21 Feb Operational Challenges and Solutions
Mike Peacock: Welcome back to Cosmic Soup. Thanks for joining me for Part 2 of this conversation with Cecil Rinker. Last time around, we closed it out with Cecil’s thoughts on staffing in the industry, so we’re going to pick up right where we left off, finish up on workforce, and dig elbows deep into operations. Here we go.
Mike: One of the models that have always been in existence is that, you know, labor, as a percentage of revenue, is the first cost that always gets cut. Really, the answer to the problem is, don’t cut the costs. Increase the revenue.
Cecil Rinker: Sure.
Mike: “Sales covers sins” is what we used to always say in the restaurant business.
Mike: I guess I don’t see that happening as often as I would think that it should in this industry as well. It seems like they’re still understaffed, for lack of a better way to put it. If we’d just increase the revenue, then we can have people onboard to avoid these super micro-manage-y timelines that they’re asked to adhere to and, like you said, they’re coming short through no fault of their own. It’s just environmental factors that affect how their day is going.
Cecil: Absolutely. Absolutely.
Mike: As a placement agent, do you look at a community and say, “Hey, listen. This is what this company’s workforce model is like”? Does that affect your decisions on where you put people?
Cecil: Absolutely. I’m just going to clarify just slightly, Mike.
Cecil: I really don’t ever feel like I’m putting somebody somewhere. I’m always trying to point out to my clients what it is that they should be looking for.
Cecil: Obviously, there are places that I would make a decision to not take somebody to because of either information that I have because I try to stay closely connected with all the communities. Maybe they have not been able to keep a nurse and there have been four nurses there in the past year. It’s very difficult for a family member or a resident to build a relationship if there’s a constant change there.
I look for stabilization. I look for places that I feel are doing a great job with retaining employees.
When I walk into a community, I’ve been doing this for so long that it really doesn’t take much for me to look around and I can tell you whether a community is being run well. One indicator is, when you walk in, take a look at the employees. How are they postured? Are they walking with their shoulders back, their head up, and a smile on their face or are they walking slumped over like they just can’t wait for the shift to be over?
Cecil: Those are things that you can visually see beyond the most common things, which is, is the building clean? When I walked up front, does it have a nice entrance? Is the entrance clean? Is the mat clean? Are there cigarette butts laying on the side of the ground? Those are things that you can visually see.
Sometimes, when we walk in, we stop paying attention to the people that are there. What are the residents looking like? Are the residents all just sitting in the lobby not doing anything? Are they sleeping in the lobby?
I’m a big proponent it’s their home. They should be able to do whatever they want to. But if there was activity in that lobby, Margaret might not be there sleeping. She might be participating in some way.
Mike: Yeah, what is the level of engagement?
Cecil: Exactly. It is about the engagement. Those are things I look for, too. When you walk in, there should be a bit of a bustling going on. There should be liveliness there. Just because somebody is in their 80s does not mean that it should be quiet and nothing going on. I think that the old saying that, “Old people don’t like noise. They want it to be quiet,” that’s not true. It’s not true at all.
I see some really, really, really great examples of aging successfully where people are living life to the fullest every day. We kind of rise and fall to the level of people who are around as well. I look for that.
I look for a lot of resident engagement. How are they engaged with the staff? How are they engaged with each other? What’s going on? What does that activity calendar have on it?
This is kind of off-topic, but another big thing that I look for is, how are the programs being attended? Are we creating programs in our communities that are diverse enough for our entire population? We hear a lot of bingo bashing.
Cecil: “We’re not a bingo community.” Well, that’s good but they’re going to have a percentage in there who are going to be bingo people. They’re going to love bingo. Are we right to just pull bingo off the calendar and say, “We’re not a bingo community”? Well, then we’re not serving a certain percentage of our population who would enjoy that activity.
In the same respect, we have a large population that may not like bingo. What are we doing to accommodate them?
What I’m finding in the big pitfall that you see over and over again in the larger communities is that they have a full-time activities person who is performing the tasks that needed to be done, writing a calendar, putting all of those things in the calendar to create events, which is used for marketing. Then when you go to see one of those activities, you see 30 people out of 200 that might be attending.
