Episode 108: Current Senior Living Development Trends

Intro: [00:00:05] Welcome to Senior Living Visionaries, a podcast for senior living leaders who are looking to stay ahead of the curve in the industry. On this show, we feature leaders and innovators in senior living who are pushing the boundaries and creating new effective services and solutions. And now, let’s settle in as host, Jennifer Drago, connects us with today’s guests.

Jennifer Drago: [00:00:31] Well, hello and welcome to Senior Living Visionaries. We’re broadcasting live from the Business RadioX studio in Phoenix, Arizona, where we showcase the leaders and innovators in the field who are shaping the future of senior living. I’m your host, Jennifer Drago, strategy consultant and CEO of Peak to Profit. And today my guest is one of my favorite people in senior living, and that’s Dana Wollschlager.

Jennifer Drago: [00:00:55] Dana is the partner and practice leader for Plante Moran Living Forward. She brings nearly 30 years of experience in the senior living and care industry, and she’s overseeing the development of more than $500 million in new construction, including 1400 units of senior housing and skilled nursing within the last five years alone. Her expertise covers a wide area of disciplines ranging from design and construction oversight to financing and regulatory compliance for onsite operations and management. Her development projects comprise a variety of senior living communities in urban and rural settings, including Greenfield new construction, significant campus expansions and remodeling projects.

Jennifer Drago: [00:01:38] And I’m so excited, Dana, to have you here. So first of all, welcome.

Dana Wollschlager: [00:01:43] Thank you. Thank you. So good to see you. Thanks for having me.

Jennifer Drago: [00:01:47] Oh, you bet. It’s my pleasure. And tell us more about Plante Moran Living Forward and the work that you and your team do.

Dana Wollschlager: [00:01:54] Yeah. Thanks. So, we are part of a much larger real estate development advisory service. Our division focuses entirely on senior living, but we also work in other asset classes, helping with consulting services, transactions, as well as oversight of construction and development.

Dana Wollschlager: [00:02:15] So, we work with senior living providers all over the country helping to reimagine what senior living is going to look like for the future and help them position their communities for success.

Jennifer Drago: [00:02:26] That’s awesome. And never more important than right now, right?

Dana Wollschlager: [00:02:30] Amen.

Jennifer Drago: [00:02:31] Because we have this changing demographic, the silver tsunami, and to the part of the changing demographic, really, we know that the generations that are now entering their retirement years have much different expectations of our product than those in the past. And so right now, being such a tumultuous time for construction financing, inflation rates are high, interest rates are high, I imagine there’s still probably a shortage in some of the construction trades and construction supplies. And so, how does that impact the work that you’re doing? Is it fewer, less project work and more planning? Tell us a little bit about that.

Dana Wollschlager: [00:03:13] I would say that the two things that we have been really, really busy with this year is, number one, supporting our – even though we’re a development advisor, we also have a tremendous amount of experience on the operations side. And so, we’ve been spending a lot of time helping our clients get their financial house in order so that they can fund the journey for the future, right? I mean, if you are not doing well financially or you’re burning through cash every month, you’re not going to be able to design your way out of a project because you won’t be able to afford to do it. You won’t be able to get financed. So in the one bucket, we’ve been focused quite a bit on ops side and helping people be successful there.

Dana Wollschlager: [00:03:55] And then the second piece, yes, construction costs, inflation and interest rates have impacted the development that we’ve been doing but I wouldn’t say that it’s halted it entirely. I think what it has done has really forced more of a disciplined approach. So clients might be maybe shrinking a little bit the size. We might be doing some redesign, but they’re not entirely canceling projects. So that’s positive because for most of our clients, they were already through design development. Maybe we’re in the construction process. A lot of the projects that we’ve been doing right now have multiple phases. And so, you know, once that domino starts, it’s not like you can just, you know, put the genie back in the bottle. So in a lot of instances, we’ve had to kind of redesign and shrink the project so that it would work financially.

Jennifer Drago: [00:04:45] Okay. Okay. That makes a lot of sense. And on the operations management side of things and trying to help improve the financial side so that future development is possible, can you give us an idea of some of the trends that you’re seeing as you’re working with clients?

