Asbury Communities, one of the largest non-profit senior housing providers in the nation, has been making headlines recently—and the news has been good.
A July 8 Washington Post article highlighted that Asbury Methodist Village, a continuing care retirement community (CCRC) in Gaithersburg, Maryland, has become the first retirement community in the Washington, D.C.-area to be certified as LGBT-friendly by national advocacy organization SAGE. And in late June, Bethany Village in Mechanicsburg, Pennsylvania (pictured above), became one of only 85 health care organizations worldwide to receive the Gold Certification for Excellence in Person-Centered Care by Planetree International, an international nonprofit organization dedicated to the transformation of how health care is delivered.
Asbury was also just named a certified Great Place to Work organization after associates completed a Trust Index Survey earlier this year.
These recognitions come after a period of major changes for Asbury, which operates eight CCRCs, located in Maryland, Pennsylvania, Tennessee and Oklahoma.
Last year, the company relocated its corporate headquarters to Frederick, Maryland, where it created a next-generation space without any private offices. And that came on the heels of a momentous change in the organization’s leadership. After being led by the same CEO for nearly three decades, a new leader—Doug Leidig—took the helm in 2015. At the same time that Leidig took that role, Sue DaCamara (pictured at right) became COO, having previously been deputy COO.
The changes have not always been easy, but Asbury recognized that business as usual was not an option given current market dynamics and health care imperatives, DaCamara told Senior Housing News. An industry veteran who joined Asbury in 1983, DaCamara has herself recently achieved recognition, receiving the 2017 LeadingAge Herbert Shore Outstanding Mentor Award. She spoke with SHN about her tenure at Asbury, the organization’s approach to leadership, and how it navigated through the period of transformation that led to its recent wins.
You’ve risen through the ranks at Asbury, what was your first position with the company?
DaCamara: I took a step back in my career to take a job at Asbury. I recognized it as an organization that seemed to have a lot of potential. It was only in Gaithersburg at the time. I took a position as director of therapeutic recreation. I quit about three months after taking that job.
You quit? Why?
I thought, I don’t know, maybe I misjudged this. And two days later, I went in and talked to my boss at the time and said, I think I made a mistake, can I rescind my resignation? She said, I have an offer for you. So, I’m not going to answer your question until I ask you this question. How would you like to be my assistant administrator? And I said, that’s exactly what I was hoping for. I became the administrator for various levels of care, Then, I became the executive director of Asbury Solomons in Maryland, and helped open Inverness Village in Oklahoma.
What made you realize that quitting had been a mistake?
I was sitting in a fast food restaurant across from the campus, literally looking at the campus, and I thought, there are so many opportunities there. I knew there was a leadership change coming because of some retirements on the horizon, and I thought, you know, I haven’t given this long enough. And this was a commitment that I made.
And honestly, there weren’t other CCRCs in the area. I started in a for-profit nursing center after college, and it was a totally different world. When I found nonprofit CCRCs—first in northern Virginia—I realized that faith-based, mission-driven organizations are just totally different. So, I thought, [Asbury] is an organization that has all the characteristics I’m looking for, just because I don’t see the opportunities coming as quickly as I hoped they would … I need to give it a chance.
So you became an assistant administrator when you returned?
The catch was, my supervisor—my mentor—didn’t have the position approved. She said, I know I’ll get it approved, but in the meantime, so you can start learning, would you be my secretary for six months? I became her secretary for six months, and at the end of that, she said, Sue, you’ll make a great assistant administrator and eventually a great administrator, but I recommend you never be a secretary. But you’ve learned.
She obviously saw leadership qualities in you. What do you think she saw?
What she saw in me, which she shared with me, was a commitment to seniors and to the dignity of all individuals, those we serve and those who serve them. My great-aunt owned a nursing home in Gettysburg, Pennsylvania, and she closed it down when the first regulations came out in the 1960s. She said, I will not have the government tell me how to care for the people in my nursing home.
There was a real love of the residents we were serving, and trying to make their quality of life the best it could be. Resident-centered care is the new buzzword, but that’s how I was raised.
My mentor—Barbara was her name—also saw I could connect the dots. Being strategic is one of my strengths, in those tests you take.
Are those the same qualities you look for in potential leaders at Asbury, who you mentor?
What I look for is being totally committed to the resident and the workforce. Seeing leaders who can combine those things and who have passion. I look for individuals who can be strategic, as well. Working in a system is so different than a standalone, so I’m looking for people who can see the greater whole, outside just one community, and who are willing to give back to the whole industry as well.
How do you approach mentorship, what lessons do you try to impart?
I try to identify high-potential leaders and give them a chance to spread their wings. To give them opportunities beyond the job they were hired for, to help support initiatives across the system. So, an assistant administrator at a health care center, we might put on a team focused on culture change or resident-directed care.
Being a resilient leader is important in our organization, so teaching that skill through role-modeling. So much of being a mentor is walking the talk.
And externally, I’ve been a champion of our folks applying for the Larry Minnix Leadership Academy. Each year, we have two people who go through. It was a delight for me [to help create] the Mid-Atlantic Leadership Academy, built off the Minnix Academy. I knew we had leaders in our organization who would benefit from that chance to learn and grow.
I like the leadership academy approach because it’s about self-reflection and inward motivation, rather than, here’s how you be a leader. It’s not a title, it’s not a position, it’s a philosophy, it’s a practice. It’s how you live your life.
You mentioned resilient leadership. What is that?
It means leading in a calm way, with clarity and conviction, keeping anxieties low and being a step-down transformer when you see anxieties building up.
It’s built off Bowen Family Theory, and there are a couple books out there. Bob Duggan has been an executive coach in our organization for many years, and he and his colleague Bridget have done resilient leadership training. It’s a program of eight hour-long modules. Resilient leadership has been taught throughout our organization, we’ve evaluated people on it. It’s a calming influence, and it’s given us a common language. We talk about, ‘Were you a step-down transformer?’ ‘Did you lead with conviction?’
What has the recent period of change been like at Asbury Communities?
We had a CEO who was with us for nearly 28 years. It was wonderful to have a new CEO who came from our organization, but he was changing, too, as a CEO. And our board was changing because they were interacting with a new person [as CEO], and they had some new members. We had a strategic plan that bridged the time between the two CEOs, and they had to start thinking about a new strategic plan. And we had some leaders who opted out, executives and community-level leaders. They had great opportunities and decided it was time to explore those.
At the same time, with health care reform, we were trying to do things in different ways and be more efficient. [CEO Doug Leidig] came up with two acronyms. REG stands for results, engagement, growth. And LEAD. That’s listen to those closest to the process, engage and embrace in a fun and low-anxiety environment, ask why/why not/what if, and become a data-driven organization.
So, really, we were really driving, how do we do business in a different way? Just pushing and pushing and pushing that, but at the same time not being directive, trying to follow the philosophy of asking a lot of questions, and standing firm on targets.
I imagine that wasn’t always easy.
I go through periods where I think, I’m not sure I’m a good leader anymore! I’m pretty transparent with our team. I share the self-reflection I go through on a quarterly basis, and share what I think I could have done better. Part of my leader impact statement has to do with optimism, and one quarter I said, I know I wasn’t optimistic with you, because our financial performance had gotten worse. So, it was hard. But holding myself accountable, that’s huge.
We’ve heard that now is a good time for CCRCs, with the housing market strong and stock market strong. But I know there are challenges as well, with supply and labor, for example. How is Asbury doing?
I’d say our occupancies generally are above national standards. There are a couple areas that are challenging. Maybe a for-profit nursing center or assisted living memory support has moved in and offered private suites, and our community isn’t yet able, from a master repositioning standpoint, to offer private rooms.
We try to focus on what’s the niche in the market that’s unmet, and talk to hospital providers about what they need. At one of our communities—this goes back about two years ago—the hospital said, we really need a nursing home where we can send people that does a great job with IV therapy, can you do that? The staff said, no, but we could if you teach us. The hospital came out and went through all the protocols, the training. That really helped that niche. It was a skilled nursing center at a CCRC.
In assisted living and residential living, we’re pretty much on budget. We do have a community going through a major repositioning, so occupancy dropped some, but all the good signs are definitely there. We’re not on our budget exactly, but we’re seeing an improved operating ratio, getting better every year.
It comes back to doing business in a new way, and finding out both what are the pain points of your hospitals and health care partners, as well as what new consumer preferences need to be met. Our organization is looking at our business model and asking, what new products or services or programs, such as our new venture into TripleCare telehealth, do we need to start getting involved with to offset declines [in reimbursement] and fulfill the mission?
Written by Tim Mullaney