By Pam McDonald
Times of crisis bring out challenges to overcome as well as chances to demonstrate one’s very best. Lori Alford, COO and a founder of Avanti Senior Living, tells Steve Moran, Senior Living Foresight’s Publisher, stories that demonstrate both. The following are takeaways from their interview. You can listen to the episode here, and learn more about Avanti here.
Very early on in this COVID crisis, we made some difficult decisions, not ones we ever thought we would have to make, and definitely not the most ideal ones. But with the bigger picture in mind — which was to keep COVID out of the buildings and protect our residents, team members, and team member families because that’s who they go home to – we took some very bold steps to bubble up our building.
Avanti Senior Living, Texas, Takes Bold Measures
Part of that was really controlling who was coming in and out. We had to let home health and hospice come in, but we basically told those providers, we just want one person. So, we literally have just two extra people coming in and out of our community versus lots of people, and we did that from day one in early March.
We were only sending folks to the hospital if it were an emergency or a critical necessity beyond our scope from the regulatory perspective. A few weeks ago, we had a situation where a resident had to go out. We told the family, “Your loved one goes out, they don’t come back unless we have a negative test.” At that point, we had testing available. We needed to make sure we were utilizing the resources we had to gain another layer of protection.
“We Need A Negative Test.”
The resident went out and into the week a family member said, “We’re bringing him back.” We said, “We need a negative test.” They pushed back, threatened to go to the media, a lawsuit was threatened. We just said, “You know, this isn’t about the residents, it isn’t about your loved one. This is about protecting all of our residents and all of our team members and all of their families. This is bigger than one person.”
We make an assumption every time [a resident] goes to a hospital, they’re going to be exposed to COVID and bring it into the building, whether or not they have symptoms. All the recognized testing doesn’t always control everything, and it doesn’t tell you everything. We’re still, as of this recording, COVID-free in all six of our buildings with staff and residents. So, with a little bit of luck, a little bit of hard work, and just a lot of diligence with keeping some good controls, we bubbled up very, very early.
The Courts Have A Different Opinion
But on Saturday afternoon I received a love letter from an attorney basically [saying] you can’t keep a resident out. He has a right back to come back. The next day on Sunday, we responded in writing with everything that we had already shared with the family member. [We] said, “I’m sorry, this is bigger. We’re protecting everybody from the virus, and these are our protocols.”
So, on Monday afternoon, seven constables showed up to the community to serve the executive director a Right of Reentry order, [basically] an order from a judge to force us to take him back. They said, “The resident will be coming this evening.” And we said, “Sorry, we don’t have a negative test. We’re not taking the resident.” And we stood by our principal.
Judge Had Never Heard Avanti’s Side
We stood by what we knew was the right thing, despite having a judge who we had never spoken to, [who had] never heard our side, so to speak, and said, “This just isn’t right. Look at New York, look what’s happened in these other states that have been forced to take them. This isn’t right.”
So, they left, and the next day, we definitely had a contempt of court, which included three days in prison in the write up. An emergency hearing ended up being scheduled for later that week. However, another motion was entered into the district court, the same thing, and on Tuesday or that afternoon, the judge issued again, “You have to do this.”
Well, we were lucky enough that we got in front of the judge as soon as we received it and said, “No, no, no, we have a whole other side. We’re not an apartment complex . . . we have sick residents, frail, and some of them are in memory care. And they said, “Okay, let’s have an emergency hearing for tomorrow.” So, we did.
Fighting the Good Fight
Everybody got on a call, it was a Zoom court hearing and, long story short, it went for a couple hours. She asked us if we could all get together and brainstorm some ideas. We said, “The resident can go home with the family again just until we receive the test. We’re not going to charge them. This isn’t about money. Again, this is really about protecting everybody.”
About halfway through the next day, the judge ruled in our favor. Eventually the resident . . . the resident is currently living with us. Actually, within 24 hours, the results came back, so we were able to happily take the resident back. He’s a delightful, delightful resident. Crisis causes a lot of stress and I was really excited because it’s not often I find that the courts stand by operators.
I was extraordinarily proud of the judge in that County because that was a bold move. There’s not a lot of situations that have been like this. In fact, in some states – this is in Texas – but in other states, it’s been the opposite; people have been forced to take residents even if they have COVID. But this particular judge actually stood by our principles. It was incredible, and it sent a great message.
Do the Right Thing for the Right Reason
It kind of gave me some faith back in the court system. There is kind of hope that things . . . if you keep doing the right thing for the right reasons, with no other motive than safety and protection — which is ultimately what we do every day for our residents — that the court system will back you up.
When this all first started – the end of February, beginning of March – I was really nervous when it came to the staffing side. It’s no secret that our industry has struggled with a staffing shortage. Everyone preaches that they have a great culture, including us. We work really hard on our culture, but in a situation with the COVID stuff, I was nervous. I didn’t know and couldn’t predict how the teams were going to respond.
Showing Admirable Courage
They’re scared like everybody else when this was coming out. They’re nervous. It’s the fear of the unknown. The world is doing things we’ve never seen before in our lifetime and in many lifetimes. So, it created a lot of worry. I’m not a big borrow-worry kind of person, but I knew that every operator in my marketplace were all thinking the same thing, how are we going to make sure we have enough staff to take care of our residents as required by law?
So, it was extraordinarily awesome when our teams showed up and they kept showing up and they kept showing up. And call outs became less, overtime became less. We’re going into May and we have the lowest overtime in the history of the company. We have the lowest amount of call-offs in the history of the company. We have more filled positions than ever before.