Dana Wollschlager: [00:05:01] Yeah. You know, what I would say is that we have spent a lot of time working with our clients to align their strategic plans with operations. As a strategy individual, you probably often see that there is misalignment there, right? Everybody’s got these great visions, but if you don’t, then develop the tactics and the outcome measures tied to that from an operations perspective, you’re not going to get the outcomes that you’re looking for, right? So those that actually have a strategic plan, we’re working very hard to get their operations in alignment with that. Sadly, it’s surprising to me how many organizations don’t have a strategic plan or haven’t updated their strategic plan, you know, since before COVID. So for some folks, we got to take like ten steps back and start with developing the strategy, the organizational strategic plan, and then align that to their operations.

Dana Wollschlager: [00:06:04] The second trend that we’re working with clients on is really rightsizing their organization and asset repositioning. Most providers, and we’ve talked about this quite a bit, most providers are really sort of what I would say upside down in terms of their product offerings or service offerings to the extent that they have too many long-term care beds and not enough other product and services to balance that out. Right? So when we work with our clients from a development perspective, we really want to make sure that we are rightsizing that campus with the proper balance of independent living, assisted living, memory care and skill.

Dana Wollschlager: [00:06:43] So we have a typical rule of thumb that we kind of focus on. So if you are just an independent living, assisted living and memory care community, you typically want to have three independent living units for every one assisted living slash memory care. If you are a larger CCRC that also includes skilled nursing, those ratios are a little bit different. And so, you really want to have anywhere from 8 to 12 independent living units for every assisted living memory care or skilled nursing bed. And right now our clients are way upside down. I’m working with a client right now that is one-to-one skilled nursing to independent living. You can’t get those numbers to work, right?

Dana Wollschlager: [00:07:37] So, asset repositioning and trying to right size the product and service offerings is really where our focus is. The challenge for many of our clients that are very heavily weighted in skilled nursing is developing a strategy around how do you cut the number of beds and get it to work financially. Whatever we do, it has to be accretive to the organization. You can’t – I’ve got a client that has, you know, 500 skilled nursing beds on one campus. We can’t just drop that to 250 and think that you’re going to cut your overhead by that same amount. Right? It’s not a dollar for dollar. So, bringing something into the mix that’s accretive is really, really important.

Jennifer Drago: [00:08:22] Yeah. In my last organization before I branched out into consulting, we were absolutely looking at, you know, should we be repositioning some of our skilled beds? And that was actually right before COVID I think that we started that conversation. And then with COVID and so we knew skilled nursing utilization is decreasing because people can increasingly be taken care of in assisted living and even some are higher acuity or higher acuity assisted living. But then what has been surprising and I’m wondering if this is playing into all the work that you’re doing too, is through the pandemic, I think we’ve seen even a more marked decrease in skilled nursing utilization. Is that correct?

Dana Wollschlager: [00:09:07] And you, the company that you were at before, is in Arizona, and Arizona is a low utilizer of long-term care and skilled nursing. You guys are at or below 1% utilization. The nation as a whole is at about 2% utilization. But since 2015, those utilization rates have dropped in the United States. Since 2015 to current, it’s dropped by 31%.

Jennifer Drago: [00:09:37] Wow.

Dana Wollschlager: [00:09:37] And so as a direct result, you see this major downturn from 2015 to current. In 2012, we were at about just under 94% occupancy and today we’re hovering at about 80%. So you can see the correlation between utilization and occupancy. And the reality is, is that people have other options, right? They can go to assisted living, they can bring services into their home. And it’s just not a product that people want. And it’s difficult to operate. It’s intensely regulated. It takes a tremendous amount of staff and it’s very, very expensive.

Dana Wollschlager: [00:10:17] And so, I expect to continue to see a drop in utilization. And so, clients are focused on what does the next product and service that we need to offer look like.

Jennifer Drago: [00:10:30] Yes. I want to return to something that you said because it gave me goosebumps when you talked about the fact that strategic planning is so important to an organization. And it’s kind of like we assume that it’s being done, but to find that many organizations don’t have that. And I’m seeing that, too. So would you say – you know one of the things you and I’ve talked about a lot in the past is with all the challenging headwinds in this industry, we really need to seek assistance from people like you and perhaps like me sooner than later so that we can get the organization on the right footing as it comes to their financials and their operations.

Dana Wollschlager: [00:11:16] So what things are you seeing that if you could say, hey, executives in senior living, look at these warning signs and if you don’t have these in order, you know, let’s talk or at least start to look at those things. What things would you say are the biggest warning signs that you tend to see as you’re working with clients?

Dana Wollschlager: [00:11:35] Well, let me even put a finer point on that. And, you know, I’m willing to give the providers a pass over the last three years. It turns out there was this thing called a pandemic going on and they were a little bit busy and so strategy probably wasn’t their top priority. But, you know, we can’t keep using that as our excuse. And let me put a little bit of a finer point on this. So I’m just going to look at my notes here.

Dana Wollschlager: [00:11:59] So, you know, we know that senior living providers are struggling to understand and really prioritize their operational challenges, which are resulting in significant financial stress that could result in bankruptcy or closure. So, nearly 50% of all muni defaults in 2023 were not in the not-for-profit sector. And let me even further go on to let you know that the Bank of America Research did recognize. They did some research and they said senior living companies accounted for more than 600 million in first-time payment defaults, representing 46% of the 3.3 billion of total first-time defaults just in 2023. We’re only in June. Okay. And the Bank of America Research also shows that first-time defaults could reach as high as 2.1 billion by the end of the year. If that doesn’t wake people up, I don’t know what will.

Dana Wollschlager: [00:13:06] So, you know, what are the top three warning signs? Number one, again, going back to your question and statement, the organization doesn’t have a comprehensive strategy, right? They’re just thinking it’s going to come together. And this is not an industry where we can, you know, build the plane while we’re flying it.

Jennifer Drago: [00:13:26] Right.

Dana Wollschlager: [00:13:26] That worked for us when we were in the 80s. And, you know, we were a cost-plus reimbursed environment and we were all fat, dumb and happy. That is not the case today. And if they don’t have a strategic plan and it isn’t aligned with their operations, you’re going to struggle.

Dana Wollschlager: [00:13:42] Number two, the lack of leadership, both at the executive level as well as at the board level, is really troublesome to me. And as a direct result, it promotes a culture. If I refer to my friend Denise, it promotes a culture where there is no accountability. Right? And so, that is really exacerbating the problem.

Dana Wollschlager: [00:14:06] And then, the third thing that I think is problematic is we still have a lot of providers out there and leaders that just kind of have their heads buried in the sand. Right? Or they’re waiting for that employee retention credit money to come through and then everything will be all right. No, your operations are not doing well. And in this particular case, ignorance is not bliss. When you’re staring down the barrel of a cash burn rate of hundreds of thousands of dollars a month, you can’t constantly go back to the foundation well and make that work. We have got to get our operational house in order. Or you can just close your doors.

Jennifer Drago: [00:14:48] Yeah. What –

Dana Wollschlager: [00:14:50] I hate to sound so grim. I’m usually a glass-is-half-full kind of gal, you know that, Jennifer. But we really need to get this fixed.

Jennifer Drago: [00:14:58] Yes. I’m so glad that you were as candid as you were just then because I don’t hear it being said enough. And I agree with every single point that you made, especially with the fact that the different funds that have come out of the pandemic, pandemic relief funds, the tax credits, things like that, they are masking the problem. And -.

Dana Wollschlager: [00:15:22] Hundred percent.

Jennifer Drago: [00:15:23] And, yeah, I see that with my clients as well, 100%. And I do want to also underscore the board leadership, right? So as CEOs, we should know when to ask for help, when to say, you know, this isn’t working, something’s off or let me, you know, I need help with what my strategy should be because, to your point earlier, it looks a lot different than what it did before. That’s all fine. And the board needs to be educating themselves also about what are the current trends. You know, some of the stats that you just gave us about defaults and how can we prevent this.

Jennifer Drago: [00:16:04] So I’m so happy, although you’re right, it was a kind of a sad message, but happy that you said that because I think we need to have more candor about this in our industry. For sure.

Dana Wollschlager: [00:16:16] Yeah, there’s no doubt.

Jennifer Drago: [00:16:18] Yeah. So we talked about some of the trends and really some of the threats to the industry that you’re seeing. Tell me about maybe a positive, one or two things that you’re seeing about our industry right now. I know you have a lot of fun in the work that you do when you get to help an organization re-envision their campus and do a repositioning project as an example. But what are some fun things that you’re working on or that you’re seeing in the industry?

Dana Wollschlager: [00:16:46] Well, you know, the clients that we’re working with that do embrace this idea of a new vision or reimagining or a new strategy for their organization are the ones that are having success. And I remember I worked with a particular client who has been doing senior living services in the United States here for 150 years. And the client called me and they were like, “Dana, listen, we need you to help us with strategic planning. We know we need to be different for the future.” And I said to them, “Well, why do you say that? You’ve been here 150 years. Turns out you’re doing pretty okay. You know why?” And she said, “My business model is broken. Our business model is broken. I can’t find staff. It’s really expensive. It’s intensely regulated and the reimbursements are horrible.” I’m like, “Well, that’s your whole business model. So you’re right. Thank you for coming to that realization. Let’s reimagine what it will be in the future.”

Dana Wollschlager: [00:17:42] And so, you know, our ability to help shape that is really honestly what’s been really fun and then watching the success. But that success is really for these organizations that we’re working with is rooted in operational discipline. Right? And so, if we can help our clients embrace that, then that success will follow.

Jennifer Drago: [00:18:05] Yeah, right. Well, and to the point about the model being broken and we need to kind of rethink some of the things we’re doing, you know, we know many organizations at this point don’t even have a strategy to work with the middle market. And yet that’s the biggest growing part of the boomer demographic, right, is the middle market. And we know those services may not be brick and mortar. So, you know, should we be expanding home and community based and looking at new ways to serve a new demographic, too? So that’s really interesting.

Jennifer Drago: [00:18:40] So you talked a little bit about skilled nursing and why organizations are rightsizing their skilled nursing. I’m kind of curious, just yesterday, I think it was on LinkedIn, I saw Presbyterian Homes was breaking ground on a new nursing center, nursing care center, which I equated to be sniff. There might have been other things in there, but do you see a lot of organizations still building skilled beds in this environment and maybe they were replacing something else? So I’m not picking on Pres Homes. I’m wondering if you’re seeing new construction in the sniff area.

Dana Wollschlager: [00:19:14] Not very much. And honestly, the organizations that did do new nursing homes over the last five years are really struggling financially. Because the problem with that – you know the problem with building new nursing home even if it’s a replacement of an existing nursing home, you’re taking on new debt and there’s nothing new or accretive by way of revenue to cover it. And most of the reimbursements, unless you’re only post-acute and that’s, you know, a hard business model to make work as well, especially given the length of stays are shrinking, shrinking, shrinking, it’s hard to take on the debt for a new nursing home and think you’re going to cover that.

Dana Wollschlager: [00:19:59] And so if you are, then then we go back to the other strategy of making sure you’ve got the right ratio of independent living to, you know, service-enriched options and making sure that you’ve got enough accretive or new revenue that’s helping to offset that. And so that is it’s really just a math exercise and helping the client see that.

Jennifer Drago: [00:20:23] Okay. Really good point. So if somebody has, say, they have an organization, has their strategy in place, their operations are singing and they know they need development, but yet they look out and they say this isn’t the right climate or economy to be working on a development project or redevelopment project at this point, would you be encouraging them to get started anyway with their planning around that during this tumultuous time?

Dana Wollschlager: [00:20:49] Yeah, you know, I would because the reality is, is that this process is very, very slow, right? I mean, from start to finish, you probably, with an organization that can make decisions really quickly, you could probably be in the ground, you know, on a new project in 16 months. Right? Depending on the entitlement process and how quickly you can get permits and the like.

Dana Wollschlager: [00:21:13] However, the not-for-profits typically move a little bit slower. And so it could be three years before you put a shovel in the ground and your ability to influence your operations while on a parallel path, creating, you know, design development and getting into the ground, you know, those can be happening on parallel paths. The one thing that I would say, and providers make this mistake quite often and this is I’m not trying to be critical of my friends that are architects, but, you know, providers often will start with an architect. Please don’t do that. That’s a really bad idea.

Jennifer Drago: [00:21:49] Tell us why.

Dana Wollschlager: [00:21:49] Because the first thing – yeah. Because what we need to start with is what are our guardrails. What works financially? What is the market telling us we need not gut intuition? You know, we need to? start with the data to help inform the architect with what they can do.

