of other shapes and sizes, perhaps growth could be something that induces fear for our team, we very much created a culture where growth creates a bit of a dreamscape. What’s possible next? What did we learn from our last five years, our last 10 years and how can we apply that moving forward? And so I see no reason why we should slow down at this point. We have a very ambitious and talented team. We have a great structure that I think is very unique to the industry, which allows for a lot more flexibility and a lot more internal growth and so we’ve got a large bench of extremely talented, ambitious people ready to take on the next challenge.
On the next generation of senior living customers:
I think the primary difference between the current customer base and the preceding generation is a fierce sense of independence. With prior generations, our approach was more suggestive or clinical. Someone comes into an office and says they have a pain in their leg. The doctor assesses it, comes up with a treatment plan and the patient follows that plan. That model was very similar to the process flow for someone coming into our communities.
The baby boomer generation is a very independent, very unique group of individuals and they want that uniqueness to follow them throughout the remainder of their days. As a result, there’s a slightly different pathway to welcoming them into the community. Frankly, that’s not where it stops. It’s also about identifying the unique wants and desires of each individual, because if you fail to incorporate those into their journey, they’re not fully satisfied, and I don’t know that we’re truly doing them a service.
Our commitment is to create a space that reduces care needs, worry, and fear so that, while someone’s capacity may be different than it was when they were 30, we’re taking on the portions they may no longer be able to compensate for themselves. That allows them to get back to the energy and zeal they had in their 20s or 30s.
On growth of Inspirit platform:
Nobody wants to have something special at two communities and then something less special at any larger number. I think we’ve achieved that in spades.
We took some very hard paths through the pandemic. We chose to be very frugal during that period of time and while it’s not talked about much now, our team as a whole sacrificed quite a lot toward the greater good. Without going into a lot of detail, it was a shared sacrifice. During that time frame, we had very open and transparent conversations with all of our team members about the challenges that beset the industry and we had zero turnover. Not a single team member, at any level, left. That’s incredible. It truly is.
That gave us a lot of enthusiasm, and more importantly, the team feels very invested. So what do you do with that investment? It becomes our opportunity to apply that investment, that interest in the future, and that desire to be part of something different and better while providing opportunity. That was the logical stair-step into growth. Growth can create challenges: logjams in processes, the identification of issues, or limitations in how you’re processing something or performing a particular task. You don’t have that when you have an army of more than 2,000 people who are singularly motivated to be the best, because those problems generally get identified, addressed, solved quickly, effectively and openly.
Although we’re not the oldest organization, I like to believe we’re the wisest because we have the ability to take the aggregate years of experience across all of our team members and, to the best of our ability, which I think is pretty good and apply that knowledge. We talk a lot about AI. It’s the buzzword of the day, most definitely. I think we’re SLI. I think we’re Senior Living Intelligent.
On senior living being more closely linked to health care:
Yeah, I think that’s one of the simpler questions to answer and the reason is that there’s a lot of precedent if you look historically at what happened to nursing homes, hospitals, respite homes, hospice, physical therapy and occupational therapy.. There’s a ton of precedent and all of them have a singular tie. There was a huge demand or need that existed and a solution set was proposed, generally speaking, by the funding source, whether that be the government, Medicare, or Medicaid. That really expedited the process and, more importantly, created the synergy for each of those respective industries to coalesce around a common approach.
Senior living has had the benefit of what I would call an incubator industry. It’s one thing to have 10,000 organizations or sites all doing the same thing because that’s perceived as the best route. That’s one option. I would propose it’s a better journey to have 10,000 sites all approaching the problem and the solution slightly differently. Therefore, you get much more rapid progression.
I think that’s where senior living is poised and more importantly for this conversation, I think that’s where Inspirit is poised—a group of individuals who can, without pride, really look at all the situations and all of the solutions, not only ours but others, and start to say, ‘We like that. That works. Let’s apply that.’ There is no technical constraint on our ability to do that and therefore we should be advancing at a much more rapid rate than any other industry.
