How Nonprofit Providers Are Powering Up the C-Suite

The nation’s largest nonprofit senior living organizations are growing in sophistication—and many now have the executive talent to prove it.

More nonprofit organizations are hiring executives in positions the companies have never had before. Chief health officers, for instance, were the most commonly added C-suite executives among the providers in the LeadingAge Ziegler 150 in 2015, according to data Ziegler presented at its conference in September. Chief information officers (CIOs) were the second most commonly added positions in 2015.

Take how CIOs have helped to advance nonprofit providers’ capabilities.


“That’s somebody with a strategic hat on, who understands the selection and deployment of electronic health records, and what’s in alignment with their organization’s goals,” Lisa McCracken, Ziegler’s senior vice president of senior living research and development, told Senior Housing News in October.

Nonprofit senior housing organizations, like their larger, for-profit counterparts, can benefit immensely from the addition of a staff person who can elevate the conversation around technology to the strategic level, according to Majd Alwan, senior vice president of technology and executive at LeadingAge.

“The CIO is crucial for elevating the technology discussion to the C-suite, the executive level, the board level,” Alwan tells Senior Housing News. “They’re crucial to securing the right investment from the board and to ensuring that the infrastructure is ready for the different applications.”


Despite this, it may take some convincing for nonprofit senior housing organizations to make this sort of investment.

“The whole idea of CIO is new, in general, to post-acute care,” Alwan says. “Finally, the long-term, post-acute care sector realized they need to be thinking about data and technology.”

Stakes are ‘too high’

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CIOs aren’t entirely new to the nonprofit senior housing space; in fact, some of the larger nonprofit organizations have employed a CIO for quite a while, Alwan notes. These companies have the size and the scale, he explains, to justify the cost.

Smaller nonprofit organizations, meanwhile, tend to feel differently about hiring CIOs. These organizations may initially conclude that they do not have the revenue levels or resources to warrant or afford employing their own CIO.

This line of thinking is a mistake, according to J. Benjamin Unkle, Jr., CEO of Westminster Canterbury at the Chesapeake Bay in Virginia Beach, Virginia.

“You think having a CIO is expensive—start thinking about the costs and missed opportunities of not having a good one,” Unkle tells Senior Housing News.

Westminster Canterbury at the Chesapeake Bay is a single-site continuing care retirement community (CCRC) that made the decision to hire an in-house CIO after first outsourcing its IT management to a contractor. Though the contractor initially increased reliability and brought down operating costs, they “weren’t very good” at system design or preventive maintenance, Unkle says.

“I came to the conclusion that hiring a CIO and bringing it back in-house was absolutely essential to remaining a pre-eminiement retirement community in an age of electronic records of all sorts,” Unkle says. “The stakes were too high in having an outdated and unstable system.”

The investment is necessary, even for single-site senior housing communities, Unkle believes.

“While we may not like the fact that operating in the last five years has required single-site communities to have CIOs, someone who’s of greater skill than your typical IT manager level person, we’re doing things that are so complex now that that’s the price of poker, and you’ve got to belly up and do it,” he says.

Residents at Westminster Canterbury, meanwhile, appreciate the fact that the CCRC has its own CIO, Unkle says. The CCRC gives all residents the opportunity to comment on its budget, and no one complained when they saw a CIO was being added.

“Our residents saw the value, particularly when they saw we were going to start keeping their health records by computer,” Unkle says. “Frankly… we would have lost credibility with our residents had we not [hired a CIO].

Health care vs. hospitality

The debate over whether senior housing is first and foremost a hospitality or a health care industry has long occupied providers’ minds—but it looks like health care may be winning out in at least some nonprofit senior living organizations.

Now, leaders in the senior housing industry are being confronted with the fact that their communities actually provide health care, according to Steven Fuller, the new vice president and corporate medical director at Dillsburg, Pennsylvania-based not-for-profit senior housing provider Presbyterian Senior Living.

Presbyterian Senior Living realized not too long ago that it’s “so important” to bring people with a health care background into upper leadership levels, Fuller tells Senior Housing News. Subsequently, the company introduced two new positions: vice president and corporate medical director, which Fuller occupies, and vice president of clinical services, which is occupied by a person with a “very, very strong nursing background,” Fuller says.

In his role, Fuller intends to implement new methods and clinical standards to enhance residents’ quality of life, as well as partner with health care providers to enhance residents’ quality of care. Fuller also plans to develop systems of accountability that stress data collection and empirical measurement outcomes, he says.

When it comes to technology, though, the health care industry as a whole has experienced some bumps in the road.

“Despite their best attempts, I think that in health care in general, we have implemented this technology in ways that have created a lot of challenges for us,” Fuller says.

One of the overall goals of health care information technology (IT) was to eliminate silos of health information so that providers could access the records of all of their patients in one place, Fuller explains. But this hasn’t happened.

“All of this health IT has created more silos than there were before,” Fuller says. “We haven’t developed the ability to share this information very well.”

Fuller, as corporate medical director, is interested in changing this in senior living for good.

“There’s a treasure of information and value stored in the medical information of our residents which has yet to be brought to a level where it’s easy to access and analyze,” Fuller says. “That’s one of the interests that I bring to Presbyterian Senior Living.”

Written by Mary Kate Nelson

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