cala news & views · 2018-01-03 · emily shipman administrative assistant...
TRANSCRIPT
News & ViewsThe Vo i c e o f Ass i s t e d L i v i n g
CALA
planning
Spring | 2013
strategic success
unexpected E V E N T
the
planning for media scrutiny
THIS ISSUE4 The Unexpected Event: Planning for Media Scrutiny
6 Planning Ahead With CCLD
9 Bubble Wrap and a Helping Hand: Supporting Residents Through the Downsizing and Moving Process
12 Strategic Success: Two Approaches to the Process of Strategic Planning
18 Emergency Preparedness in Assisted Living
21 The Creative View
22 The Punchlist: Renovations and Remodels
24 Consider, Discuss, Document: The Importance of Advance Care Planning
26 Advocacy Day Recap
27 Long Term Care Insurance: An Important Part of Retirement Planning
30 Mind the Gap: A Review of Succession Planning Research
CALA BOARD OF DIRECTORS
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Perhaps the reason the “best-laid plans of mice and men” often
go awry is that they weren’t really all that best-laid. In an era of crisis-driven news,
expectations of 24/7 access, and the need for a rapid-fire response, it’s increasingly challenging
to spend time developing and fine-tuning plans of any sort. However, in this type of environment, planning ahead becomes even more important—only then will the “best-laid” plan be ready when you need it. This News & Views considers many aspects of planning important to Assisted Living professionals.
Board Chair Don Petersen, Principal, Commons at Dallas Ranch and Co-Founder of Premiera Care
Vice Chair Sheila Garner, Regional Vice President, Brookdale Senior Living
TreasurerTodd Shetter, Chief Operating Officer,ActivCare Living
Doug Armstrong, Senior Vice President, Assistant General Counsel, Atria Senior Living GroupMichel Augsburger, Chairman & CEO, Chancellor Health Care, Inc.Bart Bolt, Divisional Vice President, Five Star Senior LivingDale Boyles, Vice President of Operations, California Division, Emeritus Senior LivingVicki Clark, Director, Vintage Senior LivingMichelle Egerer, Senior Vice President of Operations, Silverado Senior LivingLarona Farnum, Chief Operating Officer, Western Living ConceptsJoel Goldman, Partner, Hanson BridgettPaula Hertel, Executive Operations Officer, Bayside Lakeside ManagementRick Jensen, CEO and Partner, Northstar Senior LivingChris Kasulka, President & CEO, Oakmont Management GroupDanielle Morgan, Senior Vice President of Operations, MBK Senior LivingTerri Novak, Chief Operating Officer, Kisco Senior LivingNancy Schier Anzelmo, Principal, Alzheimer’s Care AssociatesJeff Slichta, Vice President of Operations, Sunrise Senior LivingCollette Valentine, Chief Operating Officer, Integral Senior LivingBrant Watson, Senior Vice President, Heffernan Insurance BrokersPatricia Will, President & CEO, Belmont Village Senior Living
Nancy BallDirector of Meetings Management and Associate [email protected]
Katie CappelloPublic Affairs [email protected]
Megan GeremiaAssociate Director of Public [email protected]
Heather HarrisonVice President of Public Policy & Public [email protected]
Sally [email protected]
Haty PietraszEducation and Graphic Design [email protected]
Emily ShipmanAdministrative [email protected]
Jan TrifiroDirector of Professional Development and Member [email protected]
CALA: 455 Capitol Mall, Suite 222Sacramento, CA 95814Phone: (916) 448-1900 Fax: (916) 448-1659www.CAassistedliving.org
SecretarySteve Delmore, Executive Vice President, Operations, Merrill Gardens, LLC
Immediate Past Board ChairSue McPherson, Senior Vice President of Resident Services, Aegis Senior Communities
CALA News and Views – Submission PolicyAt this time, CALA does not accept unsolicited articles or queries. Many of the articles we publish are written by our regular contributing writers. We appreciate the time and energy people put into making suggestions for our current and future issues. Our organization’s policy, however, prevents us from accepting for review any unsolicited submissions.
CALACALACalifornia Assisted Living
Copyright © 2013 California Assisted Living Association. All rights reserved. No part of this publication may be reproduced or transmitted in any form - print, electronic, or otherwise - without written permission from CALA.
IN
PLANNING
4
We may not always identify a particular situation as one that
warrants a full-blown crisis response. At the time, it may not seem like something that could spiral out of control or take on a life of its own. But recent events that have touched providers nationwide remind us of the importance of looking at and preparing for a disproportionate and potentially prolonged reaction to issues we face, whether they occur in individual communities or throughout the whole of Assisted Living.
Perhaps one of the most important times for effective communication is during a crisis situation. In the immediate aftermath of a crisis event, there is barely time to let people know what is happening, let alone the time to think through a strategy and make a realistic assessment of what the impact might be. Advance planning is immensely helpful in protecting against long-term
damage following an unanticipated event. Developing a plan will allow you to act promptly and decisively, and be a credible communicator in the wake of a crisis event.
Mitigating Damage During a CrisisIn recent years, Assisted Living communities have focused on the need to develop comprehensive emergency plans. Throughout California, CALA member communities have
done a tremendous job of compiling thorough, detailed approaches to disaster preparedness and response. A crucial component of any community’s emergency plan, whether it is for a natural disaster or other type of crisis, must be a media and communications response plan.
In this plan, key determinations should be made to ensure success in communicating effectively. These elements include:
Assisted Living is making its way into the news more and more every day. As our care model grows in popularity and becomes a regular part of more people’s lives, the level of attention on and scrutiny of Assisted Living will also increase dramatically.
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Planning for Media Scrutiny
unexpected E V E N T
theBy Denise Davis
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X The person responsible for assessing communication priorities–who is impacted, what information the various audiences need to receive, how and when that information is disseminated
X The person responsible for realistically evaluating the extent and severity of the crisis
X The person responsible for gathering information and ensuring its accuracy
X An established protocol to respond to or reach out to the media
Developing a MessageWhen an event impacts your community, what should you say? The message must be factual and include an honest assessment of events. An easy way to prioritize what you need to say is to develop three main message points. Write these points down and use them to frame all communication related to the crisis.
In addition, prepare a written statement that can be disseminated to reporters at a moment’s notice. When reporters call, this written statement is an effective way to educate and inform quickly. The sooner you are in the story, the more influence you will have in shaping the narrative. Written statements can be critical to minimizing misperceptions that may develop or correcting the record in the event that errors are already in the public domain.
Selecting a MessengerWho should deliver the message? Should it be the executive director? The resident services director? The activity director? The answer is all of these people, plus your marketing team, your senior dining room staff, the receptionist, and others. For the benefit of your residents, everyone in the organization should be made aware of any major event that impacts the community, the community’s planned response, and the path to long-term resolution.
Your staff needs to understand the three main message points you have developed. It is likely that residents
will ask the first staff member they see or the one they know best about a particular incident and how the community is handling it. To avoid the spread of incorrect information, be sure to equip your staff right away with the information they need so that they can work with you to inform residents.
It is also important to designate a spokesperson to handle any contact with the media. This person should be a senior-level staff member with the necessary training to effectively represent both the community and the company as a whole. Providing something in writing to residents and families as early as possible is extremely effective in getting correct, credible information into the community.
Working with the MediaMedia attention on your community during and after a crisis can be distracting and stressful. However, responding to media inquiries in a timely and professional manner is a must. As a responsible and resident-focused provider, you need to be sure that news coverage accurately reflects the truth, and that the actions taken to ensure the safety of your residents are communicated to the reporter. If you are contacted by the media during or after a crisis, there are several things to keep in mind:
X Determine three key, fact-based messages to work from. Let these message points guide your response to reporters’ questions.
X Do not respond to specific questions about individual residents or their circumstances. Speak generally about how the community is responding in the midst of unforeseen events or how the crisis was managed with the least impact on resident care.
X Understand your audience. Discussions with reporters are not conversations; they are interviews. Everything you say has the potential to appear publicly. Remember that what ends up in print or on the air will not only be
reviewed by your residents, but will be evaluated by members of your board, regulators, policy makers, your neighbors, and friends of the community.
X Determine your expectations for staff in the event that members of the media attempt to conduct interviews in or near your community.
X Do not hesitate to contact CALA for assistance. CALA will quickly assist you and provide guidance on how best to respond when the media spotlight is on you.
Reinforcing Your Core ValuesConsider the importance of careful and honest communication with residents, families, and the public. CALA member providers can use an unforeseen event as a chance to highlight the kind of service residents expect and have come to count on. Good communication will reinforce your core values, result in even higher rates of resident satisfaction, and showcase all you do on behalf of your residents to the larger community.
It may be that the help of a professional public relations, crisis, or media consultant should be engaged to assist with developing your plan. While it can be expensive, it is a worthy investment should you ever be faced with an unexpected event that is driving media attention.
Providers who understand how the media works and how to effectively deliver information through the media will be a part of Assisted Living’s continued success. Whether in times of crisis or calm, timely, accurate, and effective communication is important to strengthening individual community brands, building name recognition, and educating the public about the important role we all play in the senior care continuum. g
Denise Davis is a well respected public relations consultant and frequent CALA contributor.
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members. Do not allow CCLD to be blindsided in these situations. If CCLD hears about construction for the first time from a concerned family member, it is likely that they will react adversely. Conversely, if you have discussed your plans in advance with your Licensing Program Administrator (LPA)—perhaps even your LPA’s supervisor, if the construction is extensive—and have explained what you are doing to mitigate resident inconvenience and ensure resident safety, it is likely that CCLD will have the context necessary respond appropriately.
Programmatic or Staffing ChangesJust as physical changes in an RCFE can be disruptive to residents, so too can programmatic or staffing changes. RCFE regulations do require you to notify CCLD in the event of a significant change in your plan of operation. But if you are making changes that could generate a complaint even though formal notice is not required, notifying and engaging in a discussion with your LPA in advance can be very helpful. In particular, when an employee leaves under less than ideal circumstances, notifying your LPA can help defuse problems if that disgruntled ex-employee begins calling in complaints.
Intra-Family DisputesSimilarly, it is wise to notify your LPA when you are dealing with an intra-family dispute—what I call the dueling sibling syndrome. In these situations, it is not unlikely that
a disgruntled family member will complain to CCLD; if you have had the opportunity to convey your version of events in advance of the complaint, it may help to avoid problems with licensing. This is particularly true when you need to evict a resident. You are required in any event to notify CCLD when you send an eviction notice, so why not have a discussion with your LPA prior to sending out the notice?
CrisesI recall an incident almost 20 years ago in which a resident was murdered in an RCFE. The provider was not at fault—it was simply an unforeseeable tragic event. While the RCFE did not receive any deficiency citations, it nevertheless damaged its relationship with CCLD because its LPA learned of the homicide from a radio news broadcast and not from the provider. While Title 22 and elder abuse reporting requirements at the time did not require immediate reporting of this event to CCLD, common sense did.
In sum, it is almost always in the best interests of RCFE providers to engage in early discussions with CCLD. Doing so may minimize negative impacts, and it encourages collaboration and cooperation. g
Joel Goldman is a partner at Hanson Bridgett, founding board member of CALA and nationally known expert on Assisted Living.
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Register for Day in Your District: visit www.CAassistedliving.org.
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Supporting Residents Through the Downsizing and Moving Process
Bubble Wrap and a Helping Hand:
When I moved to a new state for the first time, all my necessary possessions fit in the back of
my Ford Taurus. A year later, moving back to my home state, I filled both the
Taurus and my parents’ Isuzu Trooper. I insisted on bringing back my mattress, which I had deemed to be the most comfortable bed I’d ever had, despite the fact that we had to stop once an hour or so to redo the bindings strapping it to the top of the SUV. That beloved mattress lengthened an already long and trying three-day drive, and by the time we arrived at our destination, I barely had the energy to get it off the top of the car before I collapsed with exhaustion.
We can accumulate things quickly, and it can be a challenge to let them go, especially if they hold a sentimental meaning, or if we feel we cannot do without them. And when someone has had a lifetime to accumulate things, picturing him- or herself in a new, more compact space like an Assisted Living apartment may be difficult. Though some residents may have no problem contemplating a move, others may experience anxiety and worry at the thought. But downsizing can be a positive experience for future residents and family members, leading to a friendlier, more livable space and a calmer state of mind.
by Katie Cappello
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Scott Evans, executive director of San Carlos Elms, can tell during community tours which potential residents are overwhelmed by the thought of downsizing. He says, “It seems to be more apparent if touring our community is their first exposure to Assisted Living. For residents, moving to an apartment that is so much smaller than their home can trigger questions like ‘What to bring? What to do with things I cannot bring? Who is going to help? Am I going to like living here?’”
Evans continues, “Often, family can help in the selection of what to bring and assist in what to do with what is left. As a community, we are sure not to put undue stress on the family, make ourselves available, help with move-in paperwork, and not place expectations or rigid time lines. For residents that do not have family to help, we are able to refer to a senior relocation specialist, and in some cases, we have actually gone to the resident’s home and assisted when the use of a relocation specialist was not feasible.”
Everyone Has a Soup TureenRegina Lark, founder and president of A Clear Path: Professional Organizing for Home, Work, Life, and a speaker at the upcoming CALA Spring Conference & Trade Show, is one such relocation specialist. She says she sees first-hand the anxiety downsizing can create in older adults and family members. “One cause,” she says, “is the emotional attachment to items, or the belief that stuff represents happier times—that if you don’t have the thing, you’ll forget the memory.”
And family members can become a part of this cycle as well. “We see value in things that other people have put value on,” she says, “and we put value on that which was common to everyday life, even if it has no value today.” She tells me to imagine an everyday object, like a soup tureen. “Say your mother made her famous borscht and served it in this soup tureen. Now, you may not particularly like borscht. You may have no use for a soup tureen. Even so, you feel that you need to keep it because it was your mother’s and because that memory of her making the borscht is attached to it.”
Another difficulty with downsizing lies in the belief that “this may be useful some day.” But, she explains, that is not a good reason to keep something in your life—it should have value to you right now rather than sometime in the future. The first, and most important step in downsizing, says Lark, is to “change your relationship with things.” She says that the objects in your life should have some use to you in the present. “Everyone has a soup tureen,” she says, referring to her previous example. “You should keep what is of value and let go of that which is no longer serving you.”
And it’s important to note that “value” is subjective, especially when thinking about transforming an Assisted Living apartment into a new resident’s home. In a recent newspiece on USA Today, AARP's caregiving expert Lynn Feinberg says, "One of the most important things to remember when an older parent moves to a new living arrangement is to make sure they have things that are meaningful. It's not just important to have mementos but something that is meaningful for them." That
soup tureen might have no value to an Assisted Living resident, but the framed photos of their grandchildren, their favorite crocheted blanket, and the mug they drink coffee out of each morning, will certainly serve to create a new home.
Lark says that self-reflection and sense of thoughtfulness about objects can help with the process. “Downsizing is really about getting people to a place of calm. Look at it this way: we have a finite amount of space. What do we want to fill that space with?” Answering these questions can help prepare for the move to Assisted Living by identifying those items that truly make you feel at home.
Taking It Step by StepCommunity staff members can help in this process as well, according to Lee Mahla, a senior move manager and owner of Right Size Your Move. I meet Mahla at a CALA Executive Director Roundtable hosted at the Chateau at River’s Edge. Executive Director Deborah Godt says Mahla is not just a resource for residents looking to move, but a key player in the marketing efforts of her community. “Dealing with stuff can be an obstacle to moving in,” says Godt. “If we have people on the outreach or waiting list who seem worried about the move, I invite them to lunch to meet with Lee. She explains her services and how she can help them, which helps move the marketing process forward.”
Mahla shares that, for certain people considering the move to Assisted Living, receiving help with the downsizing and moving process can make a huge difference. “I am ever-present to my clients, to help them through both the physical and emotional transitions of a move,” she says. And by providing assistance with moving and downsizing, communities can see a sharp drop in the length of time it takes for a resident to make a decision. “Before, it could take six to nine months for someone who is anxious about moving,” she says, “but after learning of my services, that decision time can be cut down to as little as 90 days.”
Mahla explains that looking at the downsizing and move-in process as a whole is obviously daunting, but it can help to break it up into smaller parts. A key step early in the process is creating a computerized space plan for the resident. “That way, I can help them move furniture around so they can visualize where things can go.” This plan also helps people see easily what cannot fit into the space. “If someone has ten feet of hanging clothes, but the closet only accommodates five feet, you can see pretty quickly that you need to downsize.”
The next step is to make decisions about what to bring to their new home. “It helps to look at your stuff as categories,” she says, such as clothing, kitchen items, art and decoration, etc. “Then
“...looking at the downsizing and move-in process as a whole is obviously daunting, but it can help to break it up into smaller parts.
“
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the process is simply sorting and making decisions.” According to Mahla, it’s best to identify the area which may be the most trouble, and tackle that first. For instance, if you are a prolific cook, you may have more kitchen items that need to be sorted through than other things, like clothes.
This process may take longer for some than others because people must go through what Mahla calls “meaning transfer rituals.” She explains, “We all do these rituals to detach the meaning of the object.” These rituals can involve cleaning or repairing an object, telling someone else the story behind it, or moving it from one location to another, less used area. “You may find yourself washing clothes that you know you’re going to donate to Goodwill. Or, you’ll feel the need to tell someone the story about something they’re about to buy from your garage sale.” According to Mahla, these rituals are an important part of the process, and can help a person feel ready to let go.
Once the sorting process is done, Mahla says it’s important to have an organized move day. “My goal is to have the move done and the resident in their new home in one day.” Sometimes, if the meaning transfer rituals are taking a bit longer, she says, “We focus on bringing their favorites and getting them into the community first; then, they can go through the rest at their own pace.” It’s all about making the process as seamless and calming as possible, she says, and about getting the person into their new home where they can begin to enjoy the social and supportive benefits of Assisted Living.
The Welcome CommitteeFocusing on social support is also a tactic utilized at San Carlos Elms. Scott Evans says, “Exposing the resident to the community as much as possible before move-in day is helpful; having them join in social events, meals with residents…facilitating an exchange with other residents who have gone through the process” of moving to the community can all ease the transition.
“Once the resident has arrived,” he continues, “all managers take a few moments to visit the resident and see how they are doing. We also schedule visits from our Welcome Committee who invite them to activities and meals and offer to go with them.” By placing the focus on social events rather than the daunting task of the move itself, Assisted Living communities can help the resident settle in much more quickly.
And everyone can be a part of the welcoming committee, according to Betsy Smith, executive director of The Gables at Ojai. “Our teams use what we’ve learned about our new residents to customize our offerings. For example, Leila will think of likely tablemates in the dining room when she learns where a person grew up or anything she or he may have in common with our other residents. David will have an idea
which activities to personally invite them to.”
She says that the head of housekeeping will bring a card to each new resident, and the
team members at the front desk are there to answer any questions. “And
our maintenance department helps the new residents feel welcome, chatting and visiting while they hang pictures, hook up televisions, and make the apartment into their new home.” This type of emotional support provided by Assisted Living team members is just as important as physical help.
Smith says that it’s important to offer help and support to family members as well. “We email the activity calendar to interested family members, to support their loved ones in their interests. Occasionally, a resident brings too much stuff for the new apartment. We work with the family to cull excess, encouraging safety first. Mostly,” she says, “we listen to the residents and their families, and we encourage communication with the family throughout the process.”
Home Sweet HomeMoving can be a stressful, anxiety-inducing process at any age. And, when faced with the task of downsizing a lifetime of accumulated things, some residents and family members can have a hard time knowing how to start. By offering them the support they need, whether it be access to a senior relocation specialist, an extra set of hands on moving day, or the advice of a resident who’s been through the process, Assisted Living communities can help make downsizing and moving a positive process which results in a calm, pleasing, and happy new home. g
Katie Cappello is an integral part of the CALA staff and a regular contributor to the News & Views.
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strategic success:
Two Approaches to the Process of Strategic Planning
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We need to be vaulted out of the busy, tactical, day-to-day operations to the 30,000-foot level to help us understand if what we are currently doing makes sense. We can get lost in busyness, forgetting what we are really here for, where we really want to go, and how to take advantage of opportunity.
Strategic planning honors the past by celebrating where we have been and the resident care we have offered; helps us understand the present by asking, “What’s going well, what can be even better, what would we change, what’s missing?”; and allows us to envision a future, forecast possibilities and probabilities, decide a path with measurable objectives, and plan a solid implementation.
In working with both for-profit and not-for-profit organizations, we have found that, when groups have a strategic plan in place, they tend to maximize their opportunities more compared with those organizations without a strategic document in place.
The process in developing a strategic planning document is just as important as having the “final” plan finished. The best analogies would be those to making a cake or building house—you pick if you want to be a foodie or builder for the analogy. The ingredients and materials used to make a cake or build a house are critical to the end result just like the strategic planning document. The process and the people engaged in the process will determine the long-term success and viability of the plan’s strength.
One of the strategic planning acronyms we use to analyze the external environment is EPEST. We look through the lenses of Economy, Political/Regulatory, Ecological, Sociodemographics and Technology to understand what we could impact. When planning for Assisted Living facilities, the EPST impact may manifest as:
X Economy• Baby Boomers having less retirement savings
than preceding generations• Rural/urban differences for deciding
locations
X Political/Regulatory• Ripples from upcoming healthcare reform• Workplace regulations continue to increase,
employee insurance requirements
X Ecological• Going green• Location choice
X Socio-demographic • Aged living longer, severity and complexity
of multiple medical issues• Programming expectations due to active
lifestyles and desire for life-long learning • Multicultural impacts with residents and staff
X Technology • Resident information access expectations • Company use for increasing productivity
As part of the strategic thinking process, we believe a dialogue about what change catalysts will be most affecting our healthcare facility or senior services field in the near as well as distant future. Our company typically frames these change catalysts in to four broad areas which are:
1. Government
2. Economy
3. Culture/Society
4. Technology
If a company will consider the greatest market adjustments made in the past decade, we would bet that one, if not all, have greatly shifted our strategic thinking for a healthcare or senior services facility. These change catalysts could also be identified as “train whistles” coming down the track—they are going to come no matter what, and our senior living community needs to respond.
Why is strategic planning important
for a company?
Q
Are there any issues that are particularly
important for planning in the
healthcare and senior services fields?
Q
Sherri Petro Steve SwaffordSherri Petro is the President of VPI Strategies and teaches strategy through California Miramar University. She has been assisting organizations in the Assisted Living industry for seven years.
Dr. Steve Swafford, co-founder of Leadership Outfitters, LLC, has worked for more than 20 years for and with organizations in areas of strategy, leadership development, communication, membership and executive management.
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The trends I see are strength-based approaches, changes in employee engagement and technology, time and filters, and rolling plans. I see a movement towards more strength-based planning. In previous generations of planning, we concentrated on shoring up weaknesses, which could be a real losing battle putting so much effort there instead of what we already do well. Now we see organizations amplifying their strengths and finding strategic partners that can help compensate for weaknesses. More firms are also using appreciative inquiry or a strength-oriented hybrid which starts with positivity and creates excellent idea generation, in contrast to the fix-it mentality.
Regarding employee engagement and technology, we are asking more employees to keep their ears to the ground. Some of this is driven by our quest for information. Some of it is driven by innovation being the current hot topic. The more ideas, the better shot we have at innovating. We are also asking employees and other stakeholders to participate in the planning process by using technology such as web-based surveys to canvass for their perspective. This way, we can access the most information in the shortest period of time.
Organizations are taking less time to plan due to what I call “time-compression.” We are all very busy doing more with less. It is harder to find the time for strategy when tactics take precedence, so our strategic planning process is becoming more efficient. With the break-neck speed of change, we are seeing more “what if” scenarios being developed and shorter planning horizons to take advantage of opportunities. To be efficient when those opportunities pop up, I develop a strategic filter with clients during the planning process by thinking through what is most important. They can quickly jump on the opportunities that make the most sense when presented with them.
The world is changing so fast, we can see clearly what needs to happen in the next six months but have a hard time on year three. Many organizations are doing annual strategic check-ups and, if the smart growth strategy is the same, simply adding another year
This is a very interesting question and an appropriate one to consider when a company approaches strategic planning. For more than four decades, the most common environmental scanning tool in the strategic planning process has been the SWOT (strengths, weaknesses, opportunities, and threats) analysis. However, recently our firm has been using a strengths-based model called the SOAR framework. SOAR stands for strengths, opportunities, aspirations, and results, which is grounded in the Appreciative Inquiry literature. The comparison between a SWOT analysis and SOAR framework was the focus of my dissertation at Pepperdine University resulting in new benchmark data on the strategic thinking process for trade associations and foundations.
The process and timeline concept is a powerful one to consider for all organizations. It wasn’t too long ago that organizations followed Jim Collins’ best selling concepts, from Built to Last (1995) and Good to Great (2001), of looking 20-plus years on the horizon. While appropriate in certain industries to consider this timeline, most companies would be more prudent to have a few long-term goals in the 7-to-10 year frame, with most of the strategic plan designed to be fluid and agile to respond to ever-increasing changes of the business marketplace.
What trends do you see in strategic
planning? How is the process/
timeline changing to reflect a changing
environment?
Q
Sherri Petro Steve Swafford
“Appreciative Inquiry (AI) is a way of being and seeing. It is both a worldview and a process for facilitating positive change in human systems, e.g., organizations, groups, and communities. Its assumption is simple: Every human system has something that works right–things that give it life when it is vital, effective, and successful. AI begins by identifying this positive core and connecting to it in ways that heighten energy, sharpen vision, and inspire action for change.
*Information courtesy of the Center for Appreciation Inquiry
APPRECIATIVE INQUIRY DEFINED*
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1. What does success look like? Not for the outcome of the planning session, but for the organization itself. We are visualizing what we want the company to look like several years in the future. This question also encourages us to think of how we want to achieve that success, leading the way for a discussion of our values and guiding principles.
2. What do we have to work with right now? This helps define our current internal strengths and weaknesses so we know what to amplify and what to work on or secede. In this discussion, it’s vital to start with strengths. You get a more generative discussion.
3. How is our world changing and how can we leverage those changes with what we have to work with? This allows us to identify opportunities and challenges on the horizon. By scanning the external environment, we also take ourselves out of the everyday and into a world where we can strategize.
Before the strategic planning process begins, a firm should ask:
1. Why are we doing strategic planning?2. What do we hope to accomplish?3. How will the process be designed?
During the strategic thinking process, the three questions change slightly to:
1. Why does our company exist?2. What do we hope to become?3. How will we achieve those goals?
We believe the strategic thinking steps done prior, and those that are a part of the strategic planning experience are equally important.
What are the top three questions an
organization should be asking during a strategic planning
session?
Q
Logistically, which planning steps are paramount? What
should be avoided? Who should be
involved?
Q
Sherri Petro Steve Swafford
Starting with your last question first, involve the folks who care about the company. Get them involved in different ways. The Board—or executive management team depending upon the structure—shepherds the process. Executives work on the organizational identity, or the mission, vision, and values. Staff employees are surveyed—both support and customer-interacting departments—for their ideas and perspective on “what is.” Middle management helps prioritize what is heard into themes. Executives synthesize and decide what strategy makes the most sense and decide on the communication plan.
There are seven paramount steps:1. Do your internal research by engaging your
employees at various levels2. Understand the industry and operating
environment 3. Plan different scenarios 4. Choose a strategy with five to seven goals,
measurable objectives, and tactics that support achievement
5. Commit to executing well 6. Measure success using a dashboard 7. Communicate, communicate, communicate. Just
about the time you are sick of talking about it is when understanding seems to kick in.
You should also avoid: X A long drawn out process—the momentum will
wane if it is too long X Analysis paralysis—don’t get sucked in asking for
too much data X Inflexible plans—makes no sense since the world
is changing so fast
Each strategic thinking facilitator has a bias on the different planning steps, and it is important for a group to interview at least two or three to get a good feel for what is the best fit for the company. In the same way, families will visit a variety of assisted living communities to find the best fit for their lifestyle.
With this in mind, a few core steps should always be considered:
1. What data do we have and what data do we need as we start the process? We are a firm believer in having data-driven decision-making, along with a healthy dose of gut-check entrepreneurialism.
2. What lenses and perspectives does the company need around the table to have a dynamic process? Tom Kelley (The Ten Faces of Innovation, 2005) advocates to include in the process individuals from outside the organization or a healthy blend of diversity so that multiple perspectives are included in the dialogue.
3. The process should be flexible and dynamic to reflect the culture of the organization. In other words, we should avoid a cookie-cutter approach to strategic planning. While we believe certain elements should be included in the dialogue, how it evolves should not be forced or programmed with an end result in mind.
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Yes, smaller organizations can do it themselves. Just try to be realistic and objective. Many smaller organizations make tactical plans for the next three months—not strategic plans for the next three years!
The keys are to:
X Ask the right questions
X Be brutally honest about your capabilities
X Objectively look at opportunities and threats
X Review several options before you decide
X Measure your success with metrics that you know how you will collect the data
X Allow the plan to live
We believe certain steps can by “DIY’ed” for smaller companies; however, this approach limits or reduces participation of the person facilitating the dialogue. In some cases, the opposite might be true, and the person leading the dialogue might hijack the process and not be as facilitative as an outside content guide.
We suggest some processes could be self-guided; however, it would be more effective if the group could explore options for cost-effective outside facilitators with other industry professionals or through the local Chamber of Commerce. In addition, we suggest contacting the local university for a faculty member proven in this arena as another option. While some can be “DIY’ed,” we strongly recommend finding an outside voice to help guide the process in as neutral and unbiased a way possible.
The plan must be dynamic, not stagnant. Create a dashboard to visually monitor your progress and set aside time to monitor. If you can, set aside a half day each quarter to determine if any of your foundational assumptions have changed or any changes in the external or internal environment should trigger a different scenario. If you feel too time-compressed, add quarterly strategic check-ups into already scheduled executive team meetings.
Have a checklist that your executives can use to check on activities for the initiatives with responsible parties. Since so much effort goes into the plan, don’t just move onto the next items to be accomplished—celebrate the wins. Whatever you do, don’t shelve the plan! Honor the work done.
We found the most effective and utilized plans are constantly being reviewed and updated to address changing market conditions. For this to happen, here are a few tips:
X Updates should be included at each Board or Senior Staff Meeting
X A Strategic Advocate or Guide should be appointed so there is an individual accountable to the overall Plan
X Reporting should be in a formats such as a “status update” included in the Plan or a “highlights” document identifying where the plan is exceeding or trailing expected measures during the process
X It is also critical for the Plan to be measurable. Measures could be budgetary, time-bound, growth-related, or numerical. There needs to be something to determine if the Plan is making progress or if certain elements need to be adapted.
Can strategic planning be
DIY’ed for smaller companies?
Q
What are some best practices for
tracking progress and accountability once a strategic plan has
been created?
Q
Sherri Petro Steve SwaffordJ
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emergency preparedness
When planning for unforeseen events, Assisted Living
communities of all sizes must evaluate many potential hazards and events that could impact their residents. These could include floods, earthquakes, tsunamis, wildfires, radiation releases, power outages, chemical exposures, seasonal and pandemic influenza, and acts of terrorism. Your local disaster or emergency services contact can help your community determine which events are most likely to occur in your area and provide advice on emergency
supplies and procedures. By reviewing the laws and regulations governing disaster planning outlined here, and referring to these helpful tips and resources, providers can create and maintain comprehensive disaster plans, and be prepared for any possibility.
California Laws and RegulationsThe need for formal emergency preparedness in Residential Care Facilities for the Elderly (RCFEs) was addressed by AB 749, which was signed into law in 2008 and added section 1569.695 to the California Health and Safety Code. This section specifies that RCFEs must have an emergency plan that includes the following:
X Evacuation procedures
X Plans for the community to be self-reliant for at least 72 hours immediately following any emergency disaster, including, but not limited to, a long-term power failure
X Transportation needs and evacuation procedures to ensure that the facility can communicate with emergency response personnel or can access the information necessary in order to check the emergency routes to be used at the time of an evacuation and relocation necessitated by a disaster
X Procedures that address, but are not limited to, all of the following:
in Assisted Living
Assisted Living residents rely on their caregivers for their daily needs and can be particularly vulnerable when natural disasters and emergencies strike. Times of crisis can lead to depleted supplies, staff shortages, and strain on caregivers. However, comprehensive preparedness planning can greatly help Assisted Living communities meet the needs of residents during a natural disaster or other emergency.
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• Provision of emergency power that could include identification of suppliers of backup generators
• Responding to individual residents’ needs in the event the emergency call buttons are inoperable
• Process for communicating with residents, families, hospice providers, and others, as appropriate, which might include landline telephones, cellular telephones, or walk-talkies
• Assistance with, and administration of, medications• Storage and preservation of medications• The operation of assistive medical devices that need
electric power for their operation, including, but not limited to, oxygen equipment and wheelchairs
• A process for identifying residents with special needs, such as hospice, and a plan for meeting those needs
In addition to the requirements specific to content of the emergency plan, section 1569.695 also outlines who can access the plan and at what times:
X RCFEs shall make a plan available upon request to residents onsite and available to local emergency responders.
X Community Care Licensing Division (CCLD) shall confirm, during comprehensive licensing visits, that the plan is on file at the facility.
Section 87212 of Title 22 regulations, which predates section 1569.695 of the Health and Safety Code, requires each community to have a disaster and mass casualty plan of action in writing and made readily available. The regulations do not completely reflect the new statute (which trumps the regulations), but it is important to be aware of and follow them:
X Designate administrative authority and staff assignments
X Provide evacuation guidelines for the following:* • Fire safety plan• Means of exiting• The assembly of residents to a predetermined
evacuation site• Transportation arrangements• Relocation sites equipped to provide safe temporary
accommodations for residents• Supervision of residents during evacuation or
relocation and contact after relocation to assure that relocation has been completed as planned
• Means of contacting legal agencies such as fire departments, law enforcement agencies, civil defense, and other disaster authorities.
X Provide contact information to notify a resident’s hospice agency, if any, in the event of evacuation and/or relocation*
*All emergency exiting plans and telephone numbers specified above shall be posted.
Furthermore, section 87555 of Title 22 regulations states that Assisted Living communities must have enough non-perishable
food for seven days and perishable food for two days on the premises at all times. Adequate equipment must be maintained for in-house preparation and service of food in emergencies. Some possible solutions for emergency food preparation include, but are not limited to, barbeques, gas burners, disposable plates, cup, napkins, utensils, and other cooking equipment.
In alignment with the Health and Safety Code requirement for RCFEs to prepare to be self-sufficient for 72 hours, the Center for Disease Control (CDC) recommends keeping a three-day supply of one gallon of water per person per day, for both residents and staff. CDC also recommends having enough food and water—at least three days’ worth—for residents’ pets. If many of your residents have pets, learn more about caring for animals during disasters at the FEMA site: www.ready.gov.
Reviewing and Updating Your PlanFirst, be sure that your plan is complete and includes all the requirements outlined in section 1569.695 of the Health and Safety Code section, as well as Title 22 Regulations. It is advised that you review the plan periodically and update it when necessary; your local emergency services authority can be a good resource. Also, it is important to familiarize newly hired staff with all emergency procedures and to incorporate them into the plan as needed.
Partnering with neighboring Assisted Living communities to prepare for disasters can be beneficial for many reasons, specifically when planning evacuation sites. Your evacuation plan should list a few potential relocation sites that will suit the
CALA Tips for Disaster Planning (offered by CALA Members): http://www.caassistedliving.org/web/resources/disaster_prep.asp
ALFA Emergency Preparedness Tool Kit: http://www.alfa.org/images/store/Emergency_
Preparedness_Tool_Kit.pdf
Care & Compliance Group’s Disaster and Emergency Manual: http://www.advhs.com/servlet/the-84/Disaster-and-Emergency-Manual/Detail
CDC Emergency Preparedness and Response: http://emergency.cdc.gov
CCLD Self-Assessment Guide for Emergency and Disaster Preparedness: http://ccld.ca.gov/res/pdf/DisasterGuide.pdf
The Federal Emergency Management Agency: www.fema.gov
The U.S. Department of Homeland Security: www.ready.gov
resources
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they will find CALA membersthrough New LifeStyles.
Call 1•800•869•9549or visit www.NewLifeStyles.com for more information.
However they choose to search,
print, online,
ouraward
winningApp
or mobile site.
THE SOURCE FOR SENIOR LIVING
number of residents and staff in your community. The most preferable evacuation sites are similar licensed communities that will make for an easier transition for residents, especially residents with dementia.
Planned evacuation sites should be aware that they are in your plan. Likewise, it is helpful to know which surrounding communities have your community listed in their plans as an evacuation site. Be sure to periodically check in with your evacuation sites, especially as they experience staff changes. For example, if the administrator from one of your listed evacuation sites leaves that particular community, it is wise to communicate your plans with the new administrator. The licensed capacity of evacuation sites has been questioned in the past, but the department has recognized the need for flexibility in times of crisis.
CCLD’s Self-Assessment Guide for Emergency and Disaster Preparedness is designed to help communities perform periodic self-assessments. The guide is a useful tool, but when you use it, keep in mind that it was last updated in 2007 before the law changed. To most effectively assess your disaster preparedness, it is best to reference the guide in conjunction to section 1569.695 of the Health and Safety Code.Your community’s planning efforts will help to maintain compliance, create an action plan for unforeseen events, and, most importantly, provide invaluable peace of mind to your residents, their families, and your staff. g
comprehensivecompliance
audit
CALA’s free self-audit tool helps you make sure you are fully compliant and ready for any emergency. Visit www.CAassistedliving.org to order your free self-audit today.
How do you know if you’re prepared?
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You may not know this, but Eskaton Village Carmichael is a branch office of Santa’s workshop. Throughout the year, a trio of residents works in the onsite woodshop to make toys for the U.S. Marine Corps Reserve’s Toys for Tots program. Jim Jackson, Doug Darmsted, and Sterling Parrish work together intuitively, like a well-oiled machine, constructing one hundred handmade toys each year for deserving children.
Jim says, “It’s nice to know the toys are made for a good cause. Last year, we made a hundred toys. We sold some at our craft fair and the proceeds we made went to materials for this year. The rest went in Christmas boxes to needy families.”
Sterling says, “In December, we bring the toys to the Sacramento Area Woodworkers’ meeting at the senior center. We watch the toys get loaded onto the Salvation Army truck. We follow the toy all the way from its creation to the truck.”
Show off the talent of your residents & employees. CALA is looking for poetry,
short stories, memoirs and art exploring issues such as aging, wisdom, caregiving,
and community. All submissions should be sent via email to Katie Cappello at
[email protected]. Include your contact information and a short (25-30
word) bio.
News & Views assumes the right to publish pieces on their website as well
as in the physical issue. All rights revert back to the author after printing.
“I like to wonder about the destiny of the toys,” Jim says. “Maybe they become someone’s life souvenir. You know your efforts are appreciated. It’s the spirit of giving.”
Sterling says he’s not sure where the original plans for the toys came from. “I just joined in and said I’d like to help. They showed me the parts which are all cut out on a scroll saw or hand saw, then glued, sanded, and painted. We put the wheels on them and then box them up.”
As a team of three, Sterling says, they work well together. “Without it being spoken, we just sort of divide the tasks up. After the parts are laid out, Jim will cut the shape out, and then Doug will glue the pieces, making the basic body. Any one of us can do the sanding and drilling. Before the wheels are attached, I do the painting.” He adds with a laugh, “It all works out because no one else liked to paint but me.”
Jim says that all three enjoy the creative process of working with wood. “I call it ‘making sawdust.’ It’s about doing something with your hands. I have friends that can play bridge for hours, but at the end the only thing you can point to is your score. With woodworking, you have something for your efforts, something to show. It’s a feeling of satisfaction and a challenge.”
the creative view
PhotographBy Al Hoisman
Left: Sterling Parrish in woodshop with toys.Photo courtesy of Sterling Parrish.
Right: Jim Jackson with one of his toy cars.Photo courtesy of Stuart Greenbaum, Eskaton.
MAKING SAWDUST: The Woodworkers of Eskaton
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The Punchlist:
tips
Look at the community from a resident’s point of view.
Warner Design begins with “a first impression report” based on a walk-through of the community. Cynthia Warner says, “We look at the community with fresh eyes and help them develop a scope of work. I always ask the tour to be given by the executive director and marketing director, and that they tour me through the community as if I were a prospective resident. It’s interesting to see what rooms or parts of a building are considered tour-worthy.”
Timing is everything.
Choose the time for a remodel or renovation wisely, says Warner. “One basic rule: never remodel over the holidays…residents love their decorations and family events! When I work with my clients to remodel an existing building, we really take the time to sit down with the staff and the contractors to determine timelines and to make sure each person knows they will be held accountable if a project schedule runs beyond the agreed timeframe.” The ultimate goal of any project, says Warner, is to “complete the remodel in the least amount of time so we do not disrupt the residents, staff, and families.”
