Back when I first entered senior housing in 1997, the assisted living boom was in full swing.
I can remember the biggest challenge at the time didn’t seem to be if we could care for a resident as much as if we could just get them to move in! Back then, the sales and marketing process was crucial and the operation was relatively easy. Our residents were in their mid to late 70’s; had good cognitive abilities; and were, by today’s standards, relatively healthy. Family members were cooperative, visited frequently, attended events at the community and would usually take Mom or Dad out to lunch or dinner on occasion or take them home for a few days of vacation or a holiday.
A length of stay of 36 months or longer was the industry standard.
My how things have changed!
Late last fall we held our annual Executive Director’s Meeting near our home base in Alpharetta, Georgia. We worked for months in preparation of the meeting and considered several formats for the gathering. We looked into using a guest speaker, perhaps a motivational figure.
We considered hiring a consultant to give us some advice on the best way to plan. When we formed the company we basically had two simple principals: 1) we would never buy something for more than it was sensibly worth, and 2) we wanted to keep as much corporate burden off the communities as possible; meaning, we would keep it simple with as little paperwork and distraction as possible so that our Directors could run the communities. As an example, our purpose statement for the company is simply “we take care of old people”.
That’s it. That’s all we do. And, we adapted the motto from Tony Dungy’s book Quiet Strength, “we do what we do, no excuses, no explanations”.
Operations today boil down to three components: The Financial – can they pay? The Clinical – can we take care of them? The Social – can they thrive? It is still amazing to me that as an industry, we still do not in any official manner financially qualify our prospects but our accounts receivable remains consistently current. The clinical aspects for us are fairly straight-forward; we simply manage by the regulations as published in the states in which we operate. We rarely, if ever, push the limits of regulation even if we believe the regulations to be questionable or petty.
It is just not worth the hassle, time and energy to deal with bureaucrats, surveyors, and state agencies that really aren’t concerned about the resident’s well being.
Our biggest challenge as an operator today is the Social component- can they thrive? I would estimate that on a monthly basis 70% of the questions and issues that our Directors challenge us with are social in nature. Our average resident today is 89 years old, white and female. At least half of our families have some form of dysfunction, meaning that responsible sons or daughters are divorced, have remarried, and live more than 50 miles from Mom and/or Dad. They visit infrequently, are reluctant to spend money on their parents and, don’t want to be bothered or involved. This scenario runs across the continuum of Independent Living, Assisted Living and Memory Care. In many cases, the families seem to seek out our direction and counseling on what they should do, yet very often fail to heed the advice. Today, our Directors must be skilled at managing emotions, be quick to develop generic answers for why residents question the behavior of a son or daughter and, be professional at managing the 30 day notice. We call this “family dynamics” and it is as much a part of our daily management as bingo, the bible and prune juice.
Today’s operator faces tougher challenges than ever before and they are social in nature which makes each situation unique and different. In many cases we spend as much time, if not more, managing the family as we do the resident. We have to be very meticulous in our documentation and our Directors have to have good communication skills and relentless patience. Frankly, I don’t see this scenario getting any better in the near future. But, in the meantime, we strive to provide the best care we possibly can to the resident and their families. We do what we do, no excuses, no explanations.
Chris Sides is co-founder of Senior Solutions Management Group, LLC. Chris and his partner, Todd Barker, formed SSMG in 2004. The company manages various continuums of senior living in
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