Bickford, Merrill Gardens, New Perspective Leaders Envision ‘Transformational Change’ for Senior Living Industry

Leaders of Bickford Senior Living, Merrill Gardens and New Perspective agree: the senior living industry is in need of “transformational change” in the years to come.

Looking across the senior living industry today, they see many opportunities for change, from solving workforce challenges to finding new and better ways to care for residents amid the challenges of the pandemic. And it will take new relationships and lots of creative thinking to get there.

“It’s an overhaul of what we do and how we go about doing it,” Bickford Senior Living President Joe Eby said Tuesday during a panel discussion at the 2022 Senior Living Executive Conference, which Argentum held in Minneapolis this year. LCS President and CEO Joel Nelson moderated the discussion.


Merrill Gardens President Tana Gall agreed it will take a transformational shift in senior living to usher the industry into the future. But she also thinks it will occur in many small changes, not one sudden tectonic shift. And given the demographic tailwinds the industry expects to feel in the years ahead, the prospect of change isn’t so much scary as it is exciting.

“I have just never been more optimistic about this industry in my life,” Gall said during the panel.

Underscoring the need for evolution in the future is the fact that residents themselves are changing. The arrival of the baby boomers has brought a slew of new opportunities and challenges to the industry; and at the same time, the average age of some residents is climbing, with assisted living trending toward hitting an average of 95 years in the next decade.


Leaving ‘no stone unturned’ in staffing

While staffing has long been an industry problem, it has intensified in the last year. Gall said that, while Seattle-based Merrill Gardens didn’t see a wave of turnover at the outset of the pandemic, the company is “feeling it now.”

“In the last six months to a year, we’ve seen the great resignation, we’ve seen people just flat out burning out from what we do,” Gall said. “You get a little worried about that.”

Part of the problem is that the industry has over the years essentially traded workers from one community to another, she said. Making matters worse, although the industry is swapping workers, it is also competing for them against companies with national scale like Target and Chick-Fil-A — and their $20 an hour wage rates. And in the quest to attract and retain workers, she believes the industry should “leave no stone unturned.”

But Gall remains positive about the future, despite those challenges. Underscoring that optimism is the fact that Merrill Gardens has experimented with ways to keep workers engaged, and landed on several successful concepts.

For example, the company created a new position called a resident experience partner — or REP, for shorthand — for its middle-market Truewood by Merrill concept. The position allows staff to try their hand at many different jobs, from washing dishes to maintenance requests, similar to a universal worker.

The position has been so successful since the concept’s launch that Merrill Gardens has expanded it to all of its 72 communities in 20 states. The position’s appeal for workers is that it doesn’t just give them many tasks, it gives them a career path, according to Gall.

“They’re getting exposed to our industry, to so many different things in the organization, that I think a REP will take my place someday,” she added.

Pierce Harman for HMP Global

Bickford is taking a similar focus on changing how staff work in its 62 communities. Instead of requiring more traditional eight-, 10- or 12-hour shifts, the company has started to offer shorter, more flexible shifts in its communities of four to six hours at a time.

“It’s trying to be more flexible, more understanding and more open, “ he said.

The company also onboards workers with a virtual “culture class,” educating them on the company, its purpose and values. While Eby noted that it’s still not clear what benefits this approach might yield for the company, he said it was an attempt to shake up old hiring and training practices.

“We’re trying to think outside the box to hire him, train them, show their purpose, help connect with the role in which they play in that purpose,” he added.

New Perspective is similarly revisiting its onboarding process, according to President Chris Hyatt. Because most of the Minnetonka, Minnesota-based operator’s workers leave in their first 100 days, the company is “throwing everything and the kitchen sink” at keeping workers engaged during that period.

“We’re looking at everything under the hood,” Hyatt said.

One way the company is looking to overhaul staffing is by rewarding employees who are more productive.

“I know for certain that caregivers that can do twice the workload that some others can, and I want to pay them for it,” Hyatt said.

‘The resident is different’

While staffing represents the industry’s most pressing issue at this point in 2022, it is by far the only area where operators are trying out new ideas.

Another issue relates to the model of senior living care delivery. While the industry has subsisted for years on providing the same model of care, “the resident is different, the families are different, their expectations are different — especially post-pandemic,” Eby said.

One of the larger trends leaders at the Olathe, Kansas-based company have taken note of is that more prospective residents are opting to age at home — which is partly why the company launched a home care service line last year.

In the old senior living care model, residents would typically only look to move into a senior living community after suffering a major life event that impacts their quality of life. But through its home-based services and other coordinated offerings, the company is aiming to reach them sooner in their journey.

“How can we go upstream, and try to create a different care model that’s maybe funded differently, that then improves their quality of life so that you don’t have the negative outcomes?” Eby said.

As the industry shifts toward a more value-based model, Hyatt said he sees “a lot of people trying a lot of different things,” from hospice to pharmacy services, and applauds them in their efforts. But that doesn’t mean senior living operators must take on the burden of performing these services in-house, either.

For example, while New Perspective is working hard to “dial in” its core services of independent living, assisted living and memory care, it is also working with partners to fulfill clinical needs in its 30 communities, such as physical or speech therapy.

“Are we health care, are we hospitality? If you didn’t figure it out the last two years, we’ve got a lot of health care stuff going on,” Hyatt said. “We don’t necessarily have to be a majority owner in it, we just want to be part of making sure that residents have the best experience while they’re living in one of our communities.”

Hyatt’s beliefs were underscored by the fact that incoming residents might actually be older in the future than they are today. LCS President and CEO Joel Nelson, who moderated the panel, said he believes the average age of a new assisted living resident could climb as high as 95 years in the next decade.

Having newcomers arrive in senior living at such an advanced age would likely be a scary prospect for senior living sales teams, who would have to cope with the fact that those residents likely have a far shorter length of stay. And such residents bring new challenges in the form of comorbidities that will require more assistance from staff.

And looking ahead, Hyatt said “we’ll have to figure all of that out.”

“It costs a lot of money to put all that in place, which is why we need a partner in some sort of cost- or risk-sharing pool, that helps care for that very high-acuity and frail population,” he said.

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