Newly developed senior living buildings might appear to be beautifully finished products when they open, but savvy operators know they still are works in progress, especially when it comes to their technological infrastructure.
Many providers have learned this lesson the hard way. Some operators now have locations that are only a few years old yet already are outdated, after constructing buildings that could not be easily adapted to fast-evolving technology like wireless Internet.
To avoid this situation in the future, industry leaders and experts agree on the importance of flexibility. Infrastructure should be flexible to accommodate both innovative technology and the resulting changes in resident and staff behavior. And providers should strive to be financially flexible, anticipating rising tech-related costs and altered cash flow to keep buildings on the cutting edge.
Anthem Memory Care broke ground on its first location just four years ago — and already, the building in Chico, Calif. could benefit from a retrofit, its developers say, showing just how quickly wireless technology has advanced in a short time.
“That building is a really good building,” Anthem’s Isaac Scott, principal, development and operations, tells SHN. “It’s outfitted with Wi-Fi hotspots, but, frankly, the difference in technology from 2010 to today is just dramatic.”
Anthem has implemented workarounds so that it can soon begin to offer additional Internet-based services, such as It’s Never 2 Late, at the Chico location. But the facility’s wireless backbone enables five or six hotspots, while current buildings now have 12 or more for full, seamless coverage, Scott notes.
However, Anthem and many other senior living operators have found that updating buildings to beef up Wi-Fi may not be realistic from a cost perspective. Retrofitting the Chico building would entail a huge effort and come at an “exponential cost,” Scott says.
“When you’re wiring a building, when it’s new construction, the cost of labor and materials is minimal compared to trying to go in and wire a building that already has sheetrock,” he explains. “The cost impact is kind of insurmountable.”
Given this dilemma, what are the lessons to providers developing communities today?
The logical move might be to look down the pike, try to anticipate future technological innovations, and design buildings accordingly — and that’s just what many operators are doing. Innovations in Wi-Fi itself are one area of focus.
The move to wireless networks has been inexorable. So, operators recognize that they need a network infrastructure to support robust Wi-Fi today and to allow increased stability in coming years.
“I recommend a fiber-serviced network and something that’s flexible,” says Virginia Depies, technology designer at Direct Supply Aptura, a senior living services firm that aids in construction management, planning and design.
Fiber enables a higher bandwidth than copper cabling, although it is more expensive, Depies tells SHN.
But she is seeing more communities opting for fiber, at least for the vertical cabling, a design that supports increased bandwidth, while horizontal cabling continues to be copper. Copper creates distance limitations, as at its maximum it does not exceed 90 meters (295 feet).
Whatever a community opts for, it should work with a designer to ensure that the Wi-Fi network can support growing demand, Depies emphasizes. A provider should be aware of new or forthcoming ways of configuring a wireless network that can increase flexibility.
For instance, so-called “controller-less solutions” cut out some of the hardware associated with Wi-Fi connectivity and make it easier for organizations to configure a system to support areas where wireless traffic is more congested.
“You have to maintain flexibility to add on as your community grows,” she says. “Maybe only 10 residents use iPads today, but next year every resident might be given a mobile device, so your network has to be able to support growing demand.”
Indeed, while inconveniently located elevator shafts or concrete walls proved to be major obstacles for senior living communities trying to expand a wireless network, buildings that have well-planned wireless Internet infrastructure should be able to avoid such headaches and add tech capabilities on an as-needed basis more easily going forward.
“We are embracing the use of wireless technology, which allows us to add support elements versus hard-wiring systems,” Dave McDowell, senior vice president of development at senior living advisory firm Greystone, tells SHN.
New senior living developments might be devoting more time to planning their wireless networks, but on the whole, many also are being generally conservative in their upfront tech-related investments in a new building.
“We are not seeing huge investments in technology from a development standpoint as it relates to the backbones of communities,” McDowell says. “For one, it is cost prohibitive. Technology is evolving so rapidly that you can spend money on something initially, only to have to replace it before you even open your doors.”
That said, some operators believe that changing technologies mean each development needs to be assessed and built to the most contemporary specs possible, not to a cookie-cutter template that might have been acceptable in previous eras.
“We’ve been mindful and purposeful that we’re not taking things off the shelf from 10 years ago and building it today,” says Lori Juneau-Alford, chief operating officer at Texas-based Avanti Senior Living (see photo, above).
In planning new construction, Avanti is considering emerging tech such as keyless entry, customized tablets and apps for seniors and families, fall detection monitoring in memory care and point-of-care devices that can upload data to electronic medical records, then integrate it into a multi-provider health information exchange.
Even with this aggressive push to be up-to-date at opening, Juneau-Alford recognizes that Avanti needs to plan for increasing tech investments in the coming years.
“I do see that going up,” she says of tech-related spending. “We’ve invested a lot of money and time, including in hiring tech/IT consultants, to be sure our infrastructure is strong enough to support what we have currently and support a stronger load. The further into the future we go, the more advanced in tech our residents are going to be. They’re going to expect technology such as to order their food on demand. There’s some talk of robots. I don’t think you can replace the human touch. But I think we could see some things like programming a vacuum to sweep the hallways at night.”
Money for tech also is baked into Anthem’s yearly budget — but spending is not a given, says Scott. Because it’s hard to predict what technologies will emerge in a given year, the allocated money accrues until the provider identifies an investment that promises a return, and not only for the bottom line.
“Because it’s the unknown, [the money] sits in the budget until we find something that has an ROI, not only in terms of the budget but resident safety and engagement,” he says.
One such recent investment was an expansion of the It’s Never 2 Late product, which offers a variety of computer-enabled activities for people with dementia, such as interactive games played through a touch-screen. Anthem debuted it at its second location, Highline Place in Littleton, and now is rolling it out at its other operating communities.
Scott says tools like this, which boost resident engagement, are likely candidates for future investment, as are communication technologies such as videoconferencing. On the staff side, Anthem is interested in tech that streamlines operations, such as by reducing paper records.
Evolving technology also stands to impact cash flow. Spending will start shifting from big, one-time equipment purchases to subscription costs, says Direct Supply Aptura’s Depies. For example, on-site servers are being phased out as providers move toward off-site, cloud-based solutions.
“You’re eliminating server costs and maintenance costs to maintain it, and you’re translating that to more subscription costs, [for a third-party] to create your redundancies and manage your hardware for you,” Depies says.
It’s not certain that all providers are being diligent about saving for future tech investments, observes Manny Gonzalez, principal, AIA, LEED AP, CAASH at architecture and planning firm KTGY Group, Inc.
However, he predicts that not all retrofits will be as costly and complex as those to expand wireless networks.
“It’s incumbent upon the manufacturing industry to create it as a retrofit so that you don’t have to drastically replace the hardware,” he says of new tech such as keyless-entry doors. “They’re smart enough to know that retrofitting will be a big part of someone’s market. They’ll be able to implement that.”
Written by Tim Mullaney