It’s About the Culture
Ultimately, I think during times like this, you really see the cultures that were already weak. Everyone says their culture is awesome . . . but those words are so easy to throw around. But in times of crisis, if you have a really strong culture, it gets stronger.
If you really study the wars or times of any type of crisis — whether it’s financial or 911 — people seek leadership. And what they want from those leaders: they want a plan. They want the confidence and to know how you’re going to execute the plan. They want hope and they want to feel safe. They want to know that they are safe with you. So, from the very beginning, from day one, our mantra was our people come first.
Letting Frontline Staff Know They Matter
Those weren’t just words, right? We worked really, really hard to make sure that we over-communicated with our team. During this time, people need it more and so, we started to utilize different vehicles of communication. I started, two or three times a week, sending out a message to our frontline team members. We verbally talked to our department heads, but it was really about getting to our frontline people to let them know that they mattered.
Out of the gate, and we continue every week, to put up yard signs. Our first one said, “Heroes Work Here.” One of the favorite stories I heard, that one of our salespeople shared with me, was that she was sitting in her office and overheard two care partners come into work. And one of them said, “Hey, did you see that sign out front?”
And the other one said, “Yeah, the one that said ‘Heroes Work Here’”?
And the other lady said, “Yeah, are they talking about us?”
And the girl goes, “I think so. Like Avanti thinks we’re a hero.”
And the other one was like, “Well, that’s kind of cool.”
What a great wow. And all that was was a yard sign that said, “Heroes Work Here.” And we’ve changed the message every week. So, we’ve had “Thank You Heroes.” We had “Our Heroes Rock,” “We Love Our Heroes.” I think that went a long way.
Sweetening the Pot
But at the end of the day, people like a reward. And so again, very early on, we did a $2 an hour hero pay increase across the board. It didn’t matter if our building is surrounded in a COVID area in all of our marketplaces. There’re tons of operators that have COVID. And we have a building right outside of New Orleans, so that was a very concerning one. But we did it across the board.
We didn’t wait. We pulled that trigger very, very, very early. It was supposed to end at the end of April, and on the last day, we sent a big thing that said “Extended” across the top and we’re going to continue to do the $2 an hour hero pay through the end of May.
Educating Staff So They Can Inform Family and Friends
Along the way, we have really just made sure that we’re calling department heads and thanking them. We’re sending handwritten notes to their homes. We’re making sure that our frontline team members know that we care about them. Our messaging has been more about: “We need to take care of you. So, hey, here’s information.”
We’re providing them information that isn’t necessarily pertaining to senior living. It pertains to maybe what their county is requiring or what their local judge has said. Or just basic information that we’re hearing from the CDC. And we’re saying, “Hey, take this information. Educate your friends with it, educate your family with it. And here’s why.”
Buy-In from the Whole Staff
Because we all have to do our part, since at the end of the day if we can get buy-in from all of the team members to have good hygiene, social distancing, staying home when they need to be home; if we can educate them with real information and the right information and not fake news, then again, they feel protected.
They’re going to do it. And then when they come into the building, we can know we’ve somewhat helped guide their personal life, which ultimately rolls over right into their professional life. So, when they’re coming into the building, they haven’t been exposed as much as if they were just not really following the rules.
Shoot for Authenticity Rather Than Perfection
Another nugget that I’ve learned and it’s still hard for me – as a leader, you want to be perfect – I tend to overanalyze my messaging. I tend to want to make sure that my words are perfect and on point. We have a platform in the company that we use to communicate. It’s kind of like an internal social media thing. And the first couple of my posts, I spent a lot of time doing them. I wanted them to be perfect and my own story was I want everyone to be proud that I’m this perfect leader.
And it was time-consuming. But after about the third one, I knew I needed to get communication to them, but I didn’t have the time or the bandwidth to spend to write this perfect post. So, I just started posting what was on my heart. If it was on my heart, whether it was wrong or right, whether it was something that was super important or something that really wasn’t. And all of a sudden, the responses from our teams were far greater than ever before.
What I learned is just be you, genuinely just be you. It’s okay to say, “Hey, I am not a good homeschool teacher. I’m struggling with that in my own home.” Because a lot of them are too. And, it’s okay to say, “I am scared too.” I was on a call where I said to our wellness directors, “I’m scared, and I’m scared for you. I’m more scared for you than for me.”
And it’s just really been amazing that when you speak from your heart, the way that is genuine and authentic . . . I get emails saying, “Thank you so much for just sharing this. I was struggling too, and it’s nice to hear that so were you. Now I feel better about struggling cause you’re struggling.” That’s been pretty incredible as well. That’s been a leadership lesson for me.
Thank You, the Most Powerful Phrase A Leader Can Use
I’ve also learned . . . we all have studied ways to motivate team members, right? In times like this, you have to have a lot of different vehicles that you can use to motivate everybody. Researchers have always said it’s not always about the money, it’s about making them feel a part of the purpose and appreciated.
And we’ve made them a part of the purpose by saying, “Our goal is to be COVID free. Not just for our residents, but for you too. So, let’s do this.” And along the way, the words, thank you, go far. We’ve so undervalued two very simple words that become, literally, the most powerful phrase that a leader can ever use, if it’s authentic. I think if we can learn from each other, it just continues to make our industry great, a great thing, and a great place.