Communicate with residents.
“When remodeling an occupied community,” says Warner, “residents and employees are affected. Some areas may be unusable for a time, and demolition can be noisy; all of this may cause agitation and confusion. You have residents that do not like change and others that thrive on the action and have an opinion about everything!” Sharing details about the project, asking for input, and keeping communication lines open with all residents and staff members can help keep the focus on excitement for the finished product.
Make sure contractors understand residents’ needs.
According to Warner, “When an occupied community is being considered for a remodel, I think one of the most important things to consider is the contractors’ depth of experience working within this type of environment. They need to be cognizant of debris and tools so residents do not trip or hurt themselves.” She says that choosing contractors who are experienced working in senior environments and sensitive to the needs of residents is “the key to any successful remodel.”
Meet with staff members across departments to make sure all needs are identified.
Warner says that, including meeting with the environmental services director and director of housekeeping, “I always like to get feedback from the maintenance team who repairs damaged furniture and the housekeeping team who cleans the environment. These two departments know what in the community needs to be replaced what does not. As a team, we are able to create a scope of work based on what the actual needs are for the community.”
Renovations and RemodelsHow do you renovate a community where residents currently live? When should you remodel? What do you need to do before the job starts? Cynthia Warner, principal at Warner Design Associates, shares some top tips for navigating a remodel or renovation of an Assisted Living community.
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Granucci says they considered the timing of the project carefully. “Beginning in the early spring of 2012, we met one-on-one with the residents living in the area to be converted, along with their families, to explain face-to-face the renovation and how it was going to involve them. With their understanding and buy-in, we were able to slowly but surely show them like apartments as they came available.” He says that when all residents had been satisfactorily moved in to new apartments, the conversion began.
“Of utmost importance was clear communication all the way through the project,” he says. “We held open houses and resident/family meetings regarding our soon-to-be ‘Connections for Living’ Memory Care Neighborhood, including guest speakers who were experts in Alzheimer’s and dementia. This provided insight and education to everyone involved, which brought comfort and understanding.” And the open lines of communication included employees, too. “Weekly education from management to staff members during the transition made certain the entire team was speaking the same language.”
Once the memory care conversion was completed, Granucci says, “We provided special tours to families, residents, and the community within the first week of the opening so they could see the finished product, walk through every apartment, common area, etc. This enabled everyone to experience the vision of continuous care and to visualize the beauty within our Connections for Living Neighborhood firsthand.”
By planning far enough in advance, Granucci and his tem were able to make the transition a seamless one for residents. In addition, constant communication with residents and family members about the scope and progress of the project gave them a sense of ownership and excitement in the finished product. g
Renovation: A Provider’s Perspective
Renovated bathroom and bedroom at Grand Oaks
According to Evan Granucci, executive director for Grand Oaks, timing and communication with residents and family members are paramount when planning a renovation. Last year, his community converted 13 existing Assisted Living apartments into memory care units.
“Weekly education from management to staff members during the transition made certain the entire team was speaking the same language.
“
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Consider, Discuss,
Document:
A parent…a resident…ourselves…we carefully plan vacations, moves to a new city, retirement; but many of us aren’t planning the approach to care we want when we’re
unable to speak for ourselves or when we are at the end of life. According to the study The Final Chapter: Californians’ Attitudes & Experiences with Death & Dying conducted by the California HealthCare Foundation and the Coalition for Compassionate Care of California (CCCC), 85% of those surveyed think that end-of-life planning is important. However, only 23% have actually put their advance care decisions in writing.
Of course, this is completely understandable. End-of-life issues are hard topics to bring up and discuss with loved ones. But it is an important thing to do, nonetheless. We all have different ideas of what we want when it comes to care. Some may want only specific medical interventions, or may want interventions just in certain instances. It’s hard to make quick decisions in emotionally charged situations, and what you think loved ones want may be different than what they would have chosen for themselves.
Advance care planning is the process of thinking about preferences for care at the end of life, and then having that conversation with family members. Advance planning can help ensure that your preferences are recognized and honored and also ease the decision-making process for family and loved ones.
The process begins by setting aside some time to think about your care options. Ask yourself questions like, “If I couldn’t communicate, who would I want to make medical decisions for me?” A website called PREPARE for Future Care, developed by UC San Francisco, can walk you through this first step. In addition, the Coalition for Compassionate Care of California (CCCC) website
The Importance of Advance
Care Planning Photo: Advance care planning for seriously ill individuals focuses on thoughtful discussions between the physician
and the patient. Photo used with permission from New York's MOLST Program (CompassionAndSupport.org.)
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http://coalitionccc.org/advance-health-planning.php.http://www.calhospice.org/https://www.prepareforyourcare.org/
has an advance care planning conversation guide as well as information on care options, such as CPR, to help you understand what is involved and what to consider when making a decision.
The second and most important step in advance care planning is the discussion with family. Choose a time and place that is calming and free of distraction. If you’re having trouble getting started, the CCCC website has many good resources to help facilitate this conversation.
Documenting your preferences comes next. For this step, you will need different tools depending, in part, on your situation. The Advance Health Care Directive form provides a recognized document for expressing your preferences and naming a surrogate to make decisions on your behalf if you become unable to do so. This document can be changed at any time. For copies of the form, talk to your health care provider or attorney, or visit CCCC website.
For those with a serious illness, a Physician Order for Life Sustaining Treatment (POLST) is a way to communicate end-of-life choices on an easily recognizable form that can travel between care settings and is immediately actionable by health care providers. POLST is different from a DNR in that it addresses a range of treatment options, and may order CPR, whereas a DNR only addresses resuscitation and only allows for forgoing treatment.g
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With customized plans of care addressing their end of lifeneeds, VITAS keeps your residents in your communities
and out of the hospital and nursing home.
Improve the way yourresidents age in place.
� POSLT should accompany the resident to the hospital or other care setting
� POLST must be signed by the physician
� POSLT should be on bright pink paper, but any color is valid
� POLST is not required under any circumstances
POLST in
RCFEs POLST Fact Sheet
MORE online
resources
CALA developed a list of question and answers, in collaboration with the Coalition for Compassionate Care, in order to help Assisted Living providers
understand POLST and its role in Assisted Living communities. CALA members can access this Q&A on the CALA website www.CAassistedliving.org.
www.coalitionccc.org/advance-health-planning.php
www.calhospice.org
www.prepareforyourcare.org
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Changes to social security, health care, and longer life expectancies all call for an additional facet of retirement planning: long-term care (LTC) insurance. In light of the growing elderly population, many of whom are projected to need long-term care, the federal government and California Legislature are making efforts to strengthen the LTC Insurance market.
Federal LTC Insurance EffortsA part of the 2010 health care reform law, the Community Living Assistance Services and Support Act (CLASS Act) would have established the first national, government-run LTC insurance program. The insurance pool would have been consumer-financed and overseen by a government trust. However, the CLASS Act was cancelled on October 20, 2011 because the US Department of Health and Human Services was unable to find a way to financially sustain it. More recently, Congress created the National Commission on Long-Term Care, and all seats of the 15-member panel have been appointed. The commission will have until mid-September 2013 to send Congress recommendations on how to establish, implement, and pay for a long-term care system in the United States.
Right now, the Federal government offers its LTC insurance to federal employees. Retirees of the federal government and their relatives, including same-sex domestic partners, are also eligible.
