Meet Erin Shadbolt, CEO of Ascension Living. Shadbolt joined Ascension in 2022 and held roles including Chief Nursing Officer of Post-Acute and At-Home Services and Interim Chief Operating Officer before taking the helm as CEO. Previously, she was a nurse administrator for the Mayo Clinic Health System and served as a hospice nurse.
In her role with Ascension, a St. Louis-based senior living provider spanning 30 communities across 9 states and Washington, D.C., Shadbolt oversees all aspects of the business, including change management. In this Changemakers interview, she sheds light on the areas where Ascension is focused on change, some key opportunities she sees where the senior living industry would be well served to change, as well as what she would like to change if she was able to do so with the wave of a magic wand.
In what ways do you think the senior living industry is changing right now?
The industry is realizing that the product we have historically sold is a product of last resort in people’s minds. A lot of the change I am seeing and hearing about is around creating a product that is so good that seniors are happy to move out of their homes and move in with us. In addition, many operators are trying to balance that with the growing middle-market needs. These combined pressures of needing a different, increasingly affordable product are driving new types of communities and opportunities for organizations and future residents alike.
In what ways do you think senior living operators need to change for the incoming generation of older adults?
Senior living operators will need to be much more in touch with future residents, particularly as we see the general confusion from consumers about the different levels of care provided and a misunderstanding of the value offered to seniors living in the community. Senior living can be a solution to so many of the woes of aging: loneliness, lack of mental stimulation, isolation, safety concerns and the need for regular physician engagement and cognitive activity. It’s time to partner with seniors to build a solution that meets their needs and helps them thrive.
How do you think the senior living industry can change to better educate prospective residents and their families in the years ahead?
There are several tactics the industry should take to improve education and, more importantly, the belief in the value of senior living to prospective residents. An obvious one is the increasing use of social media. Historically, the pressure for an aggressive online presence was low, as many seniors looking to move in with us weren’t technologically savvy. Today, having a social media presence is the norm and will continue to accelerate. It is the platform to tell the story of how senior living is good for aging well. It is less about educating and more about telling the story of how senior living is an answer to many of the challenges with aging, sharing how our communities can help to prevent loneliness and isolation, and support active and energetic lives full of mental stimulation and friendship.
In what ways can senior living companies change the public’s perception of the industry?
There are many ways to do this, but at Ascension Living, we are building out our programming that invites the public into our communities to experience the sense of community, the friendships and the lifestyle we offer. We are building open gym spaces for the public, offering educational events in our communities and encouraging our residents to host their friends, parties and hobby groups in our buildings. Offering this type of programming allows us to serve our residents better and give back to the local communities. Every resident with a great experience is a step towards improving the public perception.
Tell us about some of your recent efforts to change the senior living industry for the better.
Changing the senior living industry for the better begins with changing how we connect with people, both associates and residents. On the associate side, we are implementing something we call ‘just-in-time listening.’ This allows any associate to submit an issue, barrier, concern or recognition immediately through an easy-to-use survey accessed with a QR code. Leaders follow up on these, work quickly to fix them and close the loop with associates.
We also focus on ensuring competency for our associates in every level of care around screening for and intervening on cognitive deficits. Even in independent living, we know that a significant portion of our residents will have some cognitive deficits. We are building out programming and services that allow for early identification, early referral to specialists, and support to stay in that setting that is suitable for everyone. It’s especially beneficial for residents who can make fundamental changes to slow their cognitive decline and manage better with their current status. It also suits our communities that see residents aging in place for longer.
Is the senior living industry moving quickly enough to change in the ways it needs to?
The industry is moving quickly in some ways, but there are some real challenges to being at the forefront of the changes coming to health care. One of the more challenging aspects that we see is that financial incentives tend to allow the best technology to be implemented in acute care first, which immediately puts us behind, especially when our residents experience things in the hospital that are not yet an option in our setting. We are lucky to have great vendor partners in our space that are pushing to keep up. I worry about our ability to provide the services seniors need at a price point that the middle market can afford, both now and in 10 to 15 years. That is why we are focusing on how we can serve those who need our services in alignment with our mission to care for the poor and vulnerable.
Change is hard. Can you talk about a time when you tried to implement a change and things didn’t go according to plan? How did you pivot, and what did you learn as a leader?
Change is hard, and most success comes from learning from a few failures. One of the changes we successfully implemented was a shift away from reliance on agency staff. Initially, when we implemented the change around reducing the use of agency staff, we realized we had not tracked the data to prove whether our efforts worked in real time. As a result, we experienced isolated success and limited ability to track best practices and their impact. But we learned from that and put those learnings into practice when we tried again for our second round, which included a much more robust view of data as we partnered with an interdisciplinary team at each community to dive deep into the root cause analysis of agency use. It wasn’t just about not having enough associates. It was multi-factor at every community, and having the data easily accessible and actionable allowed us to reduce our agency usage by half. As a leader, as we implement change, it is important to be able to engage everyone on the ‘why’ behind the change and have data to help inform the ‘how.’
What’s the biggest change you ever made in your career or life? How did it go and what did you learn?
When I stepped into the role of interim chief operating officer and chief nursing officer at Ascension Living, I had only worked with senior living in my role as a hospice nurse, and then leader, and then working on managing cost of care for a hospital system. Stepping into senior living with limited experience was considerable in setting and scope. Looking back, I made so many mistakes and am so grateful for the team that was so nice, welcoming and willing to help me, teaching me to understand and learn from my mistakes. Overall, it has been incredible and, through this, I have learned that senior living is the place for me. The work is rewarding and fun, and the best people work in senior living!
If you could wave a magic wand and change one thing about the senior living industry, what would it be and why?
I would use that wand to change the public’s perception. This would solve our staffing challenges and would help seniors who could be really well served in our setting come live with us at the right time instead of the last minute.
What fictional character would you enlist to help change the senior living industry for the better this year?
I have young children, so we watch a lot of Bluey at my house. Bandit is Bluey’s dad, and I am bringing him with me to help tell our story! Bandit can take complex ideas and simplify them for children and parents in seven minutes and in a fun and engaging way. Plus, he’s great at creating fun activities and is an excellent asset to our life enrichment programming.
Pretend the senior living industry is a streaming service. What movie or television series best describes the industry right now? And if you could change to a new movie or television series, what would it be and why?
Senior living feels like the show ‘The Office.’ On that show, the characters are selling paper in an increasingly digital world, while we are selling senior living to increasingly tech-savvy, independent and active seniors. Our industry struggles with some of the general challenges that come with a business that has been established for a while, but is facing immense changes. If I could change us to a new series, it would be more like The Golden Girls — with a focus on friendships, living well and having fun.
