Copyright, Assisted Living Federation of America

Transcription

VOL.12. NO.5
, J U LY / A U G U S T 2 0 0 5
AssistedEXECUTIVE
Living
REFRESHING
HR Solutions
ASSISTED LIVING EXECS
LIKE CARAVITA’S BETH
CAYCE GET IDEAS FROM
COCA-COLA ENTERPRISES’
DAN BOWLING
LEADERSHIP
LEADERSHIP
Scoping Out the
Legal Minefields
SPECIAL
SPECIAL REPORT
REPORT
Senior Market—
Get to Know the
Silent Generation
THE BUSINESS MAGAZINE OF ALFA: THE ASSISTED LIVING FEDERATION OF AMERICA
THE LOW DOWN
ON THE
LOW
FLOOR.
This Is Not Your
Traditional Bus.
That’s right! No steps. No lifts. With the ramp, entry
into the advanced-design Easy On bus is from
the ground. Even passengers with wheel chairs, walkers
and other mobility aids retain their dignity by being
able to enter the bus, without assistance, right onto
the low 14-inch floor with no steps to climb. The bus
is built on the Workhorse LF72 low floor chassis,
bred for safety and designed
specifically for shuttle bus
applications. Purpose built low
floor chassis, with longer life and
full manufacturer’s warranty.
No wonder Easy On is the
perfect choice!
For more information
about the Easy On bus,
call Workhorse.
866-467-7300
Copyright,
of America
8 6 6Assisted
- 4 6 7 Living
- 7 3 0Federation
0
Make your facility visibly different.
Set yourself apart with vision-enhancing
magnification products from Optelec.
Reading. Writing. Doing crossword puzzles or looking at family photos.
For many residents in assisted living facilities, these everyday tasks
are difficult—or even impossible—because of deteriorating eyesight.
Fortunately, Optelec offers a way to give these people back their
independence with a range of innovative solutions from handheld,
portable magnifiers to easy-to-use tabletop units. Each has the power
to not only enhance vision, but also to enrich lives.
ClearView +™
For more information on how these vision aids can set your facility
apart, call 800-828-1056 ext. 111 or visit www.optelec.com.
Magnification products from Optelec. A visual edge for your
residents; a competitive edge for your business.
www.optelec.com
For more information, call 800-828-1056 ext. 111 or visit www.optelec.com.
J U LY / A U G U S T 2 0 0 5
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
, VOL. 12, NO. 6
Contents
FEATURES
12 COVER STORY
Refreshing HR Solutions from the Outside
BY ANYA MARTIN
Coca-Cola Enterprises, Southwest Airlines, and other HR-savvy corporations
offer up advice for assisted living companies looking to upgrade employee
relations to boost performance.
18 LEADERSHIP
Legal Minefields
18
BY ADAM STONE
Attorneys who defend assisted living communities say that by being prepared
for the latest causes of potential litigation, assisted living executives can save
themselves a lot of grief. Here are some ideas.
25 SPECIAL REPORT
The Senior Market
BY SUSAN FITZGERALD
With all the talk about the baby boomers, the generation before them—
the “silent generation”—doesn’t get a lot of attention. But to be successful
with the next round of customers, assisted living providers need to get to
know this group better.
DEPARTMENTS
25
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
9
31
33
COMPLIANCE CORNER
BY DARCIE DAVIS
ALFA BULLETIN
Membership update
35
39
41
42
43
44
CONSUMER VOICE
On aging and independence
AFFILIATE SPOTLIGHT: LALA
BY LISA COMEAUX
RESOURCE LINK
Classified ads
PEOPLE & PLACES
Appointments and developments
AD INDEX
Guide to advertisers in this issue
PRODUCTS & RESOURCES
Assisted living solutions
35
Cover photo by Tom Meyer, www.twmeyer.com
Assisted Living EXECUTIVE
, JULY/AUGUST 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 Rd., Suite 510
Alexandria, VA 22312
703/914-9200; fax 703/914-6777
E-mail: alexecutive@strattonpub.com
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, alisonb@strattonpub.com
Marianne Juliana, mariannej@strattonpub.com
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, Partner, 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.
Serving professionally managed
assisted living communities for
seniors by:
t driving business excellence
t influencing public policy and
t building a more informed public.
ALFA PRESIDENT/CEO
TOP OF MIND
Member Value! Member Value! Member Value!
was crossing the street at 56th and Broadway in New York City
about 15 years ago when an out-of-town couple approached
and asked,“How do you get to Carnegie Hall?” I responded
quickly,“Just go one block over and one block up towards Central
Park and it’s right there.You can’t miss it.” As a new New Yorker for
two months, I felt pleased with myself, but realized as they walked
away that I had missed a wonderful opportunity for a punch line
of an old joke.“How do you get to Carnegie Hall? Practice!
Practice! Practice!” Worse, I paused on that corner almost every
evening for 10 years and was never asked that question again!
I thought of this during a recent teleconference seminar on association management.
Someone asked “What are the top three attributes of a successful association?” I responded quickly: “Member Value! Member Value! Member Value!” All one has to know
in the association business is that people join professional associations, like ALFA, if
they perceive they are getting value. And they quit if they feel they aren’t getting value.
That’s why Member Value! is ALFA’s mantra.
ALFA (and the assisted living business) was emerging from some difficult times 18
months ago when I arrived to serve as ALFA’s new president/CEO. As a long-time association professional, I wasn’t surprised to learn that the perception of member value had
eroded as ALFA was forced to cut back in staff and resources during this tumultuous time.
A strategic audit of ALFA members and lapsed members confirmed that even though the
dues rate for members was extremely low for an association representing an industry of
our size (for example,ALFA dues are $4/unit vs. NCAL’s $9.50/unit), the greatest single
concern was that ALFA provided little value!
For most members of ALFA, this perception has changed over recent months since
ALFA has sharpened its focus, stopped trying to “be all things to all people,” changed
its value premise, and started operating like a professional association instead of a perceived “private club.” Importantly,ALFA went to work creating tangible executive-level
(as opposed to “Assisted Living 101”) products, research, and policies in pursuit of
operational excellence in assisted living. While much work remains, companies
in the business of assisted living are well-served by their membership in ALFA.
In a professional association, unlike a private club, membership is composed of
members who may have dramatically different business models, cultures, and corporate
and individual personalities. Some may be larger, smaller, or more successful than others.
The members may compete fiercely, and may not even like each other or agree with the
other’s business model. But despite these differences, people in the same business come
together in association—because they have at least one common purpose. In ALFA our
common purpose is to shape the future of assisted living in America.
ALFA provides functions your company can’t except in association with other assisted
living companies:With its member companies setting the agenda,ALFA advocates at the
federal and state level for the business of assisted living. With its member companies setting the agenda,ALFA serves as the voice of assisted living through the national media.
And with its member companies identifying the needs of its executives,ALFA provides
tangible executive-level, member-only programs that keep
executives, like you, apprised of what the “best of the best”
are doing to enhance and grow their own businesses.
This relates directly to your company’s bottom line.
Richard P. Grimes (rgrimes@alfa.org)
And that’s Member Value!
I
, JULY/AUGUST 2005
5
EXEC TO EXEC
INSIGHTS ON TODAY’S ISSUES
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.
QUESTION: SALES & MARKETING
S
ales and marketing staff play a key role in representing assisted living
residences, fostering business relationships, and contributing to company
growth. We asked a couple of sales and marketing executives to tell us
what they look for in sales staff and how that works in support of their business
models and objectives.
Sarah Curtis,
Senior Vice President
of Sales & Marketing,
Horizon Bay Senior
Communities, Tampa,
Florida
Thomas W. Baker,
Vice President of Sales
& Marketing, Country
Meadows Retirement
Communities, Hershey,
Pennsylvania
“
When we bring on someone new in
sales and marketing, our process begins
with an interview where several individuals from the staff participate.We feel it really helps us get a good perspective.
Many candidates who come to us may
have enough experience and they may
interview well—but because we are working in assisted living communities, by the
very nature of our business, we have to
work closely together.We want sales and
marketing people who can clearly demonstrate that they can interact with other
departments and with our customers.The
top two candidates for a position will go
out into the actual facility where they
would be working.They spend time interacting with administrators, residents, and
other co-workers. Candidates can see if this
is really something they want to do. A lot
of people say they love to work with older
people, but the truth is many of them are
not equipped to handle the emotions that
we must deal with day and day out.
Those who hire sales and marketing
staff may say,‘We want somebody friendly
who can convey a positive image with
experience in the business.’ But they may
not be able to demonstrate the skills that
we really need in assisted living. Our
success is based on our residents and
customers and their satisfaction with the
level of care and services they receive. Staff
members have to be aligned.They have to
be proactive and communicative.”
“
Hiring great sales and marketing staff in
the assisted living industry can be tricky.
Finding a sales person with that perfect
balance of ‘sales personal performer’ and
“compassionate team player” will have a
huge impact on a community’s success.
But so often we sacrifice one for the other,
resulting in mediocre occupancy and a
weak bottom line.
It goes without saying that our first step
is to identify a candidate with a proven
sales track record and strong sales skills
(a sales personal performer). My favorite
method for determining sales skills during
an interview is to ask the candidate to
demonstrate their abilities through a role
play. It’s amazing how much you can learn
about someone’s listening skills, ability
to overcome objections, and closing techniques in 15 minutes. As an industry,
we’ve often promoted internal candidates
because of their friendly, outgoing personality without considering the impact their
limited skill set will have on occupancy.
However, great sales skills alone aren’t
enough.A self-serving “personal performer”
is more of a liability than an asset, but the
“compassionate team player” who possesses a passion for seniors and thrives in a
team environment is invaluable. Ultimately,
hiring sales people with that perfect balance of skill and character will position
your company to more effectively achieve
its business objectives while enhancing the
industry as a whole.” ,
6 JULY/AUGUST 2005
,
Secretary: Tiffany Tomasso, COO
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
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.
YARDI Senior Housing
Comprehensive Senior Housing Management Software
Independent Living,
Assisted Living,
& Dementia Care
Fully Integrated, Browser-Based Technology
Complete Accounting Functionality
Prospect Lead Tracking
Resident Billing and Census
Third-Party Billing
Customizable Assessments
Care Plans
Scheduling
www.yardi.com
Yardi Systems, Inc.
430 S. Fairview Ave. Goleta, CA 93117
800.866.1144
Acta NonVerba
*
* Words and promises are one thing. Facts are another.
Our results speak for themselves. Call Cambridge Today!
n
n
n
n
n
$1,500,000,000 in closed senior
housing and healthcare debt and equity
financing provided by Cambridge for
more than 230 facilities.
95% success rate.
$191,500,000 in closed financings
during 2004.
Unlimited “Best in Class” capital now
available.
One-stop resource for debt or equity
financing: HUD, Conventional, Bridge,
Sale/Leaseback and Acquisitions/Equity
Investment.
Your first and last call for Senior Housing Capital ™
312.357.1601 or www.cambridgecap.com
I N D U S T R Y
U P D AT E S
&
A L F A
N E W S
NEED TO KNOW
Government Relations Update
Acta NonVerba
Medicaid Rates Rise
in Colorado, Montana
Colorado and Montana assisted
living providers have succeeded
in obtaining additional Medicaid
dollars from their state legislatures.
