Assisted Living Executive, Nov/Dec 2005

Transcription

VOL.12. NO.9
▼
NOVEMBER/DECEMBER 2005
AssistedEXECUTIVE
Living
Calm
BEFORE THE
Storm
MODELS OF OPERATIONAL
EXCELLENCE: EXECUTING YOUR
CRISIS MANAGEMENT PLAN
LEADERSHIP STRATEGIES
Q&A with Midsize
Company Execs
QUALITY RESIDENT SERVICES
Dementia Care
Liability
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VOL.12. NO.9
AssistedEXECUTIVE
Living
ADVANCING EXCELLENCE IN
A S S I S T E D L I V I N G O P E R AT I O N S & C A R E
Formerly Assisted Living Today
▼
Contents
FEATURES
12 COVER STORY
Calm Before the Storm
BY ANYA MARTIN
While a nation scrambled to cope with an unimaginable natural disaster,
assisted living providers had already mobilized to shuttle residents to safety
and try to maintain some sense of normalcy.
18 LEADERSHIP STRATEGIES
When Midsize is the Right Size
BY WHITNEY REDDING
A recent conversation with three midsize company CEOs reveals the upside
of not being the biggest fish in the pond—but not being the smallest either.
12
21 QUALITY RESIDENT SERVICES
The Dementia Care Conundrum
BY ADAM STONE
The demand for dementia care is impossible to ignore or deny.The aging
population virtually guarantees a growth market, but does the added risk
make it worth it? How do you balance autonomy with increased risk?
26 QUALITY RESIDENT SERVICES
You Sign Them Up, They Move them In BY WHITNEY REDDING
While providers benefit vicariously from community services that help new
residents make a happier transition from their former home, those communities
that have formally aligned with a senior relocation provider are reporting direct
advantages to the company’s bottom line.
18
DEPARTMENTS
5
TOP OF MIND
BY RICHARD P. GRIMES,
ALFA President and CEO
6
EXEC TO EXEC
Insights on today’s issues
NEED TO KNOW
Industry updates and ALFA news
COMPLIANCE CORNER
BY JOHN ATKINSON ESQ.
CONSUMER VOICE
On aging and independence
9
29
31
32
33
34
35
36
AFFILIATE SPOTLIGHT: WALA
BY JIM MURPHY
RESOURCE LINK
Classified ads
PEOPLE & PLACES
Appointments and developments
AD & MEMBER INDEX
Guide to advertisers & members
PRODUCTS & RESOURCES
Assisted living solutions
26
Assisted Living EXECUTIVE
▼
NOVEMBER/DECEMBER 2005 3
Executive Publisher
Richard P. Grimes, ALFA President/CEO
Publisher
Debra J. Stratton
Editor/Associate Publisher
Angela Hickman Brady
Associate Editor
Marlene L. Hendrickson
Contributing Writers
Anya Martin, Whitney Redding, Adam Stone
Art Director
Becky McClimans
PUBLISHING OFFICES
Stratton Publishing & Marketing Inc.
5285 Shawnee Road, Suite 510
Alexandria, VA 22312
703/914-9200; fax 703/914-6777
E-mail: [email protected]
For circulation information, call 703/691-8100.
A D V E RT I S I N G S A L E S T E A M
Alison Bashian, [email protected]
Marianne Juliana, [email protected]
Stratton Publishing & Marketing Inc.
800/335-7500; fax 440/349-3447
Insights and critical review provided by the
A L FA O P E R AT I O N A L E X C E L L E N C E
A D V I S O RY PA N E L
Michel Augsburger, President & CEO,
Chancellor Health Care Inc.
Cindy Chastulik, Divisional VP, Eastern Division,
Alterra Healthcare Corp.
Page Estes, VP of Operations,
CaraVita Senior Care Management Services Inc.
Jill Haselman, SVP, Organizational Development &
Culture, Benchmark Assisted Living
Justin Hutchens, SVP & COO,
Summerville Senior Living
Benjamin R. Johns, VP of Operations,
Carriage Court Communities
Susan Klein, SVP, Brandywine Senior Care
Linda L. Martin, President & COO,
Signature Senior Living
Jack Peters, VP of Operations, Silverado Senior Living
Marla Sovereign, VP of Assisted Living,
American Retirement Corp.
Daniel Schwartz, SVP of Operations,
Sunrise Senior Living
PUBLISHED BY THE ASSISTED LIVING
FEDERATION OF AMERICA, FAIRFAX, VIRGINIA
Assisted Living Executive (ISSN 1553-8281) is published
monthly, with combined issues in January/ February,
July/August, and November/ December, by the Assisted
Living Federation of America, 11200 Waples Mill Road,
Suite 150, Fairfax, VA 22030. Circulated to ALFA
members only; a portion of dues is for subscription.
Periodicals postage paid at Fairfax, VA, and additional
mailing offices.
POSTMASTER: SEND ADDRESS CHANGES TO Assisted
Living Executive, 11200 WAPLES MILL ROAD, STE. 150,
FAIRFAX, VA 22030; 703/691-8100. Printed in USA.
Copyright 2005. Prior to photocopying items for
educational classroom, internal, or personal use,
please contact the Copyright Clearance Center, Customer
Service, 978/750-8400, 222 Rosewood Dr., Danvers,
MA 01923 or check CCC Online at www.copyright.com.
Assisted Living Executive will not be responsible for the
return of any unsolicited manuscripts or photographs.
ALFA PRESIDENT/CEO
TOP OF MIND
What is a Midsize Assisted Living Company?
W
hen ALFA changed its value premise last year to
Operational Excellence and then sharpened its focus
to meeting the needs of companies operating professionally managed assisted living communities for seniors, it
was soon clear that this was exactly the right path.The creation
of Assisted Living Executive, Executive Roundtables, Executive
Insights, Executive Portfolio and other executive-level products
and services around Operational Excellence (in addition to re-doubling our federal public policy efforts and our outreach to the
national media) have resonated with everyone in the assisted living
business.We listened to the needs expressed by our members and industry partners—
and then filled the void.
If we made one tactical mistake, however, it was announcing that our executive products would be laser-focused on the needs of the “mid-to-large”-sized companies in assisted
living.Why was this a mistake? I didn’t realize the industry-wide perception that there
are only “large” companies (the “big guys”) and then everyone else! That is, everyone
who is not “large” perceives themselves as “small.” No one perceives themselves as
“midsize” operators.
For example, I was surprised to hear the dismay expressed by a 175-unit operator
with two communities that ALFA was only about the “big guys,” while he was just a
“small” operator. Another operator with 350 units in three states said that ALFA wasn’t
acting like we were about “mid-to-large”-sized since the products and services (Assisted
Living Executive, Executive Insights, etc.) were exactly what her “small” company—
and the executives within her company—needed from ALFA!
This issue of Assisted Living Executive features a great article on three “midsize”
operators with issues that will resonate with almost every Assisted Living Executive
reader—and January, 25-27, 2006, we are hosting an ALFA Summit for Assisted Living
Entrepreneurs in Washington, D.C.The Summit is especially tailored to assisted
living companies with 120 to 1,200 total assisted living units.
It’s a slippery slope to define “midsize” too precisely (what about the company
with 1,300 units? 100 units?), but hopefully ALFA’s executive-level products and services
(such as the Summit) will reinforce the notion that ALFA is for you if your company
aspires to Operational Excellence and is all about professionally managed assisted
living communities for seniors—regardless of size.
Richard P. Grimes ([email protected])
*Remember to join ALFA and your ALFA State Affiliate in 2006.
In 2006, your dues to ALFA will be paid by your corporate headquarters.
Serving professionally managed assisted
living communities for seniors by:
t driving business excellence
t ensuring a more informed public and
t influencing public policy.
▼
EXEC TO EXEC
INSIGHTS ON TODAY’S ISSUES—FINANCE
What is the best cost-saving measure
you have implemented in the
last six months?
hen our corporate
dining services
director recently retired, we
partnered with a national food
services company to ‘rent’ one
of its senior managers as his
replacement.Working exclusively with our communities,
he has contributed handsomely
to our bottom line—both in
terms of reducing raw food
costs and reorganizing the labor
in some of our kitchens—all at
approximately the same price
as we paid his predecessor.”
—Ted Janeczek
“W
Ted Janeczek,
Executive Vice
President &
CFO, Country
Meadows
Retirement
Communities,
Hershey, PA
[email protected]
DuVal Byrd,
CPA, Vice
President of
Finance &
Controller,
Southern
Assisted
Living Inc.,
Chapel Hill, NC
ne significant cost-saving measure we’ve made
recently was to change auditing
firms. While the impact on
the bottom line is important,
I would also stress that the
service level and overall ‘fit’
are equally as important.
We make it a standard practice to periodically evaluate
our strategic relationships with
vendors and service providers.
This will often include going
to the marketplace and running
a request for proposal process.
We found that we were able to
obtain better pricing and service levels by switching from a
larger firm to a mid-size firm.”
DuVal Byrd
“O
[email protected]
6 NOVEMBER/DECEMBER 2005
▼
POCH Senior Living has
spent the last several
years implementing a number
of strategies to save costs and
enhance revenue ‘above the
line’ (EBITDARM—Earnings
Before Interest,Taxes,
Depreciation,Amortization,
Rent, and Management fees),
such as real estate tax abatements, outsourcing housekeeping, and implementing new
clinical software.
This past year, we focused on
opportunities ‘below the line.’
EPOCH had a unique option to
purchase one of our assisted living properties that had been
under an operating lease.
Utilizing Freddie Mac nonrecourse debt, we were able to
reduce our monthly payments
by 50 percent and ensure the
appreciation of the real estate
benefits our company rather
“E
Debora Pfaff,
Senior Vice
President &
CFO, EPOCH
Senior Living,
Waltham, MA
than a third party.We will
continue to exercise strategic
purchase options to reap the
benefits of both the low-interest
rate environment and the
growth in real estate market
value.”
—Debora Pfaff
[email protected]
If you would like to be
interviewed for Exec to Exec,
contact Marlene Hendrickson
at [email protected].
QUICK TIPS
ven small changes can have positive bottom-line effects,
making it well worth conducting regular reviews of operating
procedures. Here are a few examples:
E
■ LOOK AT POSITIONS THAT MAY BE EFFECTIVELY OUTSOURCED.
Such positions may include those in food service or grounds
management, but be sure to address a specific community’s
needs and get feedback first.
■ REGULARLY REVIEW YOUR CONTRACTS AND PARTNERSHIPS.
A regular review of long-standing or long-term partnerships with
outside companies is worth the effort if it results in cost savings.
Periodically get quotes from other companies or send out an RFP
for particular services, such audits and background checks.
■ COLLECT INFORMATION FROM LOCAL REVIEWS. Consider
implementing an annual review of administrative expenses at
the residence level. Residence administrators and their staff may
be able to recommend cost-saving measures at the local level,
including expenditures on such items as office supplies, software
packages, and professional resources.
Help older adults stay active, have fun and make friends.
Welcome to LifeTrail .
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their maximum level of wellness.
At the same time, LifeTrail stimulates
social interaction by encouraging
people to exercise together. Learn
more about the standard features and
customizable options that can make
LifeTrail the ideal pathway to total
wellness for your community.
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Pa r t o f t h e P l a y w o r l d S y s t e m s , I n c . Fa m i l y o f B r a n d s – R e c r e a t i o n F o r L i f e .
I N D U S T R Y
U P D AT E S
&
A L F A
NEED TO KNOW
N E W S
ALFA Submits White House Conference Resolution
A
LFA has submitted a proposed resolution to the
2005 White House
Conference on Aging.The
resolution consists of three
policy issues:
■ The need to preserve
Medicaid for the truly needy;
■ Incentivizing the purchase
of long-term care insurance and
private savings for future longterm care needs; and
■ The creation of a consumer-directed, long-term care
choice plan that would make
long-term care portable across
settings.
In addition to ALFA, the resolution was formally endorsed
by the following organizations:
Sunrise Senior Living,
Jefferson Area Board on Aging,
U.S. Chamber of Commerce,
American Seniors Housing
Association,Armed Forces
Retirement Home, and the
for more information.
ALFA also wants to recognize
those heroic staff members
who have helped assisted
living residents and providers
affected by the hurricanes.
Please e-mail those stories
to ALFA’s Paul Williams at
[email protected].
Higher Premiums
on the Horizon
Center for Long-Term Care
Reform Inc.
Staff and advisors for the
White House Conference will
determine which resolutions will
be considered for passage by the
delegates on Dec. 11-14 in
Washington, D.C. ALFA
President/CEO Richard P. Grimes
is a delegate.
Hurricanes May Prompt Medicaid Cuts
T
he Medicaid Commission and the National Governors
Association (NGA) each have released proposals for cutting $10 billion from Medicaid. However, in the wake of the
recent hurricanes, many members of Congress have stated
that drastic Medicaid cuts should be reconsidered. Both proposals include the following recommendations for achieving
such cuts:
■ States should be allowed to reimburse drug manufacturers at the Average Manufacturer Price (AMP) rather than the
Average Wholesale Price (AWP).
■ The penalty periods for asset transfers applied against
Medicaid long-term care applicants should be prospective
from the date of application for Medicaid.
■ The “look back” period (the time period preceding application, which Medicaid reviews for transfers) should be
increased from three to five years.
To read the Medicaid Commission Reports issued on Sept.
1, 2005, go to www.cms.hhs.gov/faca/mc/090105rpt.pdf.
AL Communities
Survive Rita
Assisted living communities
in the path of Hurricane Rita
were spared much of the
damage that occurred during
Hurricane Katrina. ALFA State
Affiliate leaders in Texas report
that most communities that
were forced to relocate to safe
locations have moved back.
ALFA’s Louisiana State Affiliate
reports that Lake Charles communities received the most
damage during Hurricane Rita,
but to a far lesser extent than
during Hurricane Katrina.
ALFA continues to meet with
federal officials and agencies
regarding assistance for displaced assisted living residents
and operators and encourages
all assisted living providers
and supporters to contribute to
the ALFA Hurricane Katrina
Assisted Living Relief Fund.
Please note that a number of
organizations no longer are
accepting donations of clothing
and supplies.Visit www.alfa.org
Increases in Medicare premiums
are among changes in 2006
that may impact the level of
care seniors can afford.
In September, the Centers
for Medicare & Medicaid
Services (CMS) announced
that the Medicare Part B
monthly premium will be
$88.50 in 2006, an increase
of $10.30 from the current
$78.20 premium.
Though premiums are rising,
CMS says most Medicare beneficiaries will see significantly
lower out-of-pocket health-care
costs in 2006 due to savings
resulting from the new
Medicare prescription drug
benefit. For more details, visit
www.cms.hhs.gov.
JCAHO Discontinues
Accredition Program
Effective Jan. 1, 2006, the Joint
Commission on Accreditation
of Healthcare Organizations
(JCAHO) will discontinue its
assisted living accreditation,
citing lack of interest in the
program. JCAHO first introduced the accreditation program for assisted living in 2000.
The Commission on
▼
NEED TO KNOW
Accreditation of Rehabilitation Facilities
(CARF) now will become the only national
accreditation entity for assisted living.
Earlier this year, the Texas Assisted Living
Association successfully lobbied to pass
legislation that implements accreditation
requirements in lieu of annual licensing
surveys. (See “Accreditation Victory Fuels a
Legislative Campaign in last month’s issue
of Assisted Living Executive.) The
program is voluntary, but by eliminating
licensing surveys, it creates for assisted
living communities a compelling incentive
to seek accreditation.
Correction
The wrong contact information was included for Care Technologies in the October
issue Life Safety Products chart.The correct
contact number is 770/261-7844.
Now Is The Time To List
Your Facility . . .
Strongest Sellers Market in 10 Years
Many owners are taking advantage of this seller’s market
to sell their facilities that are no longer a good match
for their portfolio, geographically challenging or simply
to raise cash for other acquisitions.
Give us a call to get an honest opinion of what your
property might be worth.
JCH Consulting Group, Inc.
specializes in the Sale and Acquisition of
Assisted Living, Skilled Nursing and
Congregate Care Facilities
Experience Speaks for Itself . . .
JCH Consulting Group, Inc. has successfully closed
over $25 million dollars in Assisted Living facilities
so far this year.
We currently have over $120 million in escrow and
$200 million in listings.
Visit our web site at www.jchgroupinc.com
or call Lee Blake at 541-317-1547 or
Jim Hazzard at 888-916-1212
JCH Consulting Group, Inc.
Health Care / Retirement Housing Specialists
Offices in Anaheim & Los Angeles CA and Bend OR
Professional Resources
from ALFA
For more information about any of
these resources, visit www.alfa.org
or call 703/691-8100.
■ ALFA Executive Teleconference.
ALFA will conduct a Critical Issues
Executive Teleconference Call on
Nov. 15, 2:00 – 3:15 ET, with Silverado Senior Living executives Anne
Ellett and Steve Winner focusing
on dementia care in assisted living.
■ ALFA Executive Roundtables.
Interested in having an influential
seat at the assisted living business
table? Inquire about becoming an
ALFA Executive Roundtable member.
Contact Paul Williams at pwilliams@
alfa.org.
■ ALFA Summit for Assisted Living
Entrepreneurs. This invitation-only
event takes place Jan. 25-27, 2006, in
Washington, D.C.The summit will feature speakers and sessions that tackle
the challenges senior living companies
are facing and provide strategies and
solutions for operations excellence.
■ ALFA Executive Portfolio. ALFA’s
groundbreaking research report
details what leading assisted living
providers are planning.
■ Assisted Living Guide &
Checklist. This ALFA
brochure articulates the
philosophy of assisted living and what consumers
should look for when
choosing a community.
■ Substitute Decision-Making: A
Guide for Assisted Living Providers.
This report provides business-critical
information about the substitute decision-making process with residents
and family members.This report is
available only to ALFA members.
■ ALFA 2006 Conference & Expo,
May
2-5, 2006 in San Diego, California.Visit
www.alfaconferenceandexpo.com. ▼
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CALM
Before the
Storm
In true models of operational
excellence, assisted living providers
activated crisis plans and hastily
ferried residents to safety before
the hurricane and flood
waters arrived
By Anya Martin
C O V E R
S T O R Y
T
he image is engraved in the
memory of Deeni Shannon,
executive director of
Summerville at Kenner LLC
—that of Michael Gardner,
director of environmental services, carrying
an elderly woman who could not walk up
the stairs onto the bus.
“She was 83 pounds,” recalls Shannon
([email protected]).“She had her arm
around his neck, and he was holding her
with her knees draped over one of his
arms. I don’t know how she would have
been able to have gotten out of her own
house or even if her family could have
done that.”
It wasn’t supposed to be that way.
Shannon had an advance reservation number for comfortable handicap-accessible
tour buses in case of emergency, but when
she made the call with Hurricane Katrina
approaching, she couldn’t get anyone to
confirm they would be there. Less than
24 hours before the deadline for leaving,
Gardner had approached her with the name
of another bus company that was prepared
to commit.
Shannon calls Gardner one of the many
“heroes” among a team who went above
and beyond in a crisis that no one imagined
could have been so bad.While news media
told the tragic stories of seniors who perished in a flooded nursing home during
Hurricane Katrina, assisted living providers
were able to get their residents to safety.
The story of Summerville at Kenner in
Louisiana is just one of those inspiring tales
of how to do things right in the most difficult circumstances, demonstrating true
operational excellence.
PLANS AND PEOPLE
“I was very proud to see communities start
to move their residents to safety days
before either hurricane landed and to make
good judgments about whether they could
move residents or not,” says ALFA
President/CEO Richard P. Grimes.“Assisted
living members were out of harm’s way
before harm came their way.”
ALFA received an overwhelming
response from members to a database it set
up to match displaced seniors with residences in other locations, as well as a
fundraising campaign to benefit displaced
While news media told
the tragic stories of
seniors who perished
in a flooded nursing
home during Hurricane
Katrina, assisted living
providers were able to
get their residents to
safety.
assisted living residents.
“We’ve always talked about the importance of having a cohesive industry that
may have many differences but one key
thing in common—that we’re made up of
people who care for other people,” Grimes
says.“This was a manifestation of that in a
way we hadn’t seen before.”
While the buck stopped at Shannon in
the decision to evacuate, she stresses “it
wasn’t me, it was everyone,” a combination
of residents, local and corporate-level staff,
who made the experience a success.
Shannon and fellow staff stayed at
Summerville at Kenner, which is owned by
San Ramon, California-based Summerville
Senior Living and located just west of New
Orleans, until 2 a.m. trying to get everything
ready for the trip—from contacting family
members to packing bag lunches and
snacks, water and juice, 15 ice chests of
food, clothes, toiletries, medicine, and key
medical documents. Then she went home
to pack what she could of her own possessions and try to convince her stubborn
father to come along, knowing she had a
responsibility to 66 residents whose care
their families had entrusted in her.
In the end, Shannon’s father relented and
accompanied Shannon, her mother, and two
dogs in a car behind the bus. Shannon’s
husband, a media professional, stayed in
New Orleans to cover what would happen
next, and she wouldn’t hear from him for
several days. Meanwhile, the marketing
director and her husband were driving a
van carrying three children, two cats, a dog,
and a bird, and towing a U-Haul trailer filled
with fully stocked medical carts. Other staff
who came along included four certified
nursing assistants, the food service director,
a dishwasher, and a server.
The drive to northern Louisiana took
nine-and-a-half hours rather than the usual
four. Residents were dropped off at four different residences, with which Shannon had
made prior arrangements long before hurricane season. Once everyone was safely settled, staff checked into a nearby hotel.
“We didn’t take the time to sit and watch
the storm or listen to it on the radio; we
were too busy dealing with resident care
and trying to make everyone comfortable,”
Shannon recalls.“We tried to talk about
things not related to the storm. A lot of
residents were stressed out because they
remembered Hurricane Betsy [1965].We
spent 36-48 hours on auto-pilot. Once we
were able to sit down and watch the news,
that’s when it really hit us.”
Now communication became the biggest
challenge. Because New Orleans cell numbers wouldn’t work, the company’s corporate office obtained a California-based cell
number for Shannon. Soon, not only residents’ families, but anyone looking for a
missing senior was calling or e-mailing her,
she says.“I had a police officer who said
‘I can’t find my grandmother. I know you
evacuated seniors, do you have any idea
where she might be?’”
Staff also had to learn new roles.
Shannon remembers the dishwasher
announcing how she had to bathe a resident instead of the dishes.“It wasn’t a negative, it was ‘I have done something good.’”
Moments like this, and when a resident
didn’t recognize Shannon because he was
▼
C O V E R
S T O R Y
used to seeing her in a business suit rather
than casual clothes, are what make her
smile despite it all.“That gentleman was saying that his pajamas weren’t his. I put them
back in the closet and then said,‘Look, here
are your pajamas.’ He looked at me and said,
‘Did you come from Summerville?’ I said,
‘I’m Deeni.’And he said,‘I’m so glad to see
you.’”
In another meaningful moment, one resident’s daughter called her in tears and
said,“Thank you for saving my mother’s
life.”
Effective planning and compassionate caregivers also ensured a happy ending for residents and staff of Sunrise at Bayou St.
John and Sunrise at Slidell, both operated
by McLean,Virginia-based Sunrise Senior
Living Inc. Based on weather reports about
the storm’s intensity and its direct turn
toward the city two days before the storm
would make landfall, staff decided to evacuate the two residences, the first located in a
posh suburb on Lake Pontchartrain and the
other in a nearby rural community, says
Sherry Robinson (sherry.robinson@
sunriseseniorliving.com), Sunrise’s area
manager of operations for the four-state
area of Louisiana,Arkansas, Kentucky, and
Tennessee.
Like Summerville at Kenner, staff contacted families, allowed time for loved ones
to be picked up, and gathered supplies, as
well as personal treasures such as photos
or jewelry.“We try to be very sensitive,”
Robinson says.
