In interviews with industry thought leaders throughout the Leadership Series, executives across the senior living landscape have shared their personal stories, management hurdles and future outlook on senior housing and care.
In April, several of those leaders gathered in Washington D.C. for a candid panel discussion on some of the greatest challenges they face today as CEOs. In speaking with PointClickCare’s General Manager for Senior Living Travis Palmquist during the Senior Housing News annual spring Summit, those executives drilled down on three major challenges they are working through in today’s business climate.
These leaders, all of whom have been featured in this series during recent months, agreed: the business of senior living is not getting any easier. But they are all leading their companies to develop innovative approaches and solutions to today’s challenges, from data, to staffing, education and providing the best care along with the best lifestyle for residents.
The Data Challenge
From manufacturing to cancer research, data has become paramount in the delivery of goods and services to consumers in recent years. With technology available to help senior living providers track all kind of metrics—from the sales process to fall risks within a community’s walls—data is seen as a major opportunity for senior living to not only improve care, but also to prove outcomes to partners across the spectrum of health care providers.
On the flip side, actually putting systems into place to collect that data, and deciding which data to collect, is a two-fold challenge, leaders say.
“The missing link for this industry is data,” said Larry Cohen, CEO of Dallas-based Capital Senior Living (NYSE: CSU). “We still operate with systems that are not integrated. We don’t have real-time tools to make good decisions operationally.”
Similar sentiments have been expressed by many other senior housing CIOs and other technology stakeholders who say interoperability is a key hurdle to the effective collection of data. While a hospital may use one EHR system, a senior living provider may use another, and then gaining access to the system might provide yet another challenge.
But with integration comes a major opportunity for senior housing, Cohen said.
“We all know that the country is moving towards better outcomes over costs,” he said. “Our industry is in the sweet spot. …I think that’s the challenge, but it’s also the opportunity for our industry.”
Then deciding on which data to collect becomes a second challenge, says Brenda Bacon, president and CEO of Brandywine Living, based in Mt. Laurel, New Jersey.
“I think our biggest challenge is deciding what data we need to collect,” she said. “Sometimes I think we get caught up in collecting data just because it’s there. When we sit and talk to healthcare systems, it’s interesting to see the data that they’re looking for as opposed to the data that we typically think about when we think about a person’s clinical record.”
The Education Challenge
Leaders have often pointed to senior living’s “image problem,” especially in light of the caregiver shortage that lies ahead and the baby boom population that will be moving into senior living in the coming decades. While there has been some outreach relative to informing consumers about senior living, the idea of senior living that most consumers still have is the nursing home of 30 years ago.
“We have this huge issue about how we educate the consumer about what [the] end of life experience is,” says Pat Mulloy, CEO of Louisville, Kentucky-based Elmcroft Senior Living. “There’s no doubt about it, a resident today is a lot more frail than when I came into the business in 1996…we are all raising standards of care, but [we need to educate] the consumer that this is what happens in [our] business.”
That education also extends to the future workforce in senior living, who may not be familiar with distinctions between different care types, the different models available, and what actually happens inside a community’s walls.
Industry members have recently campaigned to change the terminology around Continuing Care Retirement Communities, for example, to Life Plan Communities. Likewise, many companies have changed their names and branding to steer away from language that says “care” or “retirement,” or “homes” such as a recent rebranding of ABHOW and be.group to the new name HumanGood. The changes appeal both to residents and prospective staff, but there’s another group that also needs educating, Bacon said: new providers.
“There’s one other challenge to this in educating the consumers…there are going to be a lot of new entrants into our business, a lot of people who have never been in this business before who think it’s easy,” Bacon said. “If you’ve got somebody coming into the industry who’s never done it before and really is not taking the precautions we take and paying the attention to quality that we are, they provide a huge risk to us.”
The Workforce Challenge
Among interviews with leaders throughout the Leadership Series, the challenge mentioned most is staffing. Recruiting and hiring workers, training and engaging them, and retaining them are among the top priorities of senior living executives no matter where they are based or what level of care they offer.
The problem is made more challenging by a U.S. economy that currently has an unemployment rate hovering below 5%, according to the Bureau of Labor Statistics. Competition for workers is fierce, as senior living providers must stand out not only from their industry competitors, but also from other industries that rely on hourly workers, such as restaurants and retail.
“I think we pay well against our competitors,” Bacon said, pointing to the challenge around other industries recruiting from the same talent pool. “[But] I was talking to one of our buildings the other day and the [local] Dunkin Donuts pays $1 more per hour to start than we do, and the Stop-n-Shop pays $1.25 more than we do for care managers. Now understand that being a care manager or a CNA is not an easy job.”
Mulloy echoed Bacon’s comments.
More from the Leadership Series
“It’s difficult work,” he said. “It’s not nearly as easy as pulling donuts off of a shelf or pouring coffee to a consumer. It’s more engaging; it’s more meaningful, and it’s got that going for it, but there’s still this whole question of: How [do] you find folks right now?”
Capital Senior Living is focused on leadership development, succession planning and employee engagement as some of the ways to help mitigate the risks around staffing.
“I’m focused at each community to make sure that we have the next executive director on set, and training—whether that person will be a successor at that property or transfer to another building,” Cohen said. “[We are] really thinking about what we need to do as a company for the leadership development and succession of every position of our key members.”
Given that millennial workers are known for “job hopping,” and recent studies show most workers enjoy a 90-day honeymoon period after which they often begin to seek new work, today’s leaders are focused on training and engagement.
Elmcroft is piloting a new hire onboarding for every single new hire and has recently rewritten all of its operations manuals for each nurse, sales director, management position, and the job description task list for every frontline housekeeper, CNA and medtech. The company is working to standardize the training in an effort to make it robust and engaging, Mulloy says.
“I think the entire industry is behind in this area: we’ve been so focused on selling that next grandmother and that next adult daughter…we’ve got to be just as vigilant at bringing the same sales efforts to hiring our employees and recruiting those employees.”
Read more—View the full Leadership Series interviews with the executives appearing in this article: