Covid-19 has clouded financial outlooks for senior living providers across the country — and perhaps nobody knows that quite like the industry’s chief financial officers.
In recent months, a spate of senior living providers have named new CFOs amid a financial landscape complicated by the pressures of the pandemic. Among the organizations with newly appointed CFOs are The Springs Living, Presbyterian Senior Living, Harmony Senior Services, Sequoia Living, Balfour Senior Living, WesleyLife, Oakmont Senior Living, Lifespace Communities and others.
There are various reasons for these CFO appointments. In some cases, long-standing company leaders have been elevated to the C-Suite, while in other cases, organizations have tapped talent from other sectors. Some providers have named their first-ever CFOs, while others have brought new faces into the role. But all these CFOs are confronting similarly challenging circumstances. The pandemic did not directly prompt all these hires and promotions, but there is no questions that this is a challenging financial time for many providers.
Since the first outbreaks spiked earlier this year, Covid-19 and its many pressures have compressed margins throughout the senior living industry, driving up expenses while hurting move-ins and occupancy. In response, providers are seeking new sources of funding to help fill the gap, such as from the federal government or from capital partners.
The Covid-19 pandemic is not expected to dissipate any time soon, all but ensuring that the current state of play persists for the foreseeable future. But even before the pandemic struck, the senior living industry was already evolving into a more sophisticated business with more complex finances. What this means for providers is that the financial math required to survive and thrive has shifted. And for CFOs, it means there are more moving parts to keep track of, and tighter margins under which to do so.
Senior Housing News connected with some providers that named CFOs in just the last two months, to hear how the role is evolving and how financial leaders are helping their companies rise to these daunting challenges.
Within the senior living industry, there is a need for financial leaders who can handle a multitude of responsibilities, including filing applications, tracking and reporting expenses and data, participating in studies and providing management with enough information to make critical decisions, according to Fee Stubblefield, CEO of McMinnville, Oregon-based The Springs Living.
“A CFO today has got to be a master juggler,” Stubblefield told Senior Housing News. “They have to know what’s going on, they have to forecast where it’s going.”
And the stakes for getting it right are high.
“Make the wrong decision, and your NOI is not recovering for many, many years,” Stubblefield said. “Or, you’re going to have to pass costs on the customers, and they’re going to be significant.”
The evolving role of health care and new payment sources in senior living has also made the CFO role more sophisticated.
“As we integrate with the health care system, and the payer mix continues to evolve … you’re just going to have to be able to access all the payer sources and all the opportunities for your customers,” Stubblefield said. “You’re going to have to have understanding and knowledge, and you have to have a very good handle on exactly what’s going on every day in your business.”
Given all of the current uncertainties caused by Covid-19, forecasting the future is a top challenge for modern financial leaders, according to Dyan McAlister, newly appointed CFO at Dillsburg, Pennsylvania-based Presbyterian Senior Living (PSL).
“Will the industry turn to M&A as companies struggle to deal with the pandemic? Will capital be available? Will we be facing inflation because of pumping money into the economy?” McAlister said. “The number of variables that CFOs need to consider has increased greatly in the past nine months.”
Yet another new and big challenge in the Covid-19 era is cost containment, according to Harmony CEO Terry Howard. The Charleston, South Carolina-based provider is focused on controlling expenses related to retention and recruitment, hero pay, personal protective equipment (PPE), overtime and contract labor at its 29 communities in the Mid-Atlantic and Southeast.
In the age of Covid-19, CFOs should be “joined at the hip” with their operating teams in working to manage daily expenses, and in evaluating programs and systems for efficiency so that the communities themselves can focus on caring for residents. Forecasting is another big part of the role.
“Being able to balance and predict and project 90 days out is a science that tomorrow’s senior living CFO should be very adept and adroit at,” Howard said.
But modern CFOs must not only look forward, but also backward, to help guide the companies they work for.
“[It’s] looking at the 2021 budgets and being able to somewhat project and forecast what Q1 will look like relative to your trailing six [months],” Howard said. “And then taking a more refined and deeper dive look at 2019 to see how you performed in a more normal environment, and using that as a barometer for forecasting into 2021 and beyond.”