Your question was around our integration into the other spaces and therein lies a challenge. The challenge is much easier now than it ever was before because of the ease of technological integration and that’s been the barrier. It’s not a willingness or a desire to integrate. The usual avenues that would drive that integration, a governmental intervention, a funding source, or a logical progression deemed necessary by Medicare, don’t exist within senior living per se. However, they can exist because senior living is a less expensive, more effective option when appropriately used within that continuum of care.
The barrier has always been, in my opinion, technological integration, so that we can meet the speed and demand of those complementary health care industries. Thanks to the advent of AI, as well as other technologies, we now integrate. We can see the information the hospital is providing in real time. We can take that admission as quickly as they need us to, or as quickly as the individual needs us to. Even better than that, once we receive that individual, we can adapt on the other end and course-correct as quickly as possible within the confines of the regulatory environment we work in to meet their needs and be successful.
On priorities in operations:
This year is really the culmination of several decades of effort, which is great. It’s a perfect question and perfect timing. For the last decade or so, we’ve been working to address what the industry has deemed the ‘broken rung,’ and we’ve really taken it upon ourselves to address this more aggressively than perhaps anyone else. The reason is that our industry is so reliant on talent. We created a program called S3, which stands for systems and supports equals success. It’s essentially an internal university, coaching method, and support system that gives all of our team members access to career progression opportunities. By doing that, we’ve developed an army of individuals whom we’ve identified as ambitious, intelligent, talented and most importantly, curious. It’s that curiosity that allows us to pair them with mentors and teachers who help prepare the next generation.
Why that matters is that it allows us to scale. This year is an opportunity for us to apply that at scale, to bring on more communities, support more team members, and serve more seniors. We’re doing it with a group of individuals who aren’t new to the landscape and weren’t hired from the outside. These are people who have been with us. They understand our systems, they understand our perspective, they add their own perspective, and now they’re ready to do something special.
So this is a year of growth, but I think the most important aspect of that growth is that it’s not growth driven by one individual, or even by a company pursuing a purpose beyond a very simple one. The reason we’re growing is because we believe we can serve more people. We believe there’s a huge demand for a certain and specific approach and when done correctly, you can save lives. You can save lives by bringing people into a community earlier, thereby preventing some of the challenges that occur when a senior is home alone, neglected, malnourished, or loses inspiration for life itself. This year is really exciting because we have over 100 people within that program. Those individuals have incredible ambition and have been coached over several years to do exactly this, to go into that next community, or to look internally at our existing communities, and say, Let’s apply everything we’ve learned from every acquisition and every engagement, not only to our new communities but also to our existing ones. Let’s keep that feedback open and honest.
On where future growth could happen:
So I see us growing at a pace that will change each year, and it will be driven, as I mentioned before, not by a rigid design forced upon a group, but by a constant evaluation of what we can do well, and perhaps more importantly, what we can do better than someone else. We feel very well positioned to grow and to offer something special and unique.
What we’ve concluded is that a growth rate of about 20% per year is sustainable, achievable, and allows us to do something that I think other organizations haven’t. Growth for the sake of scale can be a goal, but growth also means accumulating more knowledge every time you expand. You’re able to apply that knowledge to everything you’re already doing, and that brings us back to the original goal: giving us the tools to improve the senior experience, shorten the decision-making process, and increase the amount of enjoyment and time seniors get to spend within the community environment.
You also posed a really good question that we all struggle with: How do we make this as affordable and approachable as possible? Without government intervention, like you see within hospitals or nursing homes, that is challenging. But we are committed to doing our part by being intentional with our cost structure. At the end of the day, there are generally two audiences involved in the decision-making process. There’s the individual themselves, and then there’s the support group around them. Unfortunately, those audiences often have different perspectives. I think for too long our industry has focused heavily on engaging the perspective of the consumer who isn’t living with us versus the consumer who is.