If you go back and take a look at the other activity and there are 30 more people in a second activity, are they the same 30 people? If I go to the next activity, are they the same 30 people? Are they the same 30 people over and over again?
If you look at a classroom that’s got 30 people in it, you might say, well, I have a successful activity. Well, if it’s the same 30 people coming to every activity, what are the other 120 people doing?
Mike: Yeah, you’re not reaching a new audience.
Cecil: You’re not reaching a new audience, so you have to come outside the box. We all spend an exorbitant amount of time gathering up this information of what people’s preference are as far as activities and what things they enjoyed in life before retirement, what things they enjoy in life after retirement. We try to come up with these plans. They usually end up as games, movie nights, Bible study, maybe a lecture series, but we need to move past that. Moving past that means thinking outside the box.
We constantly use Margaret as an example. [Laughter] If Margaret moves into a community and you found out that Margaret grew up raising horses all of her life, had horses, and now she’s 94, obviously, we would probably — I’m not going to say no because it could happen but we probably aren’t going to put Margaret on a horse.
Cecil: And take her riding. So, you have an activities person. Activities person A says, “Oh, well, they’re too old to do that,” or, “My residents don’t want to do that,” or, “Margaret doesn’t like to do that anymore,” or can’t do that anymore. Then you have an activities person that says, “Well, if Margaret liked horses, why don’t I call the local stable that’s in our community and ask if we can do a field trip? Margaret could go and, even in a wheelchair, still pet the horses, to smell the stables, to just be around something that she loved so much when she was younger.”
I think we need to think about, it doesn’t have to be the activity as we would believe it to be, Margaret horseback riding. It could be that we just expose Margaret to horses.
Mike: At the end of the day, when we’re talking about having truly engaged residents, truly engaged communities, it does kind of all double back to making sure that there are people on staff who can provide those services on a consistent level, not even just to drive awareness of them but to make sure that they can carry out the plans. Not that it’s just a check on a calendar and you herd a bunch of people into a room, set them free, and say, “Have fun. Do your own thing.” There’d have to be some level of guidance and some level of interaction with them to get the most out of it, to draw the new people in because they’re saying, “Hey, this is really cool. You should check this out.”
Cecil: Yeah. Absolutely. Absolutely.
Mike: You’ve talked about a lot of things, how we begin to turn it around, how we change some perceptions, how we get people on board. What would you say to people at the top of the food chain, your CEOs or whomever it may be? How do they communicate to their administrative teams about workforce management? How do we trickle that information down to make sure that the people who are making decisions really understand what it is that they should be doing and to make sure that their people that they put in charge of those areas are carrying it out to a satisfactory level?
Cecil: Visit your communities.
Cecil: That would be my first thing. There are many, many CEOs out there, wonderful CEOs out there with great mission statements in their company and great ideas. But as it filters down, I think a CEO really needs to take a look at, am I comfortable knowing that the supervisor at my community understands my vision?
Cecil: I think that we lose if things get diluted as it goes down because we can have a great corporate mission statement. We can say that we want to become an employer of choice, we want all of our employees to be supported and we want their families to be supported, and we want people going home at the end of the day feeling good about the job that they did. That’s a great mission.
Cecil: Because that translates into better services for the residents. But if I now have given that to my team at the corporate level and said, you know, “ABC operations team, I want all of your communities to have this vision and this message.” Well, so now you’ve given your message to people who are going to carry that out for you. They go back to their communities and they’ll generally talk to the executive directors. Some of them will get this. Some will get on board and they’ll run with it.
Others, it may stop right there. Nobody else gets to know the vision. It stops at the ED level.
Cecil: Some may trickle it down and get it to the supervisor level. But until you talk to the entire team and make that vision known to everybody so that the dishwasher and the housekeeper understand that they are a part of that vision as well, that’s where the magic happens. We need to make sure that everybody is on board and we’re all singing off the same song sheet. It’s really hard to do unless you go out and look at your communities.
When you walk into a community, take the time, obviously, to spend time with your executive directors and your management team but take some time to go talk to the staff who is delivering the services every day, who is connecting with your residents every single day. Find out what they have to say. Find out if they know your vision. That’s the first thing I would ask is, “Do you know what the mission is of the company?”