Colorado assisted living
communities will receive a
2 percent increase in reimbursement rates, while Home and
Words and promises are one thing. Facts are another.
Community Based Services
(HCBS) waiver providers Our results speak for themselves. Call Cambridge Today!
in Montana will receive a
3 percent increase over the
next two years.
These rate increases are
n $1,500,000,000 in closed senior
remarkable given recent federal
housing and healthcare debt and equity
efforts to slash Medicaid fundfinancing provided by Cambridge for
ing dramatically.The Montana
legislature also agreed to fund
more than 230 facilities.
an additional 130 slots for HCBS
n 95% success rate.
waiver recipients.
*
Tort Reform Change
Works in Texas
Two years since the state legislature enacted a comprehensive set
of tort reform measures, physicians in Texas appear to be experiencing the changes lawmakers
intended.The reform package
took aim at the crisis in medical
malpractice liability insurance,
which in 2003 was reaching
catastrophic proportions.
The legislation, which placed
a $250,000 cap on non-economic damages, appears to be working. In the last two years, the
number of lawsuits has
declined, as have claim amounts,
and the number of physicians
leaving the state has curtailed.
The state
capitol in Denver, Colorado.
n $191,500,000
in closed
financings
during
Supplemental Appropriations
Physicians
have 2004.
even grown in
Bill, reassigns 50,000 unused
number in Corpus Christi,
n Unlimited “Best in Class” capital now
EB-3 “green card” visa slots from
where
47 additional doctors
prior years to registered nurses,
began practicing
last
year.
More
available.
physical therapists, and others
remarkable is the fact that physiChina, and the
India,
fromor
One-stop
equity
ciansn can
now shopresource
around forfor debt
Philippines.
liabilityfinancing:
insurance coverage.
New
HUD, Conventional, Bridge,
Reassignment of the visas has
carriers have entered the marand Acquisitions/Equity
already begun.The U.S. State
ket, andSale/Leaseback
recently the five largest
Department began the intercarriersInvestment.
announced a reduction
view process in June.
in rates.These rate cuts are
The United States currently
expected to save Texans more
has 125,000 vacant RN posithan $50 million.
tions, according to the Journal
of the American Medical
Association. In the next 10
years, that number is expected
™
Your
first
and
last
call
for
Senior
Capital
by 2020,
to top Housing
380,000, and
New legislation, signed into law
434,000 vacant RN positions
312.357.1601
by President
Bush as partor
of www.cambridgecap.com
are expected.
the 2005 Defense Department
Congress Approves
Visa Reassignments
HHS Introduces
New Health Info
Group
*
I
n June, Health and
Human Services
(HHS) Secretary Mike
Leavitt announced
the formation of the
American Health
Information Community (AHIC).The
new group’s main objective is to facilitate nationwide transition to electronic health records.
Formed under the
auspices of the Federal
Advisory Committee Act,
the AHIC will provide
input and recommendations to HHS on how
to make health records
digital and interoperable
while ensuring the privacy and security of individual records. The group
will include up to 17
commissioners who
will represent consumers,
privacy interests, states,
payers, providers, vendors, and purchasers.
HHS will solicit nominations for commissioners and Sec. Leavitt will
chair the AHIC and
appoint members. HHS
plans to have the group
in place by July.
The AHIC has an initial
two-year charter, with
the option to renew for
a duration of up to five
years. For details about the
AHIC, visit www.os.dhhs.
gov/healthit/ahic.html.
, JULY/AUGUST 2005
9
NEED TO KNOW
ALFA Endorses New Book
Looking toward the future of assisted living,
ALFA has endorsed a new book developed
and published by George Mason
University in Fairfax,Virginia.The book is
an initiative of the university’s Assisted
Living Administration program, the nation’s
first undergraduate and graduate program
dedicated to the assisted living field.
Moments, Memories, and Mission:
Stories from the Field of Assisted Living
is a collection of essays written by assisted
living professionals nationwide.
“These stories reflect the influence
assisted living has had on how we view
aging in America and on what we are moving toward in the future,” says ALFA
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 off 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
10 JULY/AUGUST 2005
,
President and CEO Richard Grimes.“This
is a book not only for communities to
share with their staff, but for anyone dealing
with the care and housing of seniors.”
The essays published in the book were
selected as part of a nationwide contest created by the Assisted Living Administration
program and held in conjunction with
National Assisted Living Week. For more
information and to purchase the book, visit
http://assistedliving.gmu.edu/book.html.
New Products from ALFA
- Best State Regulatory Practices. This
collection of issue papers from the ALFA
Government Relations department explains
ALFA’s public policy views on four major
topics: Staffing, Medication Management,
Administrator Requirements, and Resident
Retention. In addition to outlining ALFA’s
positions on issues related to these topics,
the papers also provide sample state regulatory language in support of these positions.
To access these papers, go to the
Government Relations section of ALFA
Online at www.alfa.org.
- ALFA Executive Portfolio. ALFA’s
groundbreaking new research report details
what leading assisted living providers are
thinking about and planning for in four key
areas: Growth Strategy; Strategic Leadership;
Quality Performance Management; and
Quality Resident Services.To order, call
703/691-8100 or go to ALFA Online at
www.alfa.org.
Save the Date
Mark your calendar now! The next ALFA
Conference & EXPO will be held May 2-5,
2006, at the San Diego Convention Center.
Plan ahead for three days of high-impact
discussions, speakers, and programming that
will help recharge your business for growth
and operational excellence. For details, visit
www.alfaconferenceandexpo.com.
Correction
Oakdale Heights Management Corp.,
based in Redding, CA, was omitted from
{the 2005 Largest Providers list that
appeared in the May 2005 issue of Assisted
Living Executive.With an assisted living
resident capacity of 1,385 and 16 properties, the company ranks #33 on the list. ,
Refreshing
HR
SOLUTIONS
from the Outside
Thirsty for successful
practices, assisted living
execs can look outside
their business to
Coke, Ritz-Carlton,
and others
By Anya Martin
12 JULY/AUGUST 2005
,
Assisted living execs like Beth Cayce of CaraVita
can adapt approaches of larger company execs
like Dan Bowling of Coca-Cola Enterprises.
QUALITY PERFORMANCE MANAGEMENT
E
mployee turnover remains one
of the toughest nuts to crack in
assisted living, especially when
it comes to recruiting and retaining the best and the brightest
frontline employees. Because assisted living
is a relatively young concept, many executives still look outside to companies in
other industries for guidance and best practices.The four companies in this article all
are stars in these areas, so we asked each to
share a few key strategies that have reaped
real results.
Photo by Tom Meyer, www.twmeyer.com
TRACKING VALUES, KEEPING PROMISES
Executives in assisted living often say that
they aspire for their communities to meet
the standards of the top players in the hospitality industry more than any other.
Atlanta-based The Ritz-Carlton Hotel Co.
has raised the bar in luxury accommodations with its concept of “ladies and gentlemen serving ladies and gentlemen.” In the
hospitality industry overall, annual employee turnover is over 100 percent, but The
Ritz-Carlton’s rate is just 24 percent, says
Verna Brown (verna.brown@ritzcarlton.
com), director of human resources at The
Ritz-Carlton,Atlanta. Some employees have
been working at Brown’s hotel since it first
opened 21 years ago.
The first step to retention is choosing
the right employee who fits a corporate
culture that values, above all else,“the care
and comfort of the guest,” Brown says. The
hotel chain hired an external firm to interview employees in every category from
housekeeper to chef to human resources
executive and, based on their answers,
established a list of talents or characteristics
that epitomize the ideal candidate for that
position. Now all applicants are asked similar questions and their responses mapped
on a graph so they can be benchmarked
against this standard tool.
“No employee is hired until they go
through this step,” Brown says.“They may
have a lot of previous experience in the
position they are interviewing for, however,
if they don’t have the talents we are looking
for in that position, they won’t be chosen.”
Once hired, employees don’t just go
through orientation and training.To make
sure that people continue to live the caring
culture to which The Ritz-Carlton aspires,
employees are encouraged to discuss one
of 20 core foundation principles daily during line-ups at the beginning of each shift
and how it applies to their department,
Brown says.An example might be number
11 on the list—“uncompromising levels of
cleanliness are the responsibility of every
employee,” she adds.“Whether you’re in
Kuala Lumpur or San Francisco or Atlanta,
every employee will be discussing that
same basic principle today. It aligns us as a
company.” Employees also carry a small card
with the “employee promise” to guests on it
and the company’s core principles for easy
reference.
While these practices are part of The
Ritz-Carlton’s corporation-wide human
resources strategy, the company also is flexible enough to allow individual hotels’ HR
departments to develop their own ideas.
At the downtown Atlanta hotel, for example, Brown has founded an Employee
Promise Team made up of representatives
from all the different employee categories.
Team members meet weekly and are
charged with “keep[ing] their fingers on the
pulse of employees at all times,” she says.
“They go out and have conversations with
them and make sure that they have the
tools to do their jobs at satisfactory levels.”
They also manage a calendar of events that
includes everything from volunteer activities to birthdays and company anniversaries.They coordinate events and report
how they went.
“Communication is key, and that’s what
this Employee Promise Team does,” Brown
says.The Ritz-Carlton encourages sharing
practices like this via the company intranet,
so Brown has posted the idea for other
hotels to consider.
UNCOVERING AND RECTIFYING
PROBLEMS
Sometimes companies turn to outside
firms for help in identifying shortcomings.
When Williamsburg, Pennsylvania-based
Susquehanna Health System, which
operates three local hospitals with 3,100
employees, first submitted an application
to be designated an Employer of Choice
as part of a joint effort by the Voluntary
Hospitals of America, it ranked among
the worst of 26 fellow members surveyed.
However, within just three years, it not only
qualified but had risen to be one of the best
hospitals ranked, eclipsing its rivals by 25
percent, says Joyce Gioia (joyce@herman
group.com), president of Greensboro, North
Carolina-based workforce strategy consulting
firm The Herman Group and co-developer
of the Employer of Choice program.
Susquehanna’s leadership had become
increasingly concerned about a tightening
workforce and increased vacancies thanks
to aging, shortages in skilled employees, and
high utilization of agency staff, says Rita
Spangler (rspangler@shscares.org), vice
president of operations.The hospital system
had conducted internal employee climate
surveys since 1994 and consistently
received scores ranging from 80 to 90 percent. However, to become an Employer of
Choice, companies undergo a rigorous evaluation by Gioia and company colleagues
that pinpoints specific areas for improvement and problems its previous surveys didn’t reveal, allowing the company to benchmark itself against other companies in
health care and across the board.
The study revealed four key findings,
Spangler says. Employees wanted greater
visibility from members of the management
team and executives, more in-house educational opportunities, and more involvement
in decisions that affect their jobs and their
lives.They also felt that the senior leadership team was more interested in recruitment incentives for new employees than
retaining current employees.
To combat the first issue, the management team declared two hours weekly
as “no meeting time” when their doors
are open to employees to drop by with
concerns or when they wander the halls
speaking to employees, Spangler says.
