What Does the LZ 150 Data Mean for You?

LeadingAge and Ziegler, a LeadingAge Gold Partner, recently released the 2014 LZ 150, a compilation of data from the 150 largest not-for-profit systems in the United States. 

The report contains a significant amount of data on the size and growth of these 150 systems. It also provides important insights into 2 emerging trends that affect all senior living organizations:

• The growing expansion of home and community based services (HCBS) to non-resident seniors in the community.  

• The steady increase in utilization of technology in senior services.

Key Findings

Here are some key findings about the 150 systems that LeadingAge and Ziegler surveyed:

• A range of sizes: The number of units provided by individual LZ 150 systems ranged widely, from 500 to 18,286. The 10 largest providers of senior living represent approximately 32% of the total number of units for all systems in the LZ 150. 

• Growth of IL and AL: In the last 10 years, the average annual growth rate in total units has been 2.2%. The number of independent living (IL) and assisted living (AL) units grew each year during the period. However, the number of nursing care beds declined. Nearly 75% of the LZ 150 offers memory care units.

• Growth through expansion: LZ 150 systems have grown primarily through expansion of their existing campuses. The number of units added through new campuses has slowed in the past few years. Organizations continue to dispose of dated nursing homes or financially stressed communities. 

• Geographic diversity: LZ 150 systems provide market-rate senior living in 44 states and subsidized housing in 4 additional states, as well as the District of Columbia, Puerto Rico and the U.S. Virgin Islands. Pennsylvania is home to the largest number of system headquarters. Minnesota has the largest total number of communities. 

• Joint ventures and partnerships: Roughly one-quarter of LZ 150 organizations are engaged in a formal joint venture, most commonly with another provider, a health system or a home health/home care agency. Almost a quarter of these organizations are engaged in a formal health care reform contract. Thirteen providers reported being part of an Accountable Care Organization (ACO) network. 

Home and Community-Based Services

For the first time, the LZ 150 survey sought to determine the number of non-residents who are served by the largest not-for-profit systems in the country. 

The findings illustrate the significant amount of growth taking place in the delivery of home-based services, including home health, continuing care at home (CC@H) programs and the Program of All-Inclusive Care for the Elderly (PACE). For example:

• 53% of the LZ 150 systems provide HCBS to non-residents. 

• 12% of the LZ 150 systems offer a CC@H program, a village/membership program or a PACE program. 

• 17.5% of the LZ 150 systems have expanded staffing levels for HCBS programs.

• 33% of survey respondents are considering offering an “at home” program in the next 2 years. 

Revenue related to HCBS increased slightly (.1%) for services provided to residents. However revenues associated with services to non-residents increased significantly, from 2.9% to 6.9%, as a percentage of total revenue.

Technology

It is clear that technology is becoming increasingly important for LZ150 members:

• 75% reported using electronic medical/health records.
• 77% use electronic point of care/services documentation systems. 
• 58% have electronic physical exercise/rehabilitation monitoring systems.

Other tech-related services aren’t used much yet:

• 4% of the LZ 150 reported using remote health monitoring systems.
• 7.6% use remote behavioral monitoring systems. 
• 21% use electronic medicine monitoring systems.

What Does the Data Mean for You?

All providers of services to seniors, especially campus-based continuing care retirement communities, need to look closely at the trends that are documented in the most recent LZ 150 report. 

I’d recommend taking 2 important steps once you’ve reviewed the data:

• First, determine how the data apply to each of your communities.

• Second, make a plan for how you will respond to these trends, particularly in the areas of HCBS and technology. 

A proactive and timely response will enhance your ability to serve older adults today and into the future.