Jill Vitale-Aussem wrote the book on changing senior living — literally. The author of “Disrupting the Status Quo of Senior Living,” Vitale-Aussem in 2020 became president and CEO of Christian Living Communities, a Colorado-based not-for-profit serving more than 3,000 older adults and their families through 22 owned and managed communities.
Taking the CEO role was a homecoming for Vitale-Aussem, who earlier in her career led a CLC community. She also has led The Eden Alternative, in which role she drove culture change across many senior housing and care organizations in the United States and abroad.
Through the Changemakers series, Vitale-Aussem discusses the steps she is taking to lead CLC to a bright future in senior living. The organization is one of the founding members of The Perennial Consortium, creating and owning Medicare Advantage plans tailor-made for senior living. CLC also is embarking on a journey of diversity, equity and inclusion, and envisioning how to better serve the middle market. All these efforts are underpinned by Vitale-Aussem’s core philosophy, which is that senior living residents are not customers to be served but citizens who can and should actively engage in creating a vibrant community.
Senior Housing News: Describe a change or changes that you’ve led throughout your career in senior living, that you’re most proud of.
Jill Vitale-Aussem: When I started with CLC back in 2009, it was in the early stages of a huge campus redevelopment project. The community had been there for more than 30 years, and it was time to breathe life into the birthplace of the organization.
The goal of this redevelopment was to bring the community together and add life plan apartment homes to the campus. This project brought together people of different socioeconomic backgrounds to create a sense of oneness and community.
We also developed a resident leadership group to curate a collective vision for the community. We wanted people with different health conditions and socioeconomic backgrounds to feel at home, and working together enabled us to accomplish that. The result of these collaborative efforts saw CLC’s new life plan building reach 99% occupancy in just 12 months.
A community is never perfect, but we really eliminated a lot of the cliques, ostracisms and divisions that often exist without a vested interest in the success of the community as a whole. In this case, the residents even founded a college.
Additionally, it had great financial and occupancy outcomes. Our staff complaints also dropped because we empowered team members to solve more problems on their own.
CLC is still a culture of empowerment, and that’s what I’m most proud of. It inspired me to write a book because I learned so much along the way. I had to rethink what I was taught over the last twenty years of my work, and it was a once-in-a-lifetime opportunity.
Did you say the residents started a college?
Yes. Clermont College of Creative Life was a result of giving residents a strong voice. Our community life director took existing learning and personal development activities a step further by molding them into a curriculum that leads to a graduate certificate of completion. Residents, team members, family members and volunteers teach classes, take classes and play a significant role in the program architecture. We even had students from the University of Denver attend Clermont classes and vice versa.
Can you talk about your education and how you first entered senior living?
My first job was as a dietary position in a nursing home. It wasn’t a great experience, but it gave me exposure to the field. Between undergrad and grad school, I did fundraising for a non-profit senior living community in western New York. I went to grad school for hospitality at Cornell. I wanted to get my MBA, but I had always been more focused on service.
The first three quarters of my career was focused on hospitality, customer service and customer experience. Eventually, this shifted with the realization that, when we get old, [this customer service approach means] we don’t have anything to give back anymore — we are simply recipients of services.
Through this [different] approach at Clermont Park, we started studying things like ageism and the key to living a long and healthy life. We need to have purpose in our lives. We need to create a community of continued learning and growth. It’s hard when you have to unlearn so much, but that’s what has driven me to think about this field differently.
That’s really interesting because I think that we still hear a lot of senior living providers actively trying to hire from the hospitality field and create that hotel model. Do you think that’s too prevalent in the industry?
I think we’re making some progress. This approach is not meant to diminish the roles of customer service and hospitality, but it is intended to stop framing older people in our communities as customers. Customers are passive and expect leadership to fix everything. Citizens are active and understand they are part of the solution.
I’m seeing and hearing a lot more of that now, and it gives me hope. That’s not to say someone from the hospitality field can’t be a great leader, but there’s a big difference between being a hotel general manager and being a community builder, which is what I think we need more of in this field.
Did you go from the Clermont community to Eden Alternative?
After over six years at Clermont Park (owned by CLC), I moved to the CLC support office and took over operations for the managed communities. There, we started Cappella Living Solutions, which is third-party management, and I oversaw operations for our managed communities within CLC. After that, I transitioned to the Eden Alternative.
It’s interesting that you made a shift to the Cappella arm because — correct me if I’m wrong — but CLC is a nonprofit organization and Cappella is a for-profit management company.
Yes, Cappella is a for-profit division of our nonprofit.
Can you talk a little bit about the decision to start Cappella, and how it benefits CLC to have both sides of the house?
We started Cappella because we wanted to grow and impact more people. Our culture is amazing and we believe that more people should experience that. We saw Cappella as an opportunity to grow without building new buildings, strengthening the organization financially while we focus on our mission.
We also started consulting work through that. With 22 owned and managed communities, we can study what has worked and what hasn’t. It’s a chance to focus on what we should be doing in the future and who it is we want to work with.
Then you made the move to Eden Alternative. What appealed to you about that opportunity, and what were some of the highlights?
I’ve been working with the Eden Alternative and implementing the Eden Alternative framework in CLC’s communities for so long. I was on the board there and I was an educator and when the CEO position opened up, I was asked to consider the opportunity and just couldn’t turn it down.
The opportunity to make an impact on the global level and interact with people from all over the world is just something you can’t say no to.
The only downside was the realization that so many countries needed the Eden Alternative. Many have gone down the path of institutionalizing frail elders and fueling the fire of ageism. It’s a catch-22 because our goal is to eliminate the problems that make our organization necessary, but we have made a lot of progress thus far.
Now you’re back at Christian Living Communities. Can you talk about making the switch and why the opportunity appealed to you?
I loved my time at the Eden Alternative, but Christian Living Communities has always had my heart. My parents live in one of the communities and I’ve always stayed connected with the organization, even when I was at the Eden Alternative. CLC has always been my home, and it’s great to be able to come back.
CLC has been on the forefront of change over the years. Can you talk about the changes being prioritized since you’ve rejoined the organization, or that were already underway?
The big thing I want to carry across the finish line is the Perennial Consortium, which launched January 1st. The pandemic put a damper on the process, but I’m very excited about the future of that plan, and the impact that it can make in our communities.
Next, we have a campus redevelopment in the works here in Denver. We’re taking a little pause to evaluate what we learned from this pandemic and adapt our plans accordingly.
We are also embarking on a diversity, equity and inclusion journey, and I’m excited about where it will lead us.
Race, gender, religion and sexual orientation are often unaddressed in senior living. I believe we need to understand what diversity, equity and inclusion look like for residents as well. You have all of the identifiers above, but you also have different cognitive and physical abilities that deserve an equal amount of consideration. That is a very complex challenge, but it is a major area of focus for us.
I would like to dig into each of those a little bit. Given the challenges posed by COVID-19, what did you learn throughout the launch process of the Consortium?
The pandemic limited our access to people who are qualified and licensed to talk to residents about joining the plan. We haven’t been able to have them on-site, and that is problematic because face-to-face interactions build trust. We are excited for that to change now that people are getting vaccinated, and we can start to have one-on-one meetings that make a greater impact.
I think it’s interesting that you’re pausing your campus redevelopment to adapt your plans. Can you speak to some of the ways that COVID-19 has changed how you’re thinking about community design and development?
If you’re rebuilding a nursing home right now, a household model of care is the ideal solution for both infection control and quality of life. I think people have also recognized the importance of accessibility to the outdoors. As a result of the pandemic, many residents ended up spending a lot of time indoors, alone. Finding ways to incorporate easy access to the outdoors is critical.
We’re also rethinking what it means to be a middle-market community, and what is important to people in a middle-market product?
