Assisted Living Executive, Nov/Dec 2005
Transcription
Assisted Living Executive, Nov/Dec 2005
VOL.12. NO.9 ▼ NOVEMBER/DECEMBER 2005 AssistedEXECUTIVE Living Calm BEFORE THE Storm MODELS OF OPERATIONAL EXCELLENCE: EXECUTING YOUR CRISIS MANAGEMENT PLAN LEADERSHIP STRATEGIES Q&A with Midsize Company Execs QUALITY RESIDENT SERVICES Dementia Care Liability New Trend: Relocation Services THE BUSINESS MAGAZINE OF ALFA: THE ASSISTED LIVING FEDERATION OF AMERICA Then you need our innovative and proven “bottom line” management services. • “Performance” Enhanced Management Services • Comprehensive “Results” Marketing • Analysis & Consulting Reach your organization’s financial goals faster. Call now 877-240-6774 www.astoncaremanagement.com ACM ASTON CARE MANAGEMENT EXCELLENCE IN SENIOR LIVING ® • LEADERSHIP • PERFORMANCE • RESULTS AMERICA’S AWARD-WINNING MANAGEMENT, MARKETING & DEVELOPMENT COMPANY ©2005 Aston Care Systems, Inc.® SM Pass Meds. Not Errors. Pass Meds. Not Errors. Does your system catch errors before they happen? Does your system catch errors before they happen? 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Peace of min OPUS medispass you are doingofeverything you can to preone system, of the many benefits the OPUSpossible system—the only syste m with eight beforeorthey occur. Each resident’ s meds are pre-loaded by the facility vent errorsvisual audible safety checks built right in. If you think your pharmacistmight in an be individual This ready tocolor-coded, move up to atamper-evident more efficient,cassette. safer, and more assures thatsecure the right person gets the right med at med pass system, give us a call. the right time. Peace of mind is one of the many benefits of the OPUS system—the only system with eight visual or audible safety checks built right For in. Ifmore you think your facility information on the OPUS med pass system, call 1-800-228-5021, ext. 120, or visit opusmedsystems.com. might be ready to move up to a more effiset upsecure a meeting with your current pharmacy or introduce an OPUS provid and more cient, safer,We’ll med pass system, give us a call. 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NO.9 AssistedEXECUTIVE Living ADVANCING EXCELLENCE IN A S S I S T E D L I V I N G O P E R AT I O N S & C A R E Formerly Assisted Living Today ▼ NOVEMBER/DECEMBER 2005 Contents FEATURES 12 COVER STORY Calm Before the Storm BY ANYA MARTIN While a nation scrambled to cope with an unimaginable natural disaster, assisted living providers had already mobilized to shuttle residents to safety and try to maintain some sense of normalcy. 18 LEADERSHIP STRATEGIES When Midsize is the Right Size BY WHITNEY REDDING A recent conversation with three midsize company CEOs reveals the upside of not being the biggest fish in the pond—but not being the smallest either. 12 21 QUALITY RESIDENT SERVICES The Dementia Care Conundrum BY ADAM STONE The demand for dementia care is impossible to ignore or deny.The aging population virtually guarantees a growth market, but does the added risk make it worth it? How do you balance autonomy with increased risk? 26 QUALITY RESIDENT SERVICES You Sign Them Up, They Move them In BY WHITNEY REDDING While providers benefit vicariously from community services that help new residents make a happier transition from their former home, those communities that have formally aligned with a senior relocation provider are reporting direct advantages to the company’s bottom line. 18 DEPARTMENTS 5 TOP OF MIND BY RICHARD P. GRIMES, ALFA President and CEO 6 EXEC TO EXEC Insights on today’s issues NEED TO KNOW Industry updates and ALFA news COMPLIANCE CORNER BY JOHN ATKINSON ESQ. CONSUMER VOICE On aging and independence 9 29 31 32 33 34 35 36 AFFILIATE SPOTLIGHT: WALA BY JIM MURPHY RESOURCE LINK Classified ads PEOPLE & PLACES Appointments and developments AD & MEMBER INDEX Guide to advertisers & members PRODUCTS & RESOURCES Assisted living solutions 26 Assisted Living EXECUTIVE ▼ NOVEMBER/DECEMBER 2005 3 Executive Publisher Richard P. Grimes, ALFA President/CEO Publisher Debra J. Stratton Editor/Associate Publisher Angela Hickman Brady Associate Editor Marlene L. Hendrickson Contributing Writers Anya Martin, Whitney Redding, Adam Stone Art Director Becky McClimans PUBLISHING OFFICES Stratton Publishing & Marketing Inc. 5285 Shawnee Road, Suite 510 Alexandria, VA 22312 703/914-9200; fax 703/914-6777 E-mail: editor@alfa.org For circulation information, call 703/691-8100. A D V E RT I S I N G S A L E S T E A M Alison Bashian, abashian@alfa.org Marianne Juliana, mjuliana@alfa.org Stratton Publishing & Marketing Inc. 800/335-7500; fax 440/349-3447 Insights and critical review provided by the A L FA O P E R AT I O N A L E X C E L L E N C E A D V I S O RY PA N E L Michel Augsburger, President & CEO, Chancellor Health Care Inc. Cindy Chastulik, Divisional VP, Eastern Division, Alterra Healthcare Corp. Page Estes, VP of Operations, CaraVita Senior Care Management Services Inc. Jill Haselman, SVP, Organizational Development & Culture, Benchmark Assisted Living Justin Hutchens, SVP & COO, Summerville Senior Living Benjamin R. Johns, VP of Operations, Carriage Court Communities Susan Klein, SVP, Brandywine Senior Care Linda L. Martin, President & COO, Signature Senior Living Jack Peters, VP of Operations, Silverado Senior Living Marla Sovereign, VP of Assisted Living, American Retirement Corp. Daniel Schwartz, SVP of Operations, Sunrise Senior Living PUBLISHED BY THE ASSISTED LIVING FEDERATION OF AMERICA, FAIRFAX, VIRGINIA Assisted Living Executive (ISSN 1553-8281) is published monthly, with combined issues in January/ February, July/August, and November/ December, by the Assisted Living Federation of America, 11200 Waples Mill Road, Suite 150, Fairfax, VA 22030. Circulated to ALFA members only; a portion of dues is for subscription. Periodicals postage paid at Fairfax, VA, and additional mailing offices. POSTMASTER: SEND ADDRESS CHANGES TO Assisted Living Executive, 11200 WAPLES MILL ROAD, STE. 150, FAIRFAX, VA 22030; 703/691-8100. Printed in USA. Copyright 2005. Prior to photocopying items for educational classroom, internal, or personal use, please contact the Copyright Clearance Center, Customer Service, 978/750-8400, 222 Rosewood Dr., Danvers, MA 01923 or check CCC Online at www.copyright.com. Assisted Living Executive will not be responsible for the return of any unsolicited manuscripts or photographs. ALFA PRESIDENT/CEO TOP OF MIND What is a Midsize Assisted Living Company? W hen ALFA changed its value premise last year to Operational Excellence and then sharpened its focus to meeting the needs of companies operating professionally managed assisted living communities for seniors, it was soon clear that this was exactly the right path.The creation of Assisted Living Executive, Executive Roundtables, Executive Insights, Executive Portfolio and other executive-level products and services around Operational Excellence (in addition to re-doubling our federal public policy efforts and our outreach to the national media) have resonated with everyone in the assisted living business.We listened to the needs expressed by our members and industry partners— and then filled the void. If we made one tactical mistake, however, it was announcing that our executive products would be laser-focused on the needs of the “mid-to-large”-sized companies in assisted living.Why was this a mistake? I didn’t realize the industry-wide perception that there are only “large” companies (the “big guys”) and then everyone else! That is, everyone who is not “large” perceives themselves as “small.” No one perceives themselves as “midsize” operators. For example, I was surprised to hear the dismay expressed by a 175-unit operator with two communities that ALFA was only about the “big guys,” while he was just a “small” operator. Another operator with 350 units in three states said that ALFA wasn’t acting like we were about “mid-to-large”-sized since the products and services (Assisted Living Executive, Executive Insights, etc.) were exactly what her “small” company— and the executives within her company—needed from ALFA! This issue of Assisted Living Executive features a great article on three “midsize” operators with issues that will resonate with almost every Assisted Living Executive reader—and January, 25-27, 2006, we are hosting an ALFA Summit for Assisted Living Entrepreneurs in Washington, D.C.The Summit is especially tailored to assisted living companies with 120 to 1,200 total assisted living units. It’s a slippery slope to define “midsize” too precisely (what about the company with 1,300 units? 100 units?), but hopefully ALFA’s executive-level products and services (such as the Summit) will reinforce the notion that ALFA is for you if your company aspires to Operational Excellence and is all about professionally managed assisted living communities for seniors—regardless of size. Richard P. Grimes (rgrimes@alfa.org) *Remember to join ALFA and your ALFA State Affiliate in 2006. In 2006, your dues to ALFA will be paid by your corporate headquarters. Serving professionally managed assisted living communities for seniors by: t driving business excellence t ensuring a more informed public and t influencing public policy. Assisted Living EXECUTIVE ▼ NOVEMBER/DECEMBER 2005 5 EXEC TO EXEC INSIGHTS ON TODAY’S ISSUES—FINANCE What is the best cost-saving measure you have implemented in the last six months? hen our corporate dining services director recently retired, we partnered with a national food services company to ‘rent’ one of its senior managers as his replacement.Working exclusively with our communities, he has contributed handsomely to our bottom line—both in terms of reducing raw food costs and reorganizing the labor in some of our kitchens—all at approximately the same price as we paid his predecessor.” —Ted Janeczek “W Ted Janeczek, Executive Vice President & CFO, Country Meadows Retirement Communities, Hershey, PA tjaneczek@countrymeadows.com DuVal Byrd, CPA, Vice President of Finance & Controller, Southern Assisted Living Inc., Chapel Hill, NC ne significant cost-saving measure we’ve made recently was to change auditing firms. While the impact on the bottom line is important, I would also stress that the service level and overall ‘fit’ are equally as important. We make it a standard practice to periodically evaluate our strategic relationships with vendors and service providers. This will often include going to the marketplace and running a request for proposal process. We found that we were able to obtain better pricing and service levels by switching from a larger firm to a mid-size firm.” DuVal Byrd “O dbryd@southernassisted.com 6 NOVEMBER/DECEMBER 2005 ▼ Assisted Living EXECUTIVE POCH Senior Living has spent the last several years implementing a number of strategies to save costs and enhance revenue ‘above the line’ (EBITDARM—Earnings Before Interest,Taxes, Depreciation,Amortization, Rent, and Management fees), such as real estate tax abatements, outsourcing housekeeping, and implementing new clinical software. This past year, we focused on opportunities ‘below the line.’ EPOCH had a unique option to purchase one of our assisted living properties that had been under an operating lease. Utilizing Freddie Mac nonrecourse debt, we were able to reduce our monthly payments by 50 percent and ensure the appreciation of the real estate benefits our company rather “E Debora Pfaff, Senior Vice President & CFO, EPOCH Senior Living, Waltham, MA than a third party.We will continue to exercise strategic purchase options to reap the benefits of both the low-interest rate environment and the growth in real estate market value.” —Debora Pfaff debora.pfaff@epochsl.com If you would like to be interviewed for Exec to Exec, contact Marlene Hendrickson at mhendrickson@alfa.org. QUICK TIPS ven small changes can have positive bottom-line effects, making it well worth conducting regular reviews of operating procedures. Here are a few examples: E ■ LOOK AT POSITIONS THAT MAY BE EFFECTIVELY OUTSOURCED. Such positions may include those in food service or grounds management, but be sure to address a specific community’s needs and get feedback first. ■ REGULARLY REVIEW YOUR CONTRACTS AND PARTNERSHIPS. A regular review of long-standing or long-term partnerships with outside companies is worth the effort if it results in cost savings. Periodically get quotes from other companies or send out an RFP for particular services, such audits and background checks. ■ COLLECT INFORMATION FROM LOCAL REVIEWS. Consider implementing an annual review of administrative expenses at the residence level. Residence administrators and their staff may be able to recommend cost-saving measures at the local level, including expenditures on such items as office supplies, software packages, and professional resources. Help older adults stay active, have fun and make friends. Welcome to LifeTrail . TM LifeTrail is a series of outdoor Wellness Stations that transforms any walking routine into a more complete body workout. Specially designed and field-tested for older adults, the sequence of activities support older adults in their quest to achieve their maximum level of wellness. At the same time, LifeTrail stimulates social interaction by encouraging people to exercise together. Learn more about the standard features and customizable options that can make LifeTrail the ideal pathway to total wellness for your community. © 2005 Playworld Systems®, Inc. w w w. p l a y w o r l d s y s t e m s . c o m ® 1-800-233-8404 Pa r t o f t h e P l a y w o r l d S y s t e m s , I n c . Fa m i l y o f B r a n d s – R e c r e a t i o n F o r L i f e . I N D U S T R Y U P D AT E S & A L F A NEED TO KNOW N E W S ALFA Submits White House Conference Resolution A LFA has submitted a proposed resolution to the 2005 White House Conference on Aging.The resolution consists of three policy issues: ■ The need to preserve Medicaid for the truly needy; ■ Incentivizing the purchase of long-term care