Susquehanna also added hundreds of
classes for employees but mitigated extra
expense by having staff members teach
in-person classes and by offering Internet
and computer-based learning.These ranged
from a course in how to stop cardiac arrest
to balancing your checkbook. Performance
reviews were retitled “Appreciation
Reviews,” and during them managers
were asked to encourage employees “to
talk about their learning desires and needs
and what they want to do professionally,”
Spangler notes.“People like this—the fact
that that my manager is taking the time to
, JULY/AUGUST 2005
13
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MANAGEMENT
*OE(ANF
#/0$2EHABSURVIVOR
discuss this with me.” By the hospital’s
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employees could be better informed about
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Did these changes pay off? Well, from
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savings more than helped cover the cost of
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seeking outside help, says Spangler. Another
benefit came from utilizing expertise and
experience of “what’s already out there as
a best practice and not having to reinvent 18MRH[DGLQGG
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CONQUEREDTHEWORLDv
NURTURING TALENT WHEREVER IT IS
Atlanta-based Coca-Cola Enterprises’
entry-level frontline labor force shares
many similarities with that of assisted living; in fact, some of them may be the same
people. It’s ethnically diverse, many employees have a high school education or less,
and salaries are low.When Dan Bowling III
(dabowling@na.cokeccee.com), became
senior vice president of human resources
for the global soft drink bottling giant four
years ago, turnover was high, employee
satisfaction scores were low, and the company was in the process of a lay-off. HR
strategy was developed on a local basis,
and Bowling was charged to craft a comprehensive HR strategy that would turn things
around for the entire company.
While Bowling had never held an executive position in HR before, he had worked
previously for the company as a labor and
employment law attorney and then as
manager of a nine-state operation. He’d
taken a non-conventional career path, so
it’s no surprise perhaps that he believes
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, JULY/AUGUST 2005
15
QUALITY PERFORMANCE MANAGEMENT
that giving every employee the chance to
build a long-term career at Coca-Cola
Enterprises not only builds employee loyalty but also helps the company retain its
best talent and forge the leaders it needs it
to excel.“A lot of people aren’t going to
take advantage of it, but those who do are
the people who are going to grow your
company,” Bowling says.“Those are the
people you want.”
His first step was to create cross-functional teams of supervisors (or managers
on a regional basis) to review talent within
the organization and identify potential
“stars” to rise to supervisor positions and
beyond.“As the talent development rolls
up, it gets more sophisticated,” Bowling
says.“If we identify a future leader at the
sales center level, we may bring him to
Atlanta for training.”
Then, in order to ensure that no one
supervisor controls an employee’s destiny,
Bowling changed the system so that all job
postings are available to all employees and
supervisor approval is not needed to apply.
Why? “Good people don’t leave good companies, they leave bad supervisors,” he says.
In many companies, what a supervisor
thinks of an employee determines whether
he or she will be recommended for
advancement.“It’s the Heart of Darkness
syndrome,” Bowling adds, referring to the
Joseph Conrad novel about a man who
turns despotic in a far-flung exotic locale.
“Sometimes people go off far enough from
headquarters and become gods or kings.
You see that in any company with far flung,
particularly small operations.”
Over the past few years, the soft drink
industry has faced numerous challenges,
including charges from the public health
lobbies that its products encourage obesity.
But engagement scores in employee satisfaction surveys at Coca-Cola Enterprises
have risen, and what employees indicate
they like correlates strongly with these
new talent development strategies, Bowling
says.The bottler’s HR turnaround has even
helped it make Fortune’s list of Most
Admired Companies.
Another reason Bowling feels the talent
development program has worked so well
is because it was one of a few targeted
strategies.“If we just looked at the talent
development committees as one of 25
Webb says Southwest
Airlines has learned that its
culture makes employees feel
that they have a vested interest
in its monetary success.
things to do, they wouldn’t be happening,”
he adds.“But if they know that when I or
the CEO comes to town, we want to look at
the minutes of the last talent development
meeting, guess what happens?”
SHARING OWNERSHIP
Perhaps no industry has been more challenged over the past few years than the airlines.Yet Dallas-based Southwest Airlines
has turned a profit for 32 consecutive years
of its 33-year total lifespan and continues to
boast the highest-rated customer service in
its industry despite being a discount carrier.
How does the company do it?
Numerous articles credit a corporate
culture that values its employees above all.
The human resources department is called
the “People Department,” but executives
ensure it’s much more than a name, says
Amy Webb (amy.webb@wnco.com),
employment manager. Interestingly the
company doesn’t do employee satisfaction
surveys, yet turnover rates for the past few
years have been an amazingly low 4.5 percent, and despite being heavily unionized,
the company has never had a major strike.
What inspires this loyalty?
Webb says Southwest has learned that
its culture makes employees feel that
they have a vested interest in its monetary
success. Every year that Southwest turns a
profit, employees receive a bonus to their
retirement funds. Most employees are stockholders, either receiving annual stock gifts
or investing themselves at discount purchase rates.
“This is one of the things that keeps
employees focused on the bottom line,”
Webb says.“A lot of times, people will say
‘that’s my profit-sharing you’re spending.’”
Southwest’s empowerment of employees
is “legend.” Frontline employees are empowered to make some customer service deci-
16 JULY/AUGUST 2005
,
sions without questioning a supervisor.
“If an exception needs to be made, they do
have the ability to do the right thing for the
customer,”Webb says.
Perhaps even more significantly, they are
also encouraged to offer ideas to leadership
for improving service and ultimately the
bottom line,Webb says. For example, a
“Heads Up Guidance Display” now in all of
the airline’s Boeing 737 jets was suggested
by Becky Reyes, a Sacramento, Californiabased customer service agent.“Becky was
dealing with delayed flights every day out
of Sacramento because of the fog, and was
continually being asked by our passengers
why other airlines were able to land and
we were not,”Webb says.“She did some
research and discovered the reason.As a
result, our aircraft are now equipped with
the HUD device that helps us land at lower
minimum weather conditions, and helps
out our bottom-line profit sharing.”
And the “Plane Smart Business”program
started by the Flight Operations Department has received more than 400 proposals
from pilots that Webb estimates could result
in millions of dollars in annual savings.
If a suggestion is not accepted, then the
airline still shows respect to the employee
by taking the time to write a letter of
thanks and also explaining why the idea
was not adopted.“Feedback is very important,”Webb says.“If people continuously
submit ideas without any feedback, they
are probably going to stop submitting
them.”
This kind of program can only work
if employees believe that their suggestions
will be taken as constructive and not as
criticisms, and if that attitude comes down
from the very top from the CEO, she
adds. It’s oft-stated but believed to the
core by Southwest’s executives that
“happy employees are going to treat
customers the right way.”
And their bosses, too. Both after the 9/11
terrorist attacks and during a previous time
of high fuel prices, Southwest employees
voted to protect the company’s profitability
in tough times by returning some of their
pay on a voluntary basis to their company. ,
Anya Martin is a staff writer for
Assisted Living Executive. Reach her at
amartin@strattonpub.com.
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L E A D E R S H I P
LEGAL
Minefields
The three-fold formula for sidestepping legal calamities
includes expectation management, clear-cut contracts, and
preemptive attention to operational details
By Adam Stone
J
ack Leebron is so ready to get sued,
it’s not even funny. As senior VP of
legal services at American
Retirement Corp. in Brentwood,
Tennessee, he has seen lawsuits
become a routine thing over the
years, and frankly he is just about fed up
with it.“I have one lawsuit where the lady
died at 101 years old and we are being sued
for wrongful death,” he says.
“We used to be bombarded with used
car ads. Now we are bombarded with
lawyer ads, and all that has to happen is
that you have a negative outcome of any
sort, regardless of whose fault it is, and relatives in their guilt will immediately call up a
lawyer,” says Leebron (jleebron@arclp.com).
You don’t have to take it lying down.
Attorneys who defend assisted living communities say that by being prepared for the
latest causes of potential litigation, assisted
living executives can save themselves a lot
of grief.
The hot topics today include issues surrounding increasing acuity levels, along
with fallout from one’s inability to stay up
to code. How to prevent stepping on a legal
landmine in any of these areas? It’s a threefold solution: Expectation management.
Clear-cut contracts.And preemptive attention to operational details.
When it comes to acuity, two classes of
legal risk arise.The first has to do with
acuity at the time of intake, while the second involves rising acuity among existing
residents.
The average person coming in to assisted
living is older than in years past, and his or
her health may be commensurately poor.
When people walk through the door older
and sicker, you already are starting out
behind the eight ball.
“There is an increase in the risks of lawsuits from injured residents, dissatisfied residents, dissatisfied families.You have the risk
of claims by employees or against employees,” says Ivan J. Punchatz (punchatzij@
bipc.com), an attorney with Buchanan
Ingersoll in Princeton, New Jersey.
How to inoculate yourself against these
kinds of suits, the likelihood of which
increases as the age of incoming residents
goes up? The first step, obviously, is excellence in care.“Is your staff adequately
trained to work with this older population?
Is it appropriately certified or licensed to
care for those kinds of people, whether
they require additional medications or
wound care, or if they have less mobility
and require assistance in transfer?”
But let’s assume you already are doing
your job right, that you have a trained, qualified, and capable staff. Still you are not safe
from lawsuits, and here we come to expectation management, for the first but not the
last time.
18 JULY/AUGUST 2005
,
, JULY/AUGUST 2005
19
L E A D E R S H I P
Even if you are doing everything right,
“still you must be clear to the resident and
to the resident’s family as to what you can
or cannot do,” Punchatz says.
G. Michael Leader backs that up.
As president and CEO of Country
Meadows Retirement Communities, with
11 campuses in Pennsylvania and northern
Maryland, he sees communication as his
first line of defense.“People have the expectation that when they come to an assisted
living community, that somehow we will
guarantee that bad things do not happen.
That is the expectation that we are fighting
here,” says Leader (mleader@country
meadows.com).
In the past couple of years, he has been
sued by a woman who got her foot caught
in an elevator door and another who got
hit by an automatic door in a doctor’s office
where she had been dropped off. Country
Meadows’ fault? Leader says no, and he adds
that a more realistic expectation on the part
of families could help prevent such suits.
To that end, Leader hands to the family of
each new resident a 25-page full disclosure
lease covering every possible aspect of
care.“It’s so detailed that I am sure that a
lot of people don’t read it, but at least
everything is in there,” he says.
ACUITY ON THE RISE
Intake acuity is only one side of the coin.
Flip it over and you’ll find rising acuity
among existing residents. Sooner or later,
the aging process will take its toll, and
that’s an open door for a lawyer to step
through.This is especially true in continuing care retirement communities (CCRC).
“Just like in any other area of life, people
are sometimes resistant to change,” says
Deborah Moskowitz (dmoskowitz@qpw
blaw.com), an attorney with Quintairos,
Prieto, Wood & Boyer in Miami.
“If they come into a community and they
are living in the independent area, and then
people are noticing that they may need a
higher level of care, sometimes they don’t
want to leave those apartments and go to
another [residence]. It is even more pronounced when you have to move somebody from assisted living to a skilled nursing facility.”
