Senior Living Clinical Leaders Carry the Accountability, But Not Always the Authority, New August Health and ASHA Survey Finds

Only 21% of clinical leaders say their authority fully aligns with their responsibilities, a gap tied to how empowered they feel to impact change

SAN FRANCISCO--(BUSINESS WIRE)--August Health and the American Seniors Housing Association (ASHA) today released the 2026 State of Senior Living Clinical Leadership Survey, revealing that only 21% of clinical leaders say their influence and authority fully match the responsibilities they are held accountable for. The findings highlight opportunities for senior living operators to better support the people leading resident care through greater decision-making authority, staff development, and access to reliable data.

Now in its third year, the survey captured responses from 77 clinical leaders across corporate, regional and community-level roles. Respondents report accountability for a broad range of results, including care-related risk (77%), regulatory compliance (74%), and staffing levels and hours (48%). Yet their ability to influence those results varies considerably.

When authority fully matches accountability, 75% of leaders feel highly empowered to affect change. That drops to 20% when the two mostly align—and to zero when they align only slightly or not at all. Community-level leaders were more than four times as likely as their corporate peers to feel not empowered at all. Corporate leaders, meanwhile, were more than five times as likely to feel highly empowered.

“Clinical leaders see the realities of care firsthand. They know where their teams need support and what residents and families need from their communities,” said Liz Jensen, PhD, MSN, RN-BC, Senior Director, Nursing Success & Care Innovation at August Health. “Giving them responsibility for those outcomes has to come with the trust and authority to shape them. This year’s findings give operators a clear opportunity to look at where clinical leaders have a voice, where they can make decisions, and where those two things need to change.”

Even with these constraints, 91% of respondents report being satisfied or very satisfied with their jobs. When asked what makes the work rewarding, leaders point to developing their teams, building relationships with residents and families, and seeing the difference their care makes in residents’ lives.

The report also examines how organizations are supporting their teams and adapting care delivery. Additional findings include:

• Leaders have greater visibility into compliance than broader resident outcomes. While 82% can reliably track compliance with scheduled assessments, only 51% can track hospital admissions and 34% can track readmissions.
• AI use is growing, but disconnected systems remain a challenge. Forty-five percent of leaders are piloting or using predictive analytics or AI-driven alerts to identify residents at rising or high risk, up from about 35% in 2025. Yet 62% say the technology issue they would most like to solve is having fewer systems to log into or more seamless data flow between them.
• Staff development supports retention and resident care. Nearly seven in ten leaders (69%) credit improved onboarding or leadership development among their most effective retention strategies. In-services and training also rank first among investments leaders say have had the greatest positive impact on resident care outcomes (43%).

“Clinical leaders’ experiences should help guide how we strengthen senior living,” said David Schless, President and CEO of ASHA. “They are telling us that investments in onboarding, training, and leadership development are making a difference. They are also showing us where more support is needed. These findings give operators practical insight into how they can support their workforce and improve the care and services residents receive.”

The survey was developed with input from a task force of clinical and operational leaders from leading senior living providers including SRG Senior Living, Innovation Senior Living, MBK Senior Living, New Perspective Senior Living, StoryPoint Group, Lifespark, and Brookdale Senior Living. The task force helped shape questions and analysis to reflect the issues clinical teams face every day.

Fielded in September 2026, the survey gathered responses from 77 clinical leaders across the senior living industry, representing organizations of varying sizes, resident populations, locations, and technology platforms. Respondents included 60 corporate or regional leaders and 17 community-level leaders. Participation was voluntary, and findings are directional rather than representative of the industry as a whole.

To download the full 2026 State of Senior Living Clinical Leadership Survey, visit https://www.augusthealth.com/clinical-leadership-survey/2026.

About August Health

August Health is the AI-enabled platform for better care and operations in senior living communities, known for improving care quality, simplifying compliance, and enabling better care tracking and analytics. Designed with senior living experts and built by world-class engineers, the software platform makes it easier for communities to provide the best care. Through August Intelligence, the platform offers AI-powered insights that help communities act more quickly and confidently. Since launching in 2020, August Health has been adopted by leading operators across the country, including Sonida Senior Living, Cogir Senior Living, Lifespark Senior Living, Bickford Senior Living, Koelsch Communities, and Atlas Senior Living. Learn more at augusthealth.com.

About the American Seniors Housing Association

Based in Washington, DC, the American Seniors Housing Association (ASHA) represents approximately 500 organizations involved in the financing, development, and operation of the full spectrum of housing and services for older adults — including active adult, independent living, assisted living, memory care, and continuing care (or life plan) communities. ASHA’s members, both for-profit and not-for-profit, collectively own and/or operate approximately 750,000 senior living units across the United States. ASHA is focused on legislative and regulatory advocacy, and the organization supports research and national initiatives that advance high quality services for older adults so they can live with dignity in the setting of their choice.