How AI & Automation Are Solving Senior Living Compliance with Sarah Richard | The AgeTech Podcast S4E19

Hello and welcome to another episode of The Age Tech podcast. Today we’re diving into a topic that doesn’t always get the spotlight, but it absolutely should. When people think about the challenges in senior living, they often think about resident engagement, staffing shortages, or communicating with families.

But what they don’t see are the behind the scenes challenges, the complex world of compliance and quality assurance. These are the kinds of problems that only industry insiders truly understand, yet they have a massive impact on operations, risk management, and ultimately the care residents receive. My guest today, Sarah Richard, is the founder and CEO of Vara, a startup that’s tackling compliance head-on, and she’s also the force behind AgeTech NYC and AgeTech SF

bringing together a growing community of innovators in the aging space. In this episode, we unpack how AI and automation can help senior living operators navigate these challenges. What Sarah learned from embedding herself in a senior living community as an entrepreneur in residence, and what founders should be asking themselves when getting started and choosing a challenge to work on.

We have a lot to unpack, so let’s dive right in

Mhm.

Keren Etkin: Sarah, welcome to the show.

Sarah Richard: thanks Karen. I’m so thrilled to be here. Yeah, happy to share a little bit more. So I am founder and CEO at Age Tech, NYC, the community of 700 plus members working to make New York the best place to grow older. But as we were kind of chitchatting earlier. I am moving to San Francisco, so I have just landed here in sf and working with a couple folks on the ground here to spin up AgeTech SF to really drive towards a similar mission to make San Francisco an incredible place to age. That’s all kind of in my community organizer side of what I do. But the other element here is I am founder and CEO at a company called Vara. And what we do at Vara is we build task management tooling for directors of nursing and administrators at senior living with a particular eye towards taking care of quality assurance tasks, whether that be quai for skilled nursing or more informalized quality assurance programs for assisted living.

Keren Etkin: That’s amazing. And as part of your entrepreneurial journey, you took part in an EIR program. In one of the major senior living

Sarah Richard: I did,

Keren Etkin: providers. So how’s that like?

Sarah Richard: The most unbelievable experience. I cannot say enough good things. So what I did is an entrepreneur and residence program that is run through United Church Homes in Ohio. And kind of the, the leading team there is Mike Hughes as well as Linda Daley, who is the executive director at the community on the ground. And I believe I was the fifth or sixth entrepreneur to take part in this program. And I spent about two weeks living in a community called Glenwood, just in Marietta, Ohio. And the team were kind enough to set me up with a, an independent living apartment, truly embedded me in the daily operations.

So I shadowed anyone and everyone kind of on the ground, whether that be the activities director, the director of nursing, all kinds of folks the person charged with maintenance Linda herself from an executive director perspective, really to get a better understanding of the daily operations, really what on the ground is happening at a senior living community. and the great thing about United Church Homes is they have the full continuum of care. So I spent time at Glenwood, which is their assisted living and independent living side. But I also got to head over to their skilled nursing harm and kind of get to know the team there and understand a little bit better the operations as well. And the fun thing about that Entrepreneur in residence program. the obvious, which is getting to spend time with the older adults in the community, getting to spend time with, you know, all the folks who work there. But the fun thing besides all of that is we do seem to have something of a an AgeTech NYC pipeline.

So there’s a couple of folks in the AgeTech NYC community who have preceded me and I do believe that there’s interest from others in, in taking part as well thereafter.

Keren Etkin: That’s amazing. So, first of all, I have to mention that we already invited Michael and Linda to the podcast. So anyone watching or listening to this subscribe to the show so you’ll get a notification when that episode is live. And. I I love that you took part in this program and I love that United Church Home is offering it. ’cause there has to be some, a lot of overhead in it for them to have a founder shadowing people around asking lots and lots of questions. How were you received by the staff, like on the ground there?

Sarah Richard: With open arms, I have nothing but positive things to say. I do think that it is in part, due to the fact that I was the fifth or sixth, so, you know, folks had gotten a chance to get comfortable with the program, understood what it meant to have an entrepreneur in residence. So it, it wasn’t kind of a net new experience for. The folks living at Glenwood or the folks working at Glenwood. And I do have to note, you know, the team at United Church, they’ve dotted their i’s crossed their T’s, so I signed A-A-B-A-A to make sure that everything would be very appropriate from the standpoint of legal concerns. Just make sure, you know, the community is protected, just everything is lined up from that regard.