A legal problem? Absolutely, especially if
the residence’s assessment runs counter to
the desires of the family.
“I had an experience where a resident’s
acuities increased over a period of time,
and the family was not prepared to accept
that,” says Punchatz.“Ultimately, the [residence] ended up in a legal dispute as to
whether the resident could be retained
at the [residence].”
As you may have guessed, prevention
comes in the form of more and better information, coupled in this case with some very
explicit contract language.
Leebron takes a big-picture approach to
communications in this case.“One of the
pushes we are doing is to educate residents
and their family members about the aging
process in general,” he says.“In America, we
are so concerned about youth and vibrancy
and all the things that go with being young,
and we fail to talk about what it means to
grow old.” Ongoing discussions and presentations help to set realistic expectations.
Solid contracts help enforce those
expectations, or at least they should.
Policies about the escalation of care
“need to be spelled out in no uncertain
terms in the admissions contracts,”
Moskowitz says.
“From the very beginning, the families
need to be informed that the [residence]
is going to make the final determination as
to what level of care is required.The families need to understand and need to be
OK with the fact that they are not going to
be the final decision-makers as far as what
is required.”
It has to be in writing, spelled out in the
admissions contract, so that no lawsuit can
possibly arise when acuity increases.
DEFENDING DEFICIENCIES
If various acuity issues represent potential
legal landmines, there’s another vital issue
that also needs to be anticipated. It has to
do with regulatory enforcement and the
possibility of non-compliance. Of course,
failure to meet a specific state requirement
comes with its own penalties: warnings,
sanctions, even the possible loss of licensure. But there’s another penalty hiding in
the wings.That is, the threat of litigation.
Here’s how it works, according to
Kinber Latsha (klatsha@ldylaw.com),
an attorney with Latsha Davis Yohe &
McKenna in Harrisburg, Pennsylvania.
20 JULY/AUGUST 2005
,
“Suppose someone fell and got hurt, and
you were understaffed at that time. Or if a
person needed some kind of assistance and
you didn’t have enough staff to do that.You
can arguably attribute that injury directly to
the [residence’s] failure to comply with that
regulation,” Latsha says.
“A plaintiff’s lawyer isn’t going to know
this at first glance, but he is going to look at
what is going on in that [residence]. If there
is a deficiency on the books for that, you are
handing it to him on a silver platter.”
How does a deficiency get on the books?
You fail an inspection somewhere along the
line, or a resident (or family) complains to
the state about a circumstance or situation.
A regulatory deficiency is not always an
invitation to sue. If a window needs new
caulking or if your admissions agreement
wording fails to meet some small technical
requirement, there’s no incentive to sue.As
soon as someone gets hurt, though, you’re
in trouble.
Will good communications help you
here? To some extent, yes. Leebron notes
that most lawsuits he faces come from relatively new residents, people who have not
formed a bond with the staff.The harder
you work to establish ongoing relationships
with residents and their families, he says,
the less likely you are to face litigation.
“You don’t sue your friends,” as Leebron
puts it.
It also helps to put some of the burden
back on the residents themselves.
Moskowitz points in particular to negotiated risk agreements, presently legal in 13
states.“Say someone is a diabetic and they
insist on having candy.They can enter into
a negotiated risk agreement where they
can do what they want, and will not hold
the [residence] responsible for the outcome,” she says.When that resident’s blood
sugar goes wrong, you are covered. No
plaintiff’s attorney will touch the case.
Is this a rough way to run a business? Is
it a sad situation for all concerned? In the
current climate of litigation, driven in large
measure by massive jury awards, assisted living executives will need to continue to take
precautions for the foreseeable future. ,
Adam Stone is a staff writer for Assisted
Living Executive. Reach him at
astone@strattonpub.com.
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S P E C I A L
R E P O R T
The Senior Market
In the next five to 10 years, a new group of seniors will enter assisted living.
Do you know what to expect from them? And are you and your staff
prepared to serve them they way they want?
By Susan L. Fitzgerald
, JULY/AUGUST 2005
23
S P E C I A L
R E P O R T
A
ssisted living providers
are constantly striving
to learn from the past,
serve present residents, and prepare for future moveins. So taking a look toward tomorrow, just what’s on the horizon?
“Seniors entering assisted living
in five to 10 years will be a mix of
older, independent-minded but frail
seniors who did not require assisted living in their 80s or even 90s
and those younger seniors in their
80s needing assistance,” predicts
Jamison Gosselin, (jamie.gosselin
@sunriseseniorliving.com) a
spokesperson for McLean,Virginiabased Sunrise Senior Living.
“There’s been so much talk about the baby boomers that
the generation before them doesn’t get a lot of attention,”
admits Bradley Johnson, editor of American Demographics.
GENERATIONS YEAR BY YEAR
Born
“There’s been so much talk about the
baby boomers, that the generation before
them doesn’t get a lot of attention,” admits
Bradley Johnson, editor of American
Demographics.
Perhaps fittingly, the precursors to the
boomers have been dubbed the “silent
generation,” a group born between 1925
and 1942. In a presentation to the
American Institute of Architects, N.
Boyce Appel, (Bapple@appel.com)
president of Appel Associates, offered
this summary of the silent generation:
- Defining events and trends:
Patriotism, families, the Great Depression,
the New Deal,World War II, the Korean
War, the golden age of radio, the silver
screen, and labor unions
- Core values, derived from those
events: Dedication, sacrifice, hard work,
conformity, law and order, patience, respect
for authority, duty before pleasure, adherence to rules, and honor
- Personality: Conformists, conservative spenders, past-oriented, and belief in
logic, not magic.
Cyber Generation . . . . . . . . . . . . . . 2002-2025
Generation Y or the
Millennial Generation . . . . . . . . . . . 1982-2001
Generation X or the
13th Generation . . . . . . . . . . . . . . . 1960-1981
Baby Boomers . . . . . . . . . . . . . . . . 1943-1960
Silent Generation. . . . . . . . . . . . . . . 1925-1942
G.I. Genenation . . . . . . . . . . . . . . . . 1901-1924
Lost Generation. . . . . . . . . . . . . . . . 1883-1900
“A depression upbringing has been part
of their lives,” adds Johnson.“Economically,
this generation has done exceptionally well;
they have accumulated wealth.” That said,
Johnson says that they are “fiscally conservative compared to the generation following them. I would expect that they’re going
to be more inclined to save money.”
Sunrise’s Gosselin adds that these individuals are “increasingly more independentminded—even if they need assistance—
and expect to maintain a standard of living
they worked so hard to achieve.”
This group is committed to balancing
leisure and work, Gosselin says.“We
wouldn’t be surprised if more residents
moving to assisted living in this time period
still ‘work’ in some capacity.”
Howard Willens, (hwillens@verizon.
net) president of Mature Marketing and
Research, discusses the “wartime babies”
(1940-1945) as the likeliest candidates for
assisted living in the next five to seven
years. He portrays this group as not too different from the true baby boomers. In fact,
he says that evidence suggests they are
quite similar. These individuals are well educated and financialy secure,Willens says.
“Because of their education and income
position, they are up with the times and
follow the trends,” he adds.“They own
computers, are on the Internet—where
they shop, invest, do research, and, of
course, are heavily into e-mail.They also
buy digital cameras, plasma TVs, cell
phones, and new cars. In other words,
unlike what many marketers believe, they
are not afraid to try new products.”
In short,Willens says,“they are as ‘with it’
as those 30 years younger.”
WHAT THEY WANT
So how does this profile translate to senior
housing preferences? While this generation
may be tagged silent, they have some serious
, JULY/AUGUST 2005
25
S P E C I A L
R E P O R T
“What has already begun to change and will continue to
evolve, are the increasing needs of residents,” says
Bernadette Wright, a policy research analyst with AARP.
Number of People Age 65 and Over, by Age Group,
(Resident Population from 1900-2000 and projected 2010-2050)
Millions
100
90
80
70
60
50
65 and over
40
30
20
80 and over
10
0
Years 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050
Projected Years
- In 2003, nearly 36 million people age 65 and over lived in the United States, accounting for just
over 12 percent of the total population. Over the 20th century, the older population grew from 3 million
to 35 million. The oldest-old population (those age 85 and over) grew from just over 100,000 in 1900
to 4.2 million in 2000.
- The growth rate of the older population is projected to slow after 2030, when the last Baby
Boomers enter the ranks of the older population. From 2030 onward, the proportion age 65 and over
will be relatively stable, at around 20 percent, even though the absolute number of people age 65 and
over is projected to continue to grow. The oldest-old population is projected to grow rapidly after 2030,
when the Baby Boomers move into this age group.
- The U.S. Census Bureau projects that the population age 85 and over could grow from 4.2 million
in 2000 to nearly 21 million by 2050. Some researchers predict that death rates at older ages will
decline more rapidly than is reflected in the U.S. Census Bureau’s projections, which could lead to
faster growth of this population.
Note: Data for 2010-2050 are projections of the population. Source: Federal Interagency Forum on Aging-Related Statistics.
Older Americans 2004: Key Indicators of Well-Being. Federal Interagency Forum on Aging-Related Statistics, Washington, DC:
U.S. Government Printing Office. November 2004.
26 JULY/AUGUST 2005
,
ideas when it comes to care and services.
“Currently, the average assisted living
resident is a woman, widowed, about
age 85,” says Bernadette Wright,
(BWright@aarp.org) a policy research
analyst with AARP.“I don’t see any reason
that will change.”
What has already begun to change, and
will continue to evolve,Wright notes, are
the increasing needs of residents. She sees
the reason as twofold. First, communities
are accepting more disabled residents and
second, the government is increasing its
assisted living funding.What’s more,Wright
says, residents are aging in place.This is
slightly altering the profile of residents. So
forecasting out five to 10 years, we should
see older residents with more needs, and
providers offering more services,Wright
explains. It’s a trend we’re already seeing
today.
Today and in the future, residents
expect a high level of services.“They want
a normal life experience, carrying on the
same hobbies, surrounded by their personal belongings; and they want to stay
involved with the outside community,”
Wright says.
“In addition to the increase of seniors
with physical limitations, we expect more
seniors with Alzheimer’s disease and other
forms of dementia will move to assisted living,” agrees Gosselin.
MONEY MATTERS
The Mature Market Institute of Met Life
demographic profile of Americans age 65
and over reports the median net worth of
seniors age 65 to 69 is $114,050, and
$27,588 excluding home equity. Seniors
age 65 to 74 spend an average of $10,052
on housing.
How will they apply that to assisted living? Financially, assisted living resident numbers may also change slightly,Wright suggests. Right now, 11 percent of residents are
receiving some Medicaid assistance to pay
for assisted living.“Over the next few years,
a growing number of states will cover
assisted living through Medicaid.”
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S P E C I A L
R E P O R T
Sunrise’s Jamison Gosselin adds that these individuals are
“increasingly more independent-minded and expect to
maintain a standard of living they worked so hard to achieve.”
Living Arrangements of the Population Age 65 and Over
(by Sex and Race and Hispanic Origin, 2003)
- With Spouse - With Other Relatives - With Nonrelatives - Alone
MEN
Percent
WOMEN
100
30
90
19
8
1
12
19
3
5
3
4
31
15
40
42
39
19
22
5
80
70
2
4
6
60
2
50
36
2
9
2
7
13
2
25
40
73
75
60
30
60
68
50
50
46
Asian
Alone
Hispanic
(of any race)
Total
Non-Hispanic
White Alone
Black
Alone
43
51
20
10
0
Total
Non-Hispanic Black
White Alone Alone
Asian
Hispanic
Alone (of any race)
- The living arrangements of America’s older population are important indicators because they are
linked to income, health status, and the availability of caregivers. Older people who live alone are more
likely than older people who live with their spouses to be in poverty.
Note: “Living with Other Relatives” indicates no spouse present. “Living with Non-relatives” indicates no spouse or other relatives present.
The term “Non-Hispanic White Alone” is used to refer to people who reported being white and no other race and who are not Hispanic.
The term “Black Alone” is used to refer to people who reported being black or African American and no other race and who are not Hispanic
and the term “Asian Alone” is used to refer to people who reported only Asian as their race. These data refer to the civilian noninstitutionalized population. Source: Federal Interagency Forum on Aging-Related Statistics. Older Americans 2004: Key Indicators of Well-Being.
Federal Interagency Forum on Aging-Related Statistics, Washington, DC: U.S. Government Printing Office. November 2004.
ways, says Gosselin.“Hobbies and activities
in which they can contribute to a cause of
society will be important. We feel intergenerational activities will become more popular with this generation that values higher
levels of education, closeness of family, and
civic activities.”
To providers,Wright proposes,“Residents
could benefit from more individualized
programs.”Already, she sees more residences
answering these needs.Whether it be a specific ethnic group or people with similar
spiritual interests, there are a growing
number of assisted living residences
tailored to one group.
Willens agrees that as far as housing—
and likely with regard to a potential assisted
living residence as well, this group “wants
to stay close to their family and friends—
and had been planning to do so before their
need to move into an assisted living facility.”
He notes many in this demographic want
to remain in a mixed-age neighborhood.
“The idea of a 55+ community, and/or
being far from family and old friends can
be a turn-off.”
“With regard to housing options—
and consistent with their other spending
habits—this is a highly knowledgeable
group of people,” stresses Willens.“They
want what is new and is modern and is
convenient right now—and they will
demand it in any assisted living facility
they consider.”
Sunrise also anticipates the growing
emphasis on modern advances.“We are
seeing some increased interest in technology in assisted living, but more so in independent living,” says Gosselin.“We expect
that demand for high-speed broadband
and high-tech assistive devices will increase
to encourage seniors to maintain their
independence. Like the pioneer residents
before them, residents in five to 10 years
will expect quality services and care with
all the comforts of home.”
Far from quiet, assisted living’s newest
residents and their families know what
they want.“The rise in the number of
assisted living facilities is likely to bring
about a highly competitive market,” says
Willens.“The facilities management that
understands its emerging market, and
builds to suit its emerging needs, will be
successful.” ,
, JULY/AUGUST 2005
29
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LAWYER/CLIENT RELATIONSHIPS
COMPLIANCE CORNER
Do You Really Trust Your
Legal Counsel?
they would do if their trusted lawyer left
his or her current law firm. Would they
remain with the firm or maintain the relationship with the individual? The majority
of executives report they would follow, and
have followed, the individual.
BY DARCIE DAVIS
FINDING GOOD, FIRING BAD LAWYERS
s an assisted living executive who
must make important business
decisions each day, do you trust
your legal counsel? If you do, how much
does your lawyer influence your overall
business operations?
When it comes to building trust with
executive clients, some lawyers are successful while others fail miserably. Davis,
Kingsley & Company, a management consulting firm in Reston,Virginia, recently surveyed 30 executives from a variety of companies in the mid-Atlantic region to determine what business leaders value and
expect from lawyers, and what lawyers can
do to build trust-based relationships with
executive clients.
We weren’t surprised by the results;
however, we were surprised by the specific
behaviors successful lawyers demonstrate to
achieve that trust-based, high level of client
service. These survey results not only provide information about current lawyer-client
trends, but also shed light on what assisted
living executives can reasonably expect
from their relationships with lawyers and
law firms.
A
MEASURING THE LAWYER-CLIENT
RELATIONSHIP
For the purpose of this survey, we categorized the lawyer-client relationship into four
categories and asked each executive to rate
their attorneys accordingly.
- Level 1 – Commodity-based. Price per
service primarily directs the lawyer-client
relationship.The lawyer has little to no
influence on business operations.
- Level 2 – Project-based. Executives
welcome the lawyer’s input because he or
Davis, Kingsley & Company
surveyed 30 executives from
a variety of companies in
the mid-Atlantic region to
determine what business
leaders value and expect from
lawyers, and what lawyers
can do to build trust-based
relationships with clients.
she has a high level of expertise in the
client’s field.
- Level 3 – Consultant-based. The
lawyer provides input that may influence an
executive’s decision, but may not influence
operational strategy. The input is grounded
in extensive field-specific expertise.
- Level 4 – Trust-based. This is the highest lawyer-client relationship rating. The
lawyer is a trusted adviser who provides
strategic input that influences an executive’s decision at an operational level.
Despite a comment from one executive,
who said “strategy and attorneys don’t mix,”
the majority of executives surveyed (54%)
say they have had a Level 4 lawyer-client
relationship—one in which the lawyer is
providing strategic legal counsel at an operational level.
Overwhelmingly, the individual lawyer
gets the credit for the quality of the relationship and, consequently, the client loyalties are vested more with the individual
lawyer than the firm he or she represents.
We followed up by asking executives what
Many of the executives we surveyed and
interviewed serve as general counsel for
their companies. Because of their background, they have solid ties to peers in law
firms and in corporate positions.This is a
tight referral network and is the first
resource these executives use when new
legal expertise is needed.
The next source executives use when
searching for a lawyer is the MartindaleHubbell exhaustive biographical database
of lawyers (www.martindale.com). This
online resource is searchable by field of
expertise, state, law school, name, and more.
For those not familiar with the legal field,
referrals from friends or colleagues continue to be the No. 1 way to find a lawyer.
But what if the relationship goes sour?
Nearly all of the executives we interviewed
have had occasion to fire a lawyer or to
sever ties before a contract is finalized. That
initial “courtship” period, when the lawyer
is vying for the prospective client’s business, is usually pretty brief, executives say,
because it is quickly apparent whether the
lawyer demonstrates the right qualities.
Here are a couple of anecdotes about
lawyers who did the wrong things and
quickly lost a prospective client:
- “I had outgrown our small law firm
and was introduced to a new attorney at a
large law firm to discuss our plans to
acquire a company. We met at lunch. I paid
for lunch, but weeks later he sent me a bill
for his time, plus travel. I called him on it
and he said,‘Welcome to the big time now.’
I told him he was fired.”
- “I once hired a local attorney to
review a shareholder agreement that was
already in place and render some opinions.
He made a few very tiny edits … and
charged me an enormous amount of
, JULY/AUGUST 2005
31
COMPLIANCE CORNER
money. … They’ve never bothered to follow
up with me to see if I was satisfied with
their work. I’d never call them again.”
No matter the company size or business
focus, executives value open and honest
customer service, and it is reasonable to
expect as much from a trustworthy lawyer.
MANAGING YOUR LEGAL COUNSEL
Although our interview pool of executives
included various types of industries, backgrounds, and levels of experience, we found
that those with legal backgrounds did a better job of managing the relationship with
outside legal counsel. They understand and
speak “legalese.” Executives without legal
backgrounds were more likely to experience
undesirable or ineffective relationships.
The study also found that those with legal
backgrounds tended to be more aggressive
and confident about making their expectations known to their legal counsel.
Given this feedback, it seems most
effective if the executive or executives who
are managing the lawyer-client relationship
have a legal background or at least feel
knowledgeable enough to work closely
with outside legal counsel.
COMMON BONE OF CONTENTION
One of the most often mentioned lawyerclient contentions cited by the executives
surveyed was invoicing. The survey results
suggest that billing and invoicing practices
are the hot spot for making or breaking
trust-based relationships. Those with legal
backgrounds are more aggressive about calling their attorneys when they believe
billings are too high. Those without legal
backgrounds often will complain about the
high cost of legal advice, but are more
reluctant about questioning the bill.
In every case, lawyers who attained Level
4 relationships with executives made concessions on their bills, with no arguments,
when their clients called to complain.We
heard many stories about discounts or
reductions that were made in response to
client concern.These actions have proven
to be powerful gestures that strengthen
client loyalty. Flexibility in this area is another feature of the client-lawyer relationship
that executives can reasonably expect.
Here are a couple of comments from the
executives we interviewed:
The survey results suggest
that billing and invoicing
practices are the hot spot
for making or breaking
trust-based relationships.
Those executives with legal
backgrounds are more
aggressive about calling their
attorneys when they believe
billings are too high.
- “The other day, I saw a charge that
wasn’t reasonable to me. I called my attorney and he said,‘Just take it off the bill.’ No
arguments. They always make the adjustment right away. They want to keep the
relationship going and know it’s not worth
$5,000 to lose our business.”
- “They adjust their prices when we
really need them to do so.They really work
with us and trust us.”
As with any business service, executives
don’t want to be “nickeled and dimed” by
their attorneys. One executive, for example,
noted that his attorney doesn’t charge for
the brief phone conversations they have
about four times a year. Another executive
noted that an attorney who was seeking to
win his company’s business offered to handle a project free of charge.
MARKETING AND MAINTENANCE
The executives surveyed were intensely
outspoken about tactics lawyers should use,
or avoid, in order to build a new or expanded relationship with them.We wanted to
know what new lawyers could do to market themselves effectively, and what executives could reasonably expect for a promising prospect.
A few traditional methods of marketing
were of no value to executives. These
include cold calls, marketing brochures,
and marketing trinkets, such as key chains.
On the flip side, law firm seminars are an
effective way for executives to gather information and confidence about a potential
32 JULY/AUGUST 2005
,
new lawyer. The executives surveyed are
quite responsive to seminars conducted by
the law firms that serve them, but also
attend seminars put on by other law firms
on issues of interest to them.We heard several stories about executives attending a
seminar and gaining a positive impression
of one of the presenting lawyers. For the
most part, however, the law firms presenting the seminars don’t do a very good job
of following up with executives, according
to the feedback we gathered.
The best case scenario, according to
executives, is when their current lawyers
are proactive about keeping them informed
about the issues that affect their business.
As one executive commented,“Our law
firm will offer to brief us on something
they know would be of interest to us.
They offer this gratis about once a year.
It’s tailored to our business and us, and is
highly valued.” When lawyers don’t do this,
executives may seek the advice of another
law firm (through a seminar, for example).
In addition to seminars, executives also
value receiving white papers or issue
briefings from their current or prospective
attorneys.
It is reasonable for assisted living executives to expect high levels of individualized
service from their lawyers, especially if they
are seeking strategic counsel at an operational level.To get the most out of the relationship, executives should feel comfortable
working with attorneys, which oftentimes
means being knowledgeable about the legal
field themselves. Likewise, successful attorneys should be knowledgeable about the
assisted living business and offer timely
ideas and materials.
Finding and hiring a trustworthy lawyer
may not be as difficult as executives may
imagine, provided they have a clear picture
of their expectations before entering into
such a relationship. Executives should
make these expectations clear from the
beginning and continue to refer to these
expectations throughout the client-lawyer
relationship. ,
Darcie Davis is president
of Davis, Kingsley &
Company. Reach her
at ddavis@daviskingsley.
com or 703/742-3761.
M E M B E R S H I P
U P D A T E
ALFA BULLETIN
ALFA Announces Dues
Structure Changes
Answers to frequently asked questions
The change in how ALFA
collects dues means that
more of your dues will go
directly to the programs
and products that you
find valuable at both the
national and state levels.
ffective January 2006, dues for membership in the Assisted Living
Federation of America will be paid
directly to ALFA, rather than collected by
individual state associations. Previously, dues
paid to state affiliates also included dues for
membership in ALFA.This change means that
more of your dues will go directly to the programs and products that you find valuable
both at the national and state levels.
If you work for a multi-state provider, the
decision to belong to ALFA will be made at
the corporate level. For example,Alterra
Healthcare has elected to join ALFA in 2006,
and is paying for its membership nationwide. All Alterra residences, including those
in all states where Alterra operates, will
receive the benefits of membership in ALFA.
Individual Alterra residences may then
choose to join their ALFA state affiliates.
The changes are outlined in detail here:
E
WHY DID ALFA DECIDE TO ADJUST
THE DUES STRUCTURE?
The decision is largely administrative.ALFA
has 40 state affiliates—each of which is an
independent nonprofit entity with different
membership requirements, reporting tools
and mechanisms, renewal cycles, and dues
structures. The cost to ALFA to manage all
the different systems for collecting dues
was more than $100,000 in 2004, nearly 20
percent of total dues. This structure was
also expensive for state affiliates.
HOW WILL ALFA AND THE STATE
AFFILIATES WORK TOGETHER?
ALFA and its state affiliates will continue to
enjoy a close national-state partnership,
with mutual support in efforts to enhance
assisted living in each state and nationwide.
Companies may choose to belong to ALFA
and state affiliates, or to ALFA or state affiliates alone. If your company chooses to
belong to both, you will get all the state and
national benefits ALFA and your state affiliate offer.
SHOULD I BELONG TO BOTH MY
STATE AFFILIATE AND ALFA?
If you are in the business of assisted living
for seniors, you will benefit from belonging
to both ALFA and ALFA state affiliates.ALFA,
specifically, is laser-focused on the needs of
owners, operators, and executives in companies operating professionally managed
assisted living communities for seniors. In
addition to its traditional role of representing your interests in public policy and the
media,ALFA is producing value-added programs, products, and services to ensure
operational excellence for your company.
WHAT ARE THE CHANGES TO THE
MEMBERSHIP CATEGORIES?
ALFA has created a new State Affiliate category of membership and will provide certain specific benefits to ALFA state affiliates
for a modest fee.A new relationship will be
crafted with ALFA state affiliates representing ALFA’s interests in their respective states
and ALFA representing ALFA state affiliates
interests in Washington, D.C. ALFA will keep
you informed about the details of this new
relationship and how the partnership will
benefit your business.
If you have additional questions, please
contact Paul Williams at
pwilliams@alfa.org.
, JULY/AUGUST 2005
33
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O N
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A N D
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Home Is Where the
Hounds Are
BY TRAVIS E. FOGLE
or the nearly 100
seniors who live
at Silverado Senior
Living – Cypresswood,
their expansive residence
in Houston,Texas, just
wouldn’t feel like home
without Penny, Gracie,
and Big Boy. In March,
these three greyhound
dogs became part of the
Cypresswood family. Now
the hounds live side-byside with residents.They
take walks with them,
visit with them, and offer
comforting companionship—especially when
not everything seems to
make sense.
Silverado Senior Living
– Cypresswood is a memory care community that
is fulfilling a top consumer preference everyday—to provide a welcoming environment of
care that truly feels like
Jesse Rodriguez (left) of Silverado Senior Living – Cypresswood and a
home.As assisted living
Cypresswood resident spend time with Big Boy, one of three greyhounds
executives well know,
recently adopted by the memory care community.
communities will go to
homemade meals … but what better way to
great lengths to create living environments
make a “house” a home than to include a
that make family members feel at ease
family pet?
about placing a loved one, and where resiPenny, Gracie, and Big Boy enhance the
dents can thrive despite the mental or physquality of life and make Cypresswood a
ical challenges associated with aging.
home for residents everyday. Whether it’s
Communities carefully choose architectural
three dogs, one cat, two birds, or an aquaridesigns and furnishings that look and feel
um of fish—a pet program can make an
like a home because they know that’s what
assisted living community stand out to
consumers want and value. Fireplaces, art,
F
CONSUMER VOICE
potential consumers and provide current
consumers with a daily, sometimes furry,
reminder that they made the right choice.
Certainly there are many factors involved
in bringing a pet to a community, but the
net gain is well worth the effort.
ENSURE THE RIGHT FIT
It’s not as simple as going to the
local shelter, adopting a dog, and
introducing a new pet to the staff
and residents. In fact, this is
absolutely the wrong approach.
Ever since Cypresswood opened
its doors seven years ago, it has
welcomed residents and their pets.
Therefore, pet policies were incorporated into the business plan
from the start.These policies
include staff support and responsibilities for pet care, in addition
to what residents are able to do.
Caring for a pet is an excellent
activity for seniors. It provides
them with daily memory stimulation, like preparing meals and
providing water every day, as well
as physical activity, like taking daily
walks with a dog.These all are
aspects of the pet program that
family members and residents
appreciate.The pet program in that
respect is a value-added feature.
On the flip side, however, staff
members must closely monitor and
support pet care.As part of their
daily responsibilities, they also
Ever since Cypresswood
opened its doors seven years
ago, it has welcomed residents
and their pets. Therefore,
pet policies were incorporated
into the business plan from
the start.
, JULY/AUGUST 2005
35
CONSUMER VOICE
assist residents with pet care and fill in
whenever necessary.
Clearly, the caregivers at Cypresswood
must also enjoy the company and care of
pets. New staff members participate in an
in-service that focuses on the community’s
pet policies and care program.They also participate in a monthly in-service to keep them
up to speed on this aspect of their jobs.
Having pets in an assisted living community shouldn’t be seen by consumers as
extra work for the staff.At Cypresswood,
having seven dogs, two cats, six cockatiels,
several schools of fish, and an aviary that
houses 25 finches isn’t a chore.This family
of pets increases the quality of life for residents.They take ownership of the pets and
the pets provide them with great joy in
return.
Prospective residents and their family
members are fully informed about the
pet policies when they first come to visit
Cypresswood—although one of the community’s greyhound ambassadors often will
greet them first. By and large, new visitors
love the pet friendly environment.There
are dog treats near the guestbook at the
entrance, but family members often come
to visit with treats in tow.
Consumers know that the pets at
Cypresswood have been screened and
deemed a good fit for an assisted living
environment. Penny, Gracie, and Big Boy
are retired greyhound racers.The breed
is gentle by nature and former greyhound
racers overwhelmingly are grateful for a
peaceful setting where they can nap and
enjoy kind company.What’s more, greyhounds are so tall that residents can easily
pet them and interact with them without
having to bend over or kneel, which could
lead to a fall or other injury.
Cypresswood does not adopt puppies
or kittens because young pets require
house training and more exercise than
mature pets. This would require more time
from staff members and the residents
would not benefit as much from these pets.
Puppies also tend to jump up or run, which
would put residents at risk of injury.
Greyhound Pets of America’s Houston
chapter worked with Cypresswood to place
Penny, Gracie, and Big Boy.The community’s
expansive grounds, staff support, and extensive pet care policies made it a good fit for
Travis Fogle, administrator at Silverado Senior Living – Cypresswood, introduces a Cypresswood resident to
Gracie, a retired greyhound racer who now lives at the memory care community.
the dogs, and the dogs’ gentle nature, maturity, and breed characteristics made them
a good fit for Cypresswood.
MIND THE DOGGIE DETAILS
Cypresswood employs four full-time activity
staff members and they are responsible for
the medical care of the community’s pets.
They take pets to regular veterinarian
appointments and make sure certain pets
get needed supplements or medicines.
There is a regular dog walking schedule
that all staff members participate in along
with residents.
The community’s maintenance staff
inspects the grounds regularly throughout the day and cleans up as needed.
All staff members are charged with maintaining high standards for a sanitary environment throughout the building. All of
these pet care-related responsibilities
also are part of their initial and monthly
in-services. Because all of the details are
accounted for as part of Cypresswood’s
business operation, the pet program
works and, above all, benefits our consumers. The cost of pet care is built into
the community’s activity budget, so con-
36 JULY/AUGUST 2005
,
sumers are not paying any “extra” fees.
Penny, Gracie, and Big Boy do a terrific
job of actually selling the community to
prospective residents and their family members because they are promoting a philosophy of love and companionship that is valued by consumers.At times, family members feel they can’t carry on conversations
with their memory-impaired loved ones. It
can even discourage them from visiting. But
with Penny, Gracie, or Big Boy by their
sides, they have a link to their loved ones.
Family members and their loved ones can
walk the dog together or just sit together
with the dog and talk about how they may
have helped care for him.
Having pets at Cypresswood really does
make the community a home for residents.
Family members and residents love it and it
makes Cypresswood a warm comforting
place that’s full of life. ,
Travis Fogle is administrator of Silverado Senior
Living in Cypresswood,
Texas. Reach him at
tfogle@silveradosenior.
com or 281/955-0880.
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ALFA EXECUTIVE PORTFOLIO:
Inside the Minds of Leading
Executives in Assisted Living
& Seniors Housing
Order the complete study at ALFA Online,
www.alfa.org.
ALFA’s groundbreaking new research report reveals
executives’ predictions and real-world strategies
already in use by the top executives in assisted living
and seniors housing. The ALFA Executive Portfolio
gives readers an insider’s view into the leading minds in the top
assisted living and seniors housing companies in America. Among the companies
interviewed for the research study are Alterra Healthcare Corp., American Retirement Corp.,
Atria Senior Living Group, Benchmark Assisted Living, Brandywine Senior Care Inc.,
Brookdale Living Communities, Chelsea Senior Living, Country Meadows Retirement
Communities, Encore Senior Living, Epoch Senior Living, Five Star Quality Care Inc., HHHunt,
Kisco Senior Living, Life Care Centers of America, Life Care Services, New Seasons Assisted
Living Communities, Newton Senior Living LLC, Silverado Senior Living, Somerford Corp.,
Southern Assisted Living, Summerville Senior Living Inc., Sunrise Senior Living, The Arbor
Company, The Laureate Group, and Village Retirement Communities.
