Two years ago, every senior living dining program in the country pivoted in accordance with the pandemic — and in 2022 many of the same challenges still apply.
Staffing pressures and some lingering restrictions on in-person dining have made keeping residents nourished and happy more challenging than arguably ever before. At the same time, many operators have reported residents are burned out after more than two years of alternating between eating in their rooms or in scaled-down communal settings.
In response, some forward-thinking operators including Watermark Retirement Communities, Aegis Living and life plan community Wake Robin have increasingly turned their focus to keeping their dining programs flexible enough to weather any sudden changes, while also promoting wellness to keep residents engaged.
The changes have included new approaches to how residents pay for meals, which at Watermark is transforming dining from a cost center to a profit center. However, supply chain disruptions and inflation are pressuring providers, even as consumer expectations are rising. And operators and residents are still coping with the effects of Covid-19.
“The psychosocial impacts of Covid were significant,” Aegis Living Enterprise Culinary Service Director Ashleigh Pedersen said during a recent Senior Housing News webinar. “Getting residents comfortable with coming back to the dining room — with talking to their fellow residents, with engaging with family members and guests that are in the community — has been critical.”
Wellness and engagement
Wellness has become a larger focus of senior living operators in recent years, particularly in their dining programs. While the pandemic has made keeping residents well more important, it has also made doing so harder.
As operators shifted their culinary programs in response to Covid, they also changed the way they fostered wellness among residents. For instance, although comfort food remains “king” among menu choices for residents at Shelburne, Vermont-based Wake Robin, the community’s leaders have also sought to educate residents on the benefits of healthier eating.
Wake Robin is not lacking in healthful choices for residents, and 40% of the food on the community’s menu is locally sourced and organic, according to Dining Director Kate Hays. The community has also worked to pare down its animal-sourced protein in favor of plant-based foods, such as colorful vegetables or meat alternatives such as beans, seitan, tofu or tempeh.
But the community still had to work to educate residents on why they should eat more of those foods. During the earlier days of the pandemic, the community hosted a series of culinary medicine classes, where residents and prospects alike could learn more about the holistic effects of eating certain foods together, such as avocados and tomatoes or green tea and lemon.
The community now holds those classes live, and the effects on resident engagement have been noticeable.
“If you educate people, they’re more engaged, and they’re more apt to eat it when they come through the dining room,” Hays said.
Aegis takes a similar approach in its 34 communities across the country. The company’s culinary teams work healthier food choices into existing menu items, such as by adding parsnips to mashed potatoes, to make them more approachable. Then, they educate residents on the benefits of picking a healthier menu item.
“That education and easing the expectations around trying something new has been critical,” Pedersen said.
Similarly, Wake Robin creates healthier alternative versions of classic foods, such as black bean brownies.
Flexibility in food
One of the biggest challenges of pandemic is the uncertainty of future case counts and local restrictions. At the same time, it is a widely held belief in the senior living industry that the incoming baby boomer demographic will bring with it a desire for more variety and choice in the food that they eat.
While Watermark, Aegis and Wake Robin are back or almost back to full in-person dining, operators have coped with past challenges by designing culinary programs with the ability to meet many different needs, or provide a myriad of options.
For example, Aegis Living has worked to “re-engage” the dining spaces at the Bellevue, Washington-based operators’ communities, according to Pedersen.
For example, the company is dividing private dining rooms into smaller, more intimate spaces, or hosting culinary events in shared spaces, such as serving tea or continental breakfast in a community’s sports lounge when residents aren’t using it.
“It’s bringing life back to those spaces, getting residents comfortable with the notion that they can leave the room and they can come join others and engage with other residents,” she said.
In a similar vein, Wake Robin is helping residents turn their own homes into shared private dining venues by delivering ready-to-cook meal kits or catering-style meal boxes to be enjoyed with friends and family.
To maintain flexibility in its culinary program, leaders with Wake Robin stay in close contact with the community’s residents. That way, they can anticipate and plan for changes based on resident preferences instead of reacting to them.
“The special sauce at Wake Robin is that staff and resident relationship,” said Hays.
Aegis’ culinary teams have also focused on creating menus that are flexible enough to nourish residents, even in the event of a disruption to supply chains. For example, the company has built out its relationships with local food purveyors.
“Leveraging those local agreements, and building relationships within the communities is critical,” Pedersen said.
Pedersen acknowledged Aegis is currently spending more on food than in the past, but she added that the company is doing so intentionally.
“We realize that it leads to other health outcomes, regardless of what that bottom line impact is,” she said. “We know it will pay for itself in the future in how our residents feel, their longevity and how they can engage with other offerings that we have within the community.”
Another current example of culinary flexibility in action is found in Tucson, Arizona-based Watermark’s culinary program, which gives residents of its newly developed Elan and Elite collections of luxury-focused senior living communities monthly spend-down cards to put toward any service they desire, from massages and personal training to fine wine and lobster dinners.
The “flex-spending” program has helped Watermark begin to turn those communities’ culinary programs into a revenue center instead of a cost center, and it has also helped meet residents’ fast-changing needs, according to Chief Investment Officer Bryan Schachter.
“We’re really running restaurants versus a dining program where we’re trying to be as efficient as possible,” Schachter said during the recent SHN webinar. “We’re really confident that it’s the right direction for the industry — resident satisfaction is high and it’s becoming a revenue source.”
Watermark manages about 60 communities across the country.
The operator’s biggest conclusion since first implementing the program last year is that it had no negative effect on operating margin. In fact, the community’s The Hacienda at the Canyon community in Tucson, Arizona — which Schachter said is farthest along with regard to implementing flex spending — currently has 40% operating margins despite being just 60% occupied.
And Schachter sees the potential for even greater margins down the road as the Covid pandemic wanes.
“We’re really not bothered by high food costs, so long as we’re charging an appropriate price for it and making a margin on it,” he added.
Looking ahead, Schachter believes the preferences of the baby boomers will push operators to adopt more flexible or country club-style culinary offerings.
“We don’t think that dining in the future is going to work if we’re still doing the things that we were doing as an industry 20 years ago,” he said.
The biggest current barrier to executing on any wellness-focused culinary strategy amid the pandemic is staffing.
For Wake Robin, “staffing has been a real challenge,” according to Hays.
Recruiting back-of-house culinary workers has not been a big challenge for the life plan community, but hiring full-time servers has been more difficult.
In response to those pressures, Wake Robin’s leaders made meal service less formal in the community’s largest dining room. The community has also adopted a meal style akin to dim sum in its higher-acuity settings, where residents can pick and choose menu items from carts.
“It’s a conversation starter and it lets me start dinner with fewer staff,” Hays said. “It also lets us still offer full-service in our skilled nursing and our memory care neighborhoods.”
In response to more general challenges finding workers, Aegis Living is piloting its own in-house staffing agency. Although culinary team members are not included in the pilot, Pedersen said the company has embraced an all-hands-on-deck approach to culinary services.
“Our life enrichment team understands that they can come in and help within the dining room, as well to drive some of that service,” Pedersen said. “Even if they’re not serving or presenting plates in front of our residents, being there to have a conversation … has been essential to maintaining that standard.”