insurance and private savings for future longterm care needs; and ■ The creation of a consumer-directed, long-term care choice plan that would make long-term care portable across settings. In addition to ALFA, the resolution was formally endorsed by the following organizations: Sunrise Senior Living, Jefferson Area Board on Aging, U.S. Chamber of Commerce, American Seniors Housing Association,Armed Forces Retirement Home, and the for more information. ALFA also wants to recognize those heroic staff members who have helped assisted living residents and providers affected by the hurricanes. Please e-mail those stories to ALFA’s Paul Williams at pwilliams@alfa.org. Higher Premiums on the Horizon Center for Long-Term Care Reform Inc. Staff and advisors for the White House Conference will determine which resolutions will be considered for passage by the delegates on Dec. 11-14 in Washington, D.C. ALFA President/CEO Richard P. Grimes is a delegate. Hurricanes May Prompt Medicaid Cuts T he Medicaid Commission and the National Governors Association (NGA) each have released proposals for cutting $10 billion from Medicaid. However, in the wake of the recent hurricanes, many members of Congress have stated that drastic Medicaid cuts should be reconsidered. Both proposals include the following recommendations for achieving such cuts: ■ States should be allowed to reimburse drug manufacturers at the Average Manufacturer Price (AMP) rather than the Average Wholesale Price (AWP). ■ The penalty periods for asset transfers applied against Medicaid long-term care applicants should be prospective from the date of application for Medicaid. ■ The “look back” period (the time period preceding application, which Medicaid reviews for transfers) should be increased from three to five years. To read the Medicaid Commission Reports issued on Sept. 1, 2005, go to www.cms.hhs.gov/faca/mc/090105rpt.pdf. AL Communities Survive Rita Assisted living communities in the path of Hurricane Rita were spared much of the damage that occurred during Hurricane Katrina. ALFA State Affiliate leaders in Texas report that most communities that were forced to relocate to safe locations have moved back. ALFA’s Louisiana State Affiliate reports that Lake Charles communities received the most damage during Hurricane Rita, but to a far lesser extent than during Hurricane Katrina. ALFA continues to meet with federal officials and agencies regarding assistance for displaced assisted living residents and operators and encourages all assisted living providers and supporters to contribute to the ALFA Hurricane Katrina Assisted Living Relief Fund. Please note that a number of organizations no longer are accepting donations of clothing and supplies.Visit www.alfa.org Increases in Medicare premiums are among changes in 2006 that may impact the level of care seniors can afford. In September, the Centers for Medicare & Medicaid Services (CMS) announced that the Medicare Part B monthly premium will be $88.50 in 2006, an increase of $10.30 from the current $78.20 premium. Though premiums are rising, CMS says most Medicare beneficiaries will see significantly lower out-of-pocket health-care costs in 2006 due to savings resulting from the new Medicare prescription drug benefit. For more details, visit www.cms.hhs.gov. JCAHO Discontinues Accredition Program Effective Jan. 1, 2006, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) will discontinue its assisted living accreditation, citing lack of interest in the program. JCAHO first introduced the accreditation program for assisted living in 2000. The Commission on Assisted Living EXECUTIVE ▼ NOVEMBER/DECEMBER 2005 9 NEED TO KNOW Accreditation of Rehabilitation Facilities (CARF) now will become the only national accreditation entity for assisted living. Earlier this year, the Texas Assisted Living Association successfully lobbied to pass legislation that implements accreditation requirements in lieu of annual licensing surveys. (See “Accreditation Victory Fuels a Legislative Campaign in last month’s issue of Assisted Living Executive.) The program is voluntary, but by eliminating licensing surveys, it creates for assisted living communities a compelling incentive to seek accreditation. Correction The wrong contact information was included for Care Technologies in the October issue Life Safety Products chart.The correct contact number is 770/261-7844. Now Is The Time To List Your Facility . . . Strongest Sellers Market in 10 Years Many owners are taking advantage of this seller’s market to sell their facilities that are no longer a good match for their portfolio, geographically challenging or simply to raise cash for other acquisitions. Give us a call to get an honest opinion of what your property might be worth. JCH Consulting Group, Inc. specializes in the Sale and Acquisition of Assisted Living, Skilled Nursing and Congregate Care Facilities Experience Speaks for Itself . . . JCH Consulting Group, Inc. has successfully closed over $25 million dollars in Assisted Living facilities so far this year. We currently have over $120 million in escrow and $200 million in listings. Visit our web site at www.jchgroupinc.com or call Lee Blake at 541-317-1547 or Jim Hazzard at 888-916-1212 JCH Consulting Group, Inc. Health Care / Retirement Housing Specialists Offices in Anaheim & Los Angeles CA and Bend OR Professional Resources from ALFA For more information about any of these resources, visit www.alfa.org or call 703/691-8100. ■ ALFA Executive Teleconference. ALFA will conduct a Critical Issues Executive Teleconference Call on Nov. 15, 2:00 – 3:15 ET, with Silverado Senior Living executives Anne Ellett and Steve Winner focusing on dementia care in assisted living. ■ ALFA Executive Roundtables. Interested in having an influential seat at the assisted living business table? Inquire about becoming an ALFA Executive Roundtable member. Contact Paul Williams at pwilliams@ alfa.org. ■ ALFA Summit for Assisted Living Entrepreneurs. This invitation-only event takes place Jan. 25-27, 2006, in Washington, D.C.The summit will feature speakers and sessions that tackle the challenges senior living companies are facing and provide strategies and solutions for operations excellence. ■ ALFA Executive Portfolio. ALFA’s groundbreaking research report details what leading assisted living providers are planning. ■ Assisted Living Guide & Checklist. This ALFA brochure articulates the philosophy of assisted living and what consumers should look for when choosing a community. ■ Substitute Decision-Making: A Guide for Assisted Living Providers. This report provides business-critical information about the substitute decision-making process with residents and family members.This report is available only to ALFA members. ■ ALFA 2006 Conference & Expo, May 2-5, 2006 in San Diego, California.Visit www.alfaconferenceandexpo.com. ▼ TIRED OF THE JUGGLING ACT? We can help you make it easy. REPS Suite, by IDEAL Software, is the Senior Living Industry’s leading software solution. Designed with the user in mind, REPS Suite is simple to use and effectively integrates your most important tasks: marketing, lead management, referral sources, BUY OR WE’LL HOST FOR A LOW MONTHLY FEE resident care and assessments, billing and accounts receivable. Each of our modules can be run separately or combined as a tightly integrated solution. Our applications are web-based, giving you access to your community’s vital information anytime, from anywhere, including powerful, multi-community roll-up reports. And unlimited technical support is included in REPS Suite’s affordable, flexible pricing plans. Call us today to find out how REPS Suite can increase your revenues and profits by improving your overall efficiencies. www.idealsoft.com 813.935.4465 CALM Before the Storm In true models of operational excellence, assisted living providers activated crisis plans and hastily ferried residents to safety before the hurricane and flood waters arrived By Anya Martin C O V E R S T O R Y T he image is engraved in the memory of Deeni Shannon, executive director of Summerville at Kenner LLC —that of Michael Gardner, director of environmental services, carrying an elderly woman who could not walk up the stairs onto the bus. “She was 83 pounds,” recalls Shannon (shannon@sslusa.com).“She had her arm around his neck, and he was holding her with her knees draped over one of his arms. I don’t know how she would have been able to have gotten out of her own house or even if her family could have done that.” It wasn’t supposed to be that way. Shannon had an advance reservation number for comfortable handicap-accessible tour buses in case of emergency, but when she made the call with Hurricane Katrina approaching, she couldn’t get anyone to confirm they would be there. Less than 24 hours before the deadline for leaving, Gardner had approached her with the name of another bus company that was prepared to commit. Shannon calls Gardner one of the many “heroes” among a team who went above and beyond in a crisis that no one imagined could have been so bad.While news media told the tragic stories of seniors who perished in a flooded nursing home during Hurricane Katrina, assisted living providers were able to get their residents to safety. The story of Summerville at Kenner in Louisiana is just one of those inspiring tales of how to do things right in the most difficult circumstances, demonstrating true operational excellence. PLANS AND PEOPLE “I was very proud to see communities start to move their residents to safety days before either hurricane landed and to make good judgments about whether they could move residents or not,” says ALFA President/CEO Richard P. Grimes.“Assisted living members were out of harm’s way before harm came their way.” ALFA received an overwhelming response from members to a database it set up to match displaced seniors with residences in other locations, as well as a fundraising campaign to benefit displaced While news media told the tragic stories of seniors who perished in a flooded nursing home during Hurricane Katrina, assisted living providers were able to get their residents to safety. assisted living residents. “We’ve always talked about the importance of having a cohesive industry that may have many differences but one key thing in common—that we’re made up of people who care for other people,” Grimes says.“This was a manifestation of that in a way we hadn’t seen before.” While the buck stopped at Shannon in the decision to evacuate, she stresses “it wasn’t me, it was everyone,” a combination of residents, local and corporate-level staff, who made the experience a success. Shannon and fellow staff stayed at Summerville at Kenner, which is owned by San Ramon, California-based Summerville Senior Living and located just west of New Orleans, until 2 a.m. trying to get everything ready for the trip—from contacting family members to packing bag lunches and snacks, water and juice, 15 ice chests of food, clothes, toiletries, medicine, and key medical documents. Then she went home to pack what she could of her own possessions and try to convince her stubborn father to come along, knowing she had a responsibility to 66 residents whose care their families had entrusted in her. In the end, Shannon’s father relented and accompanied Shannon, her mother, and two dogs in a car behind the bus. Shannon’s husband, a media professional, stayed in New Orleans to cover what would happen next, and she wouldn’t hear from him for several days. Meanwhile, the marketing director and her husband were driving a van carrying three children, two cats, a dog, and a bird, and towing a U-Haul trailer filled with fully stocked medical carts. Other staff who came along included four certified nursing assistants, the food service director, a dishwasher, and a server. The drive to northern Louisiana took nine-and-a-half hours rather than the usual four. Residents were dropped off at four different residences, with which Shannon had made prior arrangements long before hurricane season. Once everyone was safely settled, staff checked into a nearby hotel. “We didn’t take the time to sit and watch the storm or listen to it on the radio; we were too busy dealing with resident care and trying to make everyone comfortable,” Shannon recalls.“We tried to talk about things not related to the storm. A lot of residents were stressed out because they remembered Hurricane Betsy [1965].We spent 36-48 hours on auto-pilot. Once we were able to sit down and watch the news, that’s when it really hit us.” Now communication became the biggest challenge. Because New Orleans cell numbers wouldn’t work, the company’s corporate office obtained a California-based cell number for Shannon. Soon, not only residents’ families, but anyone looking for a missing senior was calling or e-mailing her, she says.“I had a police officer who said ‘I can’t find my grandmother. I know you evacuated seniors, do you have any idea where she might be?’” Staff also had to learn new roles. Shannon remembers the dishwasher announcing how she had to bathe a resident instead of the dishes.“It wasn’t a negative, it was ‘I have done something good.’” Moments like this, and when a resident didn’t recognize Shannon because he was Assisted Living EXECUTIVE ▼ NOVEMBER/DECEMBER 2005 13 C O V E R S T O R Y used to seeing her in a business suit rather than casual clothes, are what make her smile despite it all.“That gentleman was saying that his pajamas weren’t his. I put them back in the closet and then said,‘Look, here are your pajamas.’ He looked at me and said, ‘Did you come from Summerville?’ I said, ‘I’m Deeni.’And he said,‘I’m so glad to see you.’” In another meaningful moment, one resident’s daughter called her in tears and said,“Thank you for saving my mother’s life.” Effective planning and compassionate caregivers also ensured a happy ending for residents and staff of Sunrise at Bayou St. John and Sunrise at Slidell, both operated by McLean,Virginia-based Sunrise Senior Living Inc. Based on weather reports about the storm’s intensity and its direct turn toward the city two days before the storm would make landfall, staff decided to evacuate the two residences, the first located in a posh suburb on Lake Pontchartrain and the other in a nearby rural community, says Sherry Robinson (sherry.robinson@ sunriseseniorliving.com), Sunrise’s area manager of operations for the four-state area of Louisiana,Arkansas, Kentucky, and Tennessee. Like Summerville at Kenner, staff contacted families, allowed time for loved ones to be picked up, and gathered supplies, as well as personal treasures such as photos or jewelry.“We try to be very sensitive,” Robinson says. Ed Edahl/FEMA COMPASSIONATE, WELL-PLANNED CARE When 112 residents and staff from the Veranda Living residences in Texas packed into a 34-seat passenger bus, two 25-seat buses, five 15-passenger vans, and several cars, little did they realize that a drive that normally takes under six hours would last 28 to 36 hours. The next morning, they pulled out with more than 50 of 85 residents from Bayou St. John and five from Slidell, which averages around 50 residents. Twenty staff members from Bayou St. John also came, some of them bringing family members. Slidell residents went to a hotel in Natchez, Mississippi, while the destination of the Bayou St. John group was Emerald Hills Golf Resort in west-central Louisiana, where the company, thanks to an employee’s recommendation, already had negotiated arrangements in case of emergency. “We had reserved them for Hurricane Dennis [in early August] and paid for them, Jocelyn Augustino/FEMA Once the news came that the levees had broken in New Orleans, Sunrise staff knew there would be no homecoming any time soon for most of the evacuees. 14 NOVEMBER/DECEMBER 2005 ▼ Assisted Living EXECUTIVE as well as charter buses, even though that time we didn’t use them,” Robinson says. “That gives the hotel and bus companies an incentive to give us right of first refusal.” Once the news came that the levees had broken in New Orleans, staff knew there would be no homecoming any time soon for most of the evacuees. Slidell suffered only minimal damage and has reopened, but when Sunrise staff were finally able to enter Bayou St. John, they found water lines indicating flooding of up to four feet on the first floor. The Sunrise group stayed at Emerald Hills for five days with staff members trying to ensure that residents’ lives remained as normal as possible under the circumstances. They unpacked activity supplies, packed as part of the evacuation plan, and organized games, arts and crafts activities, and exercise. Meanwhile with cell phones unreliable, Robinson created a link on Sunrise’s Web site for family members to e-mail her directly.“I received a couple hundred emails a day,” she recalls.“I was able to tell people where other family members were when they couldn’t talk to each other.” Some families came to pick up their loved ones.Then it was back on buses for more than 40 headed to Houston communities and six to San Antonio, each carefully At Summerville at Kenner, the winds had blown windows out of their casings, shattering glass all over the floor, and the hinges off of doors. Photo courtesy of Summerville paired with a community suited to special needs such as Alzheimer’s care. Just 60 miles outside Houston, one bus broke down. Again, Executive Director Iris Granat followed a plan that worked, Robinson says.“She got off the bus and went into a gas station across the street, called the local fire department and they came.” Local firemen and police from the tiny town of Shepherd,Texas, (population 2,050) transported the seniors and accompanying 20 caregivers to a local restaurant, and then one of the city councilmen, who owns a car repair shop, and a team of his mechanics fixed the bus at no charge. Sunrise’s disaster plans vary across the country depending on the unique challenges faced by different geographic areas, but Daniel Schwartz (daniel.schwartz@ sunriseseniorliving.com), Sunrise’s senior vice president of corporate operations, says the entire Hurricane experience reinforced some key points. “One is that we should always prioritize ensuring the safety of our residents and team members,” he says.“The second thing is the importance of not only having disaster plans and evacuation plans, but also practicing and making sure team members are capable of implementing them.” Schwartz hails staff first and foremost. “These actions are heroic,” he says.“These folks didn’t decide not to show up for work like the TSA screeners did. I spoke with a number of department managers on the Bayou St. John team who said they didn’t know if their houses were still there or if their families were safe.They literally picked up what they had and left with the residents.” To reward staff members who evacuate, Sunrise has a policy of paying around the clock for the period of time that the employee is away from his or her home, as well as covering all room and board expenses.The company also has made sure that all affected employees, whether or not they came along for the ride, continue to receive salary and benefits, as well as helping those who wish to relocate with extra stipends to help them get started in a new location. The one tragedy Sunrise experienced has been well reported in national media.A charter bus evacuating 37 residents, six team members, and the family member of one team member from Brighton Gardens of Bellaire near Houston was involved in a tragic incident near Dallas and resulted in multiple deaths.The community, which is in a low-lying area near Houston, was evacuated in advance of Hurricane Rita.The bus that was involved in the incident was one of two charter buses that left the community within a few hours of one another. The second bus, which was transporting approximately 15 residents, arrived safely in the Dallas area. “Our primary concern is for the safety of our residents and we are shocked and saddened that this event occurred during our evacuation.We are working with authorities investigating this incident to determine its cause,” said Sunrise Founder, Chairman, and CEO Paul Klaassen, following the accident.“The team members who were traveling on the bus were there to assist these residents during their trip to Dallas.Their heroic actions helped save the lives of many residents and I am extremely proud of their actions.” The bus was chartered through a company that also provided assistance to Sunrise when evacuating residents of its New Orleans area communities during Hurricane Katrina. CREATIVITY ON THE ROAD While Hurricane Rita thankfully didn’t wreck the damage and death toll of Hurricane Katrina, the gridlock after so many Texans opted to evacuate resulted in a different set of challenges for Pasadena, Texas-based Veranda Living Inc. The city of Houston mandated evacuation of all assisted living, nursing, and special care residences in low-lying areas with potential for flooding, which included Veranda’s Pine Tree Lodge (assisted living) and Pine Tree Cottage (Alzheimer’s care). When 112 residents and staff of these residences packed into a 34-seat passenger bus, two 25-seat buses, five 15-passenger vans, and several cars, little did they realize that a drive that normally takes under six hours would last 28 to 36 hours, says Veranda President/CEO John S. (Skip) Comsia (skip@verandaliving.com). The caravan pulled out at 10:30 p.m. on Wednesday, September 21, but the last vehicle didn’t arrive until 6 p.m. on Friday at the newly opened assisted living community Courtyards of Lake Granberry in Granbury,Texas, where Comsia had negotiated temporary housing. Group members were separated due to the mess of congested traffic and abandoned vehicles and forced to take different routes out of the city. Some vehicles ran out of gas or broke down, too. “It was a very wild experience,” Comsia recalls.“It wasn’t pleasant.We were just fortunate that none of our residents got seriously overheated.” The situation required some clever thinking. In one case, negotiation with local police led to a vehicle being able to get gas from a county maintenance facility and a police escort through back roads.After one of seven residents with Alzheimer’s disease got overheated, requiring a hospital stop, staff started calling hospitals along the route to ask for permission to stop so sen- Assisted Living EXECUTIVE ▼ NOVEMBER/DECEMBER 2005 15 C O V E R HOPE ACROSS THE MILES Stories of hope, however, aren’t limited to the communities that were impacted directly by the storms. Staff and residents in assisted living communities across the nation have conducted fundraising campaigns and other activities to help. Catonsville, Maryland-based Erickson Health, which manages 13 campuses for middle-income people over 62, raised $404,115 in just two weeks, more than double its most successful previous fundraising campaign for tsunami relief last year, which totaled $196,000. The company has also Staff and residents in assisted living communities across the nation have conducted fundraising campaigns and other activities to help. Marvin Nauman/FEMA iors could be checked by medical staff and rehydrated. “It soothed tensions, and hospitals are also a great place to stock up on supplies,,” Comsia says.“Overall, it was a great little innovation, a change in plans that really worked.We even stopped at a hospital on the way back.” While Comsia is glad his communities were spared, he is now having all employees who drove vehicles write up their experience to make a comprehensive list of lessons learned. He plans to use it to revise and improve Veranda’s emergency plan for the future, he says. He also wants to use that list to help lobby government officials to create a separate, non-freeway route out of town for people with special needs in case of a future mandated evacuation. S T O R Y assembled a volunteer list of 10-20 employees ready to travel to the New Orleans area to aid in on-site disaster relief work. Another Erickson initiative offers temporary or permanent housing to seniors displaced by Hurricane Katrina, and at press time, the company was investigating providing relocation and job assistance for displaced staff and their families. Several formerly New Orleans-based employees have already been hired by Eagle’s Trace, Erickson’s newest CCRC, which opened in mid-October in Houston. Recognizing a need for low-income senior housing in New Orleans, as well as likely availability of federal funds to finance, Erickson finally is considering moving a plan to pilot a low-income CCRC from Baltimore to New Orleans. Lessons Learned ■ Ensure staff are trained and ready to assume new roles. Dishwashers may become caregivers, for example. As Sunrise’s Dan Schwartz says, in addition to having a disaster plan, ensure team members are capable of implementing it. ■ Plan for communication problems. When New Orleans cell phones weren’t working, Summerville obtained a California cell phone number for Summerville at Kenner Executive Directory Deeni Shannon. ■ Incorporate advance reservations for housing and transportation in crisis plans. Agreements with hotels or other communities and charter bus companies should be in place. ■ Expect the unexpected and be ready to adapt. Gridlock along evacuation routes can turn short drives in day-long drives, or longer. Veranda Living residents and staff endured up to 36 hours of travel, requiring creativity along the way. When some residents became overheated, buses stopped at hospitals to rehydrate residents and shore up supplies. ■ Use the experience to update crisis management plans. Veranda Living’s Skip Comsia has asked staff to write up their experiences to collect lessons learned. He’ll use what he finds to improve emergency plans. And, he plans to lobby government officials for a special route out of town for people with special needs. 16 NOVEMBER/DECEMBER 2005 ▼ Assisted Living EXECUTIVE The fundraising drive was a no-brainer, but the other ideas came straight from employees and residents who desperately wanted to help, says Mark Erickson (mark.erickson@ericksonmail.com), chief strategy officer.“After Hurricane Katrina, we started getting e-mails and phone calls.We ended up getting so many ideas that we had to sit down and consider the cost and where we wanted to commit our resources.” Milwaukee,Wisconsin-based Alterra Healthcare Corp. launched a program where employees could donate paid timeoff (PTO) hours and/or contribute via payroll deduction.The company committed to matching every dollar up to $200,000. As of September 29, a total of $138,000 had been raised, including the company’s match.Alterra also has offered to house displaced seniors and help displaced staff, but perhaps its most heartwarming program actually came from thousands of miles away, inspired by a touching request by a resident of Alterra Wynwood of McMinnville (Oregon). Frell Zink, a 91-year-old resident, couldn’t see the images of flooding and destruction on TV because he was completely blind, but he had heard the descriptions. So he went to the front desk and asked whether there was something he could do.“I could hear in his voice that he felt helpless,” recalls Residence Director Christine Rice (crice@assisted.com), who was standing nearby.“I couldn’t stop thinking about it when I went home. I’ve got to come up with something, some way.” Rice’s evening brainstorm evolved into You Can Help To contribute to ALFA’s Hurricane Relief Fund, visit ALFA Online at www.alfa.org. the company-wide giving project “Hope for the Holidays.” Residents and staff of each Alterra residence across the country will come together to wrap and fill donated shoeboxes or similarly sized gift bags with gift cards for groceries, gas, and other necessities, as well as a handmade ornament and other items a displaced family might enjoy during the holidays, such as a disposable camera and photo album. “A project like this not only helps the people affected by Katrina and Rita but also helps my residents and staff,” Rice says.At Alterra Wynwood, residents are already prewrapping shoeboxes, and a whole range of crafts projects are planned, such as making bracelets and tote bags to include in the boxes. Families and residents of the surrounding community will be invited to join residents and staff at a big stuffing party December 3. Rice sees signs that residents are grateful for the opportunity every day. For example, a resident asked her if it was OK to drop two stuffed animals into a collection box for gift items, and of course, Rice said yes.