Cecil: If they have no idea, chances are nobody has told them about it.
Mike: Really, what we’re talking about is not only kind of setting the tone, but then the follow-up and the accountability factor. Holding yourself accountable, holding your teams accountable, not in the disciplinary fashion, but making sure that they truly understand what it is that they should be doing, I think that’s a very powerful message to send is that you can have all these great ideas, but you have to follow up on it to make sure that they’re properly being implemented.
Cecil: Absolutely. Absolutely. You know there’s a saying that I’ve used for years. I can’t quite remember who shared it with me, but it stuck in my head for a long time. That is, when you walk into a retirement community, the executive director could be absent for a day or two and somebody might miss them but the operations will go on.
Cecil: If a dishwasher misses that day, the operations is hurting.
Mike: Yeah. Yeah, that’s true.
Mike: What role they play, how crucial is it in the day-to-day operations?
Cecil: Yes, so I really believe that the message to the CEOs is that we talk a lot to our management teams. We talk a lot to our directors. We talk a lot to our operations people. But do we really know, at the end of the day, that our message has made it all the way down to the people who are making a difference every day in the residents’ lives?
I know as an operations director, I used to love to go sit in the employee break rooms where most of the staff would take their breaks or eat their lunch. I learned much more by sitting there because, actually, it’s fun to kind of surprise people. Some people get a little nervous, but I found that most of the time if you go down, you have an open mind, and you share some fun times with people, they open up.
They’ll say, “Hey, you know what? I’ve been working in the housekeeping department. We haven’t been able to clean the carpets in the hallways because the carpet shampooer has been broken for three months now. We’re trying to spot clean everything and they don’t look good and I don’t like that.” Now you have an employee saying I have job pride but I don’t have the tools to do my job.
Cecil: Whose fault is that? My question is, why didn’t anybody else say that before? Why hasn’t that been taken up the ladder, if you will?
Mike: Yeah, that’s a great callout. Switching gears again, getting back into the operational side of things, there are a ton of problems that sometimes people know about that they don’t address them. Why do you think that is? Is there a fear of losing their job because they maybe will be perceived as threatening to somebody higher up?
Cecil: Possibly. It could be that there’s a fear of losing their job. It could be that maybe you haven’t created the culture and maybe we have some employees that just don’t care. It’s all part of that culture.
I think that there was the whole idea in the hospitality industry about the bubble. Anybody that would come within eight or ten feet of a resident or a client would make sure that they stopped, smiled, and spoke to them, you know, just introduced themselves.
Cecil: That’s a great thing to strive for. I think we all would like that in the industry. But we have to realize that not everybody in our team is doing that and not everybody on our team has the personality to do that.
Cecil: Which brings me to another point of employment that I think we need to look at too. That is, we tend to identify who does a great job and we just kind of let it go. We might not be giving enough kudos. We may not be communicating well enough to that person how valued they are because, as executive directors, we’re spending a lot of time trying to manage the lowest common denominator on our team.
We all have trouble. We all go through rough times. We’re not going to be stellar employees 365 days a year.
Cecil: We all have issues as well. We have sick children. We have parents that we’re caring for. We have just bad days. We have times when we get sick.
We need to support folks, but then there’s always the portion of our team that really is not carrying their load or they’re not caring enough about what it is that we find important in our communities. When we spend too much time or allow that behavior to go on too long, what we’re actually doing is sending a very poor message to the great employees in our community.
We’re sending a very poor message that, yes, I’m not giving you kudos. I’m not talking to you. I’m not paying attention to you because I’m spending all of my attention over here on this employee who may or may not get it when I should be spending all of my time with the top performers, raising them up high or raising the bar up higher. When you raise the bar up higher, you’ll lift other people below them up as well. But, when we keep just focusing on the worst employees that we have, we’re actually dragging everybody down. A lot of times your stellar employees will look for employment elsewhere because they’re frustrated.
Mike: Sure. Do you think that a lot of times, at the higher levels, maybe there is a lack of awareness on that element of the workforce?
Cecil: I believe there could be lack of awareness or it could be just frustration. I’ve been in the position before and I’ve had to deal with employees which were delicate matters because we have HR rules we have to follow as well, employment law we have to follow as well. I think that’s where most of us fall down. We don’t take the time to do the right thing.