When you ask the consumer who is living with us what matters most, the answer is often much simpler. Their core needs and desires are more fundamental than those of the younger generation. Generally speaking, they want support. The large staircase, the piano, the grand entrance, those things are nice, but do they provide care and compassion? Do they provide comfort when I’m not feeling my best and I want to meet my friends down the hall? Those are the core human desires that matter most and that’s where our focus lies. One of the positive consequences of that philosophy is that those human desires are not exponentially expensive to meet. We can meet those expectations at a much lower cost structure than if we had to install a $15,000 chandelier because it looks beautiful. When given those choices, we understand that an environment that feels opulent can breathe life into someone. I didn’t grow up in a mansion, but it might be fun to live in one with my best friends. Those things can absolutely be motivational. But there’s a balance. Those benefits can’t come at the cost of creating the same barrier that prevented many of us from living in a mansion in the first place. Perhaps that barrier was cost. Perhaps it was desire.
On staffing dynamics facing senior living:
We look at staffing and the labor force a little differently than what I’ve heard reported, seen articulated, or heard articulated by colleagues. You’ll often hear that the labor market has changed, that the talent pool has evaporated, or that it’s harder to hire people and harder to keep great people. I disagree.
I think people, for the last 10,000 years, and I wasn’t there then, but I have to guess, have been largely similar. By nature, we’re hunter-gatherers. We want to provide for the people we love. If we pay attention to those core innate desires, not only for our seniors, which we’ve talked a lot about, but also for our team members, people stick around. People want to be part of that. If we pay attention to the fractured nature of our society and the perhaps less meaningful connections we make through social media and some of the current trends around what it looks like to be successful or happy, and instead focus on what it actually means to be happy, the answer is often quite simple.I get to go home and tell my family I did a good job. I get to make sure they don’t go hungry. I have transparency into my future. I feel like I’m part of something. Regardless of my role, I’m respected enough to be informed and to be part of the decision-making process. When we do those things, we don’t have staffing issues.
On technology influencing the future of senior living:
Yeah, I’ll start answering that question with a statement: I too used to be young. When I was younger, I had tremendous hope for technology and how it could solve the challenges facing our senior population. Like everyone else, I saw the advent of technologies such as Amazon Alexa and Siri, and I also saw what felt like a missed opportunity or an awkward gaze away from our industry and toward everything else. Our industry is not inconsequential but at scale it is nowhere near the size of hotels or hospitality in general.
We are one of the few sectors I can think of that is still grounded in a mom and pop approach. As we grow as an industry, we cannot lose that. If you go back to my earlier point about 10,000 communities all solving the same problem, that is like having 10,000 scientists working to solve cancer. They will solve cancer. Likewise, we will solve and create the best senior living experience.
I personally believe that technology has finally evolved into a solution that we can all apply. While we do not have true AGI, we do have AI. As we have scaled, we have been able to build an internal team of highly talented individuals who spend a large portion of their time studying the application of AI and building custom GPTs to solve problems that are generally repetitive or rudimentary. I think the future allows for greater focus on the individual because those repetitive and time consuming tasks can be handled predominantly by machines. Not replacing people, not at all, but giving people more time to focus on other people, something machines will never be able to do.
That is where a tremendous opportunity exists. It allows us to be more comprehensive in what we offer. It also provides an opportunity to be more effective and efficient in how we apply resources. Our greatest and most cherished resource is our team. The buildings are simply the substrate for what we apply through education, learning and the culture we create within our organization. If we were an organization based solely on buildings, that would be very different. We are not. We are an organization based on team members and individuals that happens to operate within physical structures.
On outlook for senior living:
The future is very bright. It is up to all of us to embrace what is available and continue pushing the envelope on what is possible so that we can serve people more effectively, more quickly and hopefully in the most efficient manner possible. I think doing that will eventually address cost barriers as well as integration into other areas, whether through [Accountable Care Organization] integration, which is becoming more prevalent. It is not the complete solution but it is a step forward.
All of those advances depend on our ability to integrate effectively. Thankfully, one of the benefits of AI is that, unlike traditional API integrations that require one to one parity, AI can bridge differences in language and structure. In a traditional system, if I call something a hockey puck and you call it a hockey puck, everything aligns neatly. With AI, you can have different systems and different languages all attempting to address the same thing and AI can connect them efficiently. That means each operator can maintain their own unique approach while still integrating with other resources.
For the first time, I think that makes us a much better partner with governments and other payment sources outside of the senior and hopefully with the senior as well.