‘Every Customer Was White’: Senior Living’s Diversity Problems Demand Uncomfortable Conversations, Bigger Investments

The senior living industry has a diversity problem.

A recently released report from a coalition made up of Argentum, ASHA and NIC helps quantify where the industry stands on diversity, equity, inclusion and belonging (DEIB). The report shows how much work is left to be done but also says the industry is “starting from a place of strength.” 

I think the report is an important document — but recent conversations have not left me with the notion that the industry is starting from a place of strength.

Although I believe that there is a great opportunity for senior living operators to prioritize DEIB in the years to come, they must first look inward and face — and speak honestly about — difficult truths.

When I spoke with Trinity Health Senior Communities CEO Jan Hamilton-Crawford earlier this year, she said the industry must be prepared to have “uncomfortable conversations” about diversity. Brandywine CEO Brenda Bacon holds a similar view, and she did not hesitate to speak some uncomfortable truths earlier this year at the NIC conference in Washington, D.C.

“You can literally walk into buildings and see that every customer is white, and everybody who’s working for them is Black or Hispanic. … That says something to you,” she said.

Kris Brannon, who worked as a CNA for about a decade, also used the phrase “uncomfortable conversations” when I spoke to her recently about this topic.

In this week’s exclusive, members-only SHN+ Update, I share my key takeaways on diversity, including:

• How the industry still falls short of its diversity goals in 2022
• Insights from Brannon and industry execs on what must occur to make real progress
• How former Kendal Corp. executive Marvell Adams aims to be an “angelic troublemaker” for diversity

Diversity still a distant goal

For years, the senior living industry has identified diversity, equity, inclusion and belonging as a priority. But that has so far not translated into a sea change in the kinds of people in corporate leadership positions.

According to recent data from industry association Argentum and Ferguson Partners, just over a quarter of operators said they have a formal diversity, equity, inclusion, and belonging (DEIB) program in place. An equal number of operators, 27%, said they have no formal program; while the rest said they don’t currently have a formal DEIB program but still aim to promote it within their companies.

A little more than half of the companies participating in the survey were managed by white men executives, while 36% were led by white women in executive management roles. Combined, white execs make up a whopping 82% of management in the industry today.

Meanwhile, people of color make up a little more than half of the community-level workforce, and women comprise 78% of that workforce.

“We need to find ways to attract them to the industry, to give them a way to move up in the industry and feel good about what they do,” Bacon said at NIC, referring to community-level workers. “But we’ve got to pay them well and care about them for that to happen.”

Part of the problem is that executives often don’t understand what their frontline workers are going through each day. That disconnect can exacerbate existing problems or make workers feel unappreciated if they see upper management as ignorant.

Kris Brannon, a second-year graduate student at University of Southern California’s (USC) Leonard Davis School of Gerontology, has seen that dynamic play out firsthand. Before joining the program at USC, Brannon worked as a CNA for about a decade in assisted living, nursing homes and in-home care.

She said that senior living executives often fail to consider the economic conditions of their workers, particularly people of color. And she said they often can’t see how structural societal forces can exacerbate those conditions.

“They don’t understand what it’s like to be poor, marginalized, a person of color — and won’t until we bridge those gaps and have really uncomfortable conversations about what it’s like,” Brannon told Senior Housing News.

One of those uncomfortable conversations is about pay, and Brannon believes the industry must simply pay direct care workers a higher, livable wage. She described how demoralizing it can feel for workers living on a fixed income to care for residents whose monthly rent payments can equal a significant portion of their annual salary.

Even when companies fail to raise employee pay, Brannon believes at the bare minimum they still have an obligation to supplement income in other ways, such as through free food or gift cards to grocery stores.

In addition to paying workers more and providing them better benefits, Brannon wants to see a world where senior living communities are run by many different kinds of people spanning the age, gender and racial spectrum. Only through a culture that is informed by many different viewpoints does she believe the industry can truly change.

She also thinks CNAs and other direct care workers need to have a seat at the planning table, for the simple fact that they are the ones who are really running communities.

“A lot of times, we know more than the executives, we know more than the nurses, because we’re with the client pretty much throughout the day,” she said.

Diversity and belonging also need to be part of the conversation all year long, not just once or twice a year to check a box. After all, marginalized people must grapple with these issues every day — why shouldn’t management think about them as often?

Despite all of its shortcomings, I do see some areas where the industry is making progress. For example, I am heartened by the fact that there are so many women in leadership positions in the senior living industry today; and that there is a growing movement to change what has for years been an industry led by white businessmen.

But I wonder why industry efforts to address gender diversity don’t include more efforts to prioritize transgender people in leadership roles; or why broader diversity efforts don’t highlight the many LGBTQ+ folks who work in leadership roles throughout the industry, both in communities and in corporate positions.

One way to advance this cause is for executives to come down from C-suite and get to know the people working in their communities for more than just a day or a few hours at a time.

Brannon said she would like to hold a roundtable discussion with industry leaders to educate them on the struggles of marginalized workers. And most importantly, she believes that senior living companies must be serious about their commitment to that effort, and financially support key community organizations.

“Show people that you want to invest, that you … give money to these organizations that help the very people that are taking care of your older adults — start there,” she said.

Kendal COO turned ‘angelic troublemaker’

There are some organizations that want to move from discussion to action. One such organization is W Lawson, which is headed up by former Kendal Corp. COO Marvell Adams.

Adams’ journey to found W Lawson and tackle racism is rooted in personal experience. In 2021, at the LeadingAge Annual Meeting, another attendee made a racist comment that left him feeling unsafe.

W Lawson is a housing and community development company focused on creating community and doing good. The organization has several “offshoots” under its umbrella with an ultimate goal of creating 10,000 new or revitalized, affordable, sliding scale and market-rate senior housing units and memberships focused on inclusion and belonging.​

The organization’s tagline, to be “angelic troublemakers,” is a reference to a quote from Black pacifist and gay rights advocate Bayard Rustin, who coined the term when he said, “We need in every community, a group of angelic troublemakers.”

Being an “angelic troublemaker” can take many forms. But for Adams, it means disrupting the status quo in senior housing in favor of achieving a greater good. That process starts with giving older adults access to what they need, when they need it.

The need for more racial diversity extends to the older adults the industry serves. Almost two decades from now, the U.S. will have 28 million older adults who are Black, Indigenous and people of color (BIPOC), representing a 107% increase from today, according to data shared by Adams. At the same time, there is projected to be 6.1 million LGBTQ+ older adults, a 103% increase.

Senior living is gearing up to serve other large demographics of people, such as those falling in the middle-income demographic. By 2033, 22% of the population of middle-income older adults will be people of color, according to a recent update of the watershed “Forgotten Middle” study. W Lawson aims to address those inequities, too.

W Lawson’s big initiatives include creating a flexible membership model where older adults can access services through an agreement similar to a CCRC without walls, and then receive services through providers like Kendal at Home and Friends Life Care.

One partnership W Lawson has underway is with a foster home in Catonsville, Maryland, where it will focus on intergenerational connections, inclusion and belonging.The organization also has partnerships with LiveTogether International WELL Building Institute (IWBI) and the Bayard Rustin Center.

W Lawson also will include mixed-use and intergenerational ​development with business partners dedicated to social justice and community impact.

“Our objective is to really be a convener of all those resources and use them in the most economical and efficient way possible,” Adams told SHN earlier this year.

There are many in the industry willing to advance diversity. As Adams’ efforts show, it is up to larger industry players to connect with those people and help advance their plans on their platforms.