Changemakers: Maria Oliva, COO of Pathway to Living

Pathway to Living COO Maria Oliva entered the senior living industry 27 years ago and has been a changemaker ever since. From creating a wellness-focused operating model, to developing a multi-brand portfolio, to serving the middle market, Oliva has broken ground that others follow.

Oliva joined Chicago-based Senior Lifestyle Corporation when the company had only four properties. She was able to learn the industry and help shape it, as Senior Lifestyle began to grow into the industry behemoth that it is today.

From there, Oliva joined Chicago-based Pathway to Living — then called Pathway Senior Living.

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We spoke with Oliva about creating Pathway’s Viva-branded operating model, which put an emphasis on promoting resident wellness years before this became commonplace. And she shared how Pathway’s innovative DNA also comes through in its multi-brand portfolio of affordable, middle-market and market-rate senior living — with a new, active adult type of offering in the works.

Today, Pathway’s portfolio numbers about 30 buildings, and Oliva anticipates that it will expand beyond its regional footprint thanks to a recent acquisition by Chicago-based commercial real estate investor and operator Waterton.

What are some changemaking efforts you’re most proud of?

I think it was 12 years ago, we set the strategic plan for this organization to grow. We decided we need to change the way society thinks about aging and senior living.

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We started by asking, why do we exist? Why would someone choose a Pathway community versus any other community in the market?

Personally, I felt, why aren’t people interested in moving to seniors housing? People come reluctantly. It’s need-driven. I felt that we needed to address that issue.

That’s how we decided to then focus on what’s [become] our operating philosophy.

It was really this paradigm shift in thinking about people making a choice to live here in seniors housing because they want to live the best life possible with the right resources, versus remaining in their home with reliance on friends, neighbors, other caregivers [and] then piecemealing whatever socialization you could get.

And that is the operating model that you’ve branded as Viva?

We decided that our operating philosophy needed to reflect that this energy of life is still possible in elderhood. We sometimes pull names out of thin air, and Viva seemed to be right. It was about, life needs to be lived, needs to be celebrated. People use that term, viva, in celebration of something, usually someone.

There’s a wellness focus in Viva. You helped lead that change. Now, wellness is permeating the whole industry.

We started to put structure to Viva. It’s about acknowledging what are your hopes, what are your passions as an individual, why should you move here? We started changing the job descriptions of our team members. We changed all the titles. I will tell you that 10, 12 years ago, out of thin air, we pulled “life enrichment aides.” Today, it’s a norm that most organizations have that.

We started changing the job description to say, “Your role is to do all of these things that you’re required to do as being a CNA or a resident caregiver, but we want you to share your talents and engage with the residents at a much deeper level to enable them to have meaningful moments, to have purpose.”

We started asking residents to become engaged in life. We do things with them, not for them. We ask them to lead programs, and we don’t have to entertain them. We have some entertainment, but that shouldn’t be how people live.

We took residents camping and we took them horseback riding, hot air ballooning and things that empowered them to think, “Wow, life is still positive. I could still do the things I used to do 50 years ago, or I could do things now that I’ve never done, because it’s enabled where I live.”

Then we decided, in order to live here, it’s about having the wellness piece. This isn’t just a hospitality play, this isn’t just a housing play. People still need to be here for a reason. It’s not the primary reason that we’ll look at, but we have to have a coordinated care model.

For the longest time, we were the only ones that had a wellness center in our communities. The developers and construction team said, “Why do you need all those spaces? Why do you need it on the first floor?” They were trying to hide it. We said, “It can’t be in a basement, it needs to be part of our DNA. So it needs to be in the front, it needs natural light.”

Then, how do we build a network of providers that believe in our philosophy that people need to live a meaningful life and they should be able to live this life in this community for as long as they can?

We created the Viva Plus program. That’s when we aligned the home health, pharmacy. It’s about not just coordinating people, but it actually is vetting those providers every market. It’s not just talking to them about, what can you provide and what’s the relationship, it’s about, there’s the Viva commitment that we have.

Life has to be holistic.

When was Viva Plus implemented?

This started for us 10 years ago.

We built those relationships, and then we could build this program that talks about, what are we doing proactively from a preventative standpoint?

We engage behavioral health early on. Transitioning into seniors housing requires some intervention beyond your family, beyond the team. Our behavioral health partners are able to come in and say, “Let’s talk about what this looks like for you. You moved from your home and you have to give up your house.” Those are real life challenges.

For the longest time, I’d go to industry events and it would be, “This is a health care model that just has to look and feel like a hospitality.” But you have to have a robust infrastructure to support wellbeing in general.

Since you have this robust wellness model in place, is the next step working with Medicare Advantage (MA) payers or health systems?

We’ve dabbled with some of the approaches of population health, which is interesting. It’s certainly not something that we as Pathway want to be able to drive, but we want to be at the table.

I think definitely that’s the trend. There’s no question that the industry is going that way.

I still don’t think we get a seat at the table at the hospital systems, but I think from a post-acute [perspective], we’re going to start to see more and more of that. We are as an industry part of the solution.

Are you looking into MA? To start a plan or partner with existing plans?

Yes, we’re working. We’re looking at partnerships.

You’ve also been a changemaker in creating a multi-brand portfolio, which is gaining more traction in the industry now.

We started the [Victory Centre] affordable portfolio here in Illinois because of the separate licensure in Illinois for the supportive living [Medicaid] program.

As we expanded … we said, “We can’t call all of our communities Victory Centre because that’s the former model. What’s the model for our market rate?” It became Aspired Living. Then when we modeled the middle-market product out, we decided it can’t be Victory Centre, it can’t be Aspired Living, so we called it Azpira Place.

When we look at acquisitions, my team knows before they come in and present to the leadership, the first thing I’m going to say is, “Which product is this? What’s the opportunity? Why?”

It helps us grow methodically so we don’t have confusion. It helps the customer understand what brand they’re willing to pay for or can’t afford.

I think from a B2B [perspective], investors want to know, you’re charging $1,500 more for Aspired Living than Azpira Place. Why won’t you do all [Aspired Living]? Where does Aspired Living fit, in what areas? What’s the customer like? How do you deliver care and services? What’s the operating philosophy?

How do the operations differ among the brands?

We have signature programs in all of our communities regardless of whether they’re affordable housing [or] we’re the highest in the market. But it helps our team actually deliver the signature programs differently based on what the customer values.

If we have Art Path — which is one of our signature programs — residents in Azpira Place will want it to be more of, we do our classes and paint. In Aspired Living, they may want to have an artist come in and do a lecture or go to an exhibit.

Can you describe your middle-market product in greater detail?

I think it’s about evaluating the consumer and what the consumer values.

Our model is actually still built on delivering that Viva lifestyle, coordinated care model. The same commitment on that wellness center.

But we have developed bistros, bar, spas. The reality is, are we actually programming those every day?

I may walk into some of our communities going, “Boy this is a nice beauty shop, but it’s only open once a week. Why? How do we use this? Can there be a combination spa and beauty shop?” I think it’s about looking at that footprint and saying, what is the actual square footage, the rentable space.

I’ve been saying for a while, the traditional IL as we’ve known it for many years will not be what the boomers choose.

We don’t necessarily, in Azpira Place, reduce the size of the apartments. But whereas our market rate, Aspired Living, will have very few studios, in the middle market, we don’t necessarily focus on the two bedrooms. [Instead], large one bedrooms and some studios.

It really is about the efficiency of how the residents will use this space, how will it allow our team members to more efficiently do their work. Because I think the biggest challenge today is workforce. We used the have bistros that were far from the main kitchen. Now we’ve redesigned that.

That’s our solution. I don’t know that it’s the right answer. I know we’re going to be able to build and acquire under that brand more than, I think, anything else.

You have a new independent living-style product under development. Have you announced the brand?

Not yet. We’re still trying to validate. We do a lot of R&D, and we have to convince ourselves.

I think that our goal is to try and finish that this year and launch it. The acquisition team is keeping their eye out at opportunities. We’re going to have some final tweaks, but we have a framework.

Can you give a preview of the framework?

I do think that if you look at trying to get the boomers in upstream, it’s a completely different model. I’ve been saying for a while, the traditional IL as we’ve known it for many years will not be what the boomers choose.

As a boomer, we’re only going to want to pay for what we want, and we’re going to want what we want at the time we want it. I think it’s going to create this different model.

It’s not going to be your traditional IL with all included services. It really is going to be an a la carte, very wellness-focused model.

Will Waterton’s involvement help drive growth in the new active adult area, given their multifamily expertise and resources?

It really is great to have them at the table when we’re looking at design, we’re looking at construction, or we’re looking at them to say, what are you doing in multifamily housing or hospitality? I think that will help create this brand.

One of the things we’re working on now is a kind of middle- to back-of -house integration. So, we’re going to have access to a deeper bench of infrastructure. I think it gives an opportunity to scale faster.

I do think that it allows us the opportunity to grow beyond the regional footprint that we’ve had. We’re aligning some of our focus for growth in markets where Waterton already as a footprint. I think we’ll see a broader expansion of our portfolio.

And I think lastly, it allows us access to different financial partners.

Pathway was one of the first to drop “senior” from the company name, from Pathway Senior Living to Pathway to Living.

It was difficult for us.

We had spent so much time and effort trying to be recognized as Pathway that we couldn’t lose the Pathway name, but nothing worked right. So we let it go.