Dana Wollschlager: [00:22:08] If we’re not providing them with the guardrails, they’re just going to draw and draw and draw. And you know what we have seen more often than not is, you know, they create this great image and it’s fantastic. And then we get a phone call and they say, here, help us, you know, do the performer for this. And then we come back to them and say, this doesn’t pencil. It doesn’t even meet a 1.0 debt service coverage. Then what are you doing? You’re going back to the drawing board. You’re repaying architects to redraw.

Dana Wollschlager: [00:22:34] So, what we like to do is we start with the market study and we start with a debt service or a debt capacity analysis, understand your operations and what do we need to do financially to get this to work, and then I can go to the architect and say, “Mr. Architect or Mrs. Architect, we can afford a $20 million project. Don’t design me a $24 million project because it won’t work.” And then, you hold the entire team accountable to that. That’s how you get these to work.

Jennifer Drago: [00:23:04] And as part of that market research that you’re doing early on the demand study, so how many beds do we need? So is that part of the information that’s being communicated to the architect? We need 100 beds, 40 AL, yeah, whatever the mix is. Yes. Okay.

Dana Wollschlager: [00:23:21] Absolutely. And the other thing that I would say as a part of the market research that we do with our clients is, you know, we also will run sensitivity, So going back to this idea of a reduction in utilization. So if the United States is currently at 2% and we know that it’s going to continue to decline, so if I run a demand calculation for skilled nursing, it might show that, you know, there’s demand for 40 beds. I’ve never seen an area where there’s demand for skilled nursing. But let’s just assume for argument’s sake, it’s either in balance or, you know, you could do a replacement. Well, what does that look like if utilization reduces by another 25%? Like I said, it reduced by 31% since 2015. So let’s run a sensitivity to see what it looks like if it drops by another 25%. And then, let’s run another sensitivity if we get to a 1% utilization like your state is at. Guess what? There’s no demand. I mean, that is what it will show us. So, running those sensitivities is really, really important.

Jennifer Drago: [00:24:27] Yeah. I love that you brought that up because to me, that’s such an important part of planning for a big project like this and the feasibility analysis. And it brings me back to my days when I was a hospital planner in Arizona in 1996. And I think we had 1 million people here in the metro area, and now we’re like at 6 million plus. So tremendous growth and we would not have been as prepared for the growth. And we still missed it by a lot, you know, with beds that were too full and ED overcrowding and code purples and everything. But we did the sensitivity analysis in the planning phase, which allowed us intentionally to build a lot more flexibility in the project.

Jennifer Drago: [00:25:10] So to your point, we knew we had X million dollars to build a hospital expansion and I think senior living is similar. That’s why I’m bringing this up. But we couldn’t afford to finish all. So we built the floors, but we shelled in, you know, the top three floors. And then, when demand dictated, then we built out the next floor. And so, we were really able to be as flexible as we could and responsive to the demand needs. And I think that’s what you’re talking about in your flexibility analysis, is seeing how the demand shifts and then putting that into your plan and your architecture.

Dana Wollschlager: [00:25:47] Yeah, absolutely. And so on the senior living side, you know, we’re working on a project right now where we’re developing 63 units of assisted living and memory care. Well, the way – and architects would tell – good architects will tell you this, that, you know, the way that we’ve designed the building is such that if we find a cure for Alzheimer’s and we don’t need all these memory care beds, can we combine units and turn them into really nice, large assisted living units? So, designing in the greatest flexibility so that as we continue to evolve as an industry, which we will, then we can adapt accordingly into the future.

Jennifer Drago: [00:26:27] Yeah, what a nice thing to think about, right? If Alzheimer’s is cured and we don’t have a need for memory care beds anymore. That is a dream.

Dana Wollschlager: [00:26:35] Oh, that would be awesome. It is. We’ll get there. I know we will.

Jennifer Drago: [00:26:40] I know. I know. So, we’ve talked a lot about some of the specialties at Plante Moran Living Forward, and you and your team and I’ve watched you. You guys are fantastic, seeing you in action doing. And one of the things that we never got to work on together, but I was fascinated about owner’s representatives and what that does for a senior living organization, and I may not have used the right terminology, but tell us more about or tell senior living executives if they have a major construction project that’s planned for their campus why they should consider an owner’s rep and what that does.

