Guest Columns

Building up the executive director's tool kit

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Stephen LaPierre
Stephen LaPierre
Continuing care retirement communities [CCRCs] across the country face considerable challenges due to the struggling economy and depressed housing market, including reduced new sales, looming reductions in government reimbursements, uncertainty of the impacts of health care reform, and continuing poor return on investments.

Charitable contribution coffers will no longer sustain the growth required to maintain the organization's viability. Non-profit CCRCs and their executive directors must explore new, more innovative channels for generating revenues. 

Executive directors of individual CCRC campuses must fine-tune their tool kits to keep their facilities top of mind with consumers, and ahead of the impending sharp curve of consumer preference. Complacency and “resting on your laurels” will not have a place in tomorrow's market.

The following recommendations will provide executive directors guidance for continuing their campus' evolution toward growth and viability.

1. Position yourself as the “Thought Leader” for retirement living and senior care services in your community. 

Keep informed on current events and government legislation that may impact senior living and health care services. Be prepared to answer “how will this impact me?” questions from your residents, as well as from members of the community at large.

Develop relationships with local media outlets. Write editorials for the local newspapers and online media. Become a member of, and speak to local business organizations and senior centers. Volunteer to serve on the boards of directors for local healthcare agencies and county departments of aging and long-term care. 

Leverage social media. Actively manage your facility's website and web presence. Use Twitter and/or LinkediIn, along with topical blogs, to expand your networking and increase marketing exposure. These activities and interactions will develop your reputation as a being well informed and a valuable resource in the community.

Becoming the “Thought Leader” will raise the perceived quality of your brand as you introduce new services to your community.

2. Diversify your service offerings.

Home Health/Homemaker Services: The healthcare preferences of the next generation are trending toward home care. Develop home health/homemaker companion services to be delivered in the homes of your local community.  Cross training skilled and non-skilled nursing staff to provide facility-based, and home-based care services will ensure consistent quality of care in both settings, and a continuity of care for clients transitioning from their homes into your facility.

Respiratory Therapy Services: Having a respiratory therapist on staff in your nursing facility will help to reduce hospital readmissions for residents with respiratory complications. This service will benefit the resident, and help your local hospital control readmission rates, making you a great partner in the eyes of the hospital.

Outpatient Therapy Services: Most CCRC campuses are already providing a full spectrum of therapy services within their nursing facilities. Expanding services to include outpatient therapy provides another opportunity for future residents to be exposed to your facilities and quality of care culture. Outpatient therapy services are the perfect complement to your home healthcare services.

Social/Recreational Outings:  You already plan trips for the residents of your campus. Invite the general public to participate in a trip to the theater, shopping mall or dining event. Always have the trips start at your campus so the community guests can learn how to find your location, and have the opportunity to see the grounds and hobnob with your residents.

Mind & Body Wellness Programs: Offer onsite exercise programs and consultations for physical, dietary, and cognitive wellness. A health fair offering blood pressure, osteoporosis and memory screenings can be very effective at attracting the community to your campus. These programs can be offered to residents of your campus, as well as to the community-at-large, for free, or for a nominal fee.

Leverage Health Maintenance Technology: Introduce or expand the use of evolving technology to assist your residents, and their primary care providers, with managing their health conditions. These programs will track an individual's compliance with prescribed regimens for activities, treatments and medications, and provide early warning signs of impending health issues, all from the comfort and convenience of their residence. These programs can be very effective helping to avoid major personal health events, and at reducing unnecessary hospitalizations.

Home Economist Services:  Keep your organization's name in front of the community by offering home economist services. This fee-for-service program assists community seniors with organizing their monthly bills, and with filing appropriate claims with health insurers and Medicare/Medicaid intermediaries.

Senior Transportation Services: Use facility shuttle buses to offer discounted fee-for-service transportation to members of the community-at-large. Transportation routes to medical offices, senior centers and polling locations would be good fits.

Public Dining Option:  Open your dining facilities to the general public one or more evenings per week. This affords the curious future customer the opportunity to visit, sample the cuisine and conduct a pre-sale reconnaissance of your grounds and facilities. A wonderful experience in your dining room will translate into valuable “word-of-mouth” publicity.

Lease Meeting Space: Do you have a dining room or multi-purpose room that is not being used to its capacity? Generate revenue and community public relations by offering the space for lease as a meeting location for local businesses and service organizations.

3.  Build strong relationships with educational institutions

Locate the universities and community colleges in your market area and identify which schools offer degree and/or certification curriculum in healthcare professions. Participate as a clinical site for Skilled Nursing and Certified Nursing Assistant programs, Therapy Assistant, Social Services, Recreational Therapy, Pastoral Interns, and Certified Case Management programs.

Hosting educational training programs enhances the reputation of your facility, serves as a recruitment tool for new staff, and allows you to evaluate, first-hand, the aptitude of new program graduates.

Finally, invite distinguished faculty from local universities and community colleges to speak to your family council, address staff meetings and provide lectures and adult learning courses to your residents, and the public on topics of current interest related to health care.

4.  Proactively Manage Regulatory Relationships

Introduce yourself to the primary regulatory contacts at your state's Department of Insurance and Department of health. 

Don't wait for the state survey team to walk into your building. Make an appointment to visit the Field Operations Manager [FOM] for your region and tell him/her about the positive programs you are initiating. Ask the FOM for input. What have they seen work and not work at other locations?

Seek out your state ombudsman. Invite them to visit your facility. Establish a channel of communication.

Developing these relationships will help the regulatory agencies recognize your commitment to quality and give them confidence in—and a comfort level with--your entire organization. 

In these challenging economic times, there is a tendency to batten down the hatches and ride it out. But with these challenges come opportunities, and tomorrow's senior living market will not behave like today's market.

Executive directors must stay abreast of regulatory evolution, industry trends, and consumer preferences. They must explore all opportunities to expand their organization's service footprint within their communities. Use these recommendations as your guiding light to a successful tomorrow.

Stephen R. La Pierre, MBA, NHA, HFA, is the president of the OASIS: Operations Analysis Strategies Innovative Solutions LLC.


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