Problem Solvers: Handling Operator Transitions During Covid-19

The Covid-19 pandemic has created myriad problems for senior living providers. But these problems are not insurmountable, and companies across the industry are devising creative solutions.

In this series, we’re surveying industry leaders to highlight these actionable solutions. For this edition, we spoke with senior living providers who took on the challenges of starting to manage new buildings in the midst of the pandemic, and asked them: :

How are you assuming operations of a new community during Covid-19?

Terry Spitznagel, Senior Vice President and Chief Growth Officer, United Church Homes

Last month, the Marion, Ohio-based nonprofit provider acquired two age-restricted senior apartment communities in Brunswick, Ohio and Niles, Ohio.


One of the things that the pandemic has clearly identified for us is that seniors with comorbidities or health issues were primarily impacted by Covid-19. Where we feel like we have been successful in addressing that issue is we look at just independent living and senior apartment options, and then what we do is — as they continue to live and thrive in those communities — we bring a la carte health care services to them.

We connect them with a service coordinator, which basically is like a concierge. As residents identify needs, issues, and health care concerns, service coordinators start to address and connect [residents] to the services as they need them. Our interest in acquiring these communities is to continue this [middle-market] model that has identified itself as extremely important to the baby boomer generation, who’s really looking at the issue of being socially connected. We can bring to them very safe ways to socially connect with the programs and service offerings that we have that are unique to this model of independent senior living.

Our team came in on day one. We had focus groups with residents who wanted to [voice their] immediate needs. One of those was with the spread of Covid-19. We were able to come in and provide everything from PPE to flu vaccines, because they were concerned about the double whammy of Covid-19 and flu at the same time.


One of the second things we’re looking to address is what their health care needs are and what their interests are. We’re working on surveys right now, because we’ve only had ownership for the last couple weeks. [We’re getting ready] to bring to them a program called Caring Wire. It’s an app-based technology that will help us identify very quickly what their needs are going to be. We might bring in needs to address the overall community: 50% of the residents are saying, “We really need education on the vaccine. We want to know when the vaccine is coming in, how are we getting it.” But we might have two or three residents who say, you know, by the way, I also have diabetes, and nutrition counseling would be helpful.

We’re in the process of right now. It is the beginning of how we will bring [service coordination] to an independent living community, see what the residents want and what their desires are, [and] create programming specifically for them and around that.

Mario Marasigan, CEO, Meadowbrook Post-Acute

Meadowbrook acquired a 64-bed skilled nursing and 49-bed assisted living facility in Hemet, California, in August.

Coming into the facility, we understood that the assisted living side needed some work. We knew there were a lot of vacancies — I believe they only have four residents in the [assisted living wing. I evaluated whether it would be financially smart to operate the assisted living [segment], or what will be the benefit of us taking over?

What I wanted to do was focus our strength in the nursing home side, because of the Covid-19 situation. We were able to find a tenant that was willing to take over the operations for the assisted living. I wanted to find out what they can bring in terms of really helping to increase the census on the assisted living side, while we focus on the nursing home aspect. This is going to be their first big assisted living in terms of census wise and bed capacity. I was able to give them some pointers, as well, with my experience as a nursing director. I was able to guide the incoming operator and let them know what they need to start.

They’re going to change the name from Meadowbrook Assisted Living to Hemet Assisted Living, and we are assisting them in getting their license. The staffing was stable and the building was well kept. But the challenge was bringing residents into the building. We started reaching out to hospitals to make sure that we can bring in proper residents in the facility. We want to make sure that the residents that we’re bringing in need to be in assisted living.

Over the past few months, we’ve seen a steady increase of patients coming into the building. I believe they have between 10 and 15 residents now. The new operators are really hands on. They are here daily. They meet the residents. They meet with the family members, and we update them on our Covid-19 response. Thank God, there are no [positive cases] in the building right now. We just have to make sure that we maintain that.

Casey Byrnes, Vice President, Sales and Marketing, Wickshire Senior Living; Kerry Collins-Smith, Executive Director, and Cathy George, Business Manager, Wickshire Poland Senior Living, a Wickshire Senior Living community in Poland, Ohio

Brentwood, Tennessee-based Wickshire Senior Living acquired the real estate and operations of this facility, formerly Sunrise of Poland, in October. Collins-Smith, George and the entire staff remained in place through the transition.

