Presbyterian Senior Living CEO: We’re Piloting Home Care, Expanding IL Communities for Future Residents

Dan Davis took the reins as Presbyterian Senior Living CEO in September, but he’s already working on some big initiatives to improve workforce challenges and grow the organization.

The Dillsburg, Pennsylvania-based provider, also known as PSL, operates in four states with 11 life plan communities and two others currently under development, including a 172-apartment senior living rental community near Harrisburg, Pennsylvania.

As he looks to the future, Davis said PSL is focused on expanding within its current operational footprint. He noted that the company has land at various properties ripe for future development, and is planning to expand its independent living communities.

The organization is also preparing to launch a home care pilot in early 2023, with an eye toward expanding the model throughout the PSL footprint in the future.

“While we do believe there’s going to be an ongoing market for life plan communities in the future because of the expansion of numbers of older adults, there is that push for being served in your home,” Davis said during the Senior Housing News Transform podcast. “And as a mission provider, we want to be able to reach those people In every setting whatever they call home and be able to be of service to them.”

Highlights from his podcast appearance are included below edited for length and clarity. You can listen to Transform on Soundcloud and Apple Podcasts.

On Presbyterian Senior Living’s footprint and development scope:

We actually operate in four states primarily in Pennsylvania. We have 11 Life Plan communities, one in Glen Arm, Maryland, one in Dover, Delaware and the remainder in Pennsylvania. We have a small personal care home in Williamsport, Pennsylvania that offers IL as well as AL and then one small IL community in St. Clairsville, Ohio. We are currently developing a 172-bed market rate rental apartment building and a development just north of Harrisburg. It will be a truly new product for us and we are trying to reach the middle market.

On the recent transition to CEO:

I think it’s going great. I’ve had the opportunity over the past couple of weeks to meet with each of our independent living resident association executive committees and plan for the future, talking to them about resident engagement and how we can be transparent with each other and develop those strong bonds of trust.

Also having worked 21 years as Presbyterian Senior Living and having that connection with outgoing CEO Jim Bernardo as well as [former PSL CEO] Steve Proctor really has given me an opportunity to work with a couple of great people in the industry.

On new priorities for Presbyterian Senior Living as incoming CEO:

Our focus is going to be really growing where we are. At this point we have, fortunately, some land available to us in many of our communities, and we are looking to expand that independent living product within those communities, as well as taking a look at our current service offerings and seeing if there’s opportunities for conversion of personal care to assisted living. Also we’re launching a new home care agency, and we’ll be doing that at the beginning of [2023] in conjunction with one of our communities in the local market and then looking to expand that throughout the rest of our footprint.

On long-term goals for the organization:

We will truly be focused on improving the organizational health of PSL. So when we look at that and think about organizational health, it comes down to really three areas, and it’s not rocket science. It’s making sure that you have good customer engagement, that you get that service excellence piece, and that we are financially healthy. We’ve got a good stable base able to meet the needs of the organization now in position to meet it well into the future. So that’s kind of a broad base, as we look at that, and our leadership right now is in the process of developing their goals for the coming year, their individual goals in support of those themes.

On the home care agency launch:

Over the last about nine months, we did a very thorough vetting process to determine how we wanted to enter the home and community-based service market. We’ve done it a little bit here and there in the past, and we really did a deep dive into the metrics and did a lot of analysis. While we do believe there’s going to be an ongoing market for life plan communities in the future because of the expansion of numbers of older adults, there is that push for being served in your home. And as a mission provider, we want to be able to reach those people In every setting whatever they call home and be able to be of service to them.

On recouping occupancy gains and stabilizing labor:

We’ve improved our occupancies in our skilled nursing facilities actually to-budget, which is really very nice. We’ve been stagnant in the primary care AL market. We’re starting to see significant interest in independent living and improvement in the occupancy there. Our health center occupancy is pushing 92%. Our assisted living-based primary care occupancy is low. It’s probably average, but it’s much lower than what it has been for us. It’s somewhere in the mid-80s. Our skilled nursing occupancies are up in the upper 80s around 90%.

On the current state of labor in senior living:

I do believe they’re starting to soften and I was just at a meeting at one of our communities and they had 17 vacancies for employment and they had 14 people starting next week. So that gave me some hope that we’re starting to see some improvement there. However, we do continue to experience pretty high rates of nursing agency. We were making some strides in some markets. But at this point in time, the supply of nurses in the nation for the vacant positions, they don’t match up. With that we are looking to try to have programs that allow our current leadership to expand their knowledge and their degrees and as well as offering nursing scholarships to existing staff.

On characterizing operations for 2022:

I would say average. I am glad I can say average. Our staff has worked incredibly hard over the past year looking at ways to improve both our employment offerings, as well as service offerings with many times operating at staffing levels that were below budget. They’ve done a fantastic job and we’re just starting to see improvements month over month and heading into 2023. I think we’re really poised to have a good stable solid year next year.