Ed Edahl/FEMA
COMPASSIONATE, WELL-PLANNED CARE
When 112 residents and staff from the Veranda Living residences in Texas packed into a 34-seat passenger
bus, two 25-seat buses, five 15-passenger vans, and several cars, little did they realize that a drive that normally takes under six hours would last 28 to 36 hours.
The next morning, they pulled out with
more than 50 of 85 residents from Bayou St.
John and five from Slidell, which averages
around 50 residents. Twenty staff members
from Bayou St. John also came, some of
them bringing family members. Slidell
residents went to a hotel in Natchez,
Mississippi, while the destination of the
Bayou St. John group was Emerald Hills Golf
Resort in west-central Louisiana, where the
company, thanks to an employee’s recommendation, already had negotiated arrangements in case of emergency.
“We had reserved them for Hurricane
Dennis [in early August] and paid for them,
Jocelyn Augustino/FEMA
Once the news
came that the
levees had broken
in New Orleans,
Sunrise staff knew
there would be
no homecoming
any time soon
for most of the
evacuees.
▼
as well as charter buses, even though that
time we didn’t use them,” Robinson says.
“That gives the hotel and bus companies an
incentive to give us right of first refusal.”
Once the news came that the levees had
broken in New Orleans, staff knew there
would be no homecoming any time soon
for most of the evacuees. Slidell suffered
only minimal damage and has reopened, but
when Sunrise staff were finally able to enter
Bayou St. John, they found water lines indicating flooding of up to four feet on the
first floor.
The Sunrise group stayed at Emerald
Hills for five days with staff members trying to ensure that residents’ lives remained
as normal as possible under the circumstances. They unpacked activity supplies,
packed as part of the evacuation plan, and
organized games, arts and crafts activities,
and exercise.
Meanwhile with cell phones unreliable,
Robinson created a link on Sunrise’s
Web site for family members to e-mail her
directly.“I received a couple hundred emails a day,” she recalls.“I was able to tell
people where other family members were
when they couldn’t talk to each other.”
Some families came to pick up their
loved ones.Then it was back on buses for
more than 40 headed to Houston communities and six to San Antonio, each carefully
At Summerville
at Kenner, the
winds had blown
windows out of
their casings,
shattering glass
all over the floor,
and the hinges
off of doors.
Photo courtesy of Summerville
paired with a community suited to special
needs such as Alzheimer’s care. Just 60
miles outside Houston, one bus broke
down.
Again, Executive Director Iris Granat
followed a plan that worked, Robinson
says.“She got off the bus and went into a
gas station across the street, called the local
fire department and they came.” Local firemen and police from the tiny town of
Shepherd,Texas, (population 2,050) transported the seniors and accompanying 20
caregivers to a local restaurant, and then
one of the city councilmen, who owns a
car repair shop, and a team of his mechanics fixed the bus at no charge.
Sunrise’s disaster plans vary across the
country depending on the unique challenges faced by different geographic areas,
but Daniel Schwartz (daniel.schwartz@
sunriseseniorliving.com), Sunrise’s senior
vice president of corporate operations, says
the entire Hurricane experience reinforced
some key points.
“One is that we should always prioritize
ensuring the safety of our residents and
team members,” he says.“The second thing
is the importance of not only having disaster plans and evacuation plans, but also
practicing and making sure team members
are capable of implementing them.”
Schwartz hails staff first and foremost.
“These actions are heroic,” he says.“These
folks didn’t decide not to show up for work
like the TSA screeners did. I spoke with a
number of department managers
on the Bayou St. John team who said they
didn’t know if their houses were still there
or if their families were safe.They literally
picked up what they had and left with
the residents.”
To reward staff members who evacuate,
Sunrise has a policy of paying around the
clock for the period of time that the
employee is away from his or her home, as
well as covering all room and board expenses.The company also has made sure that all
affected employees, whether or not they
came along for the ride, continue to receive
salary and benefits, as well as helping those
who wish to relocate with extra stipends to
help them get started in a new location.
The one tragedy Sunrise experienced has
been well reported in national media.A
charter bus evacuating 37 residents, six
team members, and the family member of
one team member from Brighton Gardens
of Bellaire near Houston was involved in a
tragic incident near Dallas and resulted in
multiple deaths.The community, which is in
a low-lying area near Houston, was evacuated in advance of Hurricane Rita.The bus
that was involved in the incident was one
of two charter buses that left the community within a few hours of one another.
The second bus, which was transporting
approximately 15 residents, arrived safely
in the Dallas area.
“Our primary concern is for the safety
of our residents and we are shocked and
saddened that this event occurred during
our evacuation.We are working with
authorities investigating this incident to
determine its cause,” said Sunrise Founder,
Chairman, and CEO Paul Klaassen, following the accident.“The team members who
were traveling on the bus were there to
assist these residents during their trip to
Dallas.Their heroic actions helped save the
lives of many residents and I am extremely
proud of their actions.”
The bus was chartered through a company that also provided assistance to Sunrise
when evacuating residents of its New
Orleans area communities during Hurricane
Katrina.
CREATIVITY ON THE ROAD
While Hurricane Rita thankfully didn’t
wreck the damage and death toll of
Hurricane Katrina, the gridlock after so
many Texans opted to evacuate resulted
in a different set of challenges for Pasadena,
Texas-based Veranda Living Inc. The city
of Houston mandated evacuation of all
assisted living, nursing, and special care
residences in low-lying areas with potential
for flooding, which included Veranda’s Pine
Tree Lodge (assisted living) and Pine Tree
Cottage (Alzheimer’s care).
When 112 residents and staff of these
residences packed into a 34-seat passenger
bus, two 25-seat buses, five 15-passenger
vans, and several cars, little did they realize
that a drive that normally takes under six
hours would last 28 to 36 hours, says
Veranda President/CEO John S. (Skip)
Comsia ([email protected]).
The caravan pulled out at 10:30 p.m.
on Wednesday, September 21, but the last
vehicle didn’t arrive until 6 p.m. on Friday
at the newly opened assisted living community Courtyards of Lake Granberry in
Granbury,Texas, where Comsia had negotiated temporary housing. Group members
were separated due to the mess of congested traffic and abandoned vehicles and
forced to take different routes out of the
city. Some vehicles ran out of gas or broke
down, too.
“It was a very wild experience,” Comsia
recalls.“It wasn’t pleasant.We were just
fortunate that none of our residents got
seriously overheated.”
The situation required some clever thinking. In one case, negotiation with local
police led to a vehicle being able to get gas
from a county maintenance facility and a
police escort through back roads.After one
of seven residents with Alzheimer’s disease
got overheated, requiring a hospital stop,
staff started calling hospitals along the
route to ask for permission to stop so sen-
▼
C O V E R
HOPE ACROSS THE MILES
Stories of hope, however, aren’t limited
to the communities that were impacted
directly by the storms. Staff and residents
in assisted living communities across the
nation have conducted fundraising campaigns and other activities to help.
Catonsville, Maryland-based Erickson
Health, which manages 13 campuses for
middle-income people over 62, raised
$404,115 in just two weeks, more than double its most successful previous fundraising
campaign for tsunami relief last year, which
totaled $196,000. The company has also
Staff and residents
in assisted living
communities
across the nation
have conducted
fundraising
campaigns and
other activities
to help.
Marvin Nauman/FEMA
iors could be checked by medical staff and
rehydrated.
“It soothed tensions, and hospitals are
also a great place to stock up on supplies,,”
Comsia says.“Overall, it was a great little
innovation, a change in plans that really
worked.We even stopped at a hospital on
the way back.”
While Comsia is glad his communities
were spared, he is now having all employees who drove vehicles write up their experience to make a comprehensive list of lessons learned. He plans to use it to revise
and improve Veranda’s emergency plan for
the future, he says. He also wants to use
that list to help lobby government officials
to create a separate, non-freeway route out
of town for people with special needs in
case of a future mandated evacuation.
S T O R Y
assembled a volunteer list of 10-20 employees ready to travel to the New Orleans area
to aid in on-site disaster relief work.
Another Erickson initiative offers temporary or permanent housing to seniors displaced by Hurricane Katrina, and at press
time, the company was investigating providing relocation and job assistance for displaced staff and their families. Several formerly New Orleans-based employees have
already been hired by Eagle’s Trace,
Erickson’s newest CCRC, which opened in
mid-October in Houston. Recognizing a need
for low-income senior housing in New
Orleans, as well as likely availability of federal
funds to finance, Erickson finally is considering moving a plan to pilot a low-income
CCRC from Baltimore to New Orleans.
Lessons Learned
■ Ensure staff are trained and ready to assume new roles. Dishwashers may become
caregivers, for example. As Sunrise’s Dan Schwartz says, in addition to having a disaster
plan, ensure team members are capable of implementing it.
■ Plan for communication problems. When New Orleans cell phones weren’t working,
Summerville obtained a California cell phone number for Summerville at Kenner Executive
Directory Deeni Shannon.
■ Incorporate advance reservations for housing and transportation in crisis plans.
Agreements with hotels or other communities and charter bus companies should be in
place.
■ Expect the unexpected and be ready to adapt. Gridlock along evacuation routes can
turn short drives in day-long drives, or longer. Veranda Living residents and staff endured
up to 36 hours of travel, requiring creativity along the way. When some residents became
overheated, buses stopped at hospitals to rehydrate residents and shore up supplies.
■ Use the experience to update crisis management plans. Veranda Living’s Skip Comsia
has asked staff to write up their experiences to collect lessons learned. He’ll use what he
finds to improve emergency plans. And, he plans to lobby government officials for a
special route out of town for people with special needs.
▼
The fundraising drive was a no-brainer,
but the other ideas came straight from
employees and residents who desperately
wanted to help, says Mark Erickson
([email protected]),
chief strategy officer.“After Hurricane
Katrina, we started getting e-mails and
phone calls.We ended up getting so many
ideas that we had to sit down and consider
the cost and where we wanted to commit
our resources.”
Milwaukee,Wisconsin-based Alterra
Healthcare Corp. launched a program
where employees could donate paid timeoff (PTO) hours and/or contribute via payroll deduction.The company committed to
matching every dollar up to $200,000. As
of September 29, a total of $138,000 had
been raised, including the company’s
match.Alterra also has offered to house displaced seniors and help displaced staff, but
perhaps its most heartwarming program
actually came from thousands of miles
away, inspired by a touching request by
a resident of Alterra Wynwood of
McMinnville (Oregon).
Frell Zink, a 91-year-old resident, couldn’t
see the images of flooding and destruction
on TV because he was completely blind, but
he had heard the descriptions. So he went
to the front desk and asked whether there
was something he could do.“I could hear
in his voice that he felt helpless,” recalls
Residence Director Christine Rice
([email protected]), who was standing
nearby.“I couldn’t stop thinking about it
when I went home. I’ve got to come up
with something, some way.”
Rice’s evening brainstorm evolved into
You Can Help
To contribute to ALFA’s Hurricane Relief
Fund, visit ALFA Online at www.alfa.org.
the company-wide giving project “Hope for
the Holidays.” Residents and staff of each
Alterra residence across the country will
come together to wrap and fill donated
shoeboxes or similarly sized gift bags with
gift cards for groceries, gas, and other necessities, as well as a handmade ornament and
other items a displaced family might enjoy
during the holidays, such as a disposable
camera and photo album.
“A project like this not only helps the
people affected by Katrina and Rita but
also helps my residents and staff,” Rice
says.At Alterra Wynwood, residents are
already prewrapping shoeboxes, and a
whole range of crafts projects are
planned, such as making bracelets and
tote bags to include in the boxes. Families
and residents of the surrounding community will be invited to join residents and
staff at a big stuffing party December 3.
Rice sees signs that residents are grateful for the opportunity every day. For
example, a resident asked her if it was
OK to drop two stuffed animals into a
collection box for gift items, and of
course, Rice said yes.“One had a little saying on it that she showed to me. I could
tell that she was looking at it for the last
time, knowing that somebody else was
going to be getting it.”
