Tough decisions don’t have to be bad decisions.

By Steve Moran

A few days ago I published an article titled This Horrifying Nursing Home Story is Absolutely Fixable reflecting a Washington Post story about nursing home employees who were taking grossly inappropriate photos of residents and posting them online.   

In response to that article a reader sent me the link to this article: Residents Blast Samaritan Over Wiley Creek Switch. This is a story about how a not-for-profit gave residents and staff notice that in three months, they would be closing the senior living community, then reopening it as a 15-bed voluntary drug and alcohol treatment center.

Tough Decisions

You can find these kinds of stories in the press several times a year and each time; the first read is a real tug on the heartstrings, but, in reality, it is more complex than that.

  • I know both for-profit and not-for-profit companies from time to time find it necessary to shutter a community. What is puzzling is that the not-for-profits seem to end up with a lot more negative publicity than the for-profits. It is unclear whether or not this is because the expectations are higher for the not-for-profits or that the not-for-profits don’t do as good a job of informing the residents and the marketplace community.

  • The bigger problem is that the stories don’t tell the whole truth. This story is all about the outrage. There is no mention of why the owners decided to make the switch. It may very well have been that the community was losing thousands of dollars per month and was just not sustainable.  

  • What was also curious is that the reason given by the sponsoring not-for-profit was that there was a need for a treatment center in the county. The CEO did acknowledge that the senior living community was not profitable.  

    At the end of the day, when a community is not financially sustainable, it should be closed or managed by someone else. It is unreasonable for the marketplace community or for residents and family members to assume someone else should be subsidizing their care, even when that someone else is a not-for-profit.


  • Give as much notice as possible.  

  • Be transparent as to why you are considering making a change like this. If you are losing money, tell them that, tell them what you have tried to fix it and why it didn’t work. This needs to be done months and months before the decision is made.

  • Tell people in the right order, team members and family members first. It has to be done openly and with a clear and very generous plan to help residents and team members transition to something else. Only after those who care the most are told should the public and the media be notified.   

  • Continue to be transparent. You cannot disclose too much, say too much.

  • Know there will always be haters. It is a very traumatic thing to displace residents. There will be some that just love to have an excuse to complain and hate. There would be nothing you could do to make them happy. They wouldn’t care even if keeping a building open just for them, put the financial health of the whole organization in jeopardy. At the end of the day, you explain what you are doing and why. Tell them you are sorry they are upset, then move-on with doing what you need to do.

This story and these lessons are not particularly about this specific closing. I read two news articles about this particular incident, that lead me to believe there are things they could have done better . . . but, then again, maybe not. I am also pretty sure that even if they did everything right, it would not be good enough.