Interview: Why Innovation is the Future of Senior Living

While senior living rides a growth wave into an innovative new era, one provider has quietly expanded its portfolio of properties to provide housing and care for seniors while keeping costs to residents low.

At its helm is John Goodman, chairman of The Goodman Group, which counts 30 senior living and health care properties in eight states out of a 75-property portfolio overall. Goodman started in health care and apartments in 1965 and now oversees 2,300 assisted living and 1,700 skilled nursing beds. The company maintains its participation in the apartment market and management company after 50 years in business.

This month, The Goodman Group is being recognized for its excellence in business as a recipient of the 2014 Performance Excellence Award from the Performance Excellence Network (PEN), formerly the Minnesota Council for Quality. The award is based on the Malcolm Baldrige Criteria for Performance Excellence including leadership, strategic planning, customer-related processes, measurement and information systems, workforce engagement and operations. In its receiving the award, The Goodman Group joins recipients including The Mayo Clinic, Allina Health, several local public school systems and others.

Advertisement

But success did not happen overnight for Goodman. While today the company boasts a host of innovative strategies on caring for an aging population, Goodman has worked tirelessly to bring his communities to the forefront of senior living by getting back to basics. We sat down with Goodman to learn more about his take on what’s next for senior living, why it’s not just apartments with meals, and how the last 50 years are shaping the next 50.

Backing up these last 50 years, how did you get your start in senior living?

We’ve been in business since 1965. First, we were in the apartment business and health care business. In concentrating on health care, I visited a project in Oklahoma City where I walked out of a unit, and began itching. I looked down and realized I must have had fleas from the unit I had toured. I said then: I want to take care of the people who are taking care of our facilities.

We now have 33 health care properties and we are still in the apartment business. We have a management company as well.

It would have been a lot easier to buy properties and manage them from day one. But there wasn’t anything in the marketplace that was truly exceptional at the time. When we built 20 to 25 years ago, we built on average about 1,100 square feet per unit.

It was not without difficulties. We opened two of our properties three days before September 11, 2001. Nobody moved for three years. But we were able to stay with our properties and are proud of our history of 50 years.

What makes The Goodman Group so innovative when it comes to senior living? Why do you believe the PEN award selected your company for its prestigious recognition?

We place the resident at the heart of everything we do. Three times each day we get together to talk about service standards.

We look at the whole care continuum and want to be able to allow people to age in place from mind and body to spirit and emotional well being. We want to make it seamless for those going through transitions.

We use nurse practitioners to work with residents who have required hospitalization. There is someone there talking to them and helping them through the continuum and the financials. We educate the family on these transitions whether they involve dementia, Parkinson’s disease or any other health challenge.

Our Pearls for Life program allows us to address people to find out about their long-term interests: music, art, animals, horticulture. We have a director of sound and music, [for example].

We work with telehealth. We are working on a program with a set-top box to go through residents’ TVs that allows them to dialogue with family. It can allow them to interact with what’s going on in the facilities as well.

In intergenerational care, this is our eighth year in providing our programs whereby we do intergenerational theater. We’ve done Wagon Wheels a Rolling with kids as young as four or five years old and then those who are in their 90s.

Our nature immersion room has circadian lighting. We believe this can help with mindful meditation. With aromatherapy, we can reduce the use of drugs and promote well being.

Then there’s “Food for Life.” We have a whole-food plant-based diet. The chef is driven from farm to table. We believe the use of sugars and grains can really speed disease progress. If we can get more into options and educate residents through the China Study and others, food has an integral part.

Just last week we opened a 60-unit memory care facility adjacent to independent living and assisted living units. We are using it as a center of innovation for everything we have learned: plant walls, smells of the ocean and orange groves, lighting to look like the stars.

How does The Goodman Group set itself apart among local business peers and senior living operators?

There’s a notion that senior care is just real estate. That needs to be looked at very carefully. It’s not just an apartment with meals. We want to make sure people have dignity through the end of life.

In our 240-bed community in Largo, Fla. we have a nursing home. Going back 25 years, the state required that a 175-square-foot unit had one window and two beds.

We said, why not let everyone have a window? And add bird feeders. We doubled the size of the room and put a third window in. People loved the design. In a lot of nursing homes, you will wait in a hallway or waiting area. We opened it up. When you walk in, you can see all the way to the dining area. We have a director of spirituality. With guided imagery and mindfulness and compassionate listening, we can reduce the use of psychotropic drugs by half.

We have soulful environments. Design plays a big role for us. None of our two properties are the same; each calls for its own design. Traditionally in memory care, there is a secured door. What some people have done is put a mat in front of it thinking people will not cross that space.

Instead, we took that door and painted on it—books, candelabras, hats—to create a warm, inviting feeling. The agitation level [around the doors] has gone down considerably.

Right now, there are 4 people to take care of every one elderly person. When it’s our turn, that will be 1.1 caregivers. We need to develop a good quality care base.

We haven’t been able to find RNs, so we went to the Philippines in the 1990s and worked with people prior to their coming to the U.S. for nursing. We now have 165 nurses from the Philippines in 10 states.

What are some other ways The Goodman Group takes on senior living challenges?

In 2008, we had a project in Spring Hill, Florida. It was an 80-unit addition to an existing 120 units. People said they’d love to move in, but they couldn’t sell their homes.

Instead of waiting, we were proactive. Through a program called Home Connections, we went and found the best brokers, staged the houses and arranged for the moves. They sold 60 homes in the first year.

Another way is that we have a full time Ph.D. with a nursing degree doing evidence-based research so show the effect of proper nutrition on residents.

How do you provide residents with large rooms and so many amenities while keeping costs down?

We see how much we can give and how little we can charge. A lot of people build and say, “How much can we charge?” We don’t take developers’ fees. Fixtures and equipment goes in at cost. We have our own design business. We try to create 30% larger facilities and provide units below market rate.

We don’t take anything out, but we maximize returns. We took it a step further and went back to the broker base to ask for a small percentage of the fees, which we then provide to scholarships for children in high school. This can help sustain people out of these funds wherever they are best suited.

Are you engaging in partnerships with other providers or organizations?

We use partnerships with hospitals and manage for intergenerational health care. We work with universities and The Red Cross. We have sponsored a nursing program at the University of Montana.

We are working in the UK with a peer group where we have partnered with a London-area college. We want people to come in and train, and to give hands-on care. All of our relationships have a larger purpose.

[The industry is] now bundling payments, cutting down on readmissions and that will make nursing homes more responsive. We need to work more with ACOs and health care systems.

What’s next for the Goodman Group? What opportunities exist right now for growth?

We have the dashboard and metrics to make us sustainable long after I’m going. We are set up to go into perpetuity. Our investors have signed that as long as the organization exists we’ll continue to manage it.

My own estate goes to a charitable trust. We won’t have to liquidate or cut jobs.

We need, as a society, to look at how we’re doing this. Baby boomers are going to break the system. We need to treat not only the symptoms, but look at the disease.

Who is going to take care of our people? Sooner or later, it’s going to touch everybody. Why not bring it forth, bring it together and educate?

Interview by Elizabeth Ecker

Companies featured in this article: