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Senior living operators across the U.S. are assembling their regional leadership teams and strategies in an effort akin to a high-stakes chess match or solving a complex puzzle.
The challenge is that regional leaders are often in charge of driving improved performance at the communities they manage. Operators have different strategies and philosophies for solving those challenges.
As executives look at their portfolios from a 30,000-foot view – weighing tough decisions regarding where to best place regional talent to support operations and cut through staffing challenges – they are often faced with complex problems of blending soft-skills leadership, past experience and skills that meet a company’s greatest operational need.
“From a high level it’s looking at a chess board, strategizing and placing the right specialists at the regional level to help you succeed,” said Onelife Senior Living CEO Dan Williams.
For private-pay rental senior living communities, regional management teams must have “intensity, focus and nimbleness,” as the rental environment creates a “pressure-packed” space with shifting dynamics of occupancy, margin and care outcomes, according to Life Care Services (LCS) President and future CEO Chris Bird.
“We have to make sure that we have the right people driving the desired and aligned outcomes for those communities,” Bird told SHN.
Operators including LCS, Atria Senior Living, Watermark Retirement Communities, Phoenix Senior Living, Onelife Senior Living and Anthem Memory Care are taking steps to evolve the ways regional management teams support communities and execute on home office directives that impact operations.
Regional structures support hiring, retention
It’s no secret in the last four years that senior living operators have faced multiple staffing challenges including high turnover, increased wage pressure on the bottom line or inability to reach potential employees from other sectors.
Des Moines, Iowa-based LCS shifted its regional management structure in 2018 to better delineate between the company’s lifeplan community roots and its fast-growing roster of rental communities, Bird said.
By creating career pathways for new employees with strong regional engagement, LCS has cultivated homegrown talent as associate executive directors, executive directors and department heads have progressed to regional leadership positions. At the same time, LCS launched a recruitment effort to find talent previously out of reach.
For example, LCS has a four-community portfolio in Tennessee in which a regional clinician launched a med tech training program in conjunction with the local nursing board that now helps funnel new care leaders into the industry, Bird said.
“This is a benefit you have when you have people that just focus on specific markets versus having one regional clinician flying to 10 different markets and 10 different communities,” Bird added. “Large companies still have regional focuses and that’s how we have great outcomes.”
A strong regional leader is one of the “most important assets” an operator can have in supporting frontline staff, according to Atria Senior Living Vice President of Functional Operations Abby Figueroa. As valued as creating a welcoming resident experience, Figueroa said Atria aims to “create that environment” where community leaders, executive directors and department heads, feel supported.
All operators that spoke with SHN for this story highlighted the importance of placing regional experts in various areas of operations in the right role to sustain staff morale and further operating performance. For Atria, that means having “regional experts” in operations, culinary, care delivery and sales and marketing.
“The regional focus is on making sure staff are supported and that they can best do their job,” Figueroa said.
Tucson, Arizona-based Watermark Retirement Communities bulked up its recruitment effort while placing “specialists” at the regional level to support operations regarding specific needs. Watermark’s regional leaders, known as managing directors, use a data analytics platform to help prescribe resources needed to support a community’s reduction in turnover and improve retention, according to Chief Operating Officer Karen Mlawsky.
“We can see whether or not our onboarding is working, and we use that information to deploy what kinds of resources are needed,” Mlawsky said. “We’re able to centrally look at whether or not the folks that are turning over in those areas are getting training that we offer.”
But in order to provide the expert-level support from regional teams to frontline workers, operators must have strong policies and well-defined procedures in place from the corporate home office to allow resources to flow down to the communities, Phoenix Senior Living CEO Jesse Marinko told SHN.
Regional teams must be able to oversee execution of policies and procedures—especially around recruitment, hiring, onboarding and retention, Marinko added.
“Our regionals are very plugged into our hiring process because we, like all companies, see turnover,” Marinko said. “We see retention to high correlations to success, and what regionals can do from a staffing perspective is be smart about sharing staff across properties while being very tactical.”
That comes as “the goalposts over time keep moving” regarding staffing challenges that can differ by-market and by-community, Marinko added, which makes having strong communication and available resources vital to improving operations.
Strong regional structures critical to improving operating performance
The road toward pre-pandemic occupancy and operating margin can look different for senior living providers, but the dynamics surrounding a community’s recovery remain the same. That’s why it is vital organizations provide robust regional support to communities in all areas of operations.
But stabilizing a community’s operating performance starts at the community level with the executive director and other department leaders, according to Anthem Memory Care Principal and COO Lewis McCoy. He equated solving community-level problems in operations with regional leadership support to “snapping into place the right puzzle pieces” at the director level.
“We have a roundness of support from all disciplines as Anthem doesn’t seek to point the finger at one individual and say there’s the problem,” McCoy said. “It’s about finding the solution together.”
To identify areas of improvement in a given portfolio of communities, Anthem corporate leaders, regional leaders and community-level directors hold weekly calls to discuss goals and check in on progress. That is mixed with quarterly regional leadership meetings in which leaders can talk strategy and execution on priorities as a group.
To cut through market-specific challenges, Phoenix Senior Living reviews communities’ operating performance and evaluates whether or not to provide additional support from regional leadership to a community.
“I think a regional’s strongest benefit they can provide is a fresh set of eyes to community staff and see things in a different way, and our regionals go in with an open mind. It’s so different at every property and I would say the correlator to success or improvement is most tightly tied to the ED position,” Marinko said.
It takes the “most experienced” regional and director-level leaders to help push a community towards improved operating performance, Williams said. Onelife recently acquired Ally Senior Living and in the restructuring, Williams said the combined companies shuffled regional teams to best support communities that need it the most.
That includes crafting a turnaround plan and executing on that within the community in question, from operations to health services and stretching to sales and marketing efforts, Williams said. That stems from Williams’ belief in allowing regional and community-level leaders to have a certain level of autonomy in crafting a community’s recovery.
Fast-forward from a time in which Williams was a regional manager of nearly two dozen communities to today, regional teams now manage more focused areas with fewer communities to oversee.
“You can’t do that today and be effective or efficient and having more support for the building in a regional setup is critical so that you don’t overlook the communities,” Williams said. “The more regional support you have so you aren’t spread too thin, the better off you are.”
Sometimes spurring change within an underperforming community means regional staff must “literally be part of that frontline team,” assisting in operations in light of a vacancy or staffing shortage, Figueroa said. For example, Atria had a memory care community in Pennsylvania that was dealing with staffing issues in which a regional leader stepped in as the point person in improving the community’s staffing woes.
Anthem takes a similar approach in which regional experts in various areas of operations will step in and assist communities in leadership transitions or supporting existing staff while a new community-level leader is hired, McCoy said.
“We want regional directors to really be proactive and out-in-front of issues at the community level and go to where the needs are,” McCoy added. “It’s a blending of art and science.”