Keren Etkin: Is a business associate agreement, so.

Sarah Richard: Sure. Yeah. Just to make sure that, you know, folks could speak freely in front of me without any concerns that I was truly kind of under the hood. And it’s so exciting that you’re gonna speak with Mike and Linda. I am thrilled for your audience to get to hear more from their perspective about the program. But again, from my perspective it was about two weeks. We spent the first week really just in sponge mode kind of learning. I was shadowing all of the folks on the ground, kind of forming opinions on how things are run. You know, did the daily operations work. And then the second week was quite a bit more focused on my specific testing.

So, you know, really speaking with the folks who would use my product, really getting a bit more deep dive from there. And all of it culminated in, you know, of course I walked away with this incredible experience, but we do. Thanks to Mike get to hopefully give back a little bit to the community by writing a culminating memo of what did we see, what opportunities for continuous improvement, what was fantastic already. Really just deep dive on how the experience went. I.

Keren Etkin: So when we spoke a few months ago, you already were working on Vara and you had sort of a hypothesis on what opportunity was in it for you and what problem you were going to be solving and sort of. Did, did you go into this experience with a, like a mission to test this hypothesis? Did you find anything that surprised you that was like counterintuitive that you never would have known otherwise?

Sarah Richard: Yeah, I think the biggest learnings for me were really around the daily operations and the language, and those are things that you can’t really get from an outsider’s view. It’s more so I. You know, sitting in the proverbial water cooler talk, how are people talking about their daily operations? Right. So when I think you and I initially spoke, I was so early in formulating what was my hypothesis.

I knew there was something around compliance that was deeply painful for operators, and that does come from the work I did last summer. Speaking with about 25 senior living communities, you know, from the C-suite to the director of nursing, to the residents in varying degrees to better understand what’s hard about senior living right now. And I think what you and I discussed at that time is I. and their mother feels that staffing is a challenge, right? We’re in a notoriously tight labor market. Medicaid acting as an effective wage cap that overall impacts the overarching pool, whether or not you do have a Medicaid population. and that leads to when you have 65 to 80% of your staff walk out the door every year. What falls between the cracks, it is your attention to policy and procedure in ways that leave you wide open for risk, whether that be the $10,000 a day fines , civil, monetary, penalties, whether that be the million dollar plus class action lawsuits. And what it comes down to at the end of the day, is documentation and is your quality assurance process.

So again, when you and I initially spoke. knew there was something thorny, something hairy there. But it did take experiences with the eight design partners I’ve been working with. And in particular with, you know, this Entrepreneur in residence program truly being on the ground to really get a feel for what is the actual pain pain point and how can I best solve it.

Keren Etkin: Absolutely. And. In your conversations with the staff on the ground did, did you find that frontline workers are less concerned about compliance than management, which I guess that would be like my intuition. They’re just trying to get things done and not really trying to cross their ts and dot their eyes.

Sarah Richard: it’s a great question. So what I’ll say in particular. At Glenwood, I noticed is top of mind for every single person in the door is resident quality of care and resident satisfaction. So the good news is that is top of mind for every single person. I think the challenge comes with is your, are what performance metrics almost are you held to?

Right? And, and how kind of are your processes enabling? to a quality assurance process or not. So with Glenwood, again, I feel very fortunate that this was a very high quality community. So I feel like I did see kind of best practice but even still with all of my design partners and with all of the communities that I’ve gotten to know, I’ve noticed there’s a ton of pen and paper kind of manual work that things do fall between the cracks. And you know, I’ve heard sort of anecdotally. That in the two, I believe may, excuse me, the three lawsuits that I’m aware of that kind of did on win, that the full on kind of result was the skilled nursing community or the assisted living community, won, the lawsuit outright and you know, no settlement, nothing. because of the documentation at the end of the day. So I’m, I’m really heartened to kind of hear those stories and, and know that what I’m working towards is the ability to hand every single community their own documentation.

Keren Etkin: That’s amazing because you know. We talk a lot about this, the labor shortage and staffing crisis, and that is sort of intertwined with the paperwork, the insane amount of paperwork that everyone in senior living has to deal with. And I, I feel like it is sometimes that the thing that really burdens people so much to the point that it does or could cause turnover, so potentially.