LLC
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The report details what leading assisted living providers are thinking about and planning
for in four key areas. Following are a few highlights from this important research:
AREA 1: GROWTH STRATEGY
❚ Assisted living providers are increasingly facing competition from segments
that previously posed little threat: Independent living and skilled nursing homes
are encroaching upon assisted living’s domain. And CCRCs can represent a threat to some
assisted living residences as well. The CCRC model will continue to provide stiff competition
for the assisted living industry well into the future. Several different CCRC models being
marketed today have different price points that appeal to a different wellness levels and
income/asset levels. Assisted living residences also will compete directly with independent
living providers and to a lesser extent with skilled nursing centers.
❚ The research uncovered five primary growth drivers: Organic new expansion; Predatory
M&A; Strategic M&A; Vertical integration; and Horizontal Integration
❚ The research reveals potential for a new low-end assisted living model.
AREA 2: STRATEGIC LEADERSHIP
❚ Leading assisted living providers treat strategic planning as a continuous
process and eschew the annual offsite meeting.
❚ Surprisingly,
a common
theme
among
some of the
successful assisted living providers is
Copyright,
Assisted
Living
Federation
of most
America
the high value they place on building an effective, well-understood, and nurturing corporate culture.
ALFA EXECUTIVE PORTFOLIO
ALFA
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RESEARCH HIGHLIGHTS
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ALFA EXECUTIVE PORTFOLIO:
Inside the Minds of Leading
Executives in Assisted Living
& Seniors Housing
OLIO
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Order the complete study at ALFA Online,
www.alfa.org.
AREA 2: STRATEGIC LEADERSHIP
(continued from front)
❚ Referrals from current residents to prospective
residents have always been important. Yet some
providers have created incentives and motivators that have resulted
in 30 percent of referrals coming from residents.
❚ The most rapidly growing, successful organizations studied seem to have figured out ways
to foster roots and connections in their local communities in ways that other providers have
never considered.
AREA 3: QUALITY PERFORMANCE MANAGEMENT
❚ The research reveals four ways leading assisted living facilities are keeping costs
down. In some ways, all relate to knowledge and insights gained through technology.
❚ The systems and procedures put in place in the past five years are reaping benefits for
industry leaders. Some organizations, without IT systems, will be more likely to be subject
to lawsuits or to financial straits in the event of another industry downturn.
❚ Some providers realized that they were not being paid for some services and that the
fixed-price model (with some residents benefiting and others essentially supporting more
acute residents) was not viable.
Because staff turnover has been a problem in the industry, the research report identifies
a number of ways to counter this problem.
AREA 4: QUALITY RESIDENT SERVICES
❚ Some providers foresee a profound shift in the breadth, depth, and payment
for services. With most providers recognizing the importance of ongoing communications with family members, the vehicles to facilitate this communication are broadening.
❚ Providers are increasing the breadth and depth of all services, and health-care-related
services are creating new headaches.
❚ The desire for more space is not surprising. Three models have emerged to provide
residents with more room.
❚ Increasingly, providers will attempt to track and evaluate cognitive impairment to the point
where they will help facilitate the transfer of residents to a more appropriate facility that can
provide early-stage through late-stage dementia care.
Copyright, Assisted Living Federation
www.alfa.org or call 703.691.8100.
Order online of
at America
PRICE FOR MEMBERS: $750; NONMEMBERS, $1,400.
LOUISIANA ASSISTED LIVING ASSOCIATION
AL Execs Play Key Role in
State-Level Advocacy
BY LISA COMEAUX
eing an affiliate organization of ALFA brings many
advantages, including
a voice at the federal level when
it comes to legislation that affects
seniors housing and care services. ALFA also provides many
resources, including brochures,
publications, legislative news, and
online tools that provide a valuable foundation for assisted living
executives at the state level. But it
is up to the AL exec in each state
to apply those tools and knowledge effectively to reap results. In
Louisiana, the dominant challenge
has been raising awareness of the
assisted living business and advocating for more long-term care
options for seniors.
Though many states have
expanded their focus to include
more home and community-based long-term
care services for the
elderly and disabled, Louisiana has remained
locked into an inefficient care delivery system centered on nursing homes.The state
currently spends 94 percent of its long-term
care dollars on nursing home care, compared with the national average of 70 percent. In addition, Louisiana is one of only
10 states in the nation that does not allocate
Medicaid dollars for assisted living care.
While campaigning for governor of
Louisiana in 2003, Kathleen Blanco pledged
to “rebalance” the system to give the elderly
and disabled more options and choices
with respect to long-term care services.
That pledge was major factor in her election, and once in office she wasted little
B
time in commissioning a Health Care
Reform Panel to begin the daunting task.
The Louisiana Assisted Living
Association (LALA) has long been an
advocate for consumer choice with
respect to long-term care services. So, it
was a natural course of action for the
organization to become actively involved
in the state’s long-term care reform efforts.
The strategies LALA leadership is directing
throughout the state are proving effective
in Louisiana.What’s more, these strategies
are flexible, which make them useful tips
for assisted living executives in other
states who can potentially adapt them to
their own objectives.The common theme
with all of these strategies is strong leadership and mobilization.
AFFLILATE SPOTLIGHT
BE ACTIVE AL REPRESENTATIVES
It has been critical from the start for LALA
leadership and members to be active participants and representatives of the assisted
living business. For the past year, LALA
members have participated in regional
meetings designed to help the members
of the governor’s Health Care Reform Panel
identify critical issues and gather feedback.
In addition, LALA staff have attended various stakeholder meetings and provided reference information regarding the assisted
living industry. In all of these meetings,
LALA has been the voice of assisted living
and made sure the field’s input and concerns are part of the reform process.
In March, the Health Care Reform Panel
released its “Plan for Immediate Action in
Long-Term Care,” just prior to the start of
the 2005 legislative session. LALA staff
members were invited to provide comments on the draft plan, giving us an opportunity to highlight the important role of
Louisiana’s assisted living providers and
emphasize our position on key long-term
care reform strategies.
When the legislative session kicked off in
late April, a number of health-care reform
bills had been filed.Although none directly
impacted assisted living, LALA and its member communities continued to maintain a
strong presence at the State Capitol during
the legislative session.The primary objective was to continue to increase awareness
of the assisted living field, particularly
among the influential members of the
House and Senate Health and Welfare
Committees.
EDUCATE YOUR STATE OFFICIALS
In a reform or potential legislation situation
like the one in Louisiana, it is of critical
importance to reach out to the decision
makers at the state capitol.With that in
mind, LALA observed its second annual
“Assisted Living Day at the Capitol” event
on May 24. Lawmakers and key state officials received invitations that informed
them of the organization’s priorities and
activities, and invited them to meet and
, JULY/AUGUST 2005
39
AFFILIATE SPOTLIGHT
greet our members.
The day began with a gathering of
providers and family members at the capitol rotunda where everyone donned buttons declaring “Assisted Living—The
Preferred Choice of Seniors in Louisiana”
and then headed off together to attend the
House Health and Welfare Committee meeting.Two bills of concern to assisted living
providers were being considered by the
committee that day, presenting a timely
opportunity for LALA members to stand
up and be noticed.
One of the bills being considered would
have allowed the Department of Social
Services (DSS) to impose re-inspection fees
on AL communities. Prior to the bill coming
up in committee, LALA representatives met
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40 JULY/AUGUST 2005
,
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with DSS officials to discuss our opposition
to the legislation. Although we were aware
that it had been filed to address a budget
shortfall, we told DSS officials we were
opposed to the bill on the basis that it
would create an inappropriate financial
incentive for surveyors to “find things” to
cite in surveys so that re-inspection visits
would be necessary.
Based on our opposition, DSS officials
agreed to submit a substitute bill that
would allow for a flat fee increase with a
percentage reduction for a deficiency-free
survey. We polled LALA members regarding
the proposed fee increase ($100 to $175
more per year). The consensus was that
they would rather pay the flat increase than
risk having DSS surveyors make more frequent visits to their communities and
charge more for each visit.We did not
oppose the substitute bill and were commended by DSS officials and lawmakers for
working to achieve a suitable compromise.
At the hearing, LALA was commended by
DSS officials and members of the committee for working to achieve a suitable compromise.
The other bill considered by the House
Health and Welfare Committee during our
Assisted Living Day event pertained to staff
background checks. Current Louisiana regulations require that assisted living providers
obtain a state criminal background check
prior to hiring direct care staff. The proposed legislation would have required both
federal and state background checks (with
fingerprinting) from the FBI.
Our testimony at the committee hearing
focused on compliance with current background check regulations, our commitment
to ensuring a safe workforce, and concerns
regarding timely turnaround of the federal
background checks by the FBI (estimated at
30-60 days). In addition, LALA members sent
e-mails to the committee members via our
Internet-based Grassroots Advocacy Center
to express concerns that the proposed legislation could result in staffing shortages
that might adversely impact resident care.
When an amendment was proposed that
would have allowed providers to hire staff
for up to 30 days while waiting to receive
the background check reports, we protested that the proposed amendment would
actually remove one of the resident safe-
PRINCIPALS WANTED
To develop a continuing care
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located in the Appalachian
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available. The owner can be
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Clarion Bathware
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814/226-5374 ext 822
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www.clarionbathware.com
After hearing
from the opposition, the
author oflwentling@clarionbathware.com
the legislation moved to voluntarily
defer the bill, in effect killing it for this sesCelebrating
our 30th
sion. Following
the hearing,
weanniversary
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in 2003, Clarion
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but it is important to make sure your efforts
stick with your target audience; in this case,
state officials.
Following the committee meeting that
INC.
morning, LALA leadership andBUS
members
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lawmakers as Champion
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an assortment ofFax
giveaways
(pens, coffee
mugs, koozies,www.championbus.com
notepads, brochures, etc.)
sales@championbus.com
for gift bags that
were presented to each
lawmaker.And in keeping with Louisiana
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tradition
that calls
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feeding
people at
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every occasion,
we also offered
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of unit
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tives ofrequirements.
key members of the House and Senate
Health and Welfare Committees.All in all, it
MAY 2004 A S S I S T E D L I V I N G T O D A Y
was a great day for LALA’s member communities to call attention to the assisted living
industry and demonstrate their commitment to providing quality long-term care
services. ,
Lisa Comeaux is the president of the Louisiana
Assisted Living
Association (LALA). Reach
her at 225/791-5811 or
lcomeaux@laassisted.org.
www.ridgetopretirement.com
or visit
mev@app-net.com
www.mycaring.com
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, JULY/AUGUST 2005
41
Pag
PEOPLE & PLACES
SALES & NEW DEVELOPMENTS
cLean,Virginia-based
Inc. will develop a condominium project in the Turtle Creek
area of Dallas for people aged
60 and over.The planned 23floor building will include more
than 140 one-, two-, and threebedroom condominiums, as
well as dining and fitness facilities.The 350,000-square-foot
building will sit on 1.5 acres.
M
Construction is scheduled to
begin later this year, pending
approval of the building plans
by the city of Dallas, and reach
completion in early 2008.
Sunrise Senior Living also is
developing two traditional senior living communities in the
metropolitan Dallas area.The
company currently manages 15
senior living communities in
Texas.
