Senior Living Resident Acuity Rising And Underreported, New Survey Finds

Acuity levels among senior living residents are continuing to rise – and may be underreported, according to new survey results.

The most recent American Seniors Housing Association and August Health Clinical Leaders Report, released Dec. 8, collected responses from 68 clinical leaders across the senior living continuum and nation.

Just under three-quarters of the leaders, 74%, indicated acuity has increased somewhat or increased significantly in the last year, with the remaining 26% stating it has remained around the same or decreased in their communities.

Meanwhile, 63% of the surveyed leaders believe resident acuity is actually underreported in their communities. The report points to infrequent assessments and intentional under-scoring as the primary reasons, which create a discrepancy between documented and actual acuity within communities.

“Needing to have conversations with families about care rates is likely one reason for intentional underscoring,” Lynn Chalk, vice president of clinical services for MBK Senior Living, said in the report. “Most nurses aren’t equipped or comfortable with this type of financial conversation and this shouldn’t be part of a nursing responsibility.”

To address the rising levels of acuity, the survey found operators are bringing on med techs and expanding their roles, and 65% of respondents indicate improving staff quality and training is one of the top challenges for their staffing models in 2025, compared to 57% in 2024. The survey also notes “poorly designed workflows and systems, which are needlessly time-consuming, create the illusion of understaffed communities.”

In order to better care for residents, the majority of survey respondents indicated they wished to improve workplace culture, staff satisfaction and staff retention; tracking and taking action on data-driven dashboards for high-risk residents; and adjusting care team staffing models.

“We’re all battling for the same people and it’s great to see there’s a huge focus on workplace culture,” Sara Padilla, vice president of health services at Senior Resource Group, said in the report. “The churn and burn is real, so I’m not surprised by the results we’re seeing in terms of staff retention being a key challenge. It’s an accurate depiction of what’s happening.”

Staff engagement and adoption is the current greatest barrier to changing workflows according to 65% of respondents.

“Time-consuming trainings and a lack of stickiness are among the top 3 barriers to adopting new technologies,” the report’s authors wrote.

Only 22% of respondents indicated they have no plans to branch into value-based care, and 31% are actively operating within the space. Of those actively taking part, one-third are taking on some form of financial risk in the operations for it.

To become more proactive with caring for rising acuity levels, most clinical leaders are optimistic about AI’s potential. Only 19% of respondents indicated they do not have AI or are not planning on implementing it, while 36% either have it fully implemented or are in pilots for the software. The remainder are not using it yet, but are interested. The most popular use case of AI is for earlier identification of at-risk and rising risk residents, with 88% of respondents stating it’s the intended use for it.

“The survey highlights the creativity and resilience with which nursing leaders are adapting the care model to meet the needs of higher acuity residents amidst persistent staffing pressures,” Justin Schram, co-founder of August Health, told Senior Housing News. “With the support of deepening healthcare partnerships and value-based care contracting, clinical teams are better positioned to coordinate care across the continuum and drive outcomes.”

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