At the start of 2020, Kisco Senior Living founder, President and CEO Andy Kohlberg’s top priority was developing a pipeline of talent amidst what he called the toughest labor environment in his 30-year career.
That was before the coronavirus pandemic disrupted the industry and sent operators scrambling to keep residents safe, and communities across the country shut down to non-essential personnel.
The pandemic’s early weeks were marked by fear, Kohlberg said. Very little was known about the virus. Guidance from the Centers for Disease Control and Prevention (CDC), as well as state and local public health departments, changed with each new bit of information. Operators rushed to gain access to testing and personal protective equipment (PPE), and residents, staff and their families were concerned about their safety on the job and in their communities.
Nearly four months later, Kohlberg believes that while Covid-19 remains a serious concern, the fear of the unknown that swept the industry has subsided, and operators are in a better position to manage their communities through a resurgence of cases across 80% of the country. Kisco’s portfolio totals 20 communities in California, Florida, Hawaii, North Carolina, Utah and Virginia.
However, Covid-19 will be a “marathon” that could last two years, Kohlberg cautions. While preparing his teams for the long haul, the company is addressing current pain points such as patchwork rules governing Covid-19 testing, as well as managing resident expectations. While Kisco is known as an innovative provider — including its embrace of voice-enabled technology, and its approach to in-room dining during the pandemic — the company is maintaining a conservative approach to operations given the threat posed by the coronavirus.
This interview has been edited for length and clarity.
How has Kisco been impacted by the pandemic, overall?
Obviously, it’s been a big impact, but our team has done a really good job. Early on, we took a very proactive stance and had very clear protocols and policies in place. We got ahead of it pretty early. We ordered PPE for all our communities early in the process. We tested people for temperatures; when anyone had any symptoms at all, we treated it as if it was a positive case. If an associate showed symptoms, we sent them home and had them quarantine. If it was a resident, then anybody that interacted with them had full PPE, whether they had tested positive or not.
We increased sanitation, we went to in-apartment dining very early in the process for everybody.
As we’ve gone [deeper into the] pandemic, we decided to continue with a conservative approach, but based all of our decisions on local and county data which we track every day for those areas. In communities where we’re seeing very few cases in the surrounding metropolitan area, we allowed outdoor dining or wellness programs with social distancing and masks, by reservation only, in limited numbers.
How has Kisco approached relaxing some restrictions in areas experiencing a surge in positive Covid-19 cases?
Northern California and South Florida in particular have seen an upsurge in cases, and we have, as well. But we’ve managed to do a really good job of keeping those isolated cases from spreading. We haven’t had any large outbreaks. We’ve had communities that had one or two, sometimes three, and in every case, we’ve been really diligent in our protocols. We haven’t had any spread, either, from an associate to residents.
What has Kisco done at a central level to track employee movements away from a community?
One of the decisions we made, before we even had a positive case anywhere, was that we were going to be totally transparent in everything we did, so associates knew what they were dealing with. And it did create some challenges early on. We had a few people who didn’t want to come to work because they felt unsafe, and we understood that. But we felt in the long run, it would benefit us and everybody else. We’re still doing that same protocol. Whenever we have a case, we let everybody know. We put it on our website.
In the early days, there was so much emotion and fear surrounding [the pandemic]. As it’s gone on and almost everybody knows someone who’s tested positive at this point, it’s not [as] newsworthy when someone tests positive.
Likewise, we also let everyone know when the person has come back to work as an associate, they’ve had two negative tests [before] they’re allowed to come back to work. That’s been a big part, because people need to know that they have confidence in what we’re saying and doing. Transparency is critical going forward.
How has your access to testing changed as the virus becomes protracted?
Early on, we stockpiled a number of tests for each community in a central location, in case of a big outbreak and we needed to test people. We haven’t had to use a large portion of our stockpile because a lot of companies have gotten money from the CARES Act to come in and do testing.
We’re still having delays in getting results — up to two weeks, sometimes, which makes the tests almost useless. One of our biggest challenges is implementation varies, county to county and state to state. Some states now require all associates to be tested. Some are requiring a percentage be tested. Some are requiring only testing all associates when a certain number has tested positive. We’ll have a county health director tell us one thing, and the state tells us something completely contradictory.
We’re adapting to each new state and local requirement that is coming out. It’s a real challenge, but the amount of testing we’re required to be doing is increasing.
How have communications between Kisco’s central office and local leadership teams evolved over the course of this crisis?
In the early days, our senior management teams had a Covid-19 call at 9am every day. Now we’re down to three times a week. Our teams are on the phone dealing with every community issue, one by one, on a daily basis. Each community has a different set of circumstances.
You mentioned the lag in test results. What are your other big challenges as you reopen communities?
The hard part is convincing the residents that this is the appropriate way to do it, it’s in their best interest and safety, because a lot of times we will be a lot more conservative than the governor. We explain to them that their population is at risk, and we’re going to always do what’s in the interest of their safety.
What is Kisco doing to enforce social distancing in communities undergoing phased reopenings?
