Why Senior Living Can’t Afford to Underestimate Resident Satisfaction Surveys

Boost occupancy. Drive retention. Gain referrals. These aren’t just the results of a great sales approach; they’re the results of a well-executed resident satisfaction survey.

And they can be achieved by any community with the right amount of preparation and attention.

“If you look at resident satisfaction surveys, it really is the foundation of everything we do,” said Bruce Cannon, vice president and director of business development at LCS, a developer and manager of senior living communities. “When you look at the value of resident satisfaction, you are measuring everything that gets done at a community.”


Savannah, Georgia-based The Marshes at Skidaway Island is one such community where resident satisfaction surveys have driven measurable results. The continuing care retirement community (CCRC) is a not-for-profit managed by Life Care Services, an LCS company.

Driving results

The Marshes currently has a 97% overall resident satisfaction rating, but the score wasn’t always so high, said Executive Director Amanda Elliot, during a webinar hosted by LCS and SHN this week. In 2007, that number was at 72%; in 2009 it spiked to 90%; and in 2011 it increased to 94%.


In 2011, the first year The Marshes began conducting its resident satisfaction surveys, the community’s occupancy, sales, referrals and net operating income (NOI) also began increasing.

Over the last few years, occupancy has increased 4% from 92% in 2010 to 96% in 2013. The community has also seen a boost in sales, from 20 sales in 2010 to 31 in 2013 — and 24 so far this year, with average occupancy remaining at 96%.

And its leadership attributes the performance in large part to its work on surveying residents and taking their input into consideration toward improving the service it provides.

An increase in resident satisfaction has also led to more referrals, as word-of-mouth marketing spreads to prospective residents. Throughout all Life Care Services communities, 96% of residents report that they are likely to recommend their community to a friend. At The Marshes, this has translated into a referral count that has nearly doubled in the past few years, from 35 in 2010 to 68 in 2013.

Finally, The Marshes’ NOI has grown from $2 million in 2010 to $2.2 million and trending in 2014.

Making changes

But getting these results from resident satisfaction surveys doesn’t happen overnight, the webinar panelists said.

“You get out of a resident satisfaction survey what you put into it,” said Catherine Jenkins, vice president and director of operations management at Life Care Services. “I’m not talking about just the process of getting it distributed, but what you put into those results. … The commitment to put the hard work in [during] the years leading up to that survey is really critical.”

At The Marshes, the leadership team made significant changes in its health center and housekeeping departments after reviewing their resident satisfaction surveys.

The community long struggled with turnover in its director of nursing and administrator positions, which became noticeable to residents.

“We knew we had to stabilize our workforce — having a longer tenure for our director of nursing and administrator and … improving retention and recruitment strategies,” Elliot said.

Implementing shift differentials, wage analysis, staffing ratios and providing more staff training helped improve The Marshes’ hiring practices.

Service reviews, or “mini satisfaction surveys,” were also conducted to give residents a chance to voice any concerns prior to the formal survey, which is sent out every two years.

And over the years, after implementing several changes based on previous surveys, the health center has achieved 90% satisfaction, up from 59% in 2007. Turnover has also reduced from more than 60% in the health center to the low 20s.

“We continue to educate our residents, hold tours of the health center so they can see what the accommodations are like and, most importantly, focus on [the] quality of care,” Elliot said.

Another department that had low resident satisfaction scores was housekeeping.

Residents indicated in their surveys that the community needed to focus more on the quality of cleaning in both the resident homes and the common areas. So in 2011, The Marshes changed its leadership structure to better address those concerns.

Previously, one director was overseeing the housekeeping and maintenance departments, “stretching that person too thin to [devote] adequate time and attention to those departments,” Elliot said. Now, one director oversees maintenance and one oversees housekeeping.

A number of other changes were made, including more efficient assignments to housekeepers, implementation of an inspections process, better responsiveness to resident concerns, interim satisfaction surveys and increased communication.

Overall, to achieve the success that The Marshes has experienced takes an open, honest and transparent approach that includes everyone from the executive director to the resident to the staff members.

“To improve resident satisfaction, it must be a team effort,” Elliot said. “Communication is such a key part of [the] process.”

Written by Emily Study

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