On expanding Presbyterian Senior LIving’s existing footprint:

We’re planning a couple of independent living expansions at current communities. As I mentioned earlier, the launch of the home care agency is going to be a big one for us in the coming year. And we are looking at the opportunity to invest in or vertically integrate other service lines that we currently contract for. Last year, we actually bought a therapy company which was our first foray into really diversifying our revenue streams. That has been a very positive step for us and we see very similar opportunities with other lines of business as well.

On behavioral health services in senior living:

We actually met with our program and services committee this past week and talking to our chairperson of mental health services is something that is really on our radar. But our programming and services committee is going to take up the first part of 2023, not only from a resident perspective, but also from a staff perspective as well. I’m sure you’ve seen and heard of the burnout that is going on in the healthcare industry. And we need to find ways to help people not get to that point. And while we do offer EAP programs, and we’ve brought in special counseling, during the pandemic, we do believe that there is more we should be doing to try to improve our employees health and wellness.

On the future of senior living:

I see a very bright future with the coming of the baby boomers and the increasing age of older adults we’re going to see a greater demand.

Now that demand may be different, or expanded, not just in our life plan communities or our home care agency that we’re looking at launching, but one of the things that is going to play a key role is going to be technology. And we have been investing in technology in the past couple of years pretty heavily bringing on some staff members to take a look at that and ways in which we are able to make that technology easy for consumers to use, and offer that to them, whether it be in our community, in conjunction with our home care agency, or maybe as just a separate offering for folks that maybe just want that technology piece that we’ve been able to repackage into something that is easy for consumers to use.

On challenges facing the organization and more broadly for the industry:

We’ve got to re-establish ourselves as experts. We’ve been experts for years. We know the continuum of care and service. We help people to be able eto age in-place. We help them to be able to get the services that they need. So I think focusing on those areas and finding ways in which we are able to truly assist. Assist our customers in living where they want to live and living in a manner in which they want to live and being extremely happy with where they are in their lives.

On opportunities ahead for PSL:

I see us moving into the future looking at how we engage with the customer. We’re taking a huge effort right now and heading into the new year of engaging with the customers and finding out where they want to be. We’re looking at the middle market and we’re also focused on affordable housing. We’re looking at both of those things from a mission perspective and a service perspective that are very key to continuing to have a vibrant organization that’s meeting people where they want to be.

Affordable housing is going to continue to be difficult with the rising construction costs, and gaps in funding. So we need to work with corporations that have some type of ESG program looking at their social component and matching up our mission with what our mission is of where we want to go as an organization.

On affordable senior living and middle market growth:

It’s called out in our strategic plan that we will serve people across the economic spectrum and it’s something that Presbyterian Senior Living has done.

We have never asked a person to leave one of our communities because they run out of assets. We keep people for life. And that mission component is something that all of our leadership and our staff share as to what we can do, no matter what a person’s circumstance is and what can we do to make their lives better.

On integrating ESG principles into partnerships and business opportunities:

In our affordable housing corporation, we’ve begun to talk about identifying those corporations that have that similar mission, say, they want to help with housing. If their corporation says we really want to focus on housing, then there’s a match there for us and we can go in and begin to talk about what that looks like with them and how they are able to contribute to that particular mission.

On development within PSL moving forward:

We partnered with a general contractor to do the new development that we are doing. So by engaging the general contractor as a partner within that there is a concerted effort and a focus to maintain costs. So it’s a win-win for both of us. They get to develop a multimillion dollar building but they also have an ownership stake.

So the way in which we develop is it gives them ownership long-term and with us, our ownership of that and the operation of it. So that’s one of the ways we did it. We actually did bond financing prior to rates starting to plummet and the market plummeting. We were able to get some money pretty inexpensively and we have that to be able to use for these new projects.

For us, that looks like a model for us. It’s something that we anticipate replicating. This is one of those pieces where we’re able to partner with someone to do the same business that we’re doing which takes some of the capital burden off of us but allows us then to really do and that is take and provide service and care to older adults.

On where PSL is headed in 2023:

We’re going to be focusing on the workforce in the coming year in addition to the things we’ve already discussed. We’re looking at developing new and more flexible benefit plans. Everything that we can do to make our employment experience better than what it is down the street.

We launched a culture and values workgroup last year that’s being led by our vice president sales and marketing and she has has been led a tremendous group and brought about a program where we’ve had people volunteer to become culture champions at our communities, to really ingrain the values and the respect and the integrity of the organization so that they feel like they belong. From a resident perspective and from an employee perspective, people want to work and live where they feel like they belong.

On attracting the senior living customer of the future:

We’re really looking at data and how do we obtain the necessary data and how do we use it, how do we analyze it. We’re investing in software that is going to provide us with the opportunity to mine that data and look and see where preferences are going. We do focus groups. Most of the way we reach people today is digitally. We can reach so many more people easily through a digital platform.

On changing one thing in senior living:

It would be the workforce. I would wave a magic wand and have enough people to fill all of our positions because what we do is people intensive. It’s about relationships and our residents.

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