Another special moment was telling Zink
how his small request had grown into a
company-wide program.“I told him he was
going to touch way more people’s lives
than he had imagined,” Rice says.“He said
that last night he was going through his
pants. He had about a dozen pairs and said
he didn’t need them all. I had to excuse
myself because I started crying.”
“Just walking through and seeing that, I
knew if we had been there, so many people
would have been hurt,” Shannon says.
Clean-up and reconstruction is underway, and she is optimistic that residents are
among the lucky ones who will be home
again by Christmas.With her own home
flooded with three feet of water and the
front window blown in, she’s so glad she
convinced her father to come along.
“Sitting at my desk, it still looks like I left
it,” Shannon says.“There are still piles of
paper I’m supposed to be working on—
financials and variances.” ▼
Anya Martin is a contributing writer to
Assisted Living Executive. Reach her at
[email protected].
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HOLIDAY HOMECOMING
When Shannon finally walked back into
Summerville at Kenner one month after
Katrina, she thankfully found no flooding.
However, the storm’s harsh winds had
blown windows out of their casings, shattering glass all over the floor, and the hinges
off of doors.
▼
L E A D E R S H I P
S T R AT E G I E S
WHEN MIDSIZE
Is the Right Size
T
he largest assisted living companies are getting larger as the
market continues to experience
consolidation and the threshold
for going public has become
much higher. As the definition of what constitutes a “largest provider” gets bigger every
year, many midsize companies can expect
to remain midsize for a long time.
How do the ins and outs of the current
marketplace affect the so-called “midsize”
provider? Assisted Living Executive (ALE)
asked three providers representing a capacity of 300 to 840 residents about the opportunities they’ve experienced particular to
being midsize.Their responses lend insight
to the advantages that midsize providers
can have in maintaining their company’s
intimate culture and their hold on their
market, and still having enough scale at the
end of the day to make the deals they want.
Here are excerpts from our recent con-
Company Stats
Commonwealth Assisted Living
Charlottesville, VA, 270 total licensed
assisted living units, 5 residences, State
served: VA, www.CommonwealthAL.com
Intercontinental Services Inc.
(Owners of The Family Connection
communities known as Carlton Plaza
or Chateau), Martinez, CA, 698 total
licensed assisted living units, 6 residences, State served: Northern CA
www.thefamilyconnection.com
Resources for Senior Living
Charlotte, NC, 659 total licensed
assisted living units, 9 residences,
States served: NC, SC, TX
www.rsl-al.com
▼
In a business built one
customer at a time, midsize
companies often excel at
maintaining intimate
company cultures and
hands-on management
midsize is that we provide frequent onsite
corporate management of our buildings.
And we’re there every week. I’ve got
a good sense of what’s going on in each
building all the time. I think as you get bigger, that gets harder to accomplish.
But as opposed to being a small operator,
we’re still able to get attention from important vendors such as pharmacy and food
suppliers.We may not get the best pricing a
larger firm would get, but we get the attention we need to make the business work.
By Whitney Redding
HOWARD: We started out the same way;
versation with Richard Brewer (richard@
we had four buildings right in our backyard
commonwealthal.com), president of
and two buildings in South Carolina.The
Commonwealth Assisted Living of
farthest was only about two hours away.
Charlottesville,Virginia; Jonathan Howard
So we were able to maintain hands-on man(jmh40@aol. com), president of
agement. Later, we developed our teams
Resources for Senior
projects.
Living LLC of CharWe have certainly
lotte, North Carolina,
been able to negotiate
and past president of
national contracts based
RSL-Simon; and Philip
on our size. I think you
Scott (philip@isifc.
can do that—if you’re
com), CEO of Intergood—with just about
continental Services
any size.
of Martinez, California.
Maybe when you
get to 14, 15, or 16
ALE: Each of you repbuildings, you may
resents different marneed a regional office,
kets both geographibut at this point, we’re
cally and in terms of
comfortable with our
BREWER: “I’ve got a good sense of what’s
going on in each building all the time. I think as
the model or combihome office staff being
nation of services you you get bigger, that gets harder to accomplish.” able to manage nine
offer, but what are some of the combuildings.
monalities you share because of your
SCOTT: There are a few ways that I
size? Are there advantages to being
think it’s an advantage. I’ve worked with
midsize?
large publicly held companies in assisted
BREWER: While we’re each considered
living. One advantage is that we’re able to
midsize companies, we’re all actually quite
manage our culture.We’re able to really act
different. My company’s operations are a
on innovative concepts and quickly
cluster within a 20-30-minute drive of each
respond to customers in a timely manner.
other. So I consider the advantage of being
There’s also consistency of our product.
Much like Richard Brewer said, even as
CEO, I’m in the buildings probably every
other week with a presence and a schedule.We strategize consistency of product.
We do have a hub-and-spoke management
philosophy where all of our communities
are within an hour and a half of each other.
That’s been really beneficial in expense
management and response.
Managing culture consistently is key.
We really populate our communities with
the same philosophical bent very consistently from our management team.
people can understand our philosophy and
culture and why we operate the way we do.
I look forward to this consolidation. I
think the real key to managing these buildings is being able to cluster your management and run several buildings in a tight
radius. I think you will see some of these
larger operators sell off the one building
that’s far away from anything else they
own.And hopefully that will offer some
new opportunities to us.
SCOTT: We value relationship development in our selling process. I noticed that
some of the larger competitors tend to be
very reliant on advertising, which, as we’re
all aware, has a poor response rate. And our
buildings are all over 95 percent full in
markets that are exceedingly competitive.
We’ve been able to personalize our
outreach marketing effort with consistency.
We’re using relationship development selling. And when your competitors have a
high attrition rate of sales personnel, it
makes that job a lot easier because we
are a known commodity.
ALE: The recent oversupply of assisted living and senior housing stock is sorting
itself out and assisted living is in a period of
consolidation. Has this affected your business and/or the markets you operate in?
HOWARD: In Charlotte, where we operate four residences, with the exception of
our projects and maybe one or two others,
every other project has been owned by
somebody else.We’ve had some buildings
that have turned over
four or five times. I
ALE: What about any
competitive advanthink that the stability
tages? Anything that
of having the same
you can do better in a
name and management
sense by virtue of
for a period of six years,
your size?
is really beneficial in the
BREWER: This busimarketplace.
There are buildings
ness is becoming so
that are differentiating
complex that you need
themselves from others.
to have some amount
ALE: Is being midsize a good long-term
And through some of
of size.When we startstrategic choice?
these consolidations, you
ed, we acquired three
BREWER: Well, with the size of the public
end up with four or five
buildings and I was
HOWARD: “We were successful because we
offerings today, you can certainly stay middoing everything myself, were able to have a hands-on business where buildings that are run by
size for a long time.There are enough exit
the same company. If
and operations takes an customers understand our philisophy.”
strategies available, including refinancing or
you’re a customer and you’re not satisfied
incredible amount of time. It is much more
sale-leaseback type transactions, that you can
with that company, then you would knock
difficult to be small than to be midsize.
stay midsize and grow for quite a while.
out those four buildings. I think it really helps
I think our competitive advantage with
HOWARD: If you’re structured privately,
a midsized operator who doesn’t have a
clustering is that you share human capital
then you may have a different outlook than
monopoly on that market, because if cusamong buildings.You can start branding and
if you’re structured with a venture capital
tomers don’t like one operation, they’re
share marketing costs among the buildings
fund or an opportunity fund.
going to go someplace else.We’ve been
that a single entity wouldn’t be able to do.
You can certainly stay midsize for a long
very successful in maintaining our market
Our competitive advantage compared
time, but does your financial partner have
share because so many of the other compawith larger operations is consistency.When
the same goal to stay with you for a long
you’re in the buildings every couple of
nies have either played musical chairs or
weeks, you know exactly what you’re offerown so many in one
time, and how do you
ing. If it’s not what you want, you can
market that it doesn’t
define that “long time?”
move to change that quickly. In a larger
give the consumer a
Generally, if you start
operation, it’s just more difficult to do that.
out with venture capital
chance to differentiate
or have private equity,
our product vs. the
HOWARD: I agree. Plus, you have the
you have a time threshcompetition.
opportunities to meet with family members
old as well as an earnas well as employees if there are any comBREWER: That’s a
ings threshold.Your
plaints or positive comments from your
good point about this
financial backers don’t
families.
consolidation. And
necessarily have the
“Locally owned and operated” has some
that’s how we came
same passion or desire
merit in lots of markets. It certainly did in
into existence. Not only
to be in the business [as
our four buildings here in Charlotte.We
when they consolidate
you do].We really enjoy
have competition from everybody—big,
do they take on more
what we do and feel
small, all kinds. And we were successful
buildings, but they sell
SCOTT: “We’re able to really act on innovative
off whenever it doesn’t concepts quickly and respond to customers in we’re providing a great
because we were able to have a hands-on
service.They may not
business, locally owned and operated, and
fit the model.
a timely manner.”
▼
L E A D E R S H I P
look at that that way. So you really have to
sit down with your financial partner and
find out what their goals are.
If a company wants to maintain that
hands-on approach, they’re better off staying
midsized and just growing maybe a little bit
more slowly but at least growing effectively
and maintaining quality assurance, and it
sounds like all of us have that in common.
SCOTT: I would absolutely agree.What I
think we’re all saying is we’re really in the
driver’s seat. I mean we can grow concurrent
with the appetite we developed internally.
We are really in a good position.The
opportunity is available to us generally at
the right price, and we just have to look
strategically if it’s the right opportunity.
ALE: The large assisted living companies
compete with small to midsize providers in local markets but also with
each other on a national scale, and to a
certain degree must have a replicable
model or brand to take from state to
state. How does that affect your ability
S T R AT E G I E S
to compete with them in your markets?
BREWER: We compete with some of the
large operators, and I think the most difficult thing from our perspective is that they
have huge marketing budgets. They also
tend to have larger communities with higher operating budgets. So, from those two
perspectives, their models are tough to compete against, but we certainly can overcome
those things with the local flavor we offer.
SCOTT: We have developed unique selling principles, and we’ve defined those as
being family-owned and -operated.We do a
la carte care services pricing. In our personal expressions department, as opposed to
activities, we personalize everything and
encourage participation.
We also have a satisfaction guarantee.We
go to the market with that. And we are the
best at what we do no matter where we are.
HOWARD: These large companies are not
necessarily better, but they do have bigger
marketing budgets and you just have to look
at it more from a one-on-one, one-customerat-a time perspective. And we haven’t seen
much success in advertising in our local
newspaper or those types of media. It just
isn’t that effective in our markets. People like
to come and see and touch and meet the
people.We try to create an experience so
that when people come and visit us, we set
ourselves apart.And at that point, it doesn’t
make a difference if you’re in a big company
or small company. Customers want to be
with the best company. ▼
Whitney Redding is a contributing writer
to Assisted Living Executive. Reach her at
[email protected].
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Assisted Living Entrepreneurs,
Jan. 25-27, 2006 in Washington, D.C.
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sessions that tackle the challenges of
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T
F
Q U A L I T Y
R E S I D E N T
S E R V I C E S
THE DEMENTIA
Care Conundrum
Balancing autonomy
with liability risk
may require taking
a hard line with
families
Capistrano-based Silverado, are
effectively managing risk and
meeting demand.
ALL OR NOTHING
By Adam Stone
W
hen it
comes to
dementia,
assisted living executives face a thorny problem. On
the one hand, they wish to preserve maximum autonomy for residents.At the same
time, issues of liability can pull assisted living leaders in the opposite direction.
Budgie Amparo (amparo@sslusa.
com), vice president of quality and risk
management at San Ramon, California-based
Summerville Senior Living, recalls the
case of a resident in the general population
who showed signs of increasing aggression,
striking out at staff and pushing other
residents.The family refused to face the
prospect of dementia and would not permit
the psychiatric and neurological testing that
would have created a window for appropriate care.
Weighing the family’s desire for patient
autonomy against the potential liability of
dementia improperly treated,Amparo opted
for caution. He put the family on warning
that expulsion was imminent.“The family
was very upset about that, but in the end
we did have to execute that 30-day notice,
asking them to leave and seek a more
appropriate placement,” he recalls.
When it comes to liability in the context
of a dementia unit, he says, the risks are just
too great.
The demand for dementia and Alzheimer’s care is impossible to ignore.The
aging population virtually guarantees
a growth market.According to the
Alzheimer’s Association, an estimated 4.5
million Americans suffer from Alzheimer’s,
and by 2050, an estimated 11.3 million to
16 million may be diagnosed with the disease. But when you take on an older, more
fragile population, you take on risk.
“If somebody slips and falls, that is a
liability issue for us whether they have
Alzheimer’s or not,” notes Anne Ellett (aellet
@silveradosenior.com), vice president of
health services for 13-property Silverado
Senior Living.“But then you add cognitive
impairment and suddenly you have people
wandering out the front door, people forgetting to come to meals. It does create an
additional liability and it does require additional levels of oversight.”
Clearly, many companies, like San Juan
Dementia care is a highly specialized service that can’t be
delivered in half measures.
“Some assisted living providers
believe it’s OK to keep
[residents with Alzheimer’s]
living within the general community,” notes Merle Wexler
(mwexler@somerford. com),
vice president of resident services and Alzheimer’s care at
Somerford Assisted Living
& Alzheimer’s Care in Gaithersburg,
Maryland.“But is it really a safe environment
if you don’t have the secure doors, if you
have dead-end hallways where a person
can get trapped?” In a dedicated dementia
residence,“you already have all the things
one needs to make it as safe and supportive
as it can be.”
But physical spaces comprise only
a small part of the overall landscape
when it comes to mitigating the business
risks inherent in Alzheimer’s care. Even
more so than in other forms of care,
dementia care requires an intensive
hands-on component.To minimize risk,
a higher-than-usual degree of staff education is critical.
“It is very risky to take these residents
and throw them out into your staff
without proper training,” says
Summerville’s Amparo.
“The greatest risk is that you may have
potential altercations among residents, or
violence among residents toward the staff,
or you may have abuse among the staff,
▼
Q U A L I T Y
R E S I D E N T
with them being aggressive in trying to
force a resident to do something,” he notes.
“You need to have a formalized program of
training that you can impart to your staff
for them to manage this type of diagnosis.”
He adds that a more careful screening
process also is needed once dementia is
added to the mix.“People may be sent to a
dementia unit who in fact are bipolar or
schizophrenic,” he says. To avoid that kind
of mistake, the demands of marketing sometimes must yield to the need for caution.
“If someone is coming from Timbuktu, you
need to ask: Why are they coming all the
way to your building? That is a red flag.”
“It is very risky to take
these residents and
throw them out into
your staff without
proper training.”
—Budgie Amparo, Summerville Senior Living
In one case,“we had a resident who got
into the Alzheimer’s unit, but we didn’t
know that the resident had a history of
psychiatric problems,” he says. In an already
risk-laden environment, that kind of situation can spell big trouble.
As Wexler puts it: “Don’t take somebody
just because they have a pulse and a checkbook.”
CONSUMER EDUCATION
Families can be especially ready to find
fault with dementia care, says Joel
Goldman, a partner at Hanson & Bridgett,
a law firm in San Francisco.“Families may
feel a greater sense of guilt,” he says.“A lot
of people who can deal with cancer still
have a lot of trouble with Alzheimer’s. They
are not comfortable with something that
attacks the mind, and they may lash out at
providers.”
From a legal standpoint, Goldman says,
assisted living companies need to stare
down claims they feel are illegitimate,“and
insurance companies need to stop settling
frivolous claims just because it is cheaper
to settle than to go to trial.”
Educating consumers also is critical in
▼
S E R V I C E S
“If somebody slips
and falls, that is a
liability issue for us
whether they have
Alzheimer’s or not.”
—Anne Ellett, Silverado Senior Living
this respect. Set realistic expectations. If
someone’s mom has been falling, don’t
promise you can make it stop. Staff may
help to keep her safe,“but they can’t promise they’ll keep her from falling.”
Within the residences, meanwhile,
other ways can help ensure that dementia-related care runs as smoothly as possible.There is a world of human subtlety
that must be correctly interpreted if care
is to be appropriate and effective.
ATTENTION TO DIAGNOSIS
Ellett notes that some 40-70 percent of
residents within assisted living may have
at least some mild form of cognitive impairment. In order to deliver care, it is important to make a careful diagnosis of anyone
who may be teetering on the edge.
“Dementia is a global term,” she
says.“You have post-stroke, you have
Alzheimer’s, you have Parkinson’s. There
are various things that can cause dementia,
and it is important that we don’t lump
everyone together, but instead have
programs that can maximize everyone’s
potential.”
More than being merely the right thing
to do, this effort to subdivide dementia into
appropriate classes can be a direct defense
against possible liabilities, especially in the
form of family members whose expectations
for assisted living are steadily on the rise.
“The families are getting more sophisticated in their knowledge and they are no
longer satisfied with someone saying,‘We’ll
keep mom clean and dry and let her sit in
front of the TV,’ Ellett says. Specialization
allows for more appropriate care at all levels of cognition. ▼
Adam Stone is a contributing writer to
Assisted Living Executive. Reach him at
[email protected].
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Q U A L I T Y
R E S I D E N T
S E R V I C E S
You Sign Them Up,
They Move Them In
W
hen Shirlee Williams of
Peoria, Illinois, made
the major life decision
to move from her
home of 11 years to a
new continuing care retirement community
eight miles away, she got a lot of help. A
full-service moving assistance company
found her a Realtor she liked, offered downsizing assistance, checked on her regularly,
packed her belongings, and moved her in.
“I try to make my own decisions and not
rely on my family too much,” says Williams.
Using a relocation company “just took
[away] a lot of worry for me.”
In Williams’ case, the relocation organizers were hired not by Williams or by her
adult children, but by the retirement community she was moving into. In a step that
goes well beyond making a simple referral,
Lutheran Hillside Village (LHV) partnered
with a professional relocation firm so that
Williams—and scores of other new residents—truly received “executive” treatment.
While retirement communities benefit
vicariously from community services that
help new residents make a happier transition from their former home, retirement
communities such as LHV that have formally aligned with a senior relocation
provider are reporting direct advantages to
the company’s bottom line, from making
sales to improving entry fee revenues.
“Instead of trying to find a move-in coordinator, which is mostly a short-term need,
this worked so much better,” says Rita
Vicary ([email protected]), marketing
director for LHV. From opening day on Oct.
7, 2002, to the end of that same year, 97
units were occupied, according to Vicary.
“I was told the industry standard was nine
a week, and we moved nine a day,” she says.
Assisted living providers
partnering with move-in
and relocation assistance
companies are finding faster
fill-ups and a positive effect
on the bottom line
By Whitney Redding
much a local, grassroots movement,” says
Mary Jo Zeller, owner of Gero Solutions
Inc. in Chicago and co-founder of the threeyear-old National Association of Senior
Move Managers.“It’s kind of one of those
light-bulb moment.There’s a definite need
for it.”
Retirement communities view relocation
assistance as a value-added benefit that
gives them a competitive edge as well as
an efficient way to move in a number of
new residents more quickly.
SMOOTHER SALES, AND SAILING
GRASSROOTS AND GROWING
The senior relocation assistance industry,
up to now a cottage industry serving local
markets, is starting to show signs of coming
into its own. While most senior relocation
companies are still small, localized operations, often initiated by a caregiving adult
child or a former senior housing professional with a passion to make such moves less
traumatic, the industry is expanding. At
least one relocator specializing in corporate
and military clients, Chicago-based MovingStation, now offers relocation services for
seniors through its Moving Made Easy line.
“In our area, when we started providing
the service, we were just about the only
ones. Today, there are over 100,” says
Genevieve Auguste, president of the
Washington, D.C., area’s Art of Moving.
As the industry grows, some businesses
are offering more sophisticated services
such as Realtor referrals, cross-country relocations—and partnerships with retirement
communities.
“One of the things we hear all the time
is ‘I didn’t know a company like yours
existed,’ and yet we’re not movers and listed in the yellow pages under that. It’s very
Partnering with a senior move manager
can eliminate a key sales obstacle, according to several communities who have
used such services.“Especially when you
are just building, you have a couple years.
You have to work hard to keep those
sales,” says Vicary. The counselors at
MovingStation who worked in direct contact with residents-to-be such as Williams,
Vicary says,“saved a number of sales for
us—people who were overwhelmed and
were beginning to get cold feet.”
As for communities no longer in fill-up
mode, the ongoing use of a relocation service can offer a marketing edge over competitors.“It very much is a sales feature,”
says Vicary.“If we can say we make your
move easy, it really helps it along.”
Handing over new residents to personal
relocation consultants months before the
move-in also frees up a community’s sales
staff.“They can spend more time working
with new prospective residents,” says
Rick Hunsicker (rhunsicker@greystone
communities.com), corporate vice
president of marketing for Greystone
Communities of Irving,Texas, which also
uses MovingStation.“Think about it—why
Reprinted with permission from the November/December 2005 issue of Assisted Living Executive. © 2005 The Assisted Living Federation of America
▼
Q U A L I T Y
do national corporations use relocation
companies when they move people? It’s
because that’s not what they do well.”
While the relocation company can focus
on helping residents overcome point-of-origin hurdles such as the sale of a house or
the distribution of possessions, the community’s move-in coordinator can facilitate
what happens at the destination.“It is still
good to have someone in the move-in coordinator role, even if it’s not full time, to
make sure everything’s ready when the resident moves in,” says Hunsicker.
The use of a relocation service for a new
community also can make the logistics of a
mass move-in more efficient. The recent
opening of a Greystone community in
Phoenix offers a case in point. At the end of
the first four months, about 90 of 125 units
were occupied, or about 73 percent.“We had
lots of presales and they all started to move
in right away because most of the planning
and organizing, as well as the sale of the
R E S I D E N T
S E R V I C E S
house, was already taken care of,” says
Hunsicker. “That has generated nearly an
additional $1 million in unbudgeted revenue.”
CREATING A RIPPLE EFFECT
Research suggests that use of relocation
services may greatly reduce transition trauma for older adults by moving them in
more smoothly, thereby reducing anxiety
and giving them the services they need
sooner, according to Zeller.“The bottom
line is that the more people put this move
off, the more it affects their health, and the
shorter their retention can be,” she says.
It also can make for a better beginning
for a whole community, according to
Deidre Schwartz (dschwartz@hyatt
classic.com), manager of interior design
and relocation services for Chicago-based
Classic Residence by Hyatt, which supplements its own move-in services with
Moving Made Easy. Schwartz cites a new
community in Palo Alto, California, that has
Tips for Partnering with Relocators
ost senior move managers are small businesses who are used to working directly
for seniors and their families. Most senior
housing providers that use these services are
independent living or continuing care retirement
communities whose residents have not had
experience selling a house for decades and/or
face considerable downsizing challenges.
Senior move managers and the communities
who have used them offer the following advice:
■ Communicate with the sales office.
Senior move managers must be partners with
the community’s sales force, which must not take it personally that someone else is taking
over their carefully cultivated contacts. “You can rest easy. It actually helps the sale,” says
LHV’s Vicary.
■ Seek out good counselors. A good senior move manager understands seniors. “It’s a
counseling role to listen and understand people’s problems and help them solve them,”
says Adams of MovingStation. “Find companies that are flexible not only for the senior
community but also for the resident and family members,” adds Montgomery Place’s Apa.
■ Look for a variety of relocation services. Service offerings vary, as do seniors’
needs. In addition to core assistance with downsizing, packing, and moving, services
might also include housecleaning, estate sales, liquidation, charity giving, personal escorts,
Realtor referrals, reviewing floor plans for new units, and so on.
■ Pay attention to the vendor screening process. How will the relocation managers
handle long-distance moves from outside their usual service area? Do they offer choices of
vendors to residents?
For more information about senior move managers, visit www.nasmm.org.