New CFOs take the reins
Although Covid-19 is indeed making the job more complicated, many senior living providers have not named new CFOs simply due to the pandemic. Part of it, too, is that the industry is just naturally becoming more complex as it grows, requiring more dedicated financial stewardship.
“The further we get in the health care continuum, the more sophisticated we have to be, with more access to data,” Stubblefield said. “I think it’s just the maturation of senior housing and care, evolving where other businesses and other sectors have already gone.”
That’s where the company’s new CFO, Molly Vaughan, comes in. The Springs Living appointed Vaughn to the role in October — a move that was planned long before Covid-19 came along. As CFO, Vaughn is partly focused on seeing the provider through the pandemic. Particularly, she is working on controlling the costs of labor, tracking PPE supplies and navigating business relationships and transactions.
Another top priority for Vaughn is making sure the company’s management team has enough information to forecast and make the right decisions at its 18 communities in Oregon and Montana.
“For example, giving the right information and helping think through the incentives and discounts, if any, that are needed to get a particular market moving again,” Stubblefield said. “And, what’s the long term impact on that and your value?”
But Vaughn’s primary goal is building strategic infrastructure over the next 6 to 12 months — a task she is about halfway done with, Stubblefield added.
“That will allow us to make quicker and more accurate decisions for the business, and increase the efficiency,” Stubblefield said.
Elsewhere, CFOs are taking on the same kind of responsibilities and goals, and watching similar shifts in the financial complexity of the senior living industry. At PSL, McAlister is focused on maintaining the nonprofit’s good financial footing in order to mitigate the pandemic’s challenges.
“Thanks to receiving government funding quickly in the early stages of the pandemic, we were able to focus on keeping residents and staff safe from the onset instead of panicking about the expenses,” McAlister told SHN. “We’re going to continue to see a higher level of expenses compared to prior years, so our focus right now is on increasing occupancy, which will increase our revenue.”
McAlister — who worked for PSL for 22 years before taking the reins as CFO — said the biggest adjustment in the Covid-19 era has centered on tracking finances for state and federal regulators.
PSL is currently focused on how best to operate during a disruptive pandemic that shows no sign of slowing down. But the organization is also looking ahead to post-pandemic growth opportunities.
While McAlister believes a senior living CFO’s core responsibilities have not changed much with the pandemic, she does believe the way in which providers meet those responsibilities has shifted — specifically, in managing staff.
“I’ve had to stay more connected with the day-to-day operations because of working from home [and] I’ve taken a more hands-on approach in managing the mental health of my department,” McAlister said. “It also required me to be more nimble, looking for ways to assist an already stressed direct care workforce.”
In some cases, providers are welcoming new CFOs from outside the senior living industry. One such example is Sequoia Living, a nonprofit with three open continuing care retirement communities (CCRCs) and another under construction, alongside three affordable housing communities, one manufactured home park for older adults and two senior centers.
In October, Sequoia officially welcomed Charlie Shoemake as its new CFO — but he had worked with the San Francisco-based non-profit provider since January in a consulting role. Before taking the financial leadership role, Shoemake worked in the financial services and banking industries.
Although Shoemake is a newcomer to the industry, he said nothing surprised him at the outset of his hiring, especially on the finance and accounting side. But, the industry does have its unique hurdles.
“Every day I am faced with challenges to understand operationally what’s happening behind the scenes, and stepping in to provide both guidance and assistance,” Shoemake said. “Everything from paying our bills to safety protocols to working with vendors.”
Meanwhile, Harmony has been able to maintain its margin of roughly 36% at its stabilized communities, while growing its portfolio by a net gain of about 200 units since it began reopening dining and social activities in June.
The company’s new CFO, Gloria Holland, is a former Capital Senior Living (NYSE: CSU) veteran who came aboard in October. Her main task for now is finalizing the company’s 2021 budget, streamlining its processes and systems, and evaluating opportunities to preserve and potentially even grow it.
“The next four months are, I think, critical to having a strong 2021,” Howard said. “[We are] managing the virus, protecting the margin, growing the top line and … providing the support that our associates need to stay the course.”