“One had a little saying on it that she showed to me. I could tell that she was looking at it for the last time, knowing that somebody else was going to be getting it.” Another special moment was telling Zink how his small request had grown into a company-wide program.“I told him he was going to touch way more people’s lives than he had imagined,” Rice says.“He said that last night he was going through his pants. He had about a dozen pairs and said he didn’t need them all. I had to excuse myself because I started crying.” “Just walking through and seeing that, I knew if we had been there, so many people would have been hurt,” Shannon says. Clean-up and reconstruction is underway, and she is optimistic that residents are among the lucky ones who will be home again by Christmas.With her own home flooded with three feet of water and the front window blown in, she’s so glad she convinced her father to come along. “Sitting at my desk, it still looks like I left it,” Shannon says.“There are still piles of paper I’m supposed to be working on— financials and variances.” ▼ Anya Martin is a contributing writer to Assisted Living Executive. Reach her at amartin@alfa.org. *OE(ANF h"OY)THOUGHT)HAD #/0$2EHABSURVIVOR ,OWCOUNTRY3ENIOR#ENTER #HARLESTON3OUTH#AROLINA CONQUEREDTHEWORLDv h4HElRSTMACHINE)WASPUTONWASATREADMILL)LASTED SECONDSATMILESPERHOUR4HENMYTHERAPISTSAID @)VEGOTJUSTTHEMACHINEFORYOU)NMYlRST.U3TEP WORKOUTTHEWORKLOADWASONONEAND)LASTEDFORABOUT AMINUTEANDlVESECONDS h"OY)THOUGHT)HADCONQUEREDTHEWORLD h.OW)DOTHE.U3TEPJUSTABOUTEVERYDAYFORMINUTES WITHTHEWORKLOADATFOURANDUSUALLYSTEPSPER MINUTE.U3TEPMAKESITPOSSIBLEFORPEOPLE LIKEMETODOBETTERWITHEXERCISEv &ORMOREON*OESSTORYANDHOWYOU CANCONQUERTHEWORLDWITH.U3TEPSEE WWWNUSTEPCOMTRANSFORM / 2 $ % 2 $ ) 2 % # 4 18MRH[DGLQGG 30 HOLIDAY HOMECOMING When Shannon finally walked back into Summerville at Kenner one month after Katrina, she thankfully found no flooding. However, the storm’s harsh winds had blown windows out of their casings, shattering glass all over the floor, and the hinges off of doors. Assisted Living EXECUTIVE ▼ NOVEMBER/DECEMBER 2005 17 L E A D E R S H I P S T R AT E G I E S WHEN MIDSIZE Is the Right Size T he largest assisted living companies are getting larger as the market continues to experience consolidation and the threshold for going public has become much higher. As the definition of what constitutes a “largest provider” gets bigger every year, many midsize companies can expect to remain midsize for a long time. How do the ins and outs of the current marketplace affect the so-called “midsize” provider? Assisted Living Executive (ALE) asked three providers representing a capacity of 300 to 840 residents about the opportunities they’ve experienced particular to being midsize.Their responses lend insight to the advantages that midsize providers can have in maintaining their company’s intimate culture and their hold on their market, and still having enough scale at the end of the day to make the deals they want. Here are excerpts from our recent con- Company Stats Commonwealth Assisted Living Charlottesville, VA, 270 total licensed assisted living units, 5 residences, State served: VA, www.CommonwealthAL.com Intercontinental Services Inc. (Owners of The Family Connection communities known as Carlton Plaza or Chateau), Martinez, CA, 698 total licensed assisted living units, 6 residences, State served: Northern CA www.thefamilyconnection.com Resources for Senior Living Charlotte, NC, 659 total licensed assisted living units, 9 residences, States served: NC, SC, TX www.rsl-al.com 18 NOVEMBER/DECEMBER 2005 ▼ In a business built one customer at a time, midsize companies often excel at maintaining intimate company cultures and hands-on management midsize is that we provide frequent onsite corporate management of our buildings. And we’re there every week. I’ve got a good sense of what’s going on in each building all the time. I think as you get bigger, that gets harder to accomplish. But as opposed to being a small operator, we’re still able to get attention from important vendors such as pharmacy and food suppliers.We may not get the best pricing a larger firm would get, but we get the attention we need to make the business work. By Whitney Redding HOWARD: We started out the same way; versation with Richard Brewer (richard@ we had four buildings right in our backyard commonwealthal.com), president of and two buildings in South Carolina.The Commonwealth Assisted Living of farthest was only about two hours away. Charlottesville,Virginia; Jonathan Howard So we were able to maintain hands-on man(jmh40@aol. com), president of agement. Later, we developed our teams Resources for Senior projects. Living LLC of CharWe have certainly lotte, North Carolina, been able to negotiate and past president of national contracts based RSL-Simon; and Philip on our size. I think you Scott (philip@isifc. can do that—if you’re com), CEO of Intergood—with just about continental Services any size. of Martinez, California. Maybe when you get to 14, 15, or 16 ALE: Each of you repbuildings, you may resents different marneed a regional office, kets both geographibut at this point, we’re cally and in terms of comfortable with our BREWER: “I’ve got a good sense of what’s going on in each building all the time. I think as the model or combihome office staff being nation of services you you get bigger, that gets harder to accomplish.” able to manage nine offer, but what are some of the combuildings. monalities you share because of your SCOTT: There are a few ways that I size? Are there advantages to being think it’s an advantage. I’ve worked with midsize? large publicly held companies in assisted BREWER: While we’re each considered living. One advantage is that we’re able to midsize companies, we’re all actually quite manage our culture.We’re able to really act different. My company’s operations are a on innovative concepts and quickly cluster within a 20-30-minute drive of each respond to customers in a timely manner. other. So I consider the advantage of being There’s also consistency of our product. Assisted Living EXECUTIVE Much like Richard Brewer said, even as CEO, I’m in the buildings probably every other week with a presence and a schedule.We strategize consistency of product. We do have a hub-and-spoke management philosophy where all of our communities are within an hour and a half of each other. That’s been really beneficial in expense management and response. Managing culture consistently is key. We really populate our communities with the same philosophical bent very consistently from our management team. people can understand our philosophy and culture and why we operate the way we do. I look forward to this consolidation. I think the real key to managing these buildings is being able to cluster your management and run several buildings in a tight radius. I think you will see some of these larger operators sell off the one building that’s far away from anything else they own.And hopefully that will offer some new opportunities to us. SCOTT: We value relationship development in our selling process. I noticed that some of the larger competitors tend to be very reliant on advertising, which, as we’re all aware, has a poor response rate. And our buildings are all over 95 percent full in markets that are exceedingly competitive. We’ve been able to personalize our outreach marketing effort with consistency. We’re using relationship development selling. And when your competitors have a high attrition rate of sales personnel, it makes that job a lot easier because we are a known commodity. ALE: The recent oversupply of assisted living and senior housing stock is sorting itself out and assisted living is in a period of consolidation. Has this affected your business and/or the markets you operate in? HOWARD: In Charlotte, where we operate four residences, with the exception of our projects and maybe one or two others, every other project has been owned by somebody else.We’ve had some buildings that have turned over four or five times. I ALE: What about any competitive advanthink that the stability tages? Anything that of having the same you can do better in a name and management sense by virtue of for a period of six years, your size? is really beneficial in the BREWER: This busimarketplace. There are buildings ness is becoming so that are differentiating complex that you need themselves from others. to have some amount ALE: Is being midsize a good long-term And through some of of size.When we startstrategic choice? these consolidations, you ed, we acquired three BREWER: Well, with the size of the public end up with four or five buildings and I was HOWARD: “We were successful because we offerings today, you can certainly stay middoing everything myself, were able to have a hands-on business where buildings that are run by size for a long time.There are enough exit the same company. If and operations takes an customers understand our philisophy.” strategies available, including refinancing or you’re a customer and you’re not satisfied incredible amount of time. It is much more sale-leaseback type transactions, that you can with that company, then you would knock difficult to be small than to be midsize. stay midsize and grow for quite a while. out those four buildings. I think it really helps I think our competitive advantage with HOWARD: If you’re structured privately, a midsized operator who doesn’t have a clustering is that you share human capital then you may have a different outlook than monopoly on that market, because if cusamong buildings.You can start branding and if you’re structured with a venture capital tomers don’t like one operation, they’re share marketing costs among the buildings fund or an opportunity fund. going to go someplace else.We’ve been that a single entity wouldn’t be able to do. You can certainly stay midsize for a long very successful in maintaining our market Our competitive advantage compared time, but does your financial partner have share because so many of the other compawith larger operations is consistency.When the same goal to stay with you for a long you’re in the buildings every couple of nies have either played musical chairs or weeks, you know exactly what you’re offerown so many in one time, and how do you ing. If it’s not what you want, you can market that it doesn’t define that “long time?” move to change that quickly. In a larger give the consumer a Generally, if you start operation, it’s just more difficult to do that. out with venture capital chance to differentiate or have private equity, our product vs. the HOWARD: I agree. Plus, you have the you have a time threshcompetition. opportunities to meet with family members old as well as an earnas well as employees if there are any comBREWER: That’s a ings threshold.Your plaints or positive comments from your good point about this financial backers don’t families. consolidation. And necessarily have the “Locally owned and operated” has some that’s how we came same passion or desire merit in lots of markets. It certainly did in into existence. Not only to be in the business [as our four buildings here in Charlotte.We when they consolidate you do].We really enjoy have competition from everybody—big, do they take on more what we do and feel small, all kinds. And we were successful buildings, but they sell SCOTT: “We’re able to really act on innovative off whenever it doesn’t concepts quickly and respond to customers in we’re providing a great because we were able to have a hands-on service.They may not business, locally owned and operated, and fit the model. a timely manner.” Assisted Living EXECUTIVE ▼ NOVEMBER/DECEMBER 2005 19 L E A D E R S H I P look at that that way. So you really have to sit down with your financial partner and find out what their goals are. If a company wants to maintain that hands-on approach, they’re better off staying midsized and just growing maybe a little bit more slowly but at least growing effectively and maintaining quality assurance, and it sounds like all of us have that in common. SCOTT: I would absolutely agree.What I think we’re all saying is we’re really in the driver’s seat. I mean we can grow concurrent with the appetite we developed internally. We are really in a good position.The opportunity is available to us generally at the right price, and we just have to look strategically if it’s the right opportunity. ALE: The large assisted living companies compete with small to midsize providers in local markets but also with each other on a national scale, and to a certain degree must have a replicable model or brand to take from state to state. How does that affect your ability S T R AT E G I E S to compete with them in your markets? BREWER: We compete with some of the large operators, and I think the most difficult thing from our perspective is that they have huge marketing budgets. They also tend to have larger communities with higher operating budgets. So, from those two perspectives, their models are tough to compete against, but we certainly can overcome those things with the local flavor we offer. SCOTT: We have developed unique selling principles, and we’ve defined those as being family-owned and -operated.We do a la carte care services pricing. In our personal expressions department, as opposed to activities, we personalize everything and encourage participation. We also have a satisfaction