M
▼
benefited from coordinated, early move-ins.
“By the end of five months, we’re projecting it will be 80 percent occupied. It’s
wonderful. It makes for a more vibrant
community, more activity, more residents
participating,” she says.
Reviewing floor plans to organize a new
apartment in advance is among the relocation services that is most appreciated by
new residents at Classic Residence by
Hyatt, says Schwartz.“The more planning
and organizing that residents do up front,
the quicker they’re settled and out playing
bridge or swimming in the pool.”
Of course, getting off to a great start in a
community can ultimately lead to more
word-of-mouth referrals, says Michael Apa
([email protected]), executive director of Montgomery Place Hyde Park in
Chicago, which uses Gero Solutions services under its own moniker, the Stressless
Move-In Program.“It’s important economically that your current residents are happy,”
he says.
FOOTING THE BILL
The payment structure for these emerging
alliances tends to vary. Montgomery Place
will mostly foot the moving bill for new residents who use its relocation services within 30 days under a three-tier incentive plan
tied to a specific timeline. Other communities offer to pay the bulk of the bill for services only when doing special promotions to
fill communities.
Meanwhile, senior housing communities
using MovingStation’s program typically pay
an upfront fee to cover the planning and
organizing services offered through Moving
Made Easy, with residents paying for the
actual move.
It all comes down to the marketing budget of the community, and the extent to
which the relocation team is actively
involved with helping the community and
not just the resident.“Do you want someone to manage the [relocation] process or
just someone to refer people to?” poses Rob
Adams, president of MovingStation.“We’re
going to help communities sell and retain
and fill fast.” ▼
Whitney Redding is a contributing writer
to Assisted Living Executive. Reach her at
[email protected].
W O R K E R S ’ C O M P E N S AT I O N I N A S S I S T E D L I V I N G
It Takes More Than Better
Lifting to Curb Costs
BY JOHN ATKINSON ESQ.
imber-cutting, metal-working, and
truck driving are jobs you wouldn’t
normally compare with a caregiver
or certified nurse’s aide in a senior living
community. But these professions do have
something in common: statistically, they are
among the most “hazardous” lines of work.
According to the U. S. Labor Department,
providing resident care is one of the
nation’s most injury-prone jobs. In recent
years, certified nurse’s aides actually ranked
first—ahead of truck drivers and laborers—
in musculoskeletal injuries resulting in
workers’ compensation claims.Typically,
these are falls and back injuries. Perhaps
more significant, studies have shown nursing aides and vocational nurses at or near
the top in numbers of lost workdays due to
claims-related injuries.
This data comes despite OSHA’s ergonomic initiatives dating back to the 1990s, specifically targeted to the seniors housing industry, countless seminars, millions in equipment expenditures, and private management
initiatives on worker safety.
Clearly, this is a tough issue—and a costly
one. For many assisted living providers
already faced with unpredictable insurance
cycles, runaway workers’ comp costs can
become a make-or-break line item.
For national operators with locations
across different states, where they must
contend with widely varying compensation
codes, gaining a measure of control over
their costs can be critical to sustained profitability and maintaining shareholder value.
T
CLEAR SOLUTIONS NEEDED
In a few states, workers’ comp reforms have
established medical fee ceilings and may
ultimately help to cut the number of litiga-
COMPLIANCE CORNER
costs into line.A coordinated and comprehensive managed-risk program that is composed of a set of proven guidelines and
actionable steps—plus an unrelenting, dayto-day commitment at all levels of management—is required. It takes work. But the
bottom-line
results can be
immediate and
startling.
CASE IN POINT
There’s no magic bullet to slay
spiraling workers’ compensation
costs. A comprehensive
managed-risk program
composed of a set of proven
guidelines and actionable steps—
plus an unrelenting, day-to-day
commitment at all levels of
management—is required.
tions. But these compromise fixes go only
so far.With national claim trends continuing
to outpace almost all other industries, most
seniors housing executives want clear and
specific solutions—now.
There’s no magic bullet to slay spiraling
workers’ compensation costs.And it takes
more than than better lifting techniques or
equipment to pull your workers’ comp
Consider a company that has
network of
mixed seniors
housing communities in multiple states that
reduced its
workers’ compensation loss
rate by 20 percent in five
years. The company implemented a system-wide workers’
comp and injury management program,
using a generally accepted actuarial measure known as “pure loss rate.” (Pure loss
rate is calculated from reported losses over
several years, then adjusted and trended to
a common basis to allow for comparison
between years—in this case, $100 of payroll.This is a somewhat arcane insurance
statistic usually of interest only to actuaries
and risk officers. But everyone takes notice
when you begin to see dramatic workers’
comp loss reductions of 25 percent or
more in successive years.)
In the benchmark year 2000, with no
dedicated managed risk program in place,
the company had a loss rate of $3.11 per
$100 of payroll, slightly below the national
average.The next two years’ loss rates were
virtually unchanged: $2.81 and $2.78. But in
2003, the state of Florida enacted workers’
comp reform to limit attorney’s fees and
curb fraud.A risk-management consulting
firm was hired and an accountability program was installed.The result was an
COMPLIANCE CORNER
expected 15 percent loss-rate decrease to
$2.34 per $100 of payroll.These results only
strengthened the executives’ belief in further achievable cost reductions—and they
were right.
In 2004, two signal events occurred.
One was the passage of workers’ comp
reform in California, where the company
also operates a number of communities.
The other was the firm’s decision to implement a tailored, system-wide, comprehensive workers’ compensation and injury-management program.The company distributed
step-by-step handbooks to all supervisors,
human resources managers, and regional
risk officers; held Web conferences to introduce the program; and established proprietary relationships with local specialized
medical networks.
Along with functional job analyses and
safety initiatives, a cornerstone of this program is intensive (even hour-by-hour) liaison and management of the injury treatment and claims process with a particular
emphasis on return to work. Another critical element is daily and documented com-
munications between the company’s
employees, supervisors, physicians,
adjusters, and consultants.
Although multi-faceted in execution, the
philosophy is simple: An accident or injury
usually is a chance occurrence, but nothing
else in the process should be.
The result in 2004 was a 27 percent
reduction in loss rate, down to $1.72. So
far this year, the program has pared down
another 25 percent from the loss rate. In
October, it was down to $1.29—68 percent
below the national average. (The national
average is $4.24, according to the National
Council on Compensation Insurance.)
Of course, not every operator can expect
results so dramatic and so soon. But the
case has been made that you can gain a
significant, sustained measure of control
over your workers’ compensation costs
with the right program—and the sheer
corporate willpower to see it through. ▼
John Atkinson is a partner at Thilman
Filippini in Chicago. Reach him at
[email protected].
7 Steps to Effective Workers’ Comp Management
1. Establish a solid, working client relationship with a nearby clinic or physicians’
group. How important is this step? A study this year in The Journal of Occupational and
Environmental Medicine shows lost days and claims costs could be reduced by almost half
when workers are seen by proprietary group doctors, using agreed-upon treatment protocols, rather than outside-of-network physicians.
2. Communicate early and often with an employee during the initial treatment and
follow-up. Document what’s said. An expression of genuine concern, with a neutral but
responsive attitude, goes a long way toward minimizing phone calls to lawyers. Note: This
step is usually the responsibility of the HR manager.
3. Don’t wait for the adjuster—conduct a prompt, fair internal investigation based on
established procedures. Take statements. Preserve appropriate evidence. Write a report.
Use this and other reports for regular trend analyses. Note: Investigate with an eye toward
finding out what happened and fixing it—not affixing blame.
4. Never assume the best. Even if a worker attempts to shrug off an injury, see that it’s
checked out with a physician and get a written report. A sizeable number of serious claims
are reported the next day or next week.
5. Report to your carrier promptly and in detail. Be assertive. Work with your risk officer
or consultant to stay informed and manage the claims process.
6. Train your front-line staff and community managers to own the workers’ compensation claim by developing an accountability program that keeps them financially responsible.
7. Clearly outline the roles and responsibilities of each staff member and department
involved in the injury management process. This includes the injured employee, department supervisor, human resources department, risk management department, regional
manager, adjuster, and insurance broker.
O N
A G I N G
A N D
I N D E P E N D E N C E
CONSUMER VOICE
Community Partnership
Builds ‘Trail’ to New
Neighbors
boring field.
“We look forward to welcoming the
players over after a game for a cook-out,”
Blackburn says.
The community also has launched a
sports club for residents interested in reminiscing about favorite sports teams, players,
and other great memories, as well as making new memories with the group.
BY CINDY PETERSON
OPENING THE DOORS
n an innovative partnership, Sunrise
Senior Living is working jointly with
the town of Burlington, Massachusetts,
to underwrite a large portion of the
cost to create a passive recreation
trail, which will benefit both residents
of Burlington and the new Sunrise
Assisted Living of Burlington.
Dubbed The Sunrise Trail, the paved
walking path will skirt two frequently
used playing fields adjacent to the
Sunrise community and will include
benches and shaded shelters for those who
prefer to sit and watch the activity on the
fields.This project represents another solution for bringing assisted living residents
into the larger community and vice versa—
and encouraging independence.
“We believe strongly in creating a senior
living environment that is integrated with
the larger community,” says Sunrise Vice
President of Northeast Operations
Stephanie Handelson (stephanie.
[email protected]).
“Burlington is a great town that provides for
its elders, and offers innovative recreational
opportunities.The Sunrise Trail is a great
way to honor the unique characteristics of
Burlington.”
I
NEIGHBORHOOD LIVING
Sunrise of Burlington, which opened in
October, was approached by the Town of
Burlington Recreation Department earlier
this year regarding the concept of the trail.
Based on the town’s clear vision and
detail for the trail, Sunrise contributed
$25,000—65 percent of the total cost.
Making Sunrise of Burlington and its
residents a positive, engaged part of the
community also includes opening doors to
local needs. Sunrise of Burlington has contacted several community groups to
discuss their needs for meeting
space. For instance, the local chapter
of a community weight-loss group
began regular meetings at Sunrise in
October. Now, with the walking trail
in the works, community groups can
further enhance their activities.
Whether it’s Alzheimer’s support
group meetings or business planning meetThe Sunrise Trail adds a “passive recreings, the trail adds a dimension of easily
ation” component—such as bird-watching,
accessible recreation.
photography, and nature study—to the
“I envision professionals who work in
many recreation options Burlington offers
this area will walk over to the trail at
residents. Burlington will work to ensure
lunchtime for some exercise, and that our
a safe passive recreation experience for
neighbors will access the trail in the late
people of all ages and abilities.
afternoon or early evening hours. The trail
Sunrise of Burlington is capitalizing on
provides a comfortable setting and a level
the project by launching a walking club for
walking path for light exercise in a scenic
residents that includes both the commuarea,” Blackburn says.
nity’s own walking path and the new trail.
The Sunrise Walking Trail—and its off“This feeling of connection to society is
shoots—could be replicated in other comoften hard to come by as one ages and the
munities. Reaching out to the community
ability to explore the environment is affectin similar ways, such as sponsoring a local
ed by physical or cognitive limitations.We
sports team, inviting community groups to
want to challenge those limitations,” notes
meet in your buildings, and creating special
Trisha Blackburn (BurlingtonMA.ED@
interest clubs that can partake in commusunriseseniorliving.com), executive
nity events, all work toward building a
director at Sunrise of Burlington.
neighborhood environment where conSunrise also will use the trail to introsumers feel at home. ▼
duce intergenerational activities that promote interaction between residents and
Cindy Peterson is a director of sales and
their Burlington neighbors, as well as promarketing for Sunrise Senior Living.
vide engaging opportunities for family
Reach her at 781/237-0987 or
members. For example, Sunrise will sponsor
[email protected].
a local sports team that plays on the neigh-
AFFLILATE SPOTLIGHT
WISCONSIN ASSISTED LIVING ASSOCIATION
Why You Should Boost
Your Training Budget
Next Year
BY JIM MURPHY
very state ascertains its own overall
education needs for seniors housing
providers.Through formal or informal
surveys, feedback from previous conferences, and closely monitoring long-term care
trends and developments, state affiliates can
identify major areas of the business that will
require focused attention in the coming year.