The commission members are (appointed by):
X Javaid Anwar, M.D. internal medicine, Las Vegas, Nevada (Senate Majority Leader Harry Reid)
X Judith Brachman, former director of the Ohio Department of Aging (House Speaker John Boehner)
X Laphonza Butler of California, SEIU (Reid)
X Bruce Allen Chernof, M.D., President and CEO, The SCAN Foundation (House Minority Leader Nancy Pelosi)
X Henry Claypool, former HHS administrator who now serves as the executive vice president of the American Association of People with Disabilities (President Obama)
X Judith Feder, Ph.D., Georgetown University, professor of public policy, former dean, Public Policy Institute at Georgetown (Reid)
X Bruce Greenstein, Louisiana Health Secretary (Senate Minority Leader Mitch McConnell)
X Stephen Guillard, President, Belmont Nursing Corp., Chatham, MA; also, Executive Vice President and COO of HCR ManorCare (Boehner)
X Julian Harris, doctor and the director of Massachusetts' Medicaid office (President Obama)
X Neil Pruitt, chairman and CEO of UHS-Pruitt Corporation (NC and GA), and Chairman of the American Health Care Association (McConnell)
X Carol Raphael, vice chair of the AARP's board of directors (President Obama)
X Judith Stein, J.D., founder and Executive Director of the Center for Medicare Advocacy, Inc. (Pelosi)
X Grace-Marie Turner, President and founder, Galen Institute, Alexandria, VA (Boehner)
X George Vrandenburg, a civic activist, philanthropist, and President of the Vrandenburg Foundation (Pelosi)
X Mark Warshawsky, Ph.D., Former Treasury Assistant Secretary for Economic Policy (President George W. Bush), Director of Retirement Research at Towers Watson (McConnell)
Members of the National Commission on Long-Term Care
info
An Important Part of Retirement Planning
LongTermCare
insurance
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Know the Facts About Long-Term Care Insurance:
facts
California LTC Insurance EffortsCurrently, there is a bill in the California Legislature that would increase the number of Californians with LTC Insurance. AB 373 (Mullin) would strengthen the existing California Public Employees Retirement System (CalPERS) LTC Program by expanding eligibility to policyholders’ adult children aged 18 and older, with no maximum age restrictions. It would also extend eligibility to domestic partners, contingent on federal law. The CalPERS LTC Program, which began accepting policyholders in 1995, is one of the nation’s largest long-term care programs with 148,303 policyholders. It is currently available to all California public employees and retirees, as well as their spouses, parents, parents-in-law, and adult siblings between the ages of 18 and 79.
The expansion of eligibility requirements would diversify the policyholder group, specifically by adding new and younger policyholders, and direct more premium dollars into the LTC Fund; these changes would help to improve the risk pool and increase the program’s solvency and sustainability. Although the CalPERS LTC Program expansion will not extend to the general public, the growth in the pool supports the future of long term-care and creates awareness about the need for more LTC insurance options.
The Future of LTC InsuranceIt remains to be seen what the long-term care landscape will look like for future Californians. In the meantime, The California Partnership for Long-Term Care (www.rureadyca.org), a non-profit educational program developed by the State of California, can help consumers navigate the complex, costly issue of long-term care. They provide honest facts about the costs and emotional challenges of long-term care while offering various realistic solutions. According to the group, two out of three Californians will need long-term care, and they are focused on preparing California’s population for these future needs. g
X In 2009, California had 758,043 LTC Insurance policyholders, representing 9% of nationwide LTC Insurance sales.
X Nearly half of those requiring care are under 65 years of age, including 5.3 million working age adults.
X The number of California residents age 85 and older — those who are most likely to need extended care at home or in nursing homes — is likely to more than double by the year 2030.
X In 2005, about 1.5 million Californians used long-term care services. That number is expected to skyrocket as 6.5 million Californians will be age 65 and older by 2025. Nearly a million of those will be 85 and older, and many will need long-term care.
X Of the approximately 1.5 million Californians served by long-term care in 2005, 34 percent received care through home health agencies, 42% were evenly split between nursing homes and personal care services, and 12 percent lived in some form of residential care. *Information courtesy of The California Partnership for Long-Term Care
53% of respondents are, or have been, a caregiver for a loved one, yet one third said that aging was “something they’d rather not think about.”
48% thought that almost everyone would need some form of aid, but only 24% thought they would personally be likely to need assistance.
40% of respondents felt only “somewhat confident” and one third are “not at all confident” in their financial resources.
36% of respondents overestimated the cost of Assisted Living and 31% underestimated the cost of skilled nursing facilities.
55% thought that health insurance would pay the largest amount of long-term costs, and a majority overestimated what Medicare covers.
Americans’ Perceptions of Long-Term Care:
Results from the AP-NORC Center for Public Affairs Research survey
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to Our Long-Time Associate MembersThank You
CALA’s Associate Members support the association through membership, trades shows, sponsorships, advertising and more! Please join us in giving special thanks to these long-time associate members who have been supporting CALA’s efforts for many years!
•Alzheimer’sCareAssociatesLLC
•AmbroseCapitalGroupInc.
•BarcelonAssociatesManagementCorporation
•CareandComplianceGroup,Inc.
•DouglasPancakeArchitects
•DruthersAgency,Inc.
•HansonBridgett,LLP
•HeffernanInsuranceBrokers
•HPIArchitecture(HillPartnership)
•HPSIPurchasingServices
•IrwinPartnersArchitects
•LocktonInsuranceBrokers
•Morris&Garritano
•Morris,Polich&Purdy,LLP
•RealPageSeniorLiving
•SandiFloresConsultingGroup,Inc.
•SmithGroupJJR
•VITASInnovativeHospiceCare
•Walker&Dunlop
10 years or more of membership
•AlaskaNationalInsuranceCompany
•Brennan&Associates
•CommunityTrainingConnection,Inc.
•Consonus
•Cooper,White&Cooper,LLP
•CreativeBusSales
•DirectSupply,Inc.
•EcologicallySoundMedicalServices
•Gordon&Rees,LLP
•Gould&Hahn
•HKITArchitects
•Hooper,Lundy&Bookman,P.C.
•NavigatorGroupPurchasing
•NewLifeStyles,Inc./NewLifeStylesOnline
•Omnicare
•OnLokSeniorHealthServices
•PropelInsurance
•SeniorCareSolutions,Inc.
•StanleyHealthcareSolutions
•Swisher/Mt.HoodSolutions
•SyscoFoodServices
•TransitionsForVeterans
•West-ValPharmacy
•YardiSystems,Inc.
5-9 years of
membership
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A Review of Succession
Planning Research
mind the
The flight pattern known as a V formation is an ideal way for birds to optimize their energy on a long journey. According to Wikipedia, “In a V formation of 25 members, each bird can achieve a reduction of induced drag by up to 65% and as a result increase their range by 71%.” But when one of those birds leaves the formation, the drag increases, which makes the remaining birds more fatigued and limits their flying range.
[ [gap
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This is a good way of thinking about the importance of succession planning. When key members of your business team leave, are you ready to replace them, or will the rest of your team experience increased drag?
Strategic GapsThe 2012 MetLife Study of Baby Boomers at 65 reports that retirement is on the rise, and will continue to impact the workforce in the near future. The study found that “despite the conventional wisdom that Boomers are ready to ‘work forever’ and significantly extend their formal working career, many of the oldest Boomers are already well into the retirement phase.” It reports that the number of fully retired 65-year-olds has doubled since 2011. In addition, “of those still working, over one-third anticipated that they will retire within the coming year.”
Retirement isn’t the only factor affecting the loss of key personnel. According to Strategic Workforce Planning, a white paper by The Stonehaven Group – HR, other influences can threaten to leave significant gaps in business teams, including:
X The aging workforce and approaching retirement wave
X Current and projected labor shortages
X Growing use of a contingent, flexible workforce
X The need to leverage human capital to enhance return
X Mergers and acquisitions
X Evolution of technology and tools
Stonehaven Group’s senior researcher Dr. Peggy Kleinert, writes that, in order to avoid being caught off guard by any of these factors, companies should “map out the business plan for the next year, then look at two, three or five years down the road.” Kleinert says that large companies, like IBM, employ this tactic in order to prepare for both planned and unplanned gaps in leadership.
But small companies can, and should, participate in this planning process as well. According to Kleinert, there may even be some advantages for a smaller company. She says that, in a large corporation, decision-makers may have to rely more on “workforce data to project employee turnover, retirement, internal career moves, and other changes over time.” However, “in a small shop, the person in charge of planning can look around the shop floor and decide how soon someone may retire, what this person’s circumstances are, etc., because there is most likely a personal relationship with the employees.”
Replacement vs. SuccessionBefore establishing a plan, however, it’s important to understand exactly what the term “succession planning” means. According to the paper Ten Key Steps to Effective Succession Planning by William J. Rothwell of Rothwell & Associates, succession planning should not be confused with replacement planning, which “assumes that the organization chart will remain unchanged over time.” According to Rothwell, this type of planning “identifies ‘backups’ for top-level positions, as they
are identified on the organization chart, and stops there.” Under this model, a resident care supervisor would only be considered for positions directly above her, such as regional director of resident care.
On the other hand, succession planning “focuses on developing people rather than merely naming them as replacements.” In contrast to replacement planning which “encourages promotions only in ‘silos’ of specialization,” succession planning prompts “managers at all levels to regard talent in any part of the organization as a possible successor.” For instance, imagine that same resident care supervisor has shown a talent for touring prospective residents. In a company which employs true succession planning, she may be identified as a possible candidate for development into a community marketing position.
