Senior Living CEOs: How to Solve the Staffing Crisis

The U.S. faces an impending surge in the number of seniors who will require long-term care, while simultaneously facing a staggering shortage in the number of caregivers to serve them.

This situation carries serious implications for senior housing providers in the coming years, but they may be able to avoid this “caregiver cliff” by recruiting in overseas markets and adopting strategies aimed at reducing staff turnover, according to a panel of senior living chief executives at the Senior Housing News Summit in Chicago last Thursday.

“Our caregivers of the future are going to come from outside of our borders,” said Kai Hsiao, president and CEO of Holiday Retirement, one of the nation’s largest independent living providers. “They want to live here in the U.S. and they’re willing to work for it.”


These potential caregivers may come from countries with more highly rated health care systems than the U.S., such as India and Costa Rica.

Some senior housing and long-term care provider associations have pushed for immigration reform in the United States that would make it easier to recruit and retain foreign-born workers. However, there already are steps that providers are taking to create a pipeline of potential workers from international locations.

As one example, Hsiao cited a Chinese senior living community dubbed Starcastle in Shanghai, which Holiday has provided some operations counsel to in the past. The Starcastle brand was co-founded by Chinese investment firm Fosun Group and U.S.-based Fortress Investment Group (NYSE: FIG).


“My interest isn’t just providing seniors with care in China, but having Chinese who want to work here [in the U.S.] for us,” Hsiao said.

Holiday is the second-largest senior housing operator in the United States, with more than 300 properties totalling 41,508 units as of January 1, 2015, according to the Assisted Living Federation of America’s most recent annual rankings of senior living providers—second only to Brookdale Senior Living (NYSE: BKD), following the company’s 2014 merger with Emeritus. Holiday, however, is the nation’s largest independent living provider with 39,080 units.

Rising labor costs and the potential impact on senior living also sparked discussion on strategies to reduce employee turnover.

“I feel strongly that the face of our company is the frontline caregiver, which in many cases is the lowest paid and more likely to be turned over,” said Rob Gillette, chief operating officer at American House, a regional operator headquartered in Michigan.

The company, whose portfolio is predominantly independent living though it also provides assisted living and memory care, also has operations in Florida as well as in the Midwest.

American House has adopted a policy of going beyond monetary incentives in efforts of making staff feel more valuable. Typically, this occurs through relatively simple employee recognition.

“Saying ‘thank you’ goes a long way,” said Gillette. “It’s about creating that culture of appreciation and recognition of doing little things that go above and beyond—they are truly valuable and underappreciated in our industry.”

For Des Moines, Iowa-based LCS, employee recognition and appreciation is all about offering choice, flexibility and engagement.

The company plans to launch a health care exchange to allow its employee-base to have more choice as it relates to selecting their benefits, be they medical, dental or other ancillary services, said Ed Kenny, chairman and CEO of LCS.

As the third-largest manager of senior living properties behind Brookdale and Holiday, LCS operates a diverse portfolio with services that span independent living, assisted living, memory care, continuing care retirement communities and home health care. As of January 1, 2015, the company’s portfolio included 25,989 total units under management, according to the ALFA data.

“It’s something that we see as consistent with the concept of flexibility options and choice for your work staff,” he said, adding that in the future the exchange could offer opportunities for telemedicine benefits and even pet insurance.

Technology will also play an undeniable role, specifically as it helps improve efficiencies and staff processes. But it all comes down to hiring good, quality leadership from the executive director all the way down, said Jerry Finis, principal and CEO of Des Plaines, Ill.-based Pathway Senior Living, an owner and operator of 20 properties tallying over 1,900 units mostly in the Chicagoland area.

“At the end of the day, the right person is worth whatever they reasonably deserve, because they can make a huge difference at a community,” he said.

Written by Jason Oliva

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