And despite tough economic times, investing in training and education both at the corporate and residence level is essential for
providers.
The Wisconsin Assisted Living Association
will offer 24 educational opportunities
throughout 2006, and ALFA State Affiliates
across the country are planning offerings as
well.Among the opportunities:
■ A two-day intensive seminar for admin-
E
istrators and managers. In its seventh year,
this seminar is limited to 40 attendees, making it a valuable networking opportunity
that enables small group conversations on a
local or regional level.
■ A crisis management seminar that will
focus on local and regional disaster
response. New to the lineup in 2006, this
seminar will feature a guest speaker from a
Gulf Coast provider, who will share lessons
learned having survived Hurricanes Katrina
and Rita.
■ A three-day intensive sales and marketing seminar. Participants can opt to attend
all three days or just those days they
choose.The seminar will feature a new curriculum that focuses on the tips and tools
to build a provider’s census.
And assisted living providers—whether
the training is from ALFA national, their
state affiliate, or other internal programs—
need to make the investment to ensure
their organization’s continued operational
excellence.
Any training at the state level should
be matched with the greater goals of
assisted living in the state.Those goals
may be slightly different in California or
Massachusetts than in Wisconsin, but goals
are set to be met and it’s up to each state
affiliate to do the legwork for its members.
WISCONSIN’S TARGET: RISING ACUITY
Rising acuity levels among residents will
be a major theme for WALA in 2006, so
educational offerings all address this issue
in some way, in addition to other hot-button issues in the business.WALA’s educational training program also speaks to the
greater goal of warding off unnecessary
federal regulation by providing strong
care.
Since its start 10 years ago,WALA has
maintained consistent dialogue with state
regulators to review changes as they have
occurred in long-term care.And while it
may sometimes seem that the state affiliate
and state regulators are on different sides of
an issue, what ultimately drives progress is a
common goal: quality care for residents.
GOOD PROGRAM BASICS
To ensure your State Affiliate is offering
worthwhile educational programming, look
for these elements:
■ The occasional out-of-state speaker.
This outside perspective can spark
exchanges that can only come from a nonlocal person.A good example is the Gulf
Coast provider who will lead WALA’s crisis
management seminar in February.WALA is
asking participants to come prepared to
answer three questions: How do you deal
with a crisis that is your fault? What is your
emergency plan for a residence-wide disaster? And, what is your emergency plan for a
regional or national disaster? Having shared
those answers at the seminar, participants
will come away with solutions that reach
beyond their own community or town.
▼
PRINCIPALS WANTED
RESOURCE LINK
Clarion Bathware
44 Amsler Ave.
Shippenville, PA 16254
814/226-5374 ext 822
AT-A-GLANCE:Fax 814/226-0730
Assisted www.clarionbathware.com
Living in Wisconsin
[email protected]
■ www.ewala.org
■ Number
of WALA
Celebrating
ourmembers:
30th anniversary
519
in 2003, Clarion Bathware is proud
■ Number
WALA member
to be aofleader
and innovator in
assisted
living units:
the assisted
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11,000
Manufacturing over 50 models of
accessible
and ADA
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■ The
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assisted
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Clarion
has
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knowledge
and
into three categories
experience
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you.
See
our
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The largest is the CBRF category
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Total Package Hospitality Solutions
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Activity, Crafts & Wellness Supplies
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1-866-753-1012
To develop a continuing care
retirement community on property
located in the Appalachian
Mountains. This property is located
near the new I73 & I74 currently
under construction and a proposed
new county airport. Said property
is within the corporate limits of a
small town and adequate utilities
The owner
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Seeking
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Up to $ 3,000,000
Investor with 2-3 million
Property
8 Poplar
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years, triple net.
[email protected]
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(559) 288-8217
We now offer
per sonal car e
products!
■ Number of CBRF properties:
1,266 (21,000-unit capacity)
■ Total number of assisted living
properties in Wisconsin:
BUS INC.
4,082 (34,244-unit
capacity) company
a
Champion Bus, Inc.
session thatP.O.
directly
addresses
Box 158
current legislation
Imlayand
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MI 48444
Because
laws regardissues for providers.
Contact:
Rick Lee
ing long-term care can
vary greatly from
800/776-4943
state-to-state, it can
helpful for providers
Faxbe810/724-1844
to attend state-level
conferences that feawww.championbus.com
ture state-specific
content and invite state
[email protected]
officials. Sometimes a state conference also
will address
theBUSES
legislative
regulatory
TOUGH
THATand
LAST!
issues inMichigan-based
neighboring states.
Find outBus
theis a
Champion
specificsbusiness
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in case
staff from
unit of Thor
Industries,
other states
might
benefitleading
as well.
North
America's
■ Targeted
networking
opportunimanufacturer
of small
to midsize
ties. Beyond
a theme
lunch orshuttle
reception,
church,
tour, transit,
and
an organized
roundtable
session
or topicpara-transit
buses.
Ranging
in sizes
specificfrom
panel8discussion
sets the with
stage 7for
to 37 passengers
lively and
practicalmodels,
exchange
of bus
ideas.
different
each
can be
State-level
educational
equipped
to meetprogramming
all customer
can be arequirements.
useful resource for providers,
particularly as it pertains to the needs
and challenges of specific communities. In
MAY 2004for
A Sexample,
S I S T E D L communities
I V I N G T O D A Y with
Wisconsin,
a small staff or a limited budget for travel
can find a WALA session at a nearby location throughout the year. For examples
of educational programming lineups, visit
www.ewala.org. ▼
■A
Jim Murphy is executive
director of WALA. Reach him
at [email protected] or
608/288-0246.
True Fitness
P.O. Box 1747
Roswell, GA 30077
800/474-7646;
Fax 800/474-7647
www.truehospitality.com
[email protected]
Fitness facility design and leading
state-of-the-art fitness equipment.
Contact John Sarver.
Elder Transition Coaching &
Resident Staff Services
Bradley Ann Morgan & Stephan Marais
4750 Lincoln Blvd. Suite 134
Marina Del Rey, CA 90292
Office 310-577-0771
Fax 310-577-8349
www.walksbesidecoaching.com
[email protected]
STATEMENT OF OWNERSHIP, MANAGEMENT, & CIRCULATION
Walks Beside Life Coaching
(REQUIRED BY USPS)
Title of publication: Assisted Living Executive
Publication No.: 1553-8281
Date of filing: September 30, 2005
Issue Frequency: Monthly, except for Jan/Feb,
July/Aug, and Nov/Dec
No. of issues published annually: 9
Annual subscription price: na
Mailing address of known office of publication:
Assisted Living Federation of America, 11200
Waples Mill Road, Suite 150, Fairfax, VA 22030
Mailing address of general business office of the
publisher: Stratton Publishing & Marketing Inc.,
5285 Shawnee Road, Suite 510, Alexandria, VA
22312-2334
Names and addresses of publisher, editor, and
managing editor: Publisher, Debra J. Stratton,
Stratton Publishing & Marketing Inc., 5285
Shawnee Road, Suite 510, Alexandria, VA
22312-2334; Editor, Angela Hickman Brady,
Stratton Publishing & Marketing Inc., 2666
Arbor Ave., Atlanta, GA 30317
Owner: Assisted Living Federation of America,
11200 Waples Mill Road, Suite 150, Fairfax, VA
22030
Known bondholders, mortgagees, and other
security holders owning or holding 1 percent
or more of the total amount of bonds, mortgages, or other securities: None
Taxspecializes
status: na
in the transition of Elders
Publication title: Assisted Living Executive
from
their
homes
intoSeptember
independent
Issue date for circulation data:
Extent
Nature of
Circulation:
or and
assisted
living.
We are certified
Average No. Copies Each Issue During Preceding
coaches
members
of of
the
No. Copies
Single Issue
12 Months&
/ Ave.
to Filing Date
Published NearestCoaching
International
Federation.
Total no. copies (net press run: 8,797 / 8,768
Our program, ‘The Home of the Heart’
(1) Paid/requested outside-county mail subscripassists
theonElder,
their
family,
tions stated
Form 3541
7,351
/ 7,627and
(2) the
Paid community
in-county subscriptions
0 / 0the heartfelt
staff take
(3) Sales through dealers and carriers, street
steps
create
vendors,toand
countertheir
sales 0new
/ 0 home.
(4) Other classes mailed through the USPS 21 / 18
c. total paid and/or requested circulation:
7,372 / 7,645
45
d. Free distribution by mail (samples,
complimentary, and other free) 0 / 0
e. Free distribution outside the mail 1,275 / 973
f. Free distribution 1,275 / 973
g. Total distribution 8,647 / 8,618
h. Copies not distributed 150 est. / 150 est.
i. Total 8,797 / 8,768
j. Percent Paid and/or Requested Circulation
85% / 89%
I certify that statements made by me above are
correct and complete.
—Angela Brady, Editor/Associate Publisher
▼
PEOPLE & PLACES
SALES & NEW DEVELOPMENTS
communities with combined
capacity for more than 900 residents. Sunrise will manage all
of the communities under longterm management agreements.
These communities are either
currently under construction or
will begin construction in 2006.
FINANCIAL NEWS
Summit, New Jersey-based Chelsea Senior Living, owner and operator of eight assisted living communities in New York and
New Jersey, will manage Autumn Woods Assisted Living in Bridgewater, New Jersey. Autumn Woods has a capacity of about
115 and also features Oak Terrace, a 13-unit residence for the memory impaired.
American Retirement Corp.
(ARC), based in Brentwood,
Tennessee, has entered into an
asset purchase agreement with
an affiliate of Epoch Senior
Living Inc. to acquire eight senior living communities located
in seven states for an aggregate
purchase price of $138 million,
plus transaction expenses.Two
of the communities are located
in Arizona and the others are in
Georgia, Kansas, Minnesota,
Nevada, and Texas.The portfolio
has a total of 831 units, including 742 assisted living units and
89 Alzheimer’s units.
ARC also has entered into a
15-year management agreement
with American Seniors
Foundation to manage its
recently acquired Bradford
Village community, an entry-fee
community in Edmond,
Oklahoma.The residence consists of 78 cottage homes, 44
assisted living units, 10 memory
care units, and 102 skilled nursing units.
With the passage of tort reform
in Texas, program underwriting
company Lighthouse
Underwriters LLC, based in
Annandale,Virginia, has
▼
expanded its ElderCare program in that state with an
assisted living package.The
package includes general and
professional liability, automobile, and excess coverage for
assisted living communities,
independent living communities, and CCRCs in Texas.
McLean,Virginia-based Sunrise
Senior Living has entered into
an agreement with MetLife to
develop up to 10 senior living
Sunrise Senior Living, based
in McLean,Virginia, in
September announced a twofor-one stock split of its common stock in the form of a 100
percent stock dividend.The
stock split increases the number
of shares of the company’s common stock outstanding from
approximately 21.3 million to
approximately 42.6 million. ▼
APPOINTMENTS & PROMOTIONS
most recently served as executive vice president of strategic initiatives for the American
Cancer Society.
Erickson Retirement Communities, based
in Catonsville, Maryland, has named (pictured
from left to right) Bruce R. “Rick” Grindrod
president of Erickson Health and Operations.
Grindrod most recently served as executive
vice president of operations for Erickson.
Erickson also has named Mark Erickson, son
of Erickson CEO John Erickson, chief strategy
officer. Erickson most recently served as executive director of an Erickson community in
Parkville, Maryland. Matthew Narrett M.D. has
been named Erickson’s chief medical officer.
Narrett most recently served as regional vice
president and medical director for Erickson.
The Chicago-based Alzheimer’s Association has
named Harry Johns president and CEO. Johns
McLean,Virginia-based Sunrise
Senior Living has named Laure
Duhot senior vice president of
its International Capital Group.
Prior to joining Sunrise, Duhot
was founding partner and principal for Macquarie Capital Partners, an investment bank boutique in London.