Starting from ScratchIs your company new to the arena of succession planning? In a white paper for Dale Carnegie Training called The Nuts and Bolts of Succession Planning, Rothwell notes that replacement planning is actually a good place to start. The reason, he says, is that “it is not usually difficult to make the case for replacement planning… it opens a dialogue among managers about the supply of available talent in the organization [and] it will prompt many questions about what it takes for a worker to be ‘ready now’ to fill his or her boss’s shoes, how a replacement is and should be identified, and what on-the-job developmental strategies are necessary.”
(760) 547-2863 • www.islllc.com
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they are our own with experience and expertise.
The value to you as a property owner is in our results.
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Starting with replacement planning is also a good way to ensure that a company has executive commitment to the planning process. Rothwell says that “no succession planning program can work without managers and employees at all levels clearly understanding why a succession program is needed.” In addition, he says, “executives, managers, supervisors and employees must clearly understand their role in the program” for it to be successful.
Talent Pools & Development PlansSo, what roles do managers and supervisors play in succession planning? According to Rothwell, the next steps in the planning process, after securing executive commitment, are for managers and supervisors to “analyze the work and people now” and evaluate the performance of current employees to create a “talent pool”—a group of employees who possess desired talents and will be prepared for more challenging roles.
Once a talent pool has been identified, supervisors must “analyze the work and people needed in the future,” keeping in mind that “the future may not be like the past, and the competencies required at each level may be different in the future.” This requires some forward-thinking on the part of managers to anticipate ways in which service delivery might change. For example, as new aging technologies are created for Assisted Living, an employee who demonstrates proficiency in the use and understanding of these technologies should be considered for a talent pool, even though a technology-specific position may not yet exist.
Once the future needs of the company are identified, managers and supervisors must evaluate the potential of their talent pool to fill these needs and prepare them to do so by “closing developmental gaps.” Rothwell says this is done by creating “an individual development plan (IDP) for each employee to narrow gaps between what the individual does now and what he or she must do successfully in the future to function at higher levels of responsibility.”
Rothwell says to think of this IDP as a “learning contract.” Under a manager’s supervision, an employee is encouraged to identify resources which will help develop the skills he or she needs to be ready for a higher level of responsibility. These may include “training courses inside the organization, seminars or conferences outside the organization, internal job rotation experiences,” and others.
Once an employee and supervisor agree on an IDP, it is up to the supervisor to ensure that the employee follows through. This is done by evaluating the results through what Rothwell calls “succession management.” Succession management, he says, “focuses on the supervisor’s daily role in grooming employees for higher level responsibility… its goal is to build the capacity of employees through daily coaching, mentoring and feedback provided by their immediate supervisors.” By ensuring that employees are completing their IDP, managers can be confident that their talent pools will be ready for greater responsibility when the time comes.
step 1: Get commitment
step 3: Evaluate performance
step 5: Evaluate potential
step 6: Develop people
step 7: Evaluate program results
step 2: Analyze the work and people now
step 4: Analyze the work and people needed in the future
Company-wide IntegrationOf course, many companies already have succession planning processes in place, but they may be viewed as “a constant struggle…an administrative exercise rather than as a competitive advantage,” according to the study, High Impact Succession Management conducted by Bersin & Associates and the Center for Creative Leadership. “Many organizations are spending a lot of energy creating succession plans, but few are able to integrate succession management in all company operations and among all levels of employees.”
Principal analyst Kim Lamoureux and fellow researchers found that, rather than just approaching succession management as a human resources chore, high-level companies use it to “seamlessly merge employees’ capabilities and career aspirations with the company’s business strategy and talent needs.” These companies are better able to drive change and business growth because the upward movement of leadership and expertise is uninterrupted. In other words, there are no gaps in the “V formation” of a company that might slow momentum.
Lamoureux and her researchers performed in-depth interviews with business leaders and talent managers to identify typical levels of company involvement in, and integration of, succession planning. Companies at level zero have no succession process beyond identifying potential successors for just the top-level positions, and those at level one employ a replacement planning process which involves little to no development of employee skills. These two levels comprise a third of all surveyed companies.
Half of companies surveyed are at level two and utilize the traditional succession planning process described above for key positions. Companies that are at this level and have been seeing positive results may want to make the move to level three:
*Information courtesy of Dale Carnegie Training, The Nuts and Bolts of Succession Planning by William J. Rothwell
A Roadmap to Effective Succession Planning*
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integrated succession management. At this level, companies “target all critical positions at all levels” and succession planning is “tightly aligned with the business strategy and integrated with other talent management processes.” This integrated approach is followed by less than 12 percent of the companies surveyed.
So, what does integrated succession planning entail? The survey identifies key steps that companies at level three routinely take. First, succession planning is done at all levels of a company, not just top leadership positions. This ensures a transparent process, which encourages commitment and engagement at all levels.
Second, the talent review process of these companies includes three important attributes:
1. Process Integrity: a quality process for reviewing talent that is consistent across all departments.
2. Talent Review Attendance: making sure the right people—business, human resources, and department leaders—are at talent review meetings.
3. Business Strategy Alignment: ensuring that discussions of positions and capabilities always refer back to business strategy.
Third, there is a strong follow-through on development plans for employees in the talent pool. The survey notes that, “without the execution of such plans, companies are unable to prepare successors for future leadership positions, the bench strength of an organization becomes weak and leadership pipelines are truncated.”
And finally, executives have expressed not just commitment, but engagement in the succession planning process. Lamoureux and fellow researchers note that “the most critical differentiator between the ‘best’ and the ‘rest’ is the level of commitment and engagement displayed by top executives and next-level senior executives” because executives are often “more optimistic than HR leaders regarding the effectiveness of succession management in meeting business and strategic challenges.”
Taking FlightWhether a company is just starting to develop a strategy, or taking the next steps to ensure that the process is fully integrated across departments, it is clear that succession planning is an important driver of business growth and success. By identifying and developing the talent that already exists within your company, your business can avoid the “drag” of missing leadership and rise above the rest. g
Want More on This Topic?Don’t miss the keynote session at CALA’s Spring Conference & Trade Show! Mary O’Hara-Devereaux will share the ways in which work and organizational life is shifting, and what you can do to be ready to thrive in this brave new world.
Go to www.CAassistedliving.org to register.
KEEPING OUR EYE ON THE BALL
Heffernan is committed to fulfilling your insurance needs in today’s challenging environment.
For more information about our risk management and asset protection services, contact Brant Watson or Lorraine Remigio at 800.234.6787. Visit Heffernan on the web at heffins.com, and follow us on Twitter at @HeffcyAssets.
Proud CALA Sustaining Partner since 2004 Offices in Walnut Creek, San Francisco, Petaluma, Menlo Park, Los Angeles, Orange County, California; St. Louis, Missouri, Portland, Oregon and New York, New York. CA License #0564249
CALA AD.indd 1 1/30/13 10:59 AM
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Integral Senior Living............................................................................31www.islllc.com
New LifeStyles, Inc./New LifeStyles Online....................................20www.NewLifeStyles.com
Propel Insurance..........................................................................................8www.propelinsurance.com
Sandi Flores Counsulting Group, Inc..................................................2www.sandifloresconsulting.com
VITAS Innovative Hospice Care...........................................................25www.vitas.com
Wroten & Associates............................................................................17www.wrotenlaw.com
Care and Compliance.............................................................................36www.careandcompliance.com
Ecologically Sound Medical Services..................................................7www.e-ecosound.com
Gould & Hahn.............................................................................................11www.gouldhahn.com
Hanson Bridgett, LLP................................................................................7www.hansonbridgett.com
Hampton Health.......................................................................................35www.hamptonhealthltd.com
Heffernan Insurance Brokers...............................................................33www.heffins.com
HPSI Purchasing Services......................................................................17www.hpsionline.com
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Aegis Living uses the Care and Compliance Group Injury and Illness Prevention Program
as part of their OSHA compliance and employee safety programs in over 30 senior living
communities across three states.
“These policy manuals are exactly what I was looking for and were very easy to customize.
There was no need for me to reinvent the wheel,” said Kevin Rougeux, vice president of risk
management for Aegis.
Learn more about our full line of training and compliance solutions at
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