Six, nine months later, our VP of sales and marketing said, “Hey, what are we doing about it? Because it’s on the list of goals.” And I said, “I haven’t seen anything, you haven’t brought anything back, we haven’t come up with anything.”

I’m passionate about this work, I’m passionate about the mission that we set forth.

We were just having a meeting, we were sitting in my office. Sometimes I think you get these clarities, and I said, “Why don’t we just call ourselves Pathway to Living?”

The VP said, “Did you just pull that out of thin air?” It just came to me. And it made sense.

Do you thrive on change or are you generally more cautious?

We do these personality profiles and mine is a “quick start.” I’m usually the first one to say, “I think we should try to do that. Let’s prove why it can’t be done.”

When I would say, I think we need to redesign all the job descriptions and people need to have an ability to share their talents, I would go to the HR and say, “Think about it then come back and tell me why it can’t be done.”

Most of the time, most people aren’t going to come in and say, “Here’s why we can’t get it done,” because then I would take their approach and say, “Okay, you see that as an obstacle. What about if we remove that? Is that possible?” And they’ll say, yes. Great, explore that then come back.

Eventually we’d get to, “Boy, we really should pilot it.”

Can you share an example of a time when you tried a change that didn’t work out?

We were trying to innovate with our pharmacy partner about how could we reduce med errors. I think the med errors usually happen because somebody forgot to document. That was eight years ago, [we said], how do we streamline this?

[Our partner] invested all kinds of time and money into a program. And they came back with scanners. We put them in all of our supported living communities at the time.

Functionality was a major problem. [Staff] couldn’t carry them [because they were so big], so then the pharmacy partner would come back and say, “Your team is complaining they can’t carry the scanners, so they had these other contraptions.”

And at one point I said, “I appreciate the effort, and I appreciate the fact that we’ve tried. But is there’s no other option?” They said, “We looked at it, and everything else is going to be so cost-prohibitive.” And I said, “Fine, we’ll have to scrap and go back to manually charting.”

Not today. Today you can scan.

Even when we have things that don’t work, [the team is] not surprised. Because the next thing comes in, and they’re like, “Oh boy, here’s another one.” We do a lot of pilots. I think we have a lot of people that are willing to innovate with us. And most of the things work.

What are some traits or skills that allow you to be a changemaker?

People will describe me and say, “You evangelize.” I’m passionate about this work, I’m passionate about the mission that we set forth.

It’s about, how do we get people to join the journey? How do you change a mindset, how do you re-train yourself if you’ve been in this industry a long time? To think differently, to speak Viva, to welcome change and not resist it. Because we’re going to change, even when there’s no [pressing] reason to change. Because we want to move forward.

And I think people would say in order to lead organizations through change, through growth, you have to have trust. And I believe in establishing trust. I’m not afraid to stand and say, “The thing didn’t work, we screwed this up.” Or, “We’re going to take these chances and we’re going to do these things and here’s why we should do these things.”

When you grow, it’s even more important to keep those lines of communication. To tell people, “Here’s why these things are happening, good, bad, ugly.”

I also think that from a leadership perspective, as much as I can be passionate and I can be enthusiastic, you have to maintain calm, you have to say, we’ll get through this, here’s why we’re going to get through this.

Are there people you look to as changemaker role models?

I’m a huge Steve Jobs fan. I think it’s that kind of mentality of creating something that people should want and be fanatical about, then be able to stick with it. I think if it’s something you’re so passionate about, you’re willing to put a lot of time and effort and have lots of failures at it.

I’ve learned those lessons that if we’re going to fail, you’ve got to fail fast.

Is the pace of change accelerating in senior living?

Yes.

Do you think senior living is changing fast enough?

I do.

I think it’s going to take some real innovators. And I think we’re starting to see responses from some of the industry organizations, but I don’t know that necessarily there’s the full alignment. There are different, diverging priorities.

I do think there should be a more collective approach to deal with the challenge of workforce. I think there’s some opportunities to address immigration. I think there’s some opportunities to look at how we attract new talent.

And how do we change how we deliver the care and services? How do we streamline jobs and systems that don’t necessarily require the human touch and how do you make that meaningful? It’s going to take a while to do that. And I think there’s not enough of that. At least we’re making strides.

And when you look at the various companies, I think people are starting to see the need for this health care focus.

Can you speak to the immigration issue more, given your own experience?

Certainly. I don’t want to get into a political discussion, but I think as an industry, we have to look at that to attract workforce. I do think bringing families to the United States is important. People that work in this industry work because they’re committed to helping other people. It’s not like you’re bringing somebody that has IT or technical skills to work in Silicon Valley. We’re bringing people to work in hospitals and a health care environment. You need that family immigration, just my personal belief. That’s how my family came, but that was a long time ago, a very long time ago, different times.

A lot’s changed?

That’s the beauty of this industry for me. You don’t have to go anywhere else, you can just create the change.

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