New York-based Sterling Glen Senior Living
has named David E. Schneck executive director of its independent senior living residence
in Rye Brook, New York. Sterling Glen of Rye
Brook includes 166 one- and two-bedroom
apartments.
Send People & Places announcements
and photos to Marlene Hendrickson at
[email protected].
AD & MEMBER INDEX
A L FA B O A R D O F D I R E C T O R S
Chair: Steven Vick, CEO
Signature Senior Living
Vice Chair: Michel Augsburger, President & CEO
Chancellor Health Care Inc.
Secretary: Tiffany Tomasso, COO
Treasurer: John “Skip” Comsia, President
Veranda Living
Immediate Past Chair: Thomas Grape, Chairman &
CEO, Benchmark Assisted Living
Evrett W. Benton, President, CEO, and Secretary
Five Star Quality Care
Beth Cayce, CEO
CaraVita Senior Care Management Services
Horace D’Angelo Jr., President
Caretel Inns of America
Joe Eby, President
Bickford Senior Living Group Inc.
Thomas Fairchild Ph.D., Director, Special Projects on
Aging, University of North Texas Health Science Center
Jeff Johns, President
Carriage Court Communities
W. Bradford Klitsch, Vice President of Market
Development, Direct Supply
Mark Ohlendorf, President & CEO
Alterra Healthcare Corporation
Ross Roadman, SVP for Investor Relations and
Strategic Planning
American Retirement Corporation
Loren Shook, President, CEO & Chairman
Silverado Senior Living
Richard P. Grimes, President/CEO
ALFA
AAEC Representative:
Sally G. Michael, President
California Assisted Living Association
COS Representative:
Eric L. Johnston, President
Retirement Community Specialists Inc.
A L FA P R E S I D E N T ’ S C O U N C I L
Michael H. Cook, Baker & McKenzie
Brad Klitsch, Direct Supply Healthcare Equipment
Susan V. Kayser Esq., Duane Morris
Joel Goldman, Hanson Bridgett Marcus
Vlahos & Rudy
J. Michael Stephen, Health Care REIT Inc.
Joe Whitt, HomeFree Inc.
John Baker, IMA Financial Group
Vivek Bhide, Invista
Bryan A. Baird, K&B Underwriters LLC
Casey Pittock, Lifeline Systems Inc.
Art Seifert, The Lighthouse Companies
Carol A. Muratore, McKesson Medical Surgical
Lisa Hanauer, MED-PASS Inc.
Curt Schaller, Merrill Lynch Capital
Elizabeth Finn-Elder, Nathan Sallop Insurance Agency
Inc.
Debbie Zwiefelhofer, Novartis Nutrition Corp.
George F. Quintairos, Quintairos, Prieto, Wood &
Boyer PA
Stephan Axelrod, SeniorMed
Norrell Walker, Senior Psychological Services Inc.
Kevin Pope, Stanley-Senior Technologies Inc.
Loretta LeBar, Stoll Kennon & Park
Douglas MacLatchy, Sunrise REIT
John M. Atkinson, Thilman & Filippini
Greg Thompson, Thomco
Raymond J. Lewis, Ventas Healthcare Properties Inc.
AD INDEX
ASTON CARE SYSTEMS Thomas J. Harrison, 877/240-6774, www.astoncaremanagement.com . . C2
CONCURRO SOFTWARE Teresa Murphy, 650/969-2015, www.concurro.com . . . . . . . . . . . . . . 24,25
DIRECT SUPPLY HEALTH CARE EQUIPMENT, 800/480-7250, www.directsupply.net . . . . . . . . . . . . . C4
HOME INSTEAD SENIOR CARE, Holly Batchelder, 888/484-5759, www.homeinstead.com . . . . . . . . 2
IDEAL SOFTWARE, Lance Raab, 813/864-2160, www.idealsoft.com. . . . . . . . . . . . . . . . . . . . . . . 11
INTEGRAL CONSULTING SERVICES, Janet Welch, 858/677-1286, www.islllc.com . . . . . . . . . . . . . . 17
JCH CONSULTING GROUP, INC., Jim Hazzard, 888/916-1212, www.jchgroupinc.com . . . . . . . . . . 10
KWALU INC., 800/405-3441, www.kwalu.com
..........................................7
MOVE-N-SOFTWARE, Move-N Representative, 817/282-7300, www.move-n.com . . . . . . . . . . . . . . 4
NUSTEP, NuStep Representative, 800/322-2209, www.nustep.com . . . . . . . . . . . . . . . . . . . . . . . 17
OPUS UNIT DOSE SYSTEM, OPUS Representative, 800/228-5021, www.opusmedsystems.com . . . . 1
PLAYWORLD SYSTEMS, Customer Service, 800/233-8404, www.playworldsystems.com . . . . . . . . 8
RF TECHNOLOGIES, Lorna Miller, 800/669-9946, www.rft.com . . . . . . . . . . . . . . . . . . . . . . . . . . C3
SENIOR HOUSING.NET, Brad Fuqua, 888/525-2546, www.seniorhousingnet.com . . . . . . . . . . . . 23
SOOTHEZE, Paul Losch510/657-4577 or 415/269-1427, www.sootheze.com. . . . . . . . . . . . . . . . 20
WAGE WATCH, Jim Crews, 888/330-9243 ext. 6504, www.wagewatch.com . . . . . . . . . . . . . . . . . 22
MEMBER INDEX
Alterra Healthcare Corp. . . 16
Alterra Wynwood of
McMinnville ....................16
American Retirement
Corp................................34
Amparo, Budgie ...................21
Apa, Michael ........................28
Atkinson, John, Esq..............29
Blackburn,Trisha .................31
Brewer, Richard ...................18
Brighton Gardens of
Bellaire............................15
Byrd, DuVal, CPA....................6
Care Technologies ...............10
Classic Residence by
Hyatt ...............................28
Commonwealth Assisted
Living ..............................18
Comsia, John S.“Skip”..........15
Duhot, Laure........................34
Eagle’s Trace ........................16
Ellett,Anne...........................21
EPOCH Senior Living ............6
Erickson Health ...................16
Erickson Retirement
Communities ..................34
Erickson, Mark ...............16, 34
Grindrod, Bruce R.“Rick”....34
Handelson, Stephanie ..........31
Howard, Jonathan................18
Hunsicker, Rick....................26
Intercontinental Services ....18
Janeczek,Ted .........................6
Klaassen, Paul ......................15
Lighthouse Underwriters
LLC..................................34
Lutheran Hillside Village......26
Meadows Retirement
Communities ....................6
Montgomery Place
Hyde Park .......................28
Murphy, Jim .........................32
Narrett, Matthew, M.D. ........34
Pfaff, Debora..........................6
Pine Tree Cottage ................15
Pine Tree Lodge ...................15
Resources for Senior
Living LLC.......................18
Rice, Christine .....................16
Robinson, Sherry .................14
Schneck, David E. ................34
Schwartz, Daniel..................15
Schwartz, Deidre .................28
Scott, Philip .........................18
Senior Technologies/
Stanley ............................36
Shannon, Deeni ...................13
Silverado Senior Living........21
Somerford Assisted Living
& Alzheimer’s Care ........21
Southern Assisted Living .......6
Sterling Glen of Rye Brook..34
Sterling Glen Senior Living .34
Summerville Senior
Living ........................13, 21
Summerville at
Kenner LLC.....................13
Sunrise Assisted Living of
Burlington.......................31
Sunrise at Bayou St. John.....14
Sunrise at Slidell ..................14
Sunrise Senior
Living ...............9, 15, 31, 34
Thilman Filippini.................30
Veranda Living Inc...............15
Vicary, Rita...........................26
Wexler, Merle.......................21
▼
PRODUCTS & RESOURCES
Harris Communications,
based in Eden Prairie,
Minnesota, recently became the
exclusive U.S. distributor of the
ClearSounds CL600
Emergency Connect
Telephone.The multi-feature
phone includes a wrist-watch
style remote control that provides one-touch emergency
access to six pre-programmed
phone numbers. Emergency
contacts receive a pre-recorded
alert message.Adjustable amplification up to 52dB and
adjustable tone control also
make the CL600 a useful assistive device for people requiring
hearing assistance. For details,
go to www.harriscomm.com or
call 800/825-6758.
F O R
A S S I S T E D
L I V I N G
■
■ Winston-Salem, North
Carolina-based Bi-Line Systems
has added a new meal delivery
system to its line of food
service conveyors.The
Rapid Serve is a tray delivery system that features an
instant induction activator
that infuses pellet bases with
enough energy to keep food
hot throughout the delivery
process.The Rapid Serve is
made of stainless steel and is
ergonomically designed for ease
of use. Go to www.bi-line.net or
call 866/787-8367 for more
information.
Marblehead, Massachusettsbased HCPro Inc. has released
a new book and CD-ROM training package developed to help
staff prevent and deal with challenging residents. Managing
Challenging Resident
Behaviors: A Resource and
Training Guide includes 12
chapters that address topics
■
▼
BOOKSHELF
Train Your Brain: 60 Days to a Better Brain
such as understanding cultural
differences, responding appropriately to angry complaints,
protecting staff through documentation, residents’ rights and
responsibilities, evaluating customer service standards, and
more. For more information and
to order, go to www.hcmarket
place.com or call 888/209-6554.
By Ryuta Kawashima, M.D.
The author of this book is a well-known neurologist and leading brain function researcher at Tohoku University in Sendai,
Japan. Kawashima says Train Your Brain is a brain health workbook that—when used as recommended for 60 days—can
improve brain function and stave off the
mental effects of aging. Published
by Kumon Publishing North
America Inc. in Teaneck, New
Jersey, the book contains math
worksheets and reading and memory
exercises. It also includes answer
keys and a chart for recording exercise progress and results.
For details and ordering information,
go to www.kumon.com or call
800/222-6284.
go to www.lapworks.net or call
877/527-9675.
Lincoln, Nebraska-based
Senior Technologies, a
division of Stanley Security
Solutions Inc., has introduced
the TABS PSD Sensor Pad, a
point-of-care monitor system.
The TABS PSD is a disposable
sensor pad that allows staff to
monitor residents while preserving freedom of mobility.The
sensor pads can be interfaced
with TABS Professional Monitors
that alert staff.The TABS PSD
Sensor Pad is designed for
seven-day individual use. For
more information, visit
www.seniortechnologies. com
or call 800/824-2996. ▼
■
LapWorks Inc., with offices
in Rancho Cucamonga,
California, and Peoria, Illinois,
recently introduced Laptop
Legs and PC notebooks and
Mac Feet for Mac notebooks.
Sturdy and easy-to-attach Laptop
Legs (two per notebook PC) elevate the back of the laptop for
improved typing ergonomics
■
and increased cooling and
ventilation underneath the laptop, creating an improved level
of comfort for seniors or any
laptop user. Laptop Legs are a
standard PC gray and Mac Feet
are white. Both products also
can be used to elevate desktop
keyboards, telephones, and calculators. For more information,
Send your Products & Resources
announcements to Marlene
Hendrickson at mhendrickson
@alfa.org.
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-ANAGEMENT3OLUTIONS
PEACEOFMINDFORYOUYOURSTAFFAND
YOURRESIDENTS!NYTIME!NYWHERE
IS DESIGNED TO DELIVER ENHANCED SAFETY THROUGHOUT
&OR MORE INFORMATION VISIT
YOUR FACILITY WORKING IN STEP WITH YOUR POLICIES AND
WWWRFTCOMORCALL
PROCEDURESALLOWINGYOUANDYOURSTAFFTOFOCUSON
THEEVERIMPORTANTTASKATHAND
THAT CAN ONLY COME FROM YEARS OF
EXPERIENCE9EARSTHATADDUPTOAN
#534/-):!",%!.$3#!,%!",%
#OMPRISED OF MULTIPLE EASYTOINSTALL AND USE
PROVIDES A TOTAL CONTINUUM OF CARE
<H=>:E>KM &ALL-ONITORING
AND)NCONTINENCE3OLUTIONS

Assisted Living Executive, Nov/Dec 2005

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