A perfect example is looking at an employee who has been with the company for maybe a couple of years. All of a sudden, this employee, for some reason, has now done something that requirements them — it’s something that’s so bad that it requires them sitting in the executive director’s office and there’s a termination that happens.
Cecil: If an employee sits in that meeting and is terminated and it’s a shock and it’s a surprise to them, then we didn’t do our job.
Cecil: We did not do our job.
Mike: Because the expectations weren’t set nor were the repercussions of not following the basic guidelines.
Cecil: Exactly because there is a reason why we have labor laws in place that folks need to have every opportunity to succeed. Maybe they didn’t get the proper training. Maybe when they were brought on you were so short of staff that training kind of fell by the wayside and they were thrown in there on day one to just kind of sink or swim. That could be it. That could be a possibility.
An employee who is brought on board should be oriented. We need to take the time to onboard them in the proper way. We need to constantly be giving them feedback and information about how they’re doing in those first weeks and months. It needs to be ongoing.
Those annual reviews are very important. You wouldn’t believe how many people have gone years without an annual review. They’re just kind of wondering–
Mike: I see it all the time.
Cecil: “I’m not sure how I’m doing. Nobody has ever talked to me.” Or you get somebody who has never been spoken to all year long. No guidance has been given. No feedback has been given. They get their annual review and, all of a sudden, it’s very poor annual review and they’re so surprised by it because they thought they were doing a good job. Again, if an employee is that surprised by the outcome of an annual evaluation or a termination, then we probably have not done our job in communicating and getting them feedback throughout their tenure.
Mike: Yeah, and that just supports the idea that a lot of problems simply stem from either insufficient communication, insufficient training, or a combination of the two. That really sums up where a lot of these problems come from.
Mike: Whether or not that’s a budgetary issue or simply an operational issue where the system just wasn’t put in place, it leads down the same path, unfortunately.
Cecil: Exactly. A lot of folks have this mindset that when you sit down to counsel someone, and that’s an industry term I think they use outside of our industry as well.
Mike: Yeah, coach and counsel. Yeah.
Cecil: Coaching and counseling, and when you’re sitting down to coach and counsel somebody, if your end goal is to terminate them–
Mike: Then you’re not coaching or counseling.
Cecil: You’re not coaching and counseling. Your end goal should always be that I have an employee that is struggling and it’s my job to do everything I can to help them succeed and to become the best employee they can become. Those coaching and counseling sessions really need to be a focus on, how do I make this employee successful? How can I help them get through some of the struggles that they’re having and help them improve?
Maybe it’s taking the time and saying, “Okay, here are the things that I need to see you improve on. Here are the things that I think you do really well. You’ve got a great personality, a nice smile. People like you. You respond well to the residents. The residents respond well to you. But you’re having a difficult time and I see that there are charting problems at the end of each shift and you’re not charting properly, which puts us in a very difficult position. This is why.”
If you start looking at explaining to an employee why a decision has to be made, why you’re sitting there having that conversation, and why we need to change it, you wouldn’t believe how empowering that is for an employee. Once they understand why something needs to be the way it is, it can have the effect of changing the way they think about things.
Mike: The awareness — the awareness affects the impact and that’s something that I have always believed in. That’s not just at the, we’ll call it, production level. Right? That can be on any level when you realize the role that you’ve played in the operational chain. Sometimes a lot of things that don’t happen are simply because nobody was made aware that there needs to be some fire put behind this.
Cecil: Absolutely. Absolutely.
Mike: If you were, as you have been, at the CEO level, for instance, what do you say if you recognize that there’s a problem? A lot of these people at the higher level, they don’t necessarily know how to address it. Maybe I’ve got a problem, but I can’t identify it. I’m not really sure.
Clearly, there’s something going on. What steps do you take to identify if there is a problem? Then, going from there, where do you go with that?
Cecil: Well, I think that if I’ve identified a problem and I’ve tried to resolve it through a set of people that are working on my behalf. Generally speaking, your operations teams or, in our industry, the operations directors have a lot of say-so of what’s happening in the communities. If you’re not getting the results or you’re seeing that the problems aren’t being solved, that’s the first place to start is, do I have the right people delivering my message? Do I have the right people who are taking my message and implementing the culture of my company into each community? That’s the first place I look.