guarantee.We go to the market with that. And we are the best at what we do no matter where we are. HOWARD: These large companies are not necessarily better, but they do have bigger marketing budgets and you just have to look at it more from a one-on-one, one-customerat-a time perspective. And we haven’t seen much success in advertising in our local newspaper or those types of media. It just isn’t that effective in our markets. People like to come and see and touch and meet the people.We try to create an experience so that when people come and visit us, we set ourselves apart.And at that point, it doesn’t make a difference if you’re in a big company or small company. Customers want to be with the best company. ▼ Whitney Redding is a contributing writer to Assisted Living Executive. Reach her at wredding@alfa.org. MIDSIZE OPERATORS: Don’t miss the ALFA Summit for Assisted Living Entrepreneurs, Jan. 25-27, 2006 in Washington, D.C. Featuring high-impact speakers and sessions that tackle the challenges of midsize companies and providing solutions for operational excellence. For more information, call 703/691-8100. %NHANCEYOUR INDIVIDUALCAREPLANS 3OOTHEZE 4OASTY "EARS AND &RIENDS #OLLECTION AND RELATED PRODUCTS PROVIDE AUNIQUEANDSPECIALTHERAPYFORSENIORS THAT COMBINES COMFORT AND WHIMSICAL CHARM WITH THE SOOTHING QUALITIES OF HEAT OR COLD AND AROMATIC HERBS ! FEW MOMENTS IN THE MICROWAVE BRING OUT THEIR PLEASING AND LASTING THERAPEUTIC WARMTH /R USE THE FREEZER FOR COM FORTINGCOLDTHERAPY 4HEYHELPREDUCE ANXIETYANDAGITATIONANDCREATEVERY REAL AND POSITIVE CONNECTIONS WITH SENIORSWHOLOVETHESEPRODUCTS !ND IFMADEAVAILABLEASGIFTSTHEYPROVIDE ANOPPORTUNITYFORADDITIONALREVENUES WITHLITTLEORNOOVERHEAD 4OASTY©"EARSAND&RIENDS#OLLECTION "ODY WRAPSSACHETSEYEPILLOWS !WIDEVARIETYOFCHARMINGANIMALS FORHEATCOLDANDAROMATHERAPY HOMESPASETSANDMORE 20 NOVEMBER/DECEMBER 2005 ▼ Assisted Living EXECUTIVE )NFORMATION/RDERING WWWSOOTHEZECOM T F Q U A L I T Y R E S I D E N T S E R V I C E S THE DEMENTIA Care Conundrum Balancing autonomy with liability risk may require taking a hard line with families Capistrano-based Silverado, are effectively managing risk and meeting demand. ALL OR NOTHING By Adam Stone W hen it comes to dementia, assisted living executives face a thorny problem. On the one hand, they wish to preserve maximum autonomy for residents.At the same time, issues of liability can pull assisted living leaders in the opposite direction. Budgie Amparo (amparo@sslusa. com), vice president of quality and risk management at San Ramon, California-based Summerville Senior Living, recalls the case of a resident in the general population who showed signs of increasing aggression, striking out at staff and pushing other residents.The family refused to face the prospect of dementia and would not permit the psychiatric and neurological testing that would have created a window for appropriate care. Weighing the family’s desire for patient autonomy against the potential liability of dementia improperly treated,Amparo opted for caution. He put the family on warning that expulsion was imminent.“The family was very upset about that, but in the end we did have to execute that 30-day notice, asking them to leave and seek a more appropriate placement,” he recalls. When it comes to liability in the context of a dementia unit, he says, the risks are just too great. The demand for dementia and Alzheimer’s care is impossible to ignore.The aging population virtually guarantees a growth market.According to the Alzheimer’s Association, an estimated 4.5 million Americans suffer from Alzheimer’s, and by 2050, an estimated 11.3 million to 16 million may be diagnosed with the disease. But when you take on an older, more fragile population, you take on risk. “If somebody slips and falls, that is a liability issue for us whether they have Alzheimer’s or not,” notes Anne Ellett (aellet @silveradosenior.com), vice president of health services for 13-property Silverado Senior Living.“But then you add cognitive impairment and suddenly you have people wandering out the front door, people forgetting to come to meals. It does create an additional liability and it does require additional levels of oversight.” Clearly, many companies, like San Juan Dementia care is a highly specialized service that can’t be delivered in half measures. “Some assisted living providers believe it’s OK to keep [residents with Alzheimer’s] living within the general community,” notes Merle Wexler (mwexler@somerford. com), vice president of resident services and Alzheimer’s care at Somerford Assisted Living & Alzheimer’s Care in Gaithersburg, Maryland.“But is it really a safe environment if you don’t have the secure doors, if you have dead-end hallways where a person can get trapped?” In a dedicated dementia residence,“you already have all the things one needs to make it as safe and supportive as it can be.” But physical spaces comprise only a small part of the overall landscape when it comes to mitigating the business risks inherent in Alzheimer’s care. Even more so than in other forms of care, dementia care requires an intensive hands-on component.To minimize risk, a higher-than-usual degree of staff education is critical. “It is very risky to take these residents and throw them out into your staff without proper training,” says Summerville’s Amparo. “The greatest risk is that you may have potential altercations among residents, or violence among residents toward the staff, or you may have abuse among the staff, Assisted Living EXECUTIVE ▼ NOVEMBER/DECEMBER 2005 21 Q U A L I T Y R E S I D E N T with them being aggressive in trying to force a resident to do something,” he notes. “You need to have a formalized program of training that you can impart to your staff for them to manage this type of diagnosis.” He adds that a more careful screening process also is needed once dementia is added to the mix.“People may be sent to a dementia unit who in fact are bipolar or schizophrenic,” he says. To avoid that kind of mistake, the demands of marketing sometimes must yield to the need for caution. “If someone is coming from Timbuktu, you need to ask: Why are they coming all the way to your building? That is a red flag.” “It is very risky to take these residents and throw them out into your staff without proper training.” —Budgie Amparo, Summerville Senior Living In one case,“we had a resident who got into the Alzheimer’s unit, but we didn’t know that the resident had a history of psychiatric problems,” he says. In an already risk-laden environment, that kind of situation can spell big trouble. As Wexler puts it: “Don’t take somebody just because they have a pulse and a checkbook.” CONSUMER EDUCATION Families can be especially ready to find fault with dementia care, says Joel Goldman, a partner at Hanson & Bridgett, a law firm in San Francisco.“Families may feel a greater sense of guilt,” he says.“A lot of people who can deal with cancer still have a lot of trouble with Alzheimer’s. They are not comfortable with something that attacks the mind, and they may lash out at providers.” From a legal standpoint, Goldman says, assisted living companies need to stare down claims they feel are illegitimate,“and insurance companies need to stop settling frivolous claims just because it is cheaper to settle than to go to trial.” Educating consumers also is critical in 22 NOVEMBER/DECEMBER 2005 ▼ Assisted Living EXECUTIVE S E R V I C E S “If somebody slips and falls, that is a liability issue for us whether they have Alzheimer’s or not.” —Anne Ellett, Silverado Senior Living this respect. Set realistic expectations. If someone’s mom has been falling, don’t promise you can make it stop. Staff may help to keep her safe,“but they can’t promise they’ll keep her from falling.” Within the residences, meanwhile, other ways can help ensure that dementia-related care runs as smoothly as possible.There is a world of human subtlety that must be correctly interpreted if care is to be appropriate and effective. ATTENTION TO DIAGNOSIS Ellett notes that some 40-70 percent of residents within assisted living may have at least some mild form of cognitive impairment. In order to deliver care, it is important to make a careful diagnosis of anyone who may be teetering on the edge. “Dementia is a global term,” she says.“You have post-stroke, you have Alzheimer’s, you have Parkinson’s. There are various things that can cause dementia, and it is important that we don’t lump everyone together, but instead have programs that can maximize everyone’s potential.” More than being merely the right thing to do, this effort to subdivide dementia into appropriate classes can be a direct defense against possible liabilities, especially in the form of family members whose expectations for assisted living are steadily on the rise. “The families are getting more sophisticated in their knowledge and they are no longer satisfied with someone saying,‘We’ll keep mom clean and dry and let her sit in front of the TV,’ Ellett says. Specialization allows for more appropriate care at all levels of cognition. ▼ Adam Stone is a contributing writer to Assisted Living Executive. Reach him at astone@alfa.org. SHE WAS BORN IN THE AGE OF PRINT SHE’S LIVING IN THE AGE OF THE INTERNET More and more of your audience are looking for you online. So there’s no need to waste money on overpriced print advertising. With SeniorHousingNet™, you’ll get strong regional and national exposure unlike any other; only SeniorHousingNet can list your community within all of the senior housing sections of AOL, MSN, and Yahoo! And with a low cost per resident, there is no time like the present to reach this online audience. Call us today at 1-888-525-2546 to leave the past behind you. Q U A L I T Y R E S I D E N T S E R V I C E S You Sign Them Up, They Move Them In W hen Shirlee Williams of Peoria, Illinois, made the major life decision to move from her home of 11 years to a new continuing care retirement community eight miles away, she got a lot of help. A full-service moving assistance company found her a Realtor she liked, offered downsizing assistance, checked on her regularly, packed her belongings, and moved her in. “I try to make my own decisions and not rely on my family too much,” says Williams. Using a relocation company “just took [away] a lot of worry for me.” In Williams’ case, the relocation organizers were hired not by Williams or by her adult children, but by the retirement community she was moving into. In a step that goes well beyond making a simple referral, Lutheran Hillside Village (LHV) partnered with a professional relocation firm so that Williams—and scores of other new residents—truly received “executive” treatment. While retirement communities benefit vicariously from community services that help new residents make a happier transition from their former home, retirement communities such as LHV that have formally aligned with a senior relocation provider are reporting direct advantages to the company’s bottom line, from making sales to improving entry fee revenues. “Instead of trying to find a move-in coordinator, which is mostly a short-term need, this worked so much better,” says Rita Vicary (ritav@LSMpeoria.org), marketing director for LHV. From opening day on Oct. 7, 2002, to the end of that same year, 97 units were occupied, according to Vicary. “I was told the industry standard was nine a week, and we moved nine a day,” she says. Assisted living providers partnering with move-in and relocation assistance companies are finding faster fill-ups and a positive effect on the bottom line By Whitney Redding much a local, grassroots movement,” says Mary Jo Zeller, owner of Gero Solutions Inc. in Chicago and co-founder of the threeyear-old National Association of Senior Move Managers.“It’s kind of one of those light-bulb moment.There’s a definite need for it.” Retirement communities view relocation assistance as a value-added benefit that gives them a competitive edge as well as an efficient way to move in a number of new residents more quickly. SMOOTHER SALES, AND SAILING GRASSROOTS AND GROWING The senior relocation assistance industry, up to now a cottage industry serving local markets, is starting to show signs of coming into its own. While most senior relocation companies are still small, localized operations, often initiated by a caregiving adult child or a former senior housing professional with a passion to make such moves less traumatic, the industry is expanding. At least one relocator specializing in corporate and military clients, Chicago-based MovingStation, now offers relocation services for seniors through its Moving Made Easy line. “In our area, when we started providing the service, we were just about the only ones. Today, there are over 100,” says Genevieve Auguste, president of the Washington, D.C., area’s Art of Moving. As the industry grows, some businesses are offering more sophisticated services such as Realtor referrals, cross-country relocations—and partnerships with retirement communities. “One of the things we hear all the time is ‘I didn’t know a company like yours existed,’ and yet we’re not movers and listed in the yellow pages under that. It’s very Partnering with a senior move manager can eliminate a key sales obstacle, according to several communities who have used such services.“Especially when you are just building, you have a couple years. You have to work hard to keep those sales,” says Vicary. The counselors at MovingStation who worked in direct contact with residents-to-be such as Williams, Vicary says,“saved a number of sales for us—people who were overwhelmed and were beginning to get cold feet.” As for communities no longer in fill-up mode, the ongoing use of a relocation service can offer a marketing edge over competitors.“It very much is a sales feature,” says Vicary.“If we can say we make your move easy, it really helps it along.” Handing over new residents to personal relocation consultants months before the move-in also frees up a community’s sales staff.“They can spend more time working with new prospective residents,” says Rick Hunsicker (rhunsicker@greystone communities.com), corporate vice president of marketing for Greystone Communities of Irving,Texas, which also uses MovingStation.“Think about it—why Reprinted with permission from the November/December 2005 issue of Assisted Living Executive. © 2005 The Assisted Living Federation of America Assisted Living EXECUTIVE ▼ NOVEMBER/DECEMBER 2005 Q U A L I T Y do national corporations use relocation companies when they move people? It’s because that’s not what they do well.” While the relocation company can focus on helping residents overcome point-of-origin hurdles such as the sale of a house or the distribution of possessions, the community’s move-in coordinator can facilitate what happens at the destination.“It is still good to have someone in the move-in coordinator role, even if it’s not full time, to make sure everything’s ready when the resident moves in,” says Hunsicker. The use of a relocation service for a new community also can make the logistics of a mass move-in more efficient. The recent opening of a Greystone community in Phoenix offers a case in point. At the end of the first four months, about 90 of 125 units were occupied, or about 73 percent.“We had lots of presales and they all started to move in right away because most of the planning and organizing, as well as the sale of the R E S I D E N T S E R V I C E S house, was already taken care of,” says Hunsicker. “That has generated nearly an additional $1 million in unbudgeted revenue.” CREATING A RIPPLE EFFECT Research suggests that use of relocation services may greatly reduce transition trauma for older adults by moving them in more smoothly, thereby reducing anxiety and giving them the services they need sooner, according to Zeller.“The bottom line is that the more people put this move off, the more it affects their health, and the shorter their retention can be,” she says. It also can make for a better beginning for a whole community, according to Deidre Schwartz (dschwartz@hyatt classic.com), manager of interior design and relocation services for Chicago-based Classic Residence by Hyatt, which supplements its own move-in services with Moving Made Easy. Schwartz cites a new community in Palo Alto, California, that has Tips for Partnering with Relocators ost senior move managers are small businesses who are used to working directly for seniors and their families. Most senior housing providers that use these services are independent living or continuing care retirement communities whose residents have not had experience selling a house for decades and/or face considerable downsizing challenges. Senior move managers and the communities who have used them offer the following advice: ■ Communicate with the sales office. Senior move managers must be partners with the community’s sales force, which must not take it personally that someone else is taking over their carefully cultivated contacts. “You can rest easy. It actually helps the sale,” says LHV’s Vicary. ■ Seek out good counselors. A good senior move manager understands seniors. “It’s a counseling role to listen and understand people’s problems and help them solve them,” says Adams of MovingStation. “Find companies that are flexible not only for the senior community but also for the resident and family members,” adds Montgomery Place’s Apa. ■ Look for a variety of relocation services. Service offerings vary, as do seniors’ needs. In addition to core assistance with downsizing, packing, and moving, services might also include housecleaning, estate sales, liquidation, charity giving, personal escorts, Realtor referrals, reviewing floor plans for new units, and so on. ■ Pay attention to the vendor screening process. How will the relocation managers handle long-distance moves from outside their usual service area? Do they offer choices of vendors to residents? For more information about senior move managers, visit www.nasmm.org. M NOVEMBER/DECEMBER 2005 ▼ Assisted Living EXECUTIVE benefited from coordinated, early move-ins. “By the end of five months, we’re projecting it will be 80 percent occupied. It’s wonderful. It makes for a more vibrant community, more activity, more residents participating,” she says. Reviewing floor plans to organize a new apartment in advance is among the relocation services that is most appreciated by new residents at Classic Residence by Hyatt, says Schwartz.“The more planning and organizing that residents do up front, the quicker they’re settled and out playing bridge or swimming in the pool.” Of course, getting off to a great start in a community can ultimately lead to more word-of-mouth referrals, says Michael Apa (mapa@montplace.com), executive director of Montgomery Place Hyde Park in Chicago, which uses Gero Solutions services under its own moniker, the Stressless Move-In Program.“It’s important economically that your current residents are happy,” he says. FOOTING THE BILL The payment structure for these emerging alliances tends to vary. Montgomery Place will mostly foot the moving bill for new residents who use its relocation services within 30 days under a three-tier incentive plan tied to a specific timeline. Other communities offer to pay the bulk of the bill for services only when doing special promotions to fill communities. Meanwhile, senior housing communities using MovingStation’s program typically pay an upfront fee to cover the planning and organizing services offered through Moving Made Easy, with residents paying for the actual move. It all comes down to the marketing budget of the community, and the extent to which the relocation team is actively involved with helping the community and not just the resident.“Do you want someone to manage the [relocation] process or just someone to refer people to?” poses Rob Adams, president of MovingStation.“We’re going to help communities sell and retain and fill fast.” ▼ Whitney Redding is a contributing writer to Assisted Living Executive. Reach her at wredding@alfa.org. W O R K E R S ’ C O M P E N S AT I O N I N A S S I S T E D L I V I N G It Takes More Than Better Lifting to Curb Costs BY JOHN ATKINSON ESQ. imber-cutting, metal-working, and truck driving are jobs you wouldn’t normally compare with a caregiver or certified nurse’s aide in a senior living community. But these professions do have something in common: statistically, they are among the most “hazardous” lines of work. According to the U. S. Labor Department, providing resident care is one of the nation’s most injury-prone jobs. In recent years, certified nurse’s aides actually ranked first—ahead of truck drivers and laborers— in musculoskeletal injuries resulting in workers’ compensation claims.Typically, these are falls and back injuries. Perhaps more significant, studies have shown nursing aides and vocational nurses at or near the top in numbers of lost workdays due to claims-related injuries. This data comes despite OSHA’s ergonomic initiatives dating back to the 1990s, specifically targeted to the seniors housing industry, countless seminars, millions in equipment expenditures, and private management initiatives on worker safety. Clearly, this is a tough issue—and a costly one. For many assisted living providers already faced with unpredictable insurance cycles, runaway workers’ comp costs can become a make-or-break line item. For national operators with locations across different states, where they must contend with widely varying compensation codes, gaining a measure of control over their costs can be critical to sustained profitability and maintaining shareholder value. T CLEAR SOLUTIONS NEEDED In a few states, workers’ comp reforms have established medical fee ceilings and may ultimately help to cut the number of litiga- COMPLIANCE CORNER costs into line.A coordinated and comprehensive managed-risk program that is composed of a set of proven guidelines and actionable steps—plus an unrelenting, dayto-day commitment at all levels of management—is required. It takes work. But the bottom-line results can be immediate and startling. CASE IN POINT There’s no magic bullet to slay spiraling workers’ compensation costs. A comprehensive managed-risk program composed of a set of proven guidelines and actionable steps— plus an unrelenting, day-to-day commitment at all levels of management—is required. tions. But these compromise fixes go only so far.With national claim trends continuing to outpace almost all other industries, most seniors housing executives want clear and specific solutions—now. There’s no magic bullet to slay spiraling workers’ compensation costs.And it takes more than than better lifting techniques or equipment to pull your workers’ comp Consider a company that has network of mixed seniors housing communities in multiple states that reduced its workers’ compensation loss rate by 20 percent in five years. The company implemented a system-wide workers’ comp and injury management program, using a generally accepted actuarial measure known as “pure loss rate.” (Pure loss rate is calculated from reported losses over several years, then adjusted and trended to a common basis to allow for comparison between years—in this case, $100 of payroll.This is a somewhat arcane insurance statistic usually of interest only to actuaries and risk officers. But everyone takes notice when you begin to see dramatic workers’ comp loss reductions of 25 percent or more in successive years.) In the benchmark year 2000, with no dedicated managed risk program in place, the company had a loss rate of $3.11 per $100 of payroll, slightly below the national average.The next two years’ loss rates were virtually unchanged: $2.81 and $2.78. But in 2003, the state of Florida enacted workers’ comp reform to limit attorney’s fees and curb fraud.A risk-management consulting firm was hired and an accountability program was installed.The result was an Reprinted with permission from the November/December 2005 issue of Assisted Living Executive. © 2005 The Assisted Living Federation of America COMPLIANCE CORNER expected 15 percent loss-rate decrease to $2.34 per $100 of payroll.These results only strengthened the executives’ belief in further achievable cost reductions—and they were right. In 2004, two signal events occurred. One was the passage of workers’ comp reform in California, where the company also operates a number of communities. The other was the firm’s decision to implement a tailored, system-wide, comprehensive workers’ compensation and injury-management program.The company distributed step-by-step handbooks to all supervisors, human resources managers, and regional risk officers; held Web conferences to introduce the program; and established proprietary relationships with local specialized medical networks. Along with functional job analyses and safety initiatives, a cornerstone of this program is intensive (even hour-by-hour) liaison and management of the injury treatment and claims process with a particular emphasis on return to work. Another critical element is daily and documented com- munications between the company’s employees, supervisors, physicians, adjusters, and consultants. Although multi-faceted in execution, the philosophy is simple: An accident or injury usually is a chance occurrence, but nothing else in the process should be. The result in 2004 was a 27 percent reduction in loss rate, down to $1.72. So far this year, the program has pared down another 25 percent from the loss rate. In October, it was down to $1.29—68 percent below the national average. (The national average is $4.24, according to the National Council on Compensation Insurance.) Of course, not every operator can expect results so dramatic and so soon. But the case has been made that you can gain a significant, sustained measure of control over your workers’ compensation costs with the right program—and the sheer corporate willpower to see it through. ▼ John Atkinson is a partner at Thilman Filippini in Chicago. Reach him at john.atkinson@tf-risk.com. 7 Steps to Effective Workers’ Comp Management 1. Establish a solid, working client relationship with a nearby clinic or physicians’ group. How important is this step? A study this year in The Journal of Occupational and Environmental Medicine shows lost days and claims costs could be reduced by almost half when workers are seen by proprietary group doctors, using agreed-upon treatment protocols, rather than outside-of-network physicians. 2. Communicate early and often with an employee during the initial treatment and follow-up. Document what’s said. An expression of genuine concern, with a neutral but responsive attitude, goes a long way toward minimizing phone calls to lawyers. Note: This step is usually the responsibility of the HR manager. 3. Don’t wait for the adjuster—conduct a prompt, fair internal investigation based on established procedures. Take statements. Preserve appropriate evidence. Write a report. Use this and other reports for regular trend analyses. Note: Investigate with an eye toward finding out what happened and fixing it—not affixing blame. 4. Never assume the best. Even if a worker attempts to shrug off an injury, see that it’s checked out with a physician and get a written report. A sizeable number of serious claims are reported the next day or next week. 5. Report to your carrier promptly and in detail. Be assertive. Work with your risk officer or consultant to stay informed and manage the claims process. 6. Train your front-line staff and community managers to own the workers’ compensation claim by developing an accountability program that keeps them financially responsible. 7. Clearly outline the roles and responsibilities of each staff member and department involved in the injury management process. This includes the injured employee, department supervisor, human resources department, risk management department, regional manager, adjuster, and insurance broker. O N A G I N G A N D I N D E P E N D E N C E CONSUMER VOICE Community Partnership Builds ‘Trail’ to New Neighbors boring field. “We look forward to welcoming the players over after a game for a cook-out,” Blackburn says. The community also has launched a sports club for residents interested in reminiscing about favorite sports teams, players, and other great memories, as well as making new memories with the group. BY CINDY PETERSON OPENING THE DOORS n an innovative partnership, Sunrise Senior Living is working jointly with the town of Burlington, Massachusetts, to underwrite a large portion of the cost to create a passive recreation trail, which will benefit both residents of Burlington and the new Sunrise Assisted Living of Burlington. Dubbed The Sunrise Trail, the paved walking path will skirt two frequently used playing fields adjacent to the Sunrise community and will include benches and shaded shelters for those who prefer to sit and watch the activity on the fields.This project represents another solution for bringing assisted living residents into the larger community and vice versa— and encouraging independence. “We believe strongly in creating a senior living environment that is integrated with the larger community,” says Sunrise Vice President of Northeast Operations Stephanie Handelson (stephanie. handelson@sunriseseniorliving.com). “Burlington is a great town that provides for its elders, and offers innovative recreational opportunities.The Sunrise Trail is a great way to honor the unique characteristics of Burlington.” I NEIGHBORHOOD LIVING Sunrise of Burlington, which opened in October, was approached by the Town of Burlington Recreation Department earlier this year regarding the concept of the trail. Based on the town’s clear vision and detail for the trail, Sunrise contributed $25,000—65 percent of the total cost. Making Sunrise of Burlington and its residents a positive, engaged part of the community also includes opening doors to local needs. Sunrise of Burlington has contacted several community groups to discuss their needs for meeting space. For instance, the local chapter of a community weight-loss group began regular meetings at Sunrise in October. Now, with the walking trail in the works, community groups can further enhance their activities. Sunrise Senior Living Whether it’s Alzheimer’s support group meetings or business planning meetThe Sunrise Trail adds a “passive recreings, the trail adds a dimension of easily ation” component—such as bird-watching, accessible recreation. photography, and nature study—to the “I envision professionals who work in many recreation options Burlington offers this area will walk over to the trail at residents. Burlington will work to ensure lunchtime for some exercise, and that our a safe passive recreation experience for neighbors will access the trail in the late people of all ages and abilities. afternoon or early evening hours. The trail Sunrise of Burlington is capitalizing on provides a comfortable setting and a level the project by launching a walking club for walking path for light exercise in a scenic residents that includes both the commuarea,” Blackburn says. nity’s own walking path and the new trail. The Sunrise Walking Trail—and its off“This feeling of connection to society is shoots—could be replicated in other comoften hard to come by as one ages and the munities. Reaching out to the community ability to explore the environment is affectin similar ways, such as sponsoring a local ed by physical or cognitive limitations.We sports team, inviting community groups to want to challenge those limitations,” notes meet in your buildings, and creating special Trisha Blackburn (BurlingtonMA.ED@ interest clubs that can partake in commusunriseseniorliving.com), executive nity events, all work toward building a director at Sunrise of Burlington. neighborhood environment where conSunrise also will use the trail to introsumers feel at home. ▼ duce intergenerational activities that promote interaction between residents and Cindy Peterson is a director of sales and their Burlington neighbors, as well as promarketing for Sunrise Senior Living. vide engaging opportunities for family Reach her at 781/237-0987 or members. For example, Sunrise will sponsor cindy.peterson@sunriseseniorliving.com. a local sports team that plays on the neigh- Reprinted with permission from the November/December 2005 issue of Assisted Living Executive. © 2005 The Assisted Living Federation of America AFFLILATE SPOTLIGHT WISCONSIN ASSISTED LIVING ASSOCIATION Why You Should Boost Your Training Budget Next Year BY JIM MURPHY very state ascertains its own overall education needs for seniors housing providers.Through formal or informal surveys, feedback from previous conferences, and closely monitoring long-term care trends and developments, state affiliates can identify major areas of the business that will require focused attention in the coming year. And despite tough economic times, investing in training and education both at the corporate and residence level is essential for providers. The Wisconsin Assisted Living Association will offer 24 educational opportunities throughout 2006, and ALFA State Affiliates across the country are planning offerings as well.Among the opportunities: ■ A two-day intensive seminar for admin- E istrators and managers. In its seventh year, this seminar is limited to 40 attendees, making it a valuable networking opportunity that enables small group conversations on a local or regional level. ■ A crisis management seminar that will focus on local and regional disaster response. New to the lineup in 2006, this seminar will feature a guest speaker from a Gulf Coast provider, who will share lessons learned having survived Hurricanes Katrina and Rita. ■ A three-day intensive sales and marketing seminar. Participants can opt to attend all three days or just those days they choose.The seminar will feature a new curriculum that focuses on the tips and tools to build a provider’s census. And assisted living providers—whether the training is from ALFA national, their state affiliate, or other internal programs— need to make the investment to ensure their organization’s continued operational excellence. Any training at the state level should be matched with the greater goals of assisted living in the state.Those goals may be slightly different in California or Massachusetts than in Wisconsin, but goals are set to be met and it’s up to each state affiliate to do the legwork for its members. WISCONSIN’S TARGET: RISING ACUITY Rising acuity levels among residents will be a major theme for WALA in 2006, so educational offerings all address this issue in some way, in addition to other hot-button issues in the business.WALA’s educational training program also speaks to the greater goal of warding off unnecessary federal regulation by providing strong care. Since its start 10 years ago,WALA has maintained consistent dialogue with state regulators to review changes as they have occurred in long-term care.And while it may sometimes seem that the state affiliate and state regulators are on different sides of an issue, what ultimately drives progress is a common goal: quality care for residents. GOOD PROGRAM BASICS To ensure your State Affiliate is offering worthwhile educational programming, look for these elements: ■ The occasional out-of-state speaker. This outside perspective can spark exchanges that can only come from a nonlocal person.A good example is the Gulf Coast provider who will lead WALA’s crisis management seminar in February.WALA is asking participants to come prepared to answer three questions: How do you deal with a crisis that is your fault? What is your emergency plan for a residence-wide disaster? And, what is your emergency plan for a regional or national disaster? Having shared those answers at the seminar, participants will come away with solutions that reach beyond their own community or town. 32 NOVEMBER/DECEMBER 2005 ▼ Assisted Living EXECUTIVE PRINCIPALS WANTED RESOURCE LINK Clarion Bathware 44 Amsler Ave. Shippenville, PA 16254 814/226-5374 ext 822 AT-A-GLANCE:Fax 814/226-0730 Assisted www.clarionbathware.com Living in Wisconsin lwentling@clarionbathware.com ■ www.ewala.org ■ Number of WALA Celebrating ourmembers: 30th anniversary 519 in 2003, Clarion Bathware is proud ■ Number WALA member to be aofleader and innovator in assisted living units: the assisted living industry. 11,000 Manufacturing over 50 models of accessible and ADA compliant ■ The state organizes assisted livingunits. Clarion has the knowledge and into three categories experience to serve you. 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Seeking Investment reached by addressing inquiries to: Up to $ 3,000,000 Investor with 2-3 million Property 8 Poplar Hill Drive purchase of cash, seeking Charleston, 25311 assistedWV care or medical facility lease back for 25-30 www.ridgetopretirement.com years, triple net. mev@app-net.com curtnpatg@aol.com (559) 288-8217 We now offer per sonal car e products! ■ Number of CBRF properties: 1,266 (21,000-unit capacity) ■ Total number of assisted living properties in Wisconsin: BUS INC. 4,082 (34,244-unit capacity) company a Champion Bus, Inc. session thatP.O. directly addresses Box 158 current legislation Imlayand City,regulation MI 48444 Because laws regardissues for providers. Contact: Rick Lee ing long-term care can vary greatly from 800/776-4943 state-to-state, it can helpful for providers Faxbe810/724-1844 to attend state-level conferences that feawww.championbus.com ture state-specific content and invite state sales@championbus.com officials. Sometimes a state conference also will address theBUSES legislative regulatory TOUGH THATand LAST! issues inMichigan-based neighboring states. Find outBus theis a Champion specificsbusiness before attending in case staff from unit of Thor Industries, other states might benefitleading as well. North America's ■ Targeted networking opportunimanufacturer of small to midsize ties. Beyond a theme lunch orshuttle reception, church, tour, transit, and an organized roundtable session or topicpara-transit buses. Ranging in sizes specificfrom panel8discussion sets the with stage 7for to 37 passengers lively and practicalmodels, exchange of bus ideas. different each can be State-level educational equipped to meetprogramming all customer can be arequirements. useful resource for providers, particularly as it pertains to the needs and challenges of specific communities. In MAY 2004for A Sexample, S I S T E D L communities I V I N G T O D A Y with Wisconsin, a small staff or a limited budget for travel can find a WALA session at a nearby location throughout the year. For examples of educational programming lineups, visit www.ewala.org. ▼ ■A Jim Murphy is executive director of WALA. Reach him at jmurphy@ewala.org or 608/288-0246. True Fitness P.O. Box 1747 Roswell, GA 30077 800/474-7646; Fax 800/474-7647 www.truehospitality.com truefitness@mindspring.com Fitness facility design and leading state-of-the-art fitness equipment. Contact John Sarver. Elder Transition Coaching & Resident Staff Services Bradley Ann Morgan & Stephan Marais 4750 Lincoln Blvd. Suite 134 Marina Del Rey, CA 90292 Office 310-577-0771 Fax 310-577-8349 www.walksbesidecoaching.com coach@walksbesidecoaching.com STATEMENT OF OWNERSHIP, MANAGEMENT, & CIRCULATION Walks Beside Life Coaching (REQUIRED BY USPS) Title of publication: Assisted Living Executive Publication No.: 1553-8281 Date of filing: September 30, 2005 Issue Frequency: Monthly, except for Jan/Feb, July/Aug, and Nov/Dec No. of issues published annually: 9 Annual subscription price: na Mailing address of known office of publication: Assisted Living Federation of America, 11200 Waples Mill Road, Suite 150, Fairfax, VA 22030 Mailing address of general business office of the publisher: Stratton Publishing & Marketing Inc., 5285 Shawnee Road, Suite 510, Alexandria, VA 22312-2334 Names and addresses of publisher, editor, and managing editor: Publisher, Debra J. Stratton, Stratton Publishing & Marketing Inc., 5285 Shawnee Road, Suite 510, Alexandria, VA 22312-2334; Editor, Angela Hickman Brady, Stratton Publishing & Marketing Inc., 2666 Arbor Ave., Atlanta, GA 30317 Owner: Assisted Living Federation of America, 11200 Waples Mill Road, Suite 150, Fairfax, VA 22030 Known bondholders, mortgagees, and other security holders owning or holding 1 percent or more of the total amount of bonds, mortgages, or other securities: None Taxspecializes status: na in the transition of Elders Publication title: Assisted Living Executive from their homes intoSeptember independent Issue date for circulation data: Extent Nature of Circulation: or and assisted living. We are certified Average No. Copies Each Issue During Preceding coaches members of of the No. Copies Single Issue 12 Months& / Ave. to Filing Date Published NearestCoaching International Federation. Total no. copies (net press run: 8,797 / 8,768 Our program, ‘The Home of the Heart’ (1) Paid/requested outside-county mail subscripassists theonElder, their family, tions stated Form 3541 7,351 / 7,627and (2) the Paid community in-county subscriptions 0 / 0the heartfelt staff take (3) Sales through dealers and carriers, street steps create vendors,toand countertheir sales 0new / 0 home. (4) Other classes mailed through the USPS 21 / 18 c. total paid and/or requested circulation: 7,372 / 7,645 45 d. Free distribution by mail (samples, complimentary, and other free) 0 / 0 e. Free distribution outside the mail 1,275 / 973 f. Free distribution 1,275 / 973 g. Total distribution 8,647 / 8,618 h. Copies not distributed 150 est. / 150 est. i. Total 8,797 / 8,768 j. Percent Paid and/or Requested Circulation 85% / 89% I certify that statements made by me above are correct and complete. —Angela Brady, Editor/Associate Publisher Assisted Living EXECUTIVE ▼ NOVEMBER/DECEMBER 2005 33 PEOPLE & PLACES SALES & NEW DEVELOPMENTS communities with combined capacity for more than 900 residents. Sunrise will manage all of