Terri Cunliffe is President and CEO of Covenant Living Communities & Services, a non-profit operator of senior living communities dedicated to helping each resident pursue wellness of mind, body and spirit in personalized ways. Terri joined Covenant in 1988 and quickly evolved into a leader in the operations side of the business. She was appointed COO in 2010 and later CEO in 2015.
Through the Changemakers series, Terri discusses the pathway to a bright and lucrative future in senior living. She explains how she led the organization’s growth through scale and adding new business lines, with a goal to provide “housing or services to any senior adult who wants to live in Christian housing.” She also talks about her role in Covenant’s digital reinvention of marketing and communications and the adoption of a centralized finance function.
Senior Housing News: You’ve led a lot of change at Covenant. If you were to zero in on one or two of the changes that you are most proud of, what would you single out?
Terri Cunliffe: I don’t think I can be a changemaker without a strong team around me. It takes a full team to generate change. I also think that change needs to be aligned to strategy, so the clearer your strategy, the easier it is for me and the team to initiate change within our organization — or more broadly than that, if necessary.
There are three areas I am most proud of. First, LifeConnect. LifeConnect is our whole-person wellness model. It was developed and implemented in 2002.
It was cutting-edge at that moment in time because we were very early [in terms of] calling out the dimensions of wellness. The focus was to get to know our residents through a formal interview process. The purpose of it was to engage them in their new community, by integrating their preferences, interests and goals, and then using that information to keep them engaged throughout their entire life in our community, regardless of their level of living.
It’s clear that people’s preferences really don’t change over time, though how they live them out changes over time, based on abilities, or capabilities.
LifeConnect was important to me in that I wanted to see residents doing what they want to be doing, and not just whatever was made available to them through the first people they met when they moved into our communities. That was a program that I developed and rolled out, interestingly enough, with one of our residents, who was over 70. He helped me implement and develop the whole program by giving me the senior resident perspective.
LifeConnect had a lot of dimensions to it. It also had software that we built to collect the data. It included an acuity-based pricing tool for assisted living, based on the resident services that they required. It also included an acuity-based staffing tool.
One of the downsides, honestly, was that the initial interview was about a two-hour conversation spent getting to know the resident. That felt overwhelming to some of our team members, despite the fact that residents would be living with us for an average of 8 to 10 years, sometimes longer.
It’s still alive and well and I’m really proud of that and the impact that it has made in our organization all these years.
The second change that comes to mind is our rebrand. A couple of years ago, we rebranded our organization from Covenant Retirement Communities, which had been in place for many, many years, to Covenant Living Communities and Services.
The word retirement really didn’t reflect who we are as an organization. Our future residents and adult children didn’t want to live in a community with the word retirement in it, because it’s really clear that when they move in, they are really living very active lives and the image of retirement wasn’t one that they liked having in the name.
Our logo also changed from the cross to our current logo. Is still reflective of our faith-based and Christian heritage. It symbolizes new life, a safe space, and community. The color palette was chosen to communicate vitality and health. It’s just a softer descriptor of our Christian heritage, as opposed to our prior logo.
That was a really big change. It was a two-year process. It required interviews with residents, resident family members, and representatives from the Covenant Church, because of our affiliation. Then we did a lot of focus groups throughout the country, just to get their perspective.
As part of our rebranding, on one day, we handed out 15,000 branded uniforms to our employees around the country. That takes a lot of planning, and it’s transformational to be able to see your entire organization go from looking one way to a completely different look and name and image in such a short period of time — a 24-hour period.
The third area that has been a difference-maker for Covenant Living is “Inspired to Serve,” which we launched in 2015.
Inspired to Serve is our customer service platform. Like many others, we’ve had many attempts at creating a customer service platform, and we’ve failed several times over the years. We either didn’t keep it up or it wasn’t creative enough.
The interesting thing with Inspired to Serve is that we developed service standards, then we developed the behaviors for those service standards and our common purpose. All of that was built from the ground up. We started with our employees in the field, brought them together, they started to define the behaviors, the service standards, input into our common purpose and it went up through the organization, instead of the vice presidents and senior leaders creating all of that and pushing it down into the organization.
In addition to that, we’ve been able to identify [recipients for] Inspiration awards, where we recognize employees at a black-tie event, about every 18 months, for those who show exemplary service, and they are nominated by their peers.
It gives people something to strive for, then it celebrates those employees that really demonstrate those service standards.
Also then as part of that, we were able to deploy what we call Covenant Rewards. That really is a recognition program that creates dream value for our employees. They can save those points up. Then they go into a portal and they can purchase big and small items — diamond earrings, appliances, electronics, golf clubs — all kinds of things.
I think making the employee the main event is really critical. That is a third area that I’m really excited about.
Can you describe a time you tried to make a change that didn’t go well and lessons you learned?
Oh boy. Yes.
In about 2012 or ‘13, we changed our dining program to a choice dining program, which allowed residents flexibility in the number of meals that they choose to have in a month. Instead of a flat 30 meals in a month, we gave them the option of a 15-meal package a month, a 20-meal, and a 30-meal. Well, that concept was great. It was a terrible implementation. When I reflect back on what didn’t we do right, I think it was around three key things.
We didn’t have a well-defined project plan. We just didn’t plan the transition and the program model out as well as we needed to. I did not have enough input from the field, residents and employees and leaders. I needed to have much more input in terms of the model, hearing their questions and hearing their concerns on the front end.
And we didn’t have a good communication plan. The consistency of the communication back out to our communities was not strong enough or consistent enough. What happened was the clarity of the program, the acceptance of the program by residents was not very great.
What I learned is that a well-crafted change will never be perfect, but change shouldn’t create chaos, and this one did. We lived past it, but it was a brutal year getting through it. Those are some of my lessons.
To be a changemaker, you’ve got to be willing to take risks. Do you agree with that? How would you describe your own risk tolerance?
When I think of risk, I think the longer I’m in the role, the more risk I’m willing to take, because I understand the implications of that risk.
If we have a zero risk tolerance, we will never ever do anything, because everything we do has some aspect of risk and in some areas, we’ll take more risk than others. Risk goes along with confidence. From my experience, our board’s appetite for risk is dependent on the trust that they have in leadership and the leadership team in our organization. I am more of a risk-taker today than I was in my early years of leadership.
The stronger the team around me, the more comfortable I am with risk, because I know that if we see a risk developing, we can quickly pivot to either modify our approach to reduce the risk or we can shut it down, if it is that big of a concern. Now, we generally have the ability to conduct a risk analysis before we jump into something brand spanking new, but there have been times that we haven’t.
You’ve previously talked about an effort, started in 2016, to gain $23 million within five years through more efficient operations, and reinvest that into Covenant’s people, systems and physical plants. Did you accomplish that?
We are on that journey. I was just talking with one of our people yesterday in a one-on-one meeting about looking at the impact of COVID. Had we not initiated our optimization and focused on operational efficiencies, I don’t believe we would have been in a position to survive COVID as well as we did.
We started out in a really strong financial position, the strongest we’ve ever been with the highest number of days’ cash on hand. I believe that has come from three years of operational efficiencies. We’re in the process right now of updating and we lost track of keeping track, so to speak, in this last year, but I think at the end of the day, we’ll exceed $23 million of optimization, with the impact of COVID on the top of that.
Any examples you can share of ways you have been able to drive toward that goal of $23 million?
I’ll give you two examples that are really key.
I mentioned it earlier, the in-house marketing, communications, video production, creative … We spent probably $100,000 in consulting to create the brand. Once we had the name and once we had the new logo, our in-house creative did all the rest of the work. All of the brand and video communication was in-house.
That in of itself probably saved about $2 million. Now, we spent it on uniforms and other things, but to be able to do the rebranding process in-house saved the organization considerable money.
The second area: centralizing finance over the last three years. It has allowed us to process our financial information more quickly. We can focus on having specialists in our central office, financial specialists, versus what I call community-based financial generalists. We might have the same number of people, but we’re getting more information and better information and faster processing because of that centralized finance. Then the other area that we centralized is our third-party billing services.
As a result of that, our management and our compliance has improved. We’ve reduced our write-offs and quite honestly, one person can bill for several communities versus one person billing third-party services in each community. We have fewer people, better outcomes, and improved compliance.
Can you describe your relationship with technology and the role that tech played in a lot of these changes that you’ve been behind?
One of the big areas of technology for us has been in the area of digital strategies. A few years ago, we brought in house all of our digital strategies for marketing. Then we built out a communications team, and all of our in-house creative and our whole brand basically was created through this in-house team.
That was a risk because I could see the benefit, but I couldn’t see the full picture. Because it was involving so many people’s lives, I didn’t want to make a mistake, but bringing on digital strategies three and a half years ago, and being in-house in our digital marketing when COVID hit, we were able to launch a digital recruitment effort [essentially] overnight, where so many other organizations were just trying to figure out how to get digital marketing in place.
We enhanced it for the resident side, but at that time we implemented digital recruitment for the employee side. In fact, we ended up hiring over 450 employees in an eight-week period because of our ability to launch into digital recruitment so quickly. That was in April and May, after COVID hit in March. From that perspective, we were really well-positioned to withstand at least the early days of COVID and make sure that we still had access to employees, even though our access to residents was a little slow at the time.
On the back end of COVID, we also now have identified the need for telehealth, and we are in the early stages of identifying a telehealth provider and implementing telehealth starting in our health care areas. We want to make sure that our residents have access to physician services and we know that telehealth has really taken off. If nothing else, maybe our residents’ quality of life will improve if they don’t have to go to a doctor’s office for every single consultation and it can be done through telehealth.
I’d say the third area that we’re capitalizing on from … residents being more technology-savvy is looking at a new resident platform, allowing residents to interact through technology and through an app on their phone or on their iPad, with community dining, programming, and our online resident directory, because the residents who never thought they could use technology are now using technology. Let’s capitalize on that and keep it going.
I think the last area of technology is that the integration of our existing systems is key to our operational efficiencies. That is really focused on, in the simplest of terms, a single point of entry that populates multiple applications so that we can be more efficient in our day-to-day operations.
Do you think that senior living is changing fast enough these days?
Oh, boy. No, I don’t think it has been, but I believe it will need to, in order to survive.
COVID has changed everything — our business, the consumer, the employee and where services are provided. We’ve just expanded that, we’ve added to our portfolio of services, where and how they’re provided to residents. Now the residents are going to expect more from us than they did even before COVID. I think we’ve got a couple of challenges that we’ve got to get through, however, such as access to funding for innovation and change.
There’s a cost to change, but I think our bigger challenge is, quite honestly, people generally don’t like change — not our residents and not our employees. How do we execute change efficiently, while helping our people accept that change and see the benefit of that change? As leaders, we’ve got to be talking about the potential changes, every day, all day, to everybody we can [laughs].
I always say as a common phrase in our organization: “Buckle your seatbelt.”
As you think about strategic planning, say 5 or 10 years down the road, is there anything you’ve got in mind in terms of what’s next on the change-making agenda?
Yes. We still are open to acquisitions and affiliations and our growth and expansion is still a big area of focus. We are launching into a very expansive master plan and health care repositioning organization-wide, and the timing is fantastic.
I think post-COVID, our consumer will be looking for a different product in health care, and we are looking at our organization holistically, from continuing to invest and looking at how the health care repositioning fits into that, and we will continue to strengthen the financial portfolio of the organization.