CORPORATE NEWS
Bickford Cottage in Ford Dodge, Iowa, an Eby Group/Bickford Senior Living
Group residence
ewton, Massachusetts-based Five Star Quality Care Inc.
in June completed two acquisitions from Gordon Health
Ventures LLC for $58 million.The acquisitions include six
assisted living communities, all located in western
Pennsylvania, with a combined capacity of 654 residents.
Five Star in June also purchased Heartland Pharmacy,
located in Omaha, Nebraska, for approximately $4.4 million.
Heartland Pharmacy provides pharmacy services to about
1,900 residents at 44 senior care residences and operates
a mail order pharmacy business that serves about 25,000
customers in 38 states.
Olathe, Kansas-based Eby
Group/Bickford Senior
Living Group plans to build
an assisted living center with
capacity for 46 residents in
Saginaw Township, Michigan.
Eby Group plans to build the
25,000-square-foot residence
Seattle-based Emeritus Assisted Living in May reported a net
loss of $5 million in the first quarter of 2005 compared with a
net loss of $5.9 million in the year-ago period.Total 2005 firstquarter operating revenues were $95.1 million compared
with $65.6 million in the first quarter of 2004.Approximately
$25 million of the $29.5 million increase resulted from the
acquisition or lease of 40 additional communities.The additional communities also resulted in a $16 million increase in
operating expenses.
n June 1, Stephen L.
Guillard became executive vice president of Manor
Care Inc., the long-term care
company based in Toledo, Ohio
and operated by HCR Manor
Care. In his new role, Guillard
will manage all of Manor Care’s
nursing center and assisted living operations. Guillard was
previously chairman and CEO
of Harborside Healthcare Corp.
N
Sunrise Senior Living REIT, based in McLean,Virginia, will
acquire three assisted living communities for approximately
$75.4 million.The communities, with a combined capacity of
318, are located in Los Angeles, Chicago, and Raleigh, North
Carolina.The communities will continue to be managed by
Sunrise Senior Living, Inc.The REIT also has undergone equity
financing with resulting gross proceeds of approximately $25
million.
APPOINTMENTS & PROMOTIONS
O
Hearthstone Alzheimer Care,
based in Woburn, Massachusetts,
has appointed Christina Galanis
executive director of Hearthstone Alzheimer Care at
Heights Crossing, an assisted
42 JULY/AUGUST 2005
,
on a seven-acre site.The company also has received initial
approval to build similar senior
care residences in Portage,
Battle Creek, Lansing, and Midland, Michigan.All five projects
are scheduled to reach completion in the summer of 2006.
living community in
Brockton,
Massachusetts,
for persons
with Alzheimer’s and
Galanis
related disorders.The community is home
to 28 residents. ,
Send People & Places
announcements, photographs
(please label), and news releases to Assisted Living Executive,
People & Places, 5285 Shawnee
Road, Suite 510, Alexandria, VA
22312, fax 703/914-6777 or
alexecutive@strattonpub.com.
AD INDEX
CAMBRIDGE REALTY CAPITAL COMPANIES . . . . . . . . . . . . . . . . . . 8
NEW LIFESTYLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
312/357-1601, www.cambridgecap.com
800/869-9549, www.newlifestyles.com
DIRECT SUPPLY HEALTH CARE EQUIPMENT . . . . . . . . . . . . . . . . C4
NIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
800/216-4832, www.directsupply.com
410/267-0504, www.nic.org
HOMEFREE SYSTEMS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
NUSTEP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Brian Verban, 800/606-0661, www.homefreesys.com
NuStep Representative, 800/851-4511, www.nustep.com
HOME INSTEAD SENIOR CARE. . . . . . . . . . . . . . . . . . . . . . . . . . . 30
OPTELEC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Holly Batchelder, 888/484-5759, www.homeinstead.com
Customer Service, 800/828-1056, www.optelec.com
IDEAL SOFTWARE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
OPUS UNIT DOSE SYSTEM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Lance Raab, 813/864-2160, www.idealsoft.com
OPUS Representative, 800/228-5021, www.opusmedsystems.com
JCH CONSULTING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
PLAYWORLD SYSTEMS, INC.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Jim Hazzard, 888/916-1212, www.jchgroupinc.com
Customer Service, 800/233-8404, www.playworldsystems.com
KWALU, INC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
RF TECHNOLOGIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C3
800/405-3441, www.kwalu.com
Lorna Miller, 800/669-9946, www.rft.com
MEDICINE-ON-TIME . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C2
SENIOR HOUSING NET. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Ian Salditch, 800/722-8824, www.medicine-on-time.com
Brad Fuqua, 888/525-2546, www.seniorhousingnet.com
MERRILL LYNCH CAPITAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
VIGILAN, INC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
888/508-9696, http://mlcapital.ml.com
800/443-1127, www.vigilan.com
MOVE-N SOFTWARE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
WORKHORSE CUSTOM CHASSIS BUS . . . . . . . . . . . . . . . . . . . . . . . 1
Move-N Representative, 817/282-7300, www.move-n.com
Tracy Murrin, 866/467-7300, www.glavalbus.com
NASCO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
YARDI SYSTEMS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
NASCO Representative, 800/558-9595, www.enasco.com
Bonnie Novella, 800/866-1144 ext. 184, www.yardi.com
AssistedEXECUTIVE
Living
is the ONLY magazine targeted
exclusively to assisted living
senior executives and beats its
nearest competitor by a 4-to-1
ratio as THE publication that is
best read, referred to, and found
useful.
Advertise in the magazine
that reaches the real decisionmakers. Contact Alison Bashian
(alisonb@strattonpub.com)
or Marianne Juliana
(mariannej@strattonpub.com)
at 800.335.7500 TODAY!
, JULY/AUGUST 2005
43
PRODUCTS & RESOURCES
- HCPro Inc., based in
Marblehead, Massachusetts, has
released an updated resident
assessment instrument (RAI)
user’s manual to coincide with
the new coding instructions
issued by The Centers for
Medicare & Medicaid Services
(CMS) that went into effect on
June 15. The MDS 2.0 RAI
User’s Manual includes the latest revisions from CMS, which
uncharacteristically issued in
March of this year and then
again in May. Because senior
care residences often need more
than one copy of this reference
manual, HCPro is offering a 25
percent discount on orders of
10. Contact: www.hcpro.com or
800/650-6787.
F O R
- Austin,Texas-based
MicroMain Corp. has released
MicroMain XM for
Healthcare, the company’s
first industry-specific version of
its flagship computerized maintenance management system.
Hospitals and health-care
providers have used
MicroMain’s standard system
for the past decade to automate work orders, complete
inspections, and generate
reports.The new health-care
version primarily addresses
increasing requirements,
including detailed compliance
reports for regulatory agencies.
MicroMain XM for Healthcare
allows health-care providers to
create reports and action plans
A S S I S T E D
L I V I N G
that are recorded and updated
on a regular basis.The software
also allows managers to identify equipment that may be
HIPAA-related to ensure compliance when used or serviced.
Contact: www.micromain.com.
months.The roundtable workshop is led by Maxcomm Senior
Consultant Travis Anderson and
focuses on visionary leadership
ideas and practices. Contact:
www.maxcomminc.com or
801/266-8855.
- Based in Salt Lake City,
Maxcomm Inc. is an international consulting firm that specializes in coaching, senior leadership, organizational effectiveness, large-scale change, and cultural transformation strategies.
Among its workshop offerings
for company executives is the
Visionary Leadership
Roundtable. This workshop
consists of monthly half-day sessions over the course of several
- Mesa,Arizona-based Crandall
Corporate Dietitians offers an
audit system that evaluates
nutritional needs, menu and
recipe compliance, safety and
sanitation requirements, and
adherence to both state and federal regulations.The company’s
system is being used in 37
states at more than 600 contracted sites. Crandall provides
services to assisted living communities, nursing homes, and
other sites that provide food
services for seniors. Contact:
www.consultingrd.com or
888/546-3273.
BOOKSHELF
Leadership Chronicles of a Corporate Sage:
Five Keys to Becoming a More Effective Leader
By Susan J. Bethanis Ed.D.
This book was released last fall by Dearborn Trade Publishing,
a Kaplan Professional Company.The author is an executive
coach who chronicles the reflections, struggles, and triumphs
of a promising executive client. She also shares and elaborates
on her five keys to becoming a corporate sage: reflect more to attain
higher emotional intelligence; get good at small talk and build strong
networking and influencing skills; hire great people and craft an inspiring vision; coach employees in-the-moment to sustain your team’s vision; and develop a global
perspective. Contact: www.dearborn.com/trade or 800/245-2665.
businessThink: Rules for Getting It Right—
Now and No Matter What!
By Dave Marcum, Steve Smith, and Mahan Khalsa
Published by John Wily & Sons Inc. for the Franklin Covey Company,
this book includes a forward by Stephen R. Covey, author of The 7
Habits of Highly Effective People, and introduces the rules of
“businessThink.” The authors say implementing these rules as part of
a business plan will significantly increase results by adding high intuition and emotional intelligence to sound business practices. Contact:
www.businessthink.biz, info@businessthink.biz, or 801/492-9009.
44 JULY/AUGUST 2005
,
- Based in Wausau,Wisconsin,
My InnerView Inc. supplies
senior care providers with
operational management tools,
such as Quality Profile. This
management software program
allows providers to track key
areas that contribute to operational excellence.The onescreen Quality Profile tracks
monthly progress in areas
such as resident quality of life,
resident quality of care, family
satisfaction, employee commitment, and financial health
by using a system of surveys
and data collection. Contact:
www.myinnerview.com
or 715/848-2713. ,
Send product information
and photos to alexecutive
@strattonpub.com or
fax to 703/914-6777.
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YOUR STAFF CAN PROVIDE THE NECESSARY SAFETY AND SECURITY THEY
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THE PRIVACY AND DIGNITY THEY DESERVE )N CASES WHERE FALLS ARE
A POSSIBILITY #ODE !LERT® &ALL -ONITORING AND )NCONTINENCE
STAND STRONG AS PART OF AN INTEGRATED SAFETY SOLUTION THAT
MAXIMIZES STAFF EFlCIENCY WHILE MINIMIZING RISK
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#OMPRISED OF MULTIPLE EASYTOINSTALL AND USE MONITORING
SOLUTIONS THE #ODE !LERT® FAMILY OF PRODUCTS IS DESIGNED TO
DELIVER ENHANCED SAFETY THROUGHOUT YOUR FACILITY WORKING
IN STEP WITH YOUR POLICIES AND PROCEDURES ALLOWING YOU
Assisted
Living Federation
AND Copyright,
YOUR STAFF TO FOCUS
ON THE EVERIMPORTANT
TASK AT HAND
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TOTAL CONTINUUM OF CARE THAT CAN
ONLYCOMEFROMYEARSOFEXPERIENCE
9EARSTHATADDUPTOANUNPARALLELED
BENElTFOROURPARTNERS#ODE!LERT®
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YOU YOUR STAFF AND YOUR RESIDENTS
!NY TIME !NYWHERE &OR MORE
INFORMATION VISIT WWWRFTCOM OR
CALL

Copyright, Assisted Living Federation of America

Transcription

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