Dana Wollschlager: [00:27:18] Yeah, and those words are interchangeable, you know, development advisor, development consultant, owner’s rep. I mean, they’re all very interchangeable. But the reason I would say that senior living executives should consider it is for two reasons. Number one, you’re busy with your day job. Okay? Your job is to make sure that you are focused on day-to-day operations and that your organization is financially solvent.

Jennifer Drago: [00:27:46] Number two, you don’t do this every single day. You don’t – we’ve got $3 billion of construction right now that we have going on within our entire real estate division, everything from hospitals to universities to K through 12, corporate, industrial, senior living, religious, $3 billion. That’s all we do, is construction oversight, right? And so having someone at the table who does this every single day is really, really in your best interest.

Dana Wollschlager: [00:28:18] And then lastly, I would just say that you do rely on your architect. You do rely on your CM or construction manager to be a strategic partner at the table. But at the end of the day, you want to make sure that you have an independent advocate looking out for your best interests. Most of the other consultants are paid on the size of the project, so there’s a different incentive for them than it is for you as the owner.

Dana Wollschlager: [00:28:49] And so making sure that your interests are protected is absolutely critical. And, you know, because we do this every single day, you’d be shocked at the stuff that we see. You know, we spend a lot of time doing post-construction audits in different industries and fields. We did do this for one of our senior living clients. They called us three times to do a post-construction audit. The third time we finally said to them, “Would you please just hire us? Would you please let us help you on the front end? Because that’s where we can influence the greatest dollar amount to you as the provider”

Dana Wollschlager: [00:29:27] In our review of their documents, we found that there were very few folks participating in one of the sections or divisions of construction. They only got two bids. The one bid that was selected, we were reviewing all the bid documents and there was a line item in there – I can’t even make this stuff up. There was a line item in there that said BS – you insert those words – add BS, add $750,000.

Jennifer Drago: [00:29:56] Oh, my gosh. Oh, my gosh. And that was probably in addition to a contingency line, too, right?

Dana Wollschlager: [00:30:05] I mean, it’s just, you know, and to be honest, the client was like, “I didn’t even know what is a bid package,” you know? I mean, that’s what I mean about, you know, bringing the right people to the table to help you be successful.

Jennifer Drago: [00:30:05] Yeah.

Dana Wollschlager: [00:30:18] And everybody, I get that, the not-for-profits. I was in that world, you know. I did it for 30 years. We want to save a dollar, right? Every dollar that you spend on someone like me or you is a dollar that doesn’t go to resident programming or additional staff or whatever. But at the end of the day, we generally save our fee by protecting your interests through the process.

Jennifer Drago: [00:30:38] Yeah, you convinced me of that. And that’s what I was going to say to put a point on this too, is it may seem like a luxury, but it’s not. This is a necessity in today’s environment. And because our margins are so slim, our pennies are so few, we need to make sure there’s someone looking out for every penny and not having BS ads on our contracts. That’s crazy. What a crazy story.

Dana Wollschlager: [00:31:05] Yeah.

Jennifer Drago: [00:31:06] So, we’ve talked about a lot of things. And tell me, is there anything that we haven’t talked about that you think is important for our industry today or for senior living providers to know?

Dana Wollschlager: [00:31:17] Well, there are a couple of things I would just hit on. Not every organization is in a position or should focus on a new development or an expansion or maybe even a repositioning. But what I will say is that our industry has not been good stewards of the assets that they do have and they haven’t reinvested as they have gone along. So that’s definitely one thing. Sixty percent of the senior living assets in the market right now are over 20 years old.

Dana Wollschlager: [00:31:48] Jennifer, when you and I, you know, go back 20 years and think about what we were, you know, offering as a product offering in the marketplace 20 years ago, it was assisted living that had studio apartments that were 320ft². Guess what? Nobody’s going to move from an 1100-square-foot independent living unit to 320. And so, making sure that you’re constantly reinvesting is absolutely critical. And some of these assets are really, really have been neglected.

