Tips for Senior Living Providers Shaking Up Their Operations

Many senior housing providers make major changes—whether to their business model or care strategies—in the hopes of improving their bottom lines or better complying with various industry regulations.

Unfortunately, these major changes also tend to lead to something else: confused, disgruntled residents and family members.

When Holiday Retirement decided last year to abandon its longtime management model, for instance, the reasoning was primarily financial in nature—the nation’s largest independent living provider claimed it couldn’t continue to both employ live-in managers and comply with a U.S. Department of Labor overtime rule. But the switch startled some Holiday residents and their families, who contacted Senior Housing News. They had been promised live-in managers upon move-in a few years ago, and felt that care would be compromised without them.

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Holiday, for its part, says that resident pushback has been minimal and the transition has gone smoothly. But this is just one example of the type of big shift that providers sometimes make, and whenever this type of change occurs, there are ways to communicate with residents and practices to ensure your organization stays out of legal trouble, according to experts. Providers just have to employ a lot of patience—and a great deal of transparency.

People ‘hear what they want to hear’

No matter how beneficial an upcoming change may be for residents, they and their family members may not view the change as positive for some time, according to Dana Wollschlager, practice leader at Plante Moran Living Forward. That may be the case for some Holiday residents, she reckons.

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“The minute you try to take something away from someone—I don’t care who it is—they perceive that as losing something,” Wollschlager tells Senior Housing News.

Many people, after all, are very set in their ways, and some of the residents in senior housing have maintained the same “ways” for decades.

“We all dislike change—and I think people in a senior living environment are even more tuned to not wanting change,” Jason Lundy, a Chicago-based attorney with Polsinelli, explains to SHN.

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Frankly, providers and residents often approach the same change from two very different vantage points.

“To be honest, families hear what they want to hear,” Wollschlager says. “They are listening through the filter of emotion, whereas the organization is communicating through the filter of a business decision. It’s difficult when you’re coming at it from two different perspectives.”

After an action plan has been decided upon, it’s critical that residents and their family members are kept constantly in the loop.

“Transparency is the best approach, I’ve always found,” Wollschlager.

Lundy agrees.

“I think the general advice is over-communicate, and start early,” he says.

Keeping it legal

For senior housing providers considering a major change, it’s key that they thoroughly educate their sales and marketing teams regarding what exactly the change entails.

“So many times, from the lawyer’s perspective, providers will say ‘here’s our contract, revise it up for us,’” Lundy says. “We strengthen it, but if we don’t have the second step, where the people who are going to be using the contract—the marketing and admissions staff—are trained on what the contract means, and why it says this instead of that, and why it’s important to hold strong on one provision, I think the work of revising the contract doesn’t deliver its full value.”

If the sales and marketing team doesn’t understand exactly what’s in the contract, or why a change to the contract has been made, they can land their employer in some legal trouble down the road.

“The lawyer can say, ‘we never promised [that] in our contract,’ but the family members say, ‘no, it wasn’t in the contract, but you promised me that in words, and my mom’s life is in your hands,’” Lundy says. “That divergence can open up the risk for lawsuits.”

A gas station lesson

Holiday is confident that it has navigated the changes to its management model successfully.

“We’re very pleased with the progress we’ve made transitioning our communities from live-in community managers to the more traditional off-site general manager model,” Mark Prince, Holiday Retirement’s senior vice president of operations, tells SHN. He adds that Holiday is also “pleased with the response we have received so far from residents, their families, and our associates.”

Still, it’s natural to experience some pushback to any big change—especially in the first few weeks after the plan is initially announced.

“You discuss the change once and everyone might be up in arms about it, but the second time around [they may be more open to it],” Lundy explains.

Lundy recalls a case he worked on, involving a senior housing community located next to a parcel of undeveloped land. A developer, he says, sought a zoning change that would allow the land to be used for a large gas station serving commercial trucks. Residents of the senior housing community, fearful that their quality of life would diminish with a gas station next door, fought the change—but to no avail.

Ultimately, the gas station was built. The residents, surprisingly, weren’t upset.

“Something that they were initially dead set against and very fearful of, by the time it played out, they loved it,” Lundy says. The gas station, the residents realized, housed a coffee shop and various food options mere steps away from their community.

The moral of the story? Don’t expect residents to experience that “whole arc of human emotions” overnight.

“If you try to shortcut that and say, ‘the change is happening at midnight tonight—get used to it!,’ that’s not a good approach,” Lundy says.

Written by Mary Kate Nelson

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