The annual LeadingAge conference is being held at the Music City Center in Nashville.

Nonprofit long-term care providers must work together to address alarming trends, or their market share could plummet and the sector as a whole could falter, LeadingAge Chairman David Gehm told association members Tuesday.

While he is “optimistic” after his first year leading the Board, he has identified trends that “might give us pause,” Gehm said at the General Session of the association’s annual conference and exposition in Nashville.

The for-profit LTC sector is growing nearly eight times as fast as the nonprofit sector, Gehm warned, citing figures from investment bank Ziegler. In particular, nonprofit providers are shedding skilled beds. Projections indicate that this “core service” of nonprofits will continue to shrink, he said, and for-profit providers might be “buying our beds almost as fast as we put them on the market.” Contributing to and compounding this development, many nonprofits are struggling to access affordable capital, while for-profits are “leveraging and building housing and assisted living all around us,” he declared.

Add that many nonprofits are having trouble attracting top-flight workers, and the need for action becomes urgent, he said. To this end, the LeadingAge Board has “elevated the health of our members as a major strategic objective,” he announced.

A vibrant nonprofit long-term care sector benefits the whole country, Gehm emphasized. These providers occupy “high moral ground that no one else can hold,” he said. The future will be bleak if they lose market share and influence, because they inform public policy and help ensure that the long-term care system as a whole is mission-driven and high quality.

“Our collective voice is strong, our ability to drive our agenda growing, our impact poised to increase,” Gehm declared. But he concluded with a reminder that “our future isn’t guaranteed.”

Conference attendees spoke out about the challenges in the skilled nursing sector at an education session later in the day. A few noted that skilled beds increasingly are difficult to fill, as consumers opt for alternative types of care. An employee of a continued care retirement community said that she and her colleagues have discussed making assisted living the “end of the continuum” at their location. Others floated the possibility of making skilled units more niche by offering services for specific populations, such as people with ALS, cancer or COPD. The consensus was that further discussion is needed on how skilled nursing can be repositioned.

A late Tuesday session covered mental health needs in senior housing. One successful project has been at Front Porch Center for Innovation and Wellbeing in California, which worked with University of California Davis to develop a telehealth counseling program. The project included 300 hours of mental health services in English, Spanish and Korean to 30 older adult clients, four community workshops on behavioral health for 125 community members, and telemental health services at three communities, said Davis Park, Center for Innovation and Wellbeing Director. Satisfaction among 21 senior participants who completed at least 10 counseling sessions was high, with 68% saying that counseling online was just as good as going to see a counselor. 

Tuesday’s keynote speaker was Simon Sinek, known for his TED talks and books on leadership. Great leaders know they are “not responsible for results” but are responsible for the people who will deliver the results, he told the LeadingAge audience.

The LeadingAge annual convention, the country’s largest gathering of long-term care providers, will conclude on Wednesday.