New Sequoia Living CEO: ‘Sacred Cows’ Must Go For Innovation to Flourish

Sara McVey is embracing her new role as the new president and CEO of Sequoia Living, and she believes her previous experience makes her suited for the task.

San Francisco-based Sequoia owns and operates three life plan communities in downtown San Francisco, Marin County and Portola Valley. A fourth, in Walnut Creek, is set to open later this year, and the provider owns and manages The Woods, an affordable manufactured housing community in Mendocino. Sequoia also operates a senior services center in San Francisco; manages affordable senior apartments in San Francisco and San Jose; and offers home health, hospice and respite care services.

McVey, who was hired in September 2019, joins a nonprofit provider in the midst of a rebranding that is also regrouping after an affiliation attempt. It changed its name from Northern California Presbyterian Homes and Services last February, in an attempt to better represent its mission, McVey told Senior Housing News.


Prior to joining Sequoia, McVey spent four years as executive director at Horizon House, a continuing care retirement community in downtown Seattle. While there, she also followed in the footsteps of a longtime executive director and joined a community moving forward after an affiliation attempt fell through.

“The big thing coming into Sequoia now is, even though the organization has been around for 60 years and been very successful, it’s almost like we’re this brand new organization that is putting ourselves back out there and saying, ‘This is who we are, this is what we stand for.’ The name change I think is a big catalyst for that,” she said.

This interview has been edited for length and clarity.


How are your experiences at Horizon House informing your early days at Sequoia?

First, we want to [ensure] the brand and the culture — who we are and where we’re headed and why we exist — are very quickly clear to everybody and that we’re all organized around it and feel secure [moving] in that direction.That takes time because you can’t just put a memo out. It really takes one-to-one interaction, a lot of time at the communities listening, learning and helping reinforce the symbolism of the brand.

The second thing is instilling a growth mindset in the people that work at Sequoia Living. We have really talented, dedicated individuals, and [we’re] reestablishing that this is a business and that the balance sheet should be a source of pride. The executive directors are really running $30 million businesses. There’s a great deal of responsibility that comes with that and making sure that they feel like they’re in control.

The big thing about that growth mindset is encouraging people to snack away at the sacred cows. Just because we did it that way before doesn’t mean that we need to keep doing that way. And it’s not because there’s anything wrong with it. It’s just that incremental innovation really has to come through the people closest to the work. And that takes a lot of encouragement, creating safe spaces for people to do that sort of thing. But that’s a big undertaking, specifically when you’ve been around for 60 years and things are running well.

Will Sequoia consider affiliating with another provider in the future?

I do, but I also believe that affiliation doesn’t necessarily need to be between two nonprofits. You need to affiliate with a partner who can enable you to do something that you would not otherwise be able to do on your own.

We should all be open to affiliating with for-profits, nonprofits, it has to be a partner that can do something that allows us to advance. The best organizations have a nonprofit heart and a for-profit head. There are some organizations that really get that. And that’s why I think this line of not-for-profit and for-profit has really become very blurry.

How is Sequoia using its home health service line to develop a resident pipeline for its communities?

Home health for us is under a deep and serious review, just because we’re in the care business and we have care centers, doesn’t necessarily mean that we should run our own home care or home health business.

From a home health perspective, it is a different model dispensing care services across the community versus in a concentrated environment. [It is about] consumer preferences. I want to age in my apartment of origin as long as possible. That’s just the reality.

We have a catered living pilot test going on at the moment. It’s a healthy aging home care program enabling residents to live well in their apartment of origin longer. Our clinic oversees the service. Residents can choose Sequoia Living Catered Living or they can choose to work with one of the vetted home care agencies at that particular community.

We’ve done a financial study about what we have to charge per hour to actually cover the costs and make a margin, or at least cover costs. We need to be smart enough and humble enough to say, you know, we do a lot of things well, but maybe running a home care business is not the thing that we should do. But maybe we should partner with somebody who can do it.

Will Sequoia be reassessing all its service lines — hospice, rehab, and respite care — in a similar manner?

I think all the services are necessary. The big question is, who should be delivering those services? Should we partner or do it ourselves? It goes pretty much for everything we’re doing, from food service to health care and everything in between is we want we want to look at the whole big picture, but do it service line by service line to really understand it.

Where does The Woods, Sequoia Living’s manufactured housing community, fit with the portfolio?

Running a manufactured housing community is very different than running a senior living community; it’s a very specific niche. We are looking at how this fits in the portfolio. Are we good at it, or can we get good at it? And if so, why?

The Woods is a super special place. It’s very resident-driven. They really run the operations with staff. It’s very different, I think, from what most of us are used to in the senior living industry. If that’s going to fill this niche of affordable housing or middle market, we have to make sure we have the right expertise to build to deliver on it. You’re not just the landlord. Most of us want to provide services and programs that help people age well. How do you do that and still keep your prices low

What are some of the staffing pain points Sequoia is grappling with currently?

One big challenge is the cost of living in California. Right now [workers] have a lot of choices. Anybody can walk out the door tomorrow and get a job pretty quickly.

Having staff that can get [to our communities] fairly easily is also a challenge here and and then be able to live in some proximity to a community so it’s not a hardship on them or their families. Our senior living communities are located in primo locations. We spend a lot of time not only thinking about the health benefits and the pay, but our culture and those invisible benefits [for retention].

Does Sequoia Living have plans in place to expand its portfolio?

We’re always interested in new [development and acquisition] opportunities, but we also want to guard against chasing after everything at the peril of our core business operations. When you’re CEO, you like to build thingsand you like to acquire things and you like to do new things.

Our main goal for 2020 for us is to really tighten up our core operations, understand what we do best, what partners we should have, and then figure out how to scale in a strategic way.

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