the communities under longterm management agreements. These communities are either currently under construction or will begin construction in 2006. FINANCIAL NEWS Summit, New Jersey-based Chelsea Senior Living, owner and operator of eight assisted living communities in New York and New Jersey, will manage Autumn Woods Assisted Living in Bridgewater, New Jersey. Autumn Woods has a capacity of about 115 and also features Oak Terrace, a 13-unit residence for the memory impaired. American Retirement Corp. (ARC), based in Brentwood, Tennessee, has entered into an asset purchase agreement with an affiliate of Epoch Senior Living Inc. to acquire eight senior living communities located in seven states for an aggregate purchase price of $138 million, plus transaction expenses.Two of the communities are located in Arizona and the others are in Georgia, Kansas, Minnesota, Nevada, and Texas.The portfolio has a total of 831 units, including 742 assisted living units and 89 Alzheimer’s units. ARC also has entered into a 15-year management agreement with American Seniors Foundation to manage its recently acquired Bradford Village community, an entry-fee community in Edmond, Oklahoma.The residence consists of 78 cottage homes, 44 assisted living units, 10 memory care units, and 102 skilled nursing units. With the passage of tort reform in Texas, program underwriting company Lighthouse Underwriters LLC, based in Annandale,Virginia, has 34 NOVEMBER/DECEMBER 2005 ▼ expanded its ElderCare program in that state with an assisted living package.The package includes general and professional liability, automobile, and excess coverage for assisted living communities, independent living communities, and CCRCs in Texas. McLean,Virginia-based Sunrise Senior Living has entered into an agreement with MetLife to develop up to 10 senior living Sunrise Senior Living, based in McLean,Virginia, in September announced a twofor-one stock split of its common stock in the form of a 100 percent stock dividend.The stock split increases the number of shares of the company’s common stock outstanding from approximately 21.3 million to approximately 42.6 million. ▼ APPOINTMENTS & PROMOTIONS most recently served as executive vice president of strategic initiatives for the American Cancer Society. Erickson Retirement Communities, based in Catonsville, Maryland, has named (pictured from left to right) Bruce R. “Rick” Grindrod president of Erickson Health and Operations. Grindrod most recently served as executive vice president of operations for Erickson. Erickson also has named Mark Erickson, son of Erickson CEO John Erickson, chief strategy officer. Erickson most recently served as executive director of an Erickson community in Parkville, Maryland. Matthew Narrett M.D. has been named Erickson’s chief medical officer. Narrett most recently served as regional vice president and medical director for Erickson. The Chicago-based Alzheimer’s Association has named Harry Johns president and CEO. Johns Assisted Living EXECUTIVE McLean,Virginia-based Sunrise Senior Living has named Laure Duhot senior vice president of its International Capital Group. Prior to joining Sunrise, Duhot was founding partner and principal for Macquarie Capital Partners, an investment bank boutique in London. New York-based Sterling Glen Senior Living has named David E. Schneck executive director of its independent senior living residence in Rye Brook, New York. Sterling Glen of Rye Brook includes 166 one- and two-bedroom apartments. Send People & Places announcements and photos to Marlene Hendrickson at mhendrickson@alfa.org. AD & MEMBER INDEX A L FA B O A R D O F D I R E C T O R S Chair: Steven Vick, CEO Signature Senior Living Vice Chair: Michel Augsburger, President & CEO Chancellor Health Care Inc. Secretary: Tiffany Tomasso, COO Sunrise Senior Living Treasurer: John “Skip” Comsia, President Veranda Living Immediate Past Chair: Thomas Grape, Chairman & CEO, Benchmark Assisted Living Evrett W. Benton, President, CEO, and Secretary Five Star Quality Care Beth Cayce, CEO CaraVita Senior Care Management Services Horace D’Angelo Jr., President Caretel Inns of America Joe Eby, President Bickford Senior Living Group Inc. Thomas Fairchild Ph.D., Director, Special Projects on Aging, University of North Texas Health Science Center Jeff Johns, President Carriage Court Communities W. Bradford Klitsch, Vice President of Market Development, Direct Supply Mark Ohlendorf, President & CEO Alterra Healthcare Corporation Ross Roadman, SVP for Investor Relations and Strategic Planning American Retirement Corporation Loren Shook, President, CEO & Chairman Silverado Senior Living Richard P. Grimes, President/CEO ALFA AAEC Representative: Sally G. Michael, President California Assisted Living Association COS Representative: Eric L. Johnston, President Retirement Community Specialists Inc. A L FA P R E S I D E N T ’ S C O U N C I L Michael H. Cook, Baker & McKenzie Brad Klitsch, Direct Supply Healthcare Equipment Susan V. Kayser Esq., Duane Morris Joel Goldman, Hanson Bridgett Marcus Vlahos & Rudy J. Michael Stephen, Health Care REIT Inc. Joe Whitt, HomeFree Inc. John Baker, IMA Financial Group Vivek Bhide, Invista Bryan A. Baird, K&B Underwriters LLC Casey Pittock, Lifeline Systems Inc. Art Seifert, The Lighthouse Companies Carol A. Muratore, McKesson Medical Surgical Lisa Hanauer, MED-PASS Inc. Curt Schaller, Merrill Lynch Capital Elizabeth Finn-Elder, Nathan Sallop Insurance Agency Inc. Debbie Zwiefelhofer, Novartis Nutrition Corp. George F. Quintairos, Quintairos, Prieto, Wood & Boyer PA Stephan Axelrod, SeniorMed Norrell Walker, Senior Psychological Services Inc. Kevin Pope, Stanley-Senior Technologies Inc. Loretta LeBar, Stoll Kennon & Park Douglas MacLatchy, Sunrise REIT John M. Atkinson, Thilman & Filippini Greg Thompson, Thomco Raymond J. Lewis, Ventas Healthcare Properties Inc. AD INDEX ASTON CARE SYSTEMS Thomas J. Harrison, 877/240-6774, www.astoncaremanagement.com . . C2 CONCURRO SOFTWARE Teresa Murphy, 650/969-2015, www.concurro.com . . . . . . . . . . . . . . 24,25 DIRECT SUPPLY HEALTH CARE EQUIPMENT, 800/480-7250, www.directsupply.net . . . . . . . . . . . . . C4 HOME INSTEAD SENIOR CARE, Holly Batchelder, 888/484-5759, www.homeinstead.com . . . . . . . . 2 IDEAL SOFTWARE, Lance Raab, 813/864-2160, www.idealsoft.com. . . . . . . . . . . . . . . . . . . . . . . 11 INTEGRAL CONSULTING SERVICES, Janet Welch, 858/677-1286, www.islllc.com . . . . . . . . . . . . . . 17 JCH CONSULTING GROUP, INC., Jim Hazzard, 888/916-1212, www.jchgroupinc.com . . . . . . . . . . 10 KWALU INC., 800/405-3441, www.kwalu.com ..........................................7 MOVE-N-SOFTWARE, Move-N Representative, 817/282-7300, www.move-n.com . . . . . . . . . . . . . . 4 NUSTEP, NuStep Representative, 800/322-2209, www.nustep.com . . . . . . . . . . . . . . . . . . . . . . . 17 OPUS UNIT DOSE SYSTEM, OPUS Representative, 800/228-5021, www.opusmedsystems.com . . . . 1 PLAYWORLD SYSTEMS, Customer Service, 800/233-8404, www.playworldsystems.com . . . . . . . . 8 RF TECHNOLOGIES, Lorna Miller, 800/669-9946, www.rft.com . . . . . . . . . . . . . . . . . . . . . . . . . . C3 SENIOR HOUSING.NET, Brad Fuqua, 888/525-2546, www.seniorhousingnet.com . . . . . . . . . . . . 23 SOOTHEZE, Paul Losch510/657-4577 or 415/269-1427, www.sootheze.com. . . . . . . . . . . . . . . . 20 WAGE WATCH, Jim Crews, 888/330-9243 ext. 6504, www.wagewatch.com . . . . . . . . . . . . . . . . . 22 MEMBER INDEX Alterra Healthcare Corp. . . 16 Alterra Wynwood of McMinnville ....................16 American Retirement Corp................................34 Amparo, Budgie ...................21 Apa, Michael ........................28 Atkinson, John, Esq..............29 Blackburn,Trisha .................31 Brewer, Richard ...................18 Brighton Gardens of Bellaire............................15 Byrd, DuVal, CPA....................6 Care Technologies ...............10 Classic Residence by Hyatt ...............................28 Commonwealth Assisted Living ..............................18 Comsia, John S.“Skip”..........15 Duhot, Laure........................34 Eagle’s Trace ........................16 Ellett,Anne...........................21 EPOCH Senior Living ............6 Erickson Health ...................16 Erickson Retirement Communities ..................34 Erickson, Mark ...............16, 34 Grindrod, Bruce R.“Rick”....34 Handelson, Stephanie ..........31 Howard, Jonathan................18 Hunsicker, Rick....................26 Intercontinental Services ....18 Janeczek,Ted .........................6 Klaassen, Paul ......................15 Lighthouse Underwriters LLC..................................34 Lutheran Hillside Village......26 Meadows Retirement Communities ....................6 Montgomery Place Hyde Park .......................28 Murphy, Jim .........................32 Narrett, Matthew, M.D. ........34 Pfaff, Debora..........................6 Pine Tree Cottage ................15 Pine Tree Lodge ...................15 Resources for Senior Living LLC.......................18 Rice, Christine .....................16 Robinson, Sherry .................14 Schneck, David E. ................34 Schwartz, Daniel..................15 Assisted Living EXECUTIVE Schwartz, Deidre .................28 Scott, Philip .........................18 Senior Technologies/ Stanley ............................36 Shannon, Deeni ...................13 Silverado Senior Living........21 Somerford Assisted Living & Alzheimer’s Care ........21 Southern Assisted Living .......6 Sterling Glen of Rye Brook..34 Sterling Glen Senior Living .34 Summerville Senior Living ........................13, 21 Summerville at Kenner LLC.....................13 Sunrise Assisted Living of Burlington.......................31 Sunrise at Bayou St. John.....14 Sunrise at Slidell ..................14 Sunrise Senior Living ...............9, 15, 31, 34 Thilman Filippini.................30 Veranda Living Inc...............15 Vicary, Rita...........................26 Wexler, Merle.......................21 ▼ NOVEMBER/DECEMBER 2005 35 PRODUCTS & RESOURCES Harris Communications, based in Eden Prairie, Minnesota, recently became the exclusive U.S. distributor of the ClearSounds CL600 Emergency Connect Telephone.The multi-feature phone includes a wrist-watch style remote control that provides one-touch emergency access to six pre-programmed phone numbers. Emergency contacts receive a pre-recorded alert message.Adjustable amplification up to 52dB and adjustable tone control also make the CL600 a useful assistive device for people requiring hearing assistance. For details, go to www.harriscomm.com or call 800/825-6758. F O R A S S I S T E D L I V I N G ■ ■ Winston-Salem, North Carolina-based Bi-Line Systems has added a new meal delivery system to its line of food service conveyors.The Rapid Serve is a tray delivery system that features an instant induction activator that infuses pellet bases with enough energy to keep food hot throughout the delivery process.The Rapid Serve is made of stainless steel and is ergonomically designed for ease of use. Go to www.bi-line.net or call 866/787-8367 for more information. Marblehead, Massachusettsbased HCPro Inc. has released a new book and CD-ROM training package developed to help staff prevent and deal with challenging residents. Managing Challenging Resident Behaviors: A Resource and Training Guide includes 12 chapters that address topics ■ 36 NOVEMBER/DECEMBER 2005 ▼ BOOKSHELF Train Your Brain: 60 Days to a Better Brain such as understanding cultural differences, responding appropriately to angry complaints, protecting staff through documentation, residents’ rights and responsibilities, evaluating customer service standards, and more. For more information and to order, go to www.hcmarket place.com or call 888/209-6554. By Ryuta Kawashima, M.D. The author of this book is a well-known neurologist and leading brain function researcher at Tohoku University in Sendai, Japan. Kawashima says Train Your Brain is a brain health workbook that—when used as recommended for 60 days—can improve brain function and stave off the mental effects of aging. Published by Kumon Publishing North America Inc. in Teaneck, New Jersey, the book contains math worksheets and reading and memory exercises. It also includes answer keys and a chart for recording exercise progress and results. For details and ordering information, go to www.kumon.com or call 800/222-6284. go to www.lapworks.net or call 877/527-9675. Lincoln, Nebraska-based Senior Technologies, a division of Stanley Security Solutions Inc., has introduced the TABS PSD Sensor Pad, a point-of-care monitor system. The TABS PSD is a disposable sensor pad that allows staff to monitor residents while preserving freedom of mobility.The sensor pads can be interfaced with TABS Professional Monitors that alert staff.The TABS PSD Sensor Pad is designed for seven-day individual use. For more information, visit www.seniortechnologies. com or call 800/824-2996. ▼ ■ LapWorks Inc., with offices in Rancho Cucamonga, California, and Peoria, Illinois, recently introduced Laptop Legs and PC notebooks and Mac Feet for Mac notebooks. Sturdy and easy-to-attach Laptop Legs (two per notebook PC) elevate the back of the laptop for improved typing ergonomics ■ Assisted Living EXECUTIVE and increased cooling and ventilation underneath the laptop, creating an improved level of comfort for seniors or any laptop user. Laptop Legs are a standard PC gray and Mac Feet are white. Both products also can be used to elevate desktop keyboards, telephones, and calculators. For more information, Send your Products & Resources announcements to Marlene Hendrickson at mhendrickson @alfa.org. 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Assisted Living Executive (ISSN 1553-8281) is published monthly, with combined issues in January/ February, July/August, and November/ December, by the Assisted Living Federation of America, 11200 ...
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