Like you could be also fixing some of that problem as well.

Sarah Richard: I am hesitant to bake that as a promise, but what I will say is a community that I’ve been working with. Sort of back of envelope estimated that my tool is gonna save his administrator 60 hours a month. And that’s unbelievable. That time could be

Keren Etkin: Wow.

Sarah Richard: with sort of FaceTime with residents, with really any number of other things. So I am really excited to drive towards being able to prove that out as a proof point.

Keren Etkin: Wow, that is amazing. 60 hours a month, that is like an extra, extra 30%.

Sarah Richard: Unbelievable.

Keren Etkin: Wow.

Sarah Richard: and it is very fascinating. You know, I come from a, a bit more of a traditional tech background. My prior roles were head of product at a, an early stage FinTech. And it is really fascinating for me to come from that more higAgeTech crypto AI kind of slant and realize how much senior living and older adults aging have just been not served at all. Or fully mis served. You know, a lot of what we’ve seen so far, in my opinion, is really tech enabled services, which is awesome. That is a fantastic stop gap. But when we are in such a tight labor market, we cannot be reliant on the services part of tech enabled services. We really do need to be full stack, full tech.

Keren Etkin: And do you think that AI is going to take us to that next milestone? Because I feel like a lot of startups right now, not necessarily in age tech, but in other highly regulated fields in which labor is in short supply, are really trying to work on dealing with paperwork and dealing with everything you can delegate to a machine right now using LLMs.

Sarah Richard: Yeah. I absolutely think that AI can help kind of mitigate the current gap that we have. I would say by no stretch does it replace a labor force, but it’s certainly augments, right? When we think about what we can do with LLMs even from the stance of, you know, the RAG functionality is fantastic, and for those who might not be aware, rag effectively is a way for you to really customize the output from a language model. And that gets me really excited from the standpoint of how can we take into account that certainly within senior living, certainly within aging, every case is unique and different. But when we do abstract a little bit one level up, we do find commonalities in ways that AI can really help mitigate a ton of paperwork, mitigate a ton of kind of overhead.

And you know, actually a lot of the work that I’ve done in the past couple of months has been. Building out custom tooling for various senior living communities because we do have that functionality right now. Whether that be some level of expedited sales flow, you know, a more streamlined CRM, more streamlined billing functionality.

How can we automate the boring stuff and automate the paperwork so that the people we’ve hired to do good work actually get to do the good work?

Keren Etkin: Absolutely. And like you said, everyone, at, at least everyone that I’ve met goes into this line of work is like their top priority is to provide good care. Whether it is through residents in senior living or whether that’s care in the home. And because these industries are regulated some more, some less, there is a lot of paperwork involved.

And you know, when you, when you go into this line of work, you’re like a people’s person and not, not paperwork person and, and definitely not the type that wants to sit in front of the computer 60 hours a month typing in whatever it is you gotta type in because the regulations mandate it. So I love that technology is finally like able, like you said, to mitigate a lot of that.

And to help people do their best work and not feel like I spent three hours today with a computer that I could have spent with residents.

Sarah Richard: Exactly. I mean. Even when I think through some of the most classic workflows that I know of in senior living, know, case number one being am a senior living salesperson and I am working with a place for mom lead referrals. fact that the current workflow is so manual with, you know, manual touchpoints.

I receive a lead and I’m going to go call them myself, and have a pretty rote initial conversation. that could be something that a salesperson is freed up from doing. You know, maybe the, the first kind of qualifying touchpoint doesn’t need to be a human because that human has a lot more on their plate that they could be better served.

Focusing on number two, being, you know, of course I’ve gotta say compliance. A lot of what’s done today from a plan of correction standpoint, from a sort of overarching Is really, I’m going to take my 400, 500 policy and procedure pages pull out my three ring binder, flip through to the program that I’m gonna run today, my antibiotic stewardship program. I’m gonna pull out that sheet of paper. I’m gonna write out my audit log by hand, walk through the community, check this, check that anything that goes wrong, I’ll manually kind of manage that task resolution by email. oh my gosh, of course. An automated solution could save 60 hours a, a month, of course. So of course there’s, there’s any number of different workflows that I think are really well positioned to be served by AI so long as the communities themselves are open to trying.