By Jack Cumming
Nearly 50 years have passed since senior living found a new birth in a conference room at the IRS. From that day forward all housing for the aged could qualify for tax exemption. That birth of not-for-profit market-priced affluent housing promised a new era in which older people could live in comfort with dignity.
Now, fifty years later, senior living is a mature industry with a relatively set structure. For a growing number of prospective residents, senior living is seen as a fallback life choice. It’s a refuge of last resort, to be accepted only after a “trigger” calamitous health event signals readiness for “that.”
As we emerge from the pandemic, the workforce challenge has come to prominence, suggesting that even employees consider senior living fallback employment, the job of last resort, when there is no other choice. Thankfully, many employees persist because they love the residents and love helping others. Let’s hope we can retain them. But we can be more than the last choice; we can be the best choice.
But, before we get into that, let’s revisit the optimism of the birth of today’s senior living fifty years ago.
There’s A Place You Can Go
It was a new age. Remember the song of that era, YMCA? Of course, you do. With very little paraphrasing it fits the reborn senior living industry as well.
Old folks, there’s no need to feel down
We say, old folks, pick yourselves off the ground
We say, old folks, ‘cause you’re in a new age
There’s no need to be unhappy.
Old folks, there’s a place you can go
We say, old folks, when you’re short on your dough
You can stay there and We’re sure you will find
Many ways to have a good time
It’s fun to stay at the CCRC
It’s fun to live at the CCRC
Ronald Reagan was President, and he promised us “morning in America.” And indeed, by the end of the 1980s, the Berlin Wall came down, the end of the Cold War seemed imminent, and a new era dawned for senior living. What joy it was in that time to be alive.
To work in senior living was to be called to a promising new industry, marked by public service, and committed to the well-being of both those served and of those who served them. No longer was housing for the elderly philanthropic with hospital wards for those near life’s end. Senior living had a fresh, new vision. It was a time of uplift. People working in senior living felt good about themselves.
Having a welcoming place to live where one feels at home is not unique to the young, as the young author of “YMCA,” Jacques Morali, newly landed from Paris in the seeming anonymity of New York. It’s not unique to old people either. It’s a human wish for people of all ages. Morali found it at the YMCA. That newborn CCRC of the 1970s and 1980s gave old people who could afford it a place where they, too, belonged and were welcome. It was exhilarating.
Senior Living Today
Recently, there has been much gnashing of teeth in the halls of power over the “workforce challenge.” There is widespread difficulty finding people willing to fill the low-paying, demanding jobs that abound in today’s senior living. Something I overheard recently, brought me insight to share with you.
Now I know that eavesdropping is wrong, so I know that I did wrong. I was listening recently to two employees talking shop. I shouldn’t have. Still, I was sitting in plain sight and didn’t think I should have to leave. “Loyalty should cut both ways,” one employee was saying. That caught my ear. “Mary shouldn’t have been penalized for getting her LVN.” What!?, I thought as the conversation continued.
It seems that Mary (not her real name) had worked as a CNA but had gone to school on her off-hours to qualify as an LVN. The resident-funded scholarship program had helped pay for her success. Instead of praise for her achievement, she was told there were no openings for an LVN. She could continue as a CNA or she would have to leave. She found an LVN job nearby and, then, when an opening arose she came back to the colleagues and residents she loved working with.
That’s when she discovered that the employer treats such a break in service as an act of disloyalty. She lost her seniority. She lost her 401(k) match. Now I understood what was meant by what caught my attention, “Loyalty should cut both ways.”
Loyalty Is Mutual
Employers show loyalty to employees by encouraging their growth, supporting their achievements, and paying them fairly and competitively. Employees show loyalty by persisting on the job even as opportunities elsewhere present themselves. That mutual loyalty, that commitment to each other, lies at the heart of the workforce challenge.
If you’re a fan of business and love episodes of Shark Tank or Marcus Lemonis’s, “The Profit”, as I do, then you know that there’s more to business than self-aggrandizement, wealth, and profit maximization. The endless fascination of business is how nuanced it is and how it brings together all the elements of our humanity for a common good.
Senior living is a people business in which employees interact with residents to form a unified mutually supportive community. Marcus Lemonis likes to share his 3Ps for business success which are “People + Process + Product = Success.” The senior living product is a people-serving product. So showing people – employees, residents, families, prospects – that they are valued is central to performance, and performance is the key to profit. If a business is loyal to the people it engages with, they will return that loyalty with dividends.
Otherwise . . .
It’s A Team Effort
The mutuality of managers and employees in loyalty to a service mission is easily lost when decisions and approvals are made in remote central offices, far removed from the communities where that service mission is fulfilled. Those central offices may be staffed by qualified, select, high-paid, elite functional executives. Still, that very authority and lofty position shield them from the trials of those who do the work.
Think about that. Remote managers set the rules for employees in local communities. When work standards fall short, it’s the residents who are impacted, not the folks in the central office. Logic then suggests that a senior living enterprise can improve operations by integrating more closely with local community life and operations. Conclusion: every central office should be collocated with an operating community that can serve as a laboratory for new ideas and that can also sensitize elite executives to the dignity of frontline workers.
Of course, bridging the distance from high level to low-level employees will also likely bring about other changes, including creating paths for career advancement so talented workers with ambition stay with the enterprise. As respect for workers increases, so derivatively will respect for residents. Happy residents can lift the prospects for the entire organization both financially and with potential future residents.
Breaking the Bonds
Entrenched beliefs create boundaries that limit senior living prosperity. We’ve touched on these elsewhere. Clinging to nonprofit qualification and tax exemption limits financing options, inhibits growth, and may contribute to a more stagnant corporate culture. Retaining age boundaries prevents younger people from benefiting from the comprehensive services which senior living is expert in offering.
Age segregation also deprives older people of the more natural mixed-generational living that most prefer. No wonder people choose to “age in place.” Senior living is becoming the fallback living choice, the last choice, for more and more people who want to remain part of the larger community.
The hierarchical vision of corporate organization and governance results in central control and multi-layered approvals, which likewise inhibit innovation. Senior living lags other housing alternatives. Its properties are dated. It’s less welcoming of change. There are leaders who see the need for change but who fear the bold action to realize the promise. As the industry lags, the market gap widens, making it more likely that the decline will continue.
Looking at the working culture, benefits like onsite childcare and corporate paid tuition reimbursement seem like they should be natural perks consistent with the positive service values of senior living. The prohibition on tipping, except for the holiday gratuity program, makes the industry seem archaic even as it could structure such recognition to benefit both back of house and front of house workers fairly. Other industries are beginning to rise to the challenge, and workers know that.
The arrival of gig economy flexibility makes the rigidity demanded of employees seem unattractive. Having low-level workers punch a clock while others are exempt creates a class structure that some industries have eliminated. Wage rates are only part, and a minor part though an important one, in resolving the challenge of an industry that increasingly is fallback employment for those who can’t find work elsewhere.
Meeting the Challenge
The workforce challenge, the reputation challenge, and the sales challenge are difficult indeed. It will take bold, imaginative, pragmatic leadership to bring about the great leap forward that would be required to make senior living, perhaps reclothed as “better living,” the prestigious choice that was its birth legacy.
That’s the opportunity for those who test it, pilot it, gain needed knowhow, and lead the way forward. The change that was born in that conference room so long ago was dramatic and gave us the industry in which most of today’s senior living executives have thrived. Equally dramatic evolution can give us better living for the 21st century.