Dana Wollschlager: [00:32:16] The other thing that I am concerned about is and you talk, you hit on it specific to the middle market, but also affordable housing. Our industry has not done the job that we did in the ’60s and the ’70s and the ’80s investing in new affordable housing. And part of that is just, you know, the federal government is having to, you know, reinvest in the existing assets that they have, right, to keep them up to date. But, you know, when the feds are only releasing $60 million a year for new 202 program, I’m going to get two buildings. I mean, it is just not going to be enough. And when you look at the reduced utilization and, you know, we’ve lost more than 46,000 skilled nursing beds since 2008, the skilled nursing environment was the safety net, right, for people that couldn’t afford stuff.

Dana Wollschlager: [00:33:12] So, you know, we have got to reimagine how we’re going to provide for that population, whether it’s through Medicaid waivers or, you know, a la carte services, care navigators. We need to be talking about that as an industry.

Dana Wollschlager: [00:33:31] So important. And I’m so glad that you brought that up. You’re right. The resources to support more affordable housing, which we know we need because the population is increasing and less affluent than in the past, it’s just not there. It’s not at the level that we need it. So, that’s a policy point, too, right? It’s a provider issue and a policy issue and everything in between.

Dana Wollschlager: [00:33:53] Yeah, there are a lot of policy points here. I mean, we didn’t even talk about staffing and I’m sure you’ve had other folks on that have, you know, tried to address that issue, but that is immigration reform written all over it. Right? I mean – and when you look at the workforce, you know, individuals age 20 to 64 as compared to the 75-plus population, nationally the workforce is only increasing by 6% but the 75-plus population is increasing by 93%.

Jennifer Drago: [00:34:27] Yeah.

Jennifer Drago: [00:34:28] So that ratio in 2020 was 8.3, and by 2040 it will be cut in half, 4.6, to every older adult. I mean, the numbers are staggering. So we can’t expect other people to affect change. We all need to get on the same page and start driving those policy conversations.

Jennifer Drago: [00:34:51] Yeah. So, are you running for office any time soon?

Dana Wollschlager: [00:34:55] I should. I really should. But I’ve got too many skeletons in my closet.

Jennifer Drago: [00:34:59] I’m not buying it. But you’d be a great policymaker, for sure.

Dana Wollschlager: [00:35:03] Oh, bless your heart. Thank you.

Jennifer Drago: [00:35:05] So, Dana, will you tell us, tell our listeners where they can find you and how they can get in touch if they want to learn more about Plante Moran Living Forward and the services that you provide?

Dana Wollschlager: [00:35:15] Absolutely. Thanks. Yeah, I would just invite you to come to our website. So it’s livingforward – pm, excuse me, pmlivingforward.com, and we would love to connect with you whether we’re helping you with market study, research, financial feasibility, development, operations. You know, we’ve got a tremendous number of resources that are available to us and we’d love to be able to help.

Jennifer Drago: [00:35:39] Thank you. And I will also put a plug in that Dana is pretty active on LinkedIn and she posts a lot of great resources that I really enjoy reading. So just get the spelling right and you’ll find her.

Dana Wollschlager: [00:35:51] Now, I’m in trouble.

Jennifer Drago: [00:35:53] We’ll put all the links in the show notes below, but –

Dana Wollschlager: [00:35:56] Awesome.

Jennifer Drago: [00:35:57] Yeah, but thank you so much. You’ve given us such great things to think about today. Such great advice as always. And I just appreciate that you are such an important resource for all of us in the senior living industry. So, thank you for being here today.

Dana Wollschlager: [00:36:12] Yeah, you bet. Jennifer, thank you. I appreciate the opportunity.

Jennifer Drago: [00:36:16] You bet. So this has been Senior Living Visionaries where every episode we feature leaders like Dana who have really important things to say that are shaping the future of the senior living industry. I’m your host, Jennifer Drago.

Jennifer Drago: [00:36:31] I invite you to subscribe to our podcast so that you’ll always be notified of new episodes, at seniorlivingvisionaries.com. That’s all for now. We’ll see you next week.

Outro: [00:36:45] You’ve been listening to the Senior Living Visionaries podcast and radio show where we showcase the leaders and innovators in the industry who are pushing the boundaries and setting the stage for the future in senior living and services. Join us next time as we share the bold ideas and breakthroughs of the industry’s most forward-thinking leaders here on Senior Living Visionaries.