Monday, March 05, 2007
Still Hopes' Executive Dir. Danny Sanford Elaborates on Executive and Industry Issues
Top Five Still Hopes Issues:
1) Making a decision on whether we will continue to do traditional Assisted Living as a level of care or if we will use our Home Care Agency to deliver that level of care inside apartments and cottages.
2) Completing the transformation of the campus to include a Main Street concept for amenities and services.
3) Determining what "culture change skilled nursing" will look like at Still Hopes
4) Dealing effectively with the new residents' expectations to be included in decision making for almost every aspect of Still Hopes' operation while simultaneously honoring the older residents' expectations that Still Hopes' staff and Board will not allow the new residents to "take over."
5) Developing an active adult component in downtown Columbia
Top Five Industry Issues:
1) Board Leadership with great governance skills. I truly believe that the governance level that has gotten us this far will not be sufficient to get us to where we are going.
2) Management's expertise, skills and ability to operate highly diverse and complex organizations. I see a real talent shortage in our future.
3) Dealing, virtually simultaneously, with all the new paradigms, i.e. 1) "culture change skilled nursing," 2) resident participation in decision making processes, 3) determining what the continuum should look like (does assisted living have a continuing role and what is it), and 4) dealing with the tangle of aging-in-place, regulatory challenges/inconsistencies, federal fair housing laws.
4) Getting a preventative wellness centered operations model, as opposed to a restorative/palliative health care centered model, to permeate our business; so that future marketing efforts are centered around how healthy you will stay/become once you move to a CCRC instead of how you will be able to "go down in style" at a CCRC as you have chronic and progressive debilitation and move through our continuum.
5) Actually operating our industry with sound business practices, do the right things right and pricing what we do so that we continue to be successful and profitable, and building reserves to renew our infrastructure on time and in a quality way.
More than you asked for:
Now, if you allow, I'll digress a little just for your eyes. The real struggle I see is that we are trying to move with the necessary agility and speed while we are actually re-inventing an industry. I see us like the old saying of "trying to build a plane while we fly it." At Still Hopes we have embraced prevention and wellness focused care for our independent residents. We are also working to create a Home Care Agency to allow people to age-in-place basically to their heart's content. The huge issue/problem is that I don't have a clue what these two simultaneously running new approaches will do to our business. For the first time in a long time I can't depend on historical industry data to help me. I've disrupted the chronic decline curve with the wellness initiative. I've disrupted the move from independent to assisted living with the home care initiative. So... people will live well longer, but how much longer? People will live healthier, but how much healthier? People will use home care instead of moving to assisted living, but how many will choose this route and how successful will they be at doing it? How many assisted living beds should I truly have to support that? For that matter, how many skilled nursing beds do I really need to support a group that embraces the wellness initiatives we are putting before them? I know at least a majority of the questions, but I don't know the first answer, nor do I know where to go get them.
The last time this amount of critical business decision information was not available to our industry, we saw lots of them get into financial trouble and fail. In my career we have relied on pretty good actuarial information to keep our boats fairly well afloat. I could, up to now, predict with accuracy how many of my independent living units would turn over each year, and just about how long a new resident would live there before they needed assisted care and then skilled care. I could even tell you with some high degree of accuracy how long they would use both of these service levels. Now, I don't have a handle on that, except that I do understand that the new way is the right way and that people will live independently longer and stay healthier and then need less skilled care for a shorter period of time.
We are truly embarked on a USS Enterprise type journey. We are going where no man has gone before. And, Captain Kirk is hocking cheap hotel rates via an internet company. What are we to do? In the immortal words of Scotty: "I'm giving her all she's got Captain."
To succeed, we must find a way to continue to make reliable predictions to how people will age and when and how they will die in order to continue to price our entrance fees correctly and to offer the right service models in the right sized and designed buildings. The $64,000 question: How do we do it?
1) Making a decision on whether we will continue to do traditional Assisted Living as a level of care or if we will use our Home Care Agency to deliver that level of care inside apartments and cottages.
2) Completing the transformation of the campus to include a Main Street concept for amenities and services.
3) Determining what "culture change skilled nursing" will look like at Still Hopes
4) Dealing effectively with the new residents' expectations to be included in decision making for almost every aspect of Still Hopes' operation while simultaneously honoring the older residents' expectations that Still Hopes' staff and Board will not allow the new residents to "take over."
5) Developing an active adult component in downtown Columbia
Top Five Industry Issues:
1) Board Leadership with great governance skills. I truly believe that the governance level that has gotten us this far will not be sufficient to get us to where we are going.
2) Management's expertise, skills and ability to operate highly diverse and complex organizations. I see a real talent shortage in our future.
3) Dealing, virtually simultaneously, with all the new paradigms, i.e. 1) "culture change skilled nursing," 2) resident participation in decision making processes, 3) determining what the continuum should look like (does assisted living have a continuing role and what is it), and 4) dealing with the tangle of aging-in-place, regulatory challenges/inconsistencies, federal fair housing laws.
4) Getting a preventative wellness centered operations model, as opposed to a restorative/palliative health care centered model, to permeate our business; so that future marketing efforts are centered around how healthy you will stay/become once you move to a CCRC instead of how you will be able to "go down in style" at a CCRC as you have chronic and progressive debilitation and move through our continuum.
5) Actually operating our industry with sound business practices, do the right things right and pricing what we do so that we continue to be successful and profitable, and building reserves to renew our infrastructure on time and in a quality way.
More than you asked for:
Now, if you allow, I'll digress a little just for your eyes. The real struggle I see is that we are trying to move with the necessary agility and speed while we are actually re-inventing an industry. I see us like the old saying of "trying to build a plane while we fly it." At Still Hopes we have embraced prevention and wellness focused care for our independent residents. We are also working to create a Home Care Agency to allow people to age-in-place basically to their heart's content. The huge issue/problem is that I don't have a clue what these two simultaneously running new approaches will do to our business. For the first time in a long time I can't depend on historical industry data to help me. I've disrupted the chronic decline curve with the wellness initiative. I've disrupted the move from independent to assisted living with the home care initiative. So... people will live well longer, but how much longer? People will live healthier, but how much healthier? People will use home care instead of moving to assisted living, but how many will choose this route and how successful will they be at doing it? How many assisted living beds should I truly have to support that? For that matter, how many skilled nursing beds do I really need to support a group that embraces the wellness initiatives we are putting before them? I know at least a majority of the questions, but I don't know the first answer, nor do I know where to go get them.
The last time this amount of critical business decision information was not available to our industry, we saw lots of them get into financial trouble and fail. In my career we have relied on pretty good actuarial information to keep our boats fairly well afloat. I could, up to now, predict with accuracy how many of my independent living units would turn over each year, and just about how long a new resident would live there before they needed assisted care and then skilled care. I could even tell you with some high degree of accuracy how long they would use both of these service levels. Now, I don't have a handle on that, except that I do understand that the new way is the right way and that people will live independently longer and stay healthier and then need less skilled care for a shorter period of time.
We are truly embarked on a USS Enterprise type journey. We are going where no man has gone before. And, Captain Kirk is hocking cheap hotel rates via an internet company. What are we to do? In the immortal words of Scotty: "I'm giving her all she's got Captain."
To succeed, we must find a way to continue to make reliable predictions to how people will age and when and how they will die in order to continue to price our entrance fees correctly and to offer the right service models in the right sized and designed buildings. The $64,000 question: How do we do it?