Most of our communities have either a room or an outdoor area where residents can meet with their loved ones, and there’s a separation with a plastic shield, and maybe a telephone on a desk if it’s inside. We’ve created these isolated areas where residents can meet via social distancing with loved ones and family members.
We’ve had all kinds of programs. We had a Kentucky Derby horse race at one of our communities that was outside, where our associates dressed up horses and ran around, and the residents were on their balconies or outside betting on which [one] was going to come first.
In terms of technology, we’re trying to leverage telehealth and create a room where residents have telehealth visits with their doctors. It certainly doesn’t replace the normal lifestyle that they’ve had in the past.
How has the virus impacted residents based on care level?
Memory care has clearly been the most challenging because [residents] tend to wander, and loved ones and family play a more important role with them. Our communities that have memory care wings are in separate buildings. We have been able to keep them separated.
In independent and assisted living, we’re able to deliver the same level of care and as we were before. We use PPE when someone is showing symptoms or had a positive test and life kind of continues.
How adversely has the pandemic impacted Kisco’s occupancy rates, and how have you approached move-ins over the past three months?
In the first 60 days it was very difficult to get any move-ins. Now it’s getting better. It’s still not back to normal.
We’re requiring all new residents coming in to have negative tests [before moving in]. Our number of move-ins have picked up the last two to three months consecutively. Move-outs have actually been below normal for a while. Over the last four to four to five months, it hasn’t been all that different than a typical year in terms of average number of move outs for us.
We’ve reported on how some sales and marketing teams are not adequately developing new leads and referrals during mystery shops. How are Kisco’s sales and marketing teams transitioning from in person tours to virtual settings?
We stopped all marketing spends for a couple of months. We’re now re-engaging, but it’s more online and digital — bigger presences on Facebook and Instagram. We’ve done virtual tours and the good news is people are home and wanting to talk a lot more than they were in the past. It’s easier to get hold of people and have those conversations.
We do a lot of training and repetition around asking the right questions and qualifying people. It certainly is more challenging to get somebody to move in, especially on the independent living side, which is a more choice-driven decision. A lot of people feel safer in a community rather than living at home alone, especially if their loved ones are in a different town or state. We’ll do grocery shopping and things for people now. People are realizing there are positive and negative aspects to moving into senior living. And for some, the positives outweigh the negatives even in this environment.
Can you describe the employee recruitment process during Covid-19? Has it improved or gotten harder to recruit people?
I think early on, there was a lot of fear, and people were afraid to come in for an interview or consider senior living. That is diminishing.
The hospitality and restaurant industries have been part of it. Those folks are looking for a job opportunity, so we’re getting a larger increase of applicants. For other positions, like caregivers and assisted living providers, it’s extremely difficult right now because hospitality and restaurant folks don’t want to shift into that line of work. It’s a little bit a little bit easier for roles like housekeepers, dining servers and maintenance, and probably a little bit easier now that the huge fear of Covid-19 is diminished a bit.
Do you see wage and benefit incentives that were implemented during the pandemic establishing a new wage baseline once the virus subsides?
We’ve talked about that. That’s likely, but it’s market dependent. Northern California remains a difficult market from a labor perspective. We are talking about that, anticipating where we’re forecasting the second half of this year and then looking to 2021 budgets.
Is Kisco considering rate increases in order to provide some cushion on margins? If so, how are you balancing that with maintaining resident care and safety?
We’re trying to get more efficient in every aspect of the business. We’re trying to reduce costs where we can, get more efficient from a labor perspective, and getting the communities better scheduling tools and real-time information on labor, scheduling hours and overtime.
We do see the impact of Covid-19 over the next 18 or 24 months, and I told our team this is a marathon. The things we’ve got to be doing now we’ve got to be able to maintain for a long period of time. Don’t think this is a three-week thing. Our team was prepared that whatever we were going to do, we had to do it in a way we could maintain it for a long period of time and that’s what we’ve done.
We’re well prepared to deal with this for the next 12, 18, 24 months.
How is Kisco gauging resident and employee satisfaction levels as the crisis continues?
Our normal process is twice a year for associates and residents. Our resident survey goes out next week, actually. We did change the questions to address the [current] environment. We’ll be getting real time results in a couple weeks.
How has the pandemic impacted your development pipeline?
We’re still going forward as projects but they’ll take a little bit longer. We think there’s still a lot of demand. We’re always tweaking performance based on construction costs, lease upgrades and rental rates. We’re always doing that on an ongoing basis. We’re just doing it more frequently, now.
Are you considering any building and plant retrofits to help keep residents safe moving forward?
We’re spreading out dining tables when we do get back to serving in the dining room. We’re going to be hiring somebody in charge of environmental health and safety at the home office to oversee a revised program in terms of the health and safety [needs] as relates to Covid-19 and other infectious diseases.
We’re looking at building some new communities, and we’re thinking and rethinking some of the design. All those things are on the table. People have to trust us to do the right thing to keep them safe and so far that’s worked. But the dynamic of what’s important to a prospect and their family is different than it was six months ago. They want transparency and trust that they’re going to be looked after and all the safety protocols are actually going to be done and not just talked about. They have to feel confident that they’re going to be living with a company that does the right thing on their behalf.