CEO Fresh Take: Embracing Seniors’ Aging-in-Place Dreams

Lutheran Homes Society CEO Rick Marshall knows most seniors want to age in place, but he doesn’t let that scare him.

Instead, Marshall, who took the helm at the Toledo, Ohio-based senior housing provider in February, is working to make sure his residents can stay wherever they want to, longer—while also keeping the organization’s bottom line healthy.

The new CEO is no stranger to nonprofit senior living providers. Marshall joined Lutheran Homes Society after more than 11 years at Christian Care Communities—most recently serving as the organization’s executive vice president and chief operating officer. At Lutheran Homes Society, Marshall has already turned around the organization’s finances, with further hopes of boosting transparency among employees about the organization’s strategy.

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Rick Marshall
Rick Marshall

Marshall has also embraced telehealth, adult day care and home health as ways to help seniors age in place—hopefully at one of Lutheran Homes Society’s independent living, assisted living or CCRC locations spread across Northwest Ohio and Southeast Michigan, but not necessarily.

This is the latest installment of CEO Fresh Take, a series of conversations with nonprofit CEOs who are taking the reins as signs point to more urgency around scaling up and competing with a booming for-profit sector.

SHN: What, in your opinion, is the biggest opportunity for senior housing providers in 2016?

RM: There’s a tremendous demand for senior housing, and so the opportunity is to expand the services that we’re providing within housing to allow our elders to stay there for a longer period of time. Folks, of course, want to age in their homes—or in their assisted living units, wherever they might be—so there are opportunities for us to provide services to allow them to stay there as long as possible.

SHN: What do you think has been the biggest challenge for Lutheran Homes Society in the last year?

RM: For us, it has been financial. During 2014, we had a difficult year financially, and we had work to do to turn that around in 2015. We’ve been very successful in that. Our net operating income has improved by $2.4 million from this time last year.

SHN: How did you go about changing that?

RM: A lot of that is our focus in our long-term care communities and skilled nursing facilities. We’ve expanded our rehabilitation services for elders, both within our skilled nursing facilities and on an outpatient basis. We’re serving folks on an outpatient basis that come from assisted living, and that come from our housing sites. We’ve also been just paying attention to the details and managing our costs.

SHN: Do you think that nonprofits are at a competitive disadvantage compared to for-profits?

RM: I do think we’re at a disadvantage from the standpoint of the availability of capital. Many of the larger for-profit entities have capital readily available to fuel expansion, or to fuel acquisition opportunities, and that’s more difficult for the nonprofit providers.

However, I think the quality of our services in the nonprofit arena, and the fact that we generally provide additional services—for example, spiritual care—give us a competitive advantage when it comes to people’s perceptions and needs for our services.

SHN: What are the two or three biggest themes/trends in the industry right now?

RM: Trend-wise, I would say the ability or the need to provide more services to individuals to allow them to stay in their housing longer. One of the things we are working on at LHS is providing elder wellness, not just providing services when individuals are sick or need medical attention. These activities create meaningful engagement for our residents at our housing sites so they are staying well longer.

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SHN: What is in store for LHS in 2016?

RM: Since I’ve been at LHS, we’ve developed a strategic plan, which is guiding us for the next 3-5 years. We are seeking opportunities to manage affordable housing for elders for other providers. We have a great infrastructure here, and we’ve dabbled in managing housing for others over the years, but we want to make a much more intentional effort about that so we can take advantage of our experience and the size of the organization.

We’re looking at opportunities to expand our own housing through tax credit financing, both within Ohio and within Michigan. About a year ago, we found a joint venture partner in a home health agency, and we are diligently looking at expanding our home health services to our housing sites.

Another thing that we are working on, that we have hopes for, is telehealth. We are currently working with one of our physicians who has received a grant to test and provide telehealth services. We’re hopeful that if we establish telehealth programming and can convince others that it is a way to keep elders healthy and safe in their own homes longer, and to reduce costs, there will be ongoing funding for that type of programming.

SHN: What’s at the top of your agenda as a new CEO?

RM: The first thing on the agenda was to develop a strategic plan, which we’ve done and are now in the process of implementing. It’s very specific, with specific goals, specific time frames and accountability—that was something that the organization did not have as I arrived. Continuing to revise that plan and ensure that it’s implemented appropriately is a top priority.

Also, I’ve been very diligent as I’ve come on board to have a culture shift for the organization toward more collaborative leadership and more transparency. We have a tremendous leadership team at Lutheran Homes Society, and we’re really engaging those leaders in strategy about where the organization needs to go. And we’re also being much more transparent than what I gather the organization has been in the past. We are sharing our strategic plan with all of our employees, and they can provide input based on their insights. We’re also very transparent about our financial situation. We want everybody to know where Lutheran Homes Society is going and how we are doing.

SHN: What’s the most exciting thing your company has done since you’ve taken charge?

RM: We opened up our first adult day center. It opened on September 1 to serve elders in the Toledo market. It is growing beyond our expectations. It primarily serves adults with dementia, and it has been very well-received. We’re serving residents that are living in their own homes, but we’re also connecting to our housing facilities in the area, for residents who many need some medical care during the day.

SHN: Why now?

RM: The opportunity was there for us. There were a senior center and a church that had partnered to create a program for seniors in the senior market, and they had space that was appropriate for an adult day center. We have a number of elders who are living with spouses that cannot take care of them all day, for instance. It’s a great alternative to skilled nursing facility placement.

I think over time, adult day is going to continue to grow as a mechanism for allowing folks to stay in their homes longer. We’re also hopeful that over time that the Medicare program will recognize the advantage of adult day programming, and the overall cost reduction by providing care to seniors there.

SHN: Lutheran Homes Society has two CCRCs. Do you plan to adopt the term Life Plan Community?

RM: We are reviewing it internally, and also taking a look at the industry and seeing how well it’s adopted. We have a neutral stance right now.

Written by Mary Kate Nelson

Read previous CEO Fresh Take interviews:

Improving the Bottom Line with ‘Gatorade Philosophy’

Why CCRCs Need to Turn Competitors Into Allies

How ACTS Invests Big in Both People, Property

How Nonprofits Should Use Their Competitive Advantages

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