Collins-Smith: There was nothing in terms of this acquisition or transition that was unusual. There were no interruptions with services or care. The entire team that works here — every single person — stayed, so there was no disruption with staffing. Everything really was business as usual.

Byrnes: Kerry has been there for 17 years. All of the department leaders have tenure like that. We were just honestly excited to add them to the portfolio. We’re a hands-on organization from a management standpoint. Our goal is to provide support to the community. I think the size and nimbleness of our organization allows us to do that a little bit easier than some of the larger organizations in our industry.

Collins-Smith: [Wickshire] allowed us to do what we do best every day, which is continue to care for the residents. They reiterated over and over and over: Nobody was here to disrupt care or make things more challenging. We are just piece-by-piece rolling out ways to enhance care.

Byrnes: We have a program called “Wise and Well-Plus.” We look at every resident compared to our five dimensions of wellness — holistic, physical, intellectual, social and emotional — and we make sure that every rolling seven days, every resident has the opportunity to complete a dimension of wellness, then how it’s realized in the form of care. If we are looking at physical wellness, it’s a reduction in falls. If we’re looking at emotional wellness, it’s a reduction in dementia cases, potentially. So that’s been something that we’ve done that really combines our programming and our care together.

George: When it comes to memory care, that’s a challenge. We know one of the large attributes of a memory care resident or those that are suffering from dementia or Alzheimer’s is they like to wander. The ability to keep them isolated or quarantined is a challenge. What we need to do is to make sure that we have enough staffing, and that those individuals are able to facilitate programming, interacting with those residents and validating their emotions so that they are maintaining the distance that they need from other residents, and from ourselves.

One of the main things that we like to do is facilitate activities that maintain the health and wellness of our memory care residents as well as our assisted living residents, such as hand hygiene activities. Before they enter the communal dining area, which of course everyone is six feet apart, but there are some residents, they safely cannot dine on their own in their rooms, specifically in memory care. We make sure that we’re doing hand hygiene with them, that they’re six feet apart unless they’re if they’re sitting at a table with a resident that they share a room with, and that we’re maintaining that distance, but also validating and programming with them to make sure that they are still feeling their own sense of security, that they still have their own individuality and that their day is going as seamless as it can be to maintain their wellbeing as much as we can.

Amber Rogotzke, President/Principal, Health Dimensions Group

Health Dimensions Group (HDG) provides management and oversight for Terova Senior Living, a senior housing community in Mequon, Wisconsin acquired by Marcus Investments in October.

Terova Senior Living assumed operations of a community that had previously operated with skilled nursing and senior living services. At the end of 2019, the location transitioned away from skilled nursing services, yet continued to operate its independent living, assisted living, and memory care programs. Terova’s goal was to implement the operational practices you’d typically see in a senior living environment and improve the efficiency and service provided to the residents.

Terova and HDG leadership partnered to develop a strategic plan which included aligning with new vendor partners, staffing realignment, culture transformation, staff retraining, expanded sales and marketing strategies, and implementing a more purposeful flow of day-to-day operations. Covid-19 challenged Terova and HDG to get creative with how we typically implement an operational transition.

The pandemic has required more integrated digital platforms for sales and marketing, employee onboarding, and leading transformational culture change when on-site visits were prohibited.

Although it created challenges, it also opened new opportunities for our workforce and our families to be even more connected with our team members and residents in a virtual way—an existing mode of communication that was prominent but not viewed as a necessity before Covid-19.

The focus is to implement best practices for screening, PPE use, social distancing, education, and testing as per state and federal recommendations. Like many others in the senior care field, we still work to encourage prospects to join our community, which involves ensuring them that we have good practices in place and that they won’t be isolated or lonely when they join our community. We make Terova a great place to live by promoting the social environment, quality food and culinary experience, personal care, life enrichment, and events that occur within our walls.

We are moving forward implementing best practices in senior living care and services, refining our operations to focus on resident experience, employee engagement, and strong financial performance. While COVID-19 has shown us the resilience of our leadership team and our strong systems around infection control, we are looking forward to a vaccine for our residents and staff as well as the day when Covid-19 is no longer the primary focus of our services.

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