Health & Wellness HealthCare September 2023

Cross Keys Village – Pennsylvania, USA

October 2, 2023

Cross Keys Village

The Cross Keys Village Experience

Long-established CCRC in Pennsylvania thriving in fast-changing Senior Living landscape

Cross Keys Village-The Brethren Home Community is Pennsylvania’s largest single-site, nonprofit retirement community and currently the fifth largest in the country. As a continuing care retirement community (CCRC, also known as a Life Plan Community), Cross Keys Village has been enriching the lives of older adults since 1908.

Its rural setting notwithstanding, the organization prides itself on being a CCRC ahead of the curve. Oliver Hazan, Vice President of Sales and Marketing, explains what a CCRC is: “The CCRC model was first implemented in the 60s and started flourishing in the 70s. It was the earliest example of Managed Care in the US. CCRCs care for individuals from late retirement until the end of their earthly journey. In addition to residential housing, the facility – we don’t like that word, but we can use it this one time – must include Assisted Living or Personal Care, and a nursing home (rehab and long-term) to be considered a CCRC.”

“Roughly 10% of the 2,000 CCRCs in the US are located in Pennsylvania, the majority of them are nonprofit and faith-based. Other areas in the country have not adopted the CCRC model as enthusiastically. You could call South Central Pennsylvania ground zero for continuing care… it’s a cultural thing” Hazan adds.

Serving today’s and tomorrow’s retirees

Far from the rather spartan Residential Living accommodations that once were the norm, modern communities like Cross Keys Village offer a wide range of options, with single-family Country Homes (other organizations call them Villas) exceeding 1,500 square feet. In addition to spacious, convenient residences, modern retirees expect a wide range of wellness, dining, cultural arts and lifelong learning programs, hosted in inviting and up-to-date common spaces. Furthermore, they require that supportive services be available, allowing the community’s residents to safely “age in place” if their mobility or intellectual capacities should be affected by age. The average stay in Residential Living is just under 11 years, with some long-term residents remaining in their apartment or cottage for 25 years or longer.

Cross Keys Village is proud of a culture that celebrates aging as a growing opportunity. Few CCRCs dedicate more space or more resources to their lifelong learning and wellness initiatives. A wide catalogue of classes, trips, concerts and creative art activities is offered under a general umbrella of “Life Enrichment.” Holly Fetting, the Director of Life Enrichment at Cross Keys Village, works with a multi-talented team. Classes, lectures and demonstrations are held by local instructors, by Life Enrichment staff, and even by villagers with a lifetime of experience.

Cross Keys Village - Pennsylvania, USA

Not one to simply let matters cruise along, Fetting shares: “I like to get people out of their comfort zones and I try to get them thinking about things they’ve not thought of before. It seems like just yesterday older adults were expected to slow down, or even fade away. But my team and I organize a new, large-scale art exhibit several times a year, and you should see the quality of the submissions from our villagers. Their curiosity and their enthusiasm continue to amaze me.”

Memory Care always in focus

Following the pathbreaking vision of CEO Jeff Evans and COO Joy Bodnar, Cross Keys Village has evolved since 2014 into a center of excellence for everything related to Memory Care and Memory Support. Every team member at Cross Keys Village receives ongoing education about the symptoms of dementia and how to respond appropriately. This enables them to assist those who make Cross Keys Village their home with greater respect and empathy as their needs evolve. They are also trained in how to intervene when they identify a situation that might be potentially unsafe.

One flagship on the 334-acre Cross Keys Village campus is Brookside, a 32-bed specialized residence for individuals with a diagnosis of neurocognitive disorder or dementia, designed to provide an optimal environment during the intermediate and later stages of the disease. A secure environment, Brookside offers a comprehensive recreation Life Engagement calendar, extending into the late evening and incorporating elements that engage mind, body and spirit.

Technology “behind the scenes”

While talented team members are Cross Keys Village’s not-so secret sauce when providing compassionate and innovative services to older adults, recent years have seen the adoption of several cutting-edge technologies to help make the experience of living and working at Cross Keys Village even better.

Ali Neiderer, Life Engagement Coordinator at Brookside, elaborates, “We have a system called It’s Never Too Late, developed by IN2L. The software program creates content that is customized for an older individual or a resident with memory impairment. The program recognizes each participant from their previous session and challenges them, via quizzes, games, dexterity exercises and trivia, just enough to stimulate them without aggravating or discouraging them. Rewards, also part of the system, include traveling segments, favorite music selections from the past, and more.”

Neiderer continues: “Another innovation at Brookside is a specialized lighting system in our common areas, that works to help regulate the circadian rhythm of residents who have lost their perception of time. Morning light encourages appetite and activity… while evening light gently leads to a gradual winding down as the day’s calendar gently wraps up.”

Back in Residential Living, Holly Fetting is an enthusiastic convert to a newly-installed communication tool. TouchTown is an app that the village has used for a year now, and it has become the primary way of communicating reliably with more than 800 villagers.

Cross Keys Village - Pennsylvania, USA

Fetting explains: “Over the years, communicating the various calendars and announcements from administration and dozens of groups had become fragmented and confusing: Posters, flyers, newsletters, CCTV bulletins, you name it. With such a massive volume of activities, residents just couldn’t keep track, but with TouchTown they can access all the information in the palm of their hands. Honestly, I was surprised how quickly the new format has been adopted. Most villagers are thrilled to have the information available on their phone 24/7. Of course, we still have a sign-up binder for our villagers who aren’t yet on board with TouchTown.”

Oliver Hazan confirms: “The image that older adults are resistant to technology is seriously out-of-date. The majority of our new leads come to us through our website forms. The COVID-19 years brought accelerated acceptance to teleconferencing apps like Zoom and to electronic paperwork solutions such as DocuSign, which can assist our out-of-state future Independent Living residents in completing their various documents.

Shifting the CCRC model

While it was innovative and valuable to begin with, the original CCRC model depended on older adults transitioning physically from one “level of care” to the next as their needs increased. For example, in a standard 1990s village, administration would frown on Residential Living residents using mobility devices such as a walker or a scooter in the residential dining areas. Residents who were getting frailer would be “encouraged” to transfer from their apartment or cottage to a higher level of care, provided in a more hospital-like setting.

Today, progressive villages like Cross Keys Village and the many excellent communities that dot the corridor from Chambersburg to Lancaster, PA are evolving into an increasingly home-based model for their delivery of care. Residents remain longer in their Independent Living quarters. As a consequence, “Length of Stay” is shrinking in assisted living homes and in the nursing centers, causing many CCRCs to consider reducing their nursing bed capacity, all the while making their clinical settings more pleasant and more conducive to residents’ dignity (sooner or later the old semi-private nursing room will be a thing of the past).

While Cross Keys Village has experienced the staffing challenges that are common to the industry, somewhat compounded by its rural location in the middle of a finite talent pool, staff turnover is much lower than average. Cross Keys Village has a committee dedicated to retaining staff and actively planning programs, expanded benefits, and more.

Hazan concludes, “We are standing on the shoulders of previous Brethren Home servant leaders, starting way back in 1908. Innovation was always part of the community’s fabric. We don’t lose sight of what we’re doing here. It’s God’s work, and we’re serving our community with every tool we have.”