When new buildings are envisioned, there is a tendency to design extravagant compounds with seven dining venues and loaded amenities. Before you know it, you can’t charge middle-market rates anymore. We’ve been thinking about that, what are we doing for amenities for the apartment home. We reached out; we’ve asked some guests to come and join our group.
Bill Thomas and Bob Kramer joined our group and we had a meeting with Dan Lindh, from Presbyterian Homes … It seems like every conversation we have results in more questions than answers, but I know it will lead us to the right solution.
Based on your experience with Eden Alternative and working with Bill Thomas, do you have any words of advice for people who are starting to consider the small house model?
One of the big things is to understand that it’s not just building a new building. You have to make household models of care work.
It’s changing the way everybody works and creating interdependent household teams that are there supporting the residents. Nurses, nursing assistants and administrators have to unlearn what they learned about the institutional framework of care and empower the direct care of partners in a way that hasn’t been done before.
Then you have to rethink the way people live in these households. The idea behind these models is that the residents play an active role in the household. That’s a big switch from what we’re used to in nursing homes and assisted living facilities, but the payoff is tremendous.
How are you approaching the diversity, equity, and inclusion journey?
We are working with a consultant that knows the organization well and has worked with us for years. We thought it was really important to work with somebody who understands our culture to create an organizational profile that informs our plan moving forward.
Can you describe a difficult experience trying to create change, and what you learned through that experience?
Before I came to Christian Living Communities, I was the administrator of a very large nursing home. I went to an Eden Alternative training and when I came back, I started driving change and educating people, and having training for the team members.
It was going well. I was very proud of what we were accomplishing.
Then I was recruited to come work for Christian Living Communities. I left there feeling good. Then everything started falling apart with the Eden Alternative journey. I would hear from team members … everything’s going back to the way it was.
There was a moment where I was like, “Wow, I must have been a really good leader, because now I’ve gone and everything fell apart.”
What I realized is, it was such a huge leadership failure because I didn’t get the board involved enough, so that they would make sure to hire the right person to keep the focus on that work. Nobody else in the organization really owned it but me. It was all the “Jill show” driving this change. That is a huge failure because if you really want to drive change, you need to put the structures in place so that it’s sustainable.
There’s nothing worse than bringing this new way of being to the residents and team members then taking it away. You can’t lead this type of change if you don’t empower everyone in the organization to own it as well. If you take that approach, you’re setting the community up for failure, and that is the mistake I made.
Making changes is all about taking risks. How high is your tolerance for risk?
I’m open to taking risks and trying new things, but when it comes to things that have a big financial impact, I’m much more measured. What I’ve learned over time is to minimize the risk of leadership decisions. Get more perspectives and look at all sides of a decision.
A lot of times I’ll introduce a pre-mortem exercise in the planning process to break down barriers and surface new ideas.
Can you talk about technologies that you’re excited about, or that you’re thinking of implementing at CLC in the coming years?
One of the really exciting things we’ve learned from this pandemic is that older people can learn how to use technology. I think it plays a really important role, but I’m not a fan of technology for the sake of technology. I think technology should be there to support residents in autonomy, finding purpose, connecting with each other and creating efficiencies.
I think technology can play a huge role in creating more efficiencies that make senior living more affordable for people.
I’m excited, we are doing a pilot program with It’s Never Too Late at one of our managed communities, and it’s all about identifying residents’ passions and using technology to match people together.
When it comes to using tech to support a middle-market model, I’ve started to hear more people talk about matching residents by identifying their interests.
In this way, resident-led “programming” becomes a little more organic, and that’s another way of freeing up staff and reducing operating costs. Is that something that you think is fair to say?
Absolutely. I’m interested in exploring models where residents can volunteer in their communities to keep staffing costs low while providing opportunities for meaningful purpose. Using technology to reduce staffing is going to be a really important thing in the future. Can we also use technology to support individuals living with dementia, to keep them safe in communities rather than behind locked doors? That’s another area I think we can make a lot of progress.