The second thing is if I’m finding that the numbers just aren’t adding up, again, I would say that my advice to a CEO is to go visit your community. We all know what it’s supposed to look like and feel like. You can walk in the door and you can feel, like anybody else can, if this community feels good. They all have a personality. They all have a feeling.
Again, I think that it’s very difficult. CEOs are very busy and some of these companies are so large, I wouldn’t know how a CEO would get around to see every community. But I have also known many, many, many CEOs in our industry who are very active and are out visiting the communities, visiting the residents, visiting the staff, visiting the executive directors and the management team and talking to them directly. It takes some time to do, but the information that you gain is going to be the most valuable information you can get because you’re seeing it first-hand.
Mike: Yeah. Aside from workforce and some of the other, smaller operational issues we’ve talked to, what are some of the other big operational issues and challenges that communities face?
Cecil: Operational challenges?
Cecil: It’s really hard to come up with a close first to staffing.
Mike: Sure. It doesn’t have to be a ranked file. Just in general, things that pop up that you see as being common obstacles.
Cecil: I think that another big thing for operations, we’re a very crowded field out here in senior housing. There are a lot of providers here. Many times, I feel like we get stuck in a rut and we keep singing the same song from the same songbook.
I believe that, operationally, we have to take a look at marketing, we have to take a look at operations and how they go together because what I see a lot of times is, I see really pretty websites, pretty marketing material, great commercials and great mailers with stunning pictures of plated food that looks like it came out of a five-star restaurant, waited on by a server who looks very happy at their job, and a resident who looks absolutely beautiful in the photograph.
Mike: Like they just won their bingo match.
Cecil: Yeah, and they have no health issues at all.
Cecil: The reality is that when you are a person out looking for that either A) you look at that and go, “Oh, that doesn’t look like me,” or B) you go, “Wow, that’s the place for me.” You walk in and that’s not what you see.
Cecil: I think that we look at, how do we differentiate ourselves from our competitors? I think that’s looking at niches.
There’s a community here in Tucson that very much so like many of the large communities in Tucson: independent living, assisted living, they do have some memory care. But they decided to take a left turn and go, “You know what? We are going to focus on care in assisted living. We are going to put our focus there. We’re going to tout that.”
“Then we’re going to back it up because we are going to have a larger care team. We’re going to have more nurses on staff. We’re going to have things that mean something to people looking for care.” That has differentiated them in our market.
That’s just one suggestion. Pick something that you’re passionate about and home in on that.
It could be that you’re looking at your community and saying, “What makes me different? What makes me different in the rest of my communities? What is it that I want to be known for?”
Foodservice can always be one of those things. We have a large focus on food. You’re going to attract a different kind of clientele for that. It could be activities and programs.
There is another community in Tucson that focuses on higher learning. I don’t know of any other community that does that. They have been working in conjunction with the University of Arizona. The community was actually developed by a dean of the University of Arizona. They have 100-year-olds who are living there who have 4 or 5 different degrees and they still want to learn something, either a new language or they want to sit there and they want to hear TED Talks or they want to have speakers coming in talking about world issues. That community stays fairly full because it’s not a large community, but they built it and they’ve been able to fill it with a niche of people that have the same kind of idea of aging as the community does.
I’m not saying that those things that you have to run out and do. You have to really do some soul searching and find out what is important to you. If it’s important to you, it’s probably important to other people too. Then how do you get that message out and, more importantly, how do you deliver upon that message when they come in to see you?
Mike: Yeah. It is a very important thing to identify that a lot of the marketing elements don’t necessarily represent the realities when you go into places. Cynthia and I have talked about that quite extensively. We’ll get into that down the road on future episodes.
When we talk about it in terms of operations, absolutely, at the end of the day, are you pulling off all of the things that you’re telling people you’re going to do for them?
Cecil: Right. Absolutely.
Mike: Are you not doing enough or are you trying to take on too much with the resources that you have available and now you find yourself just cutting corners to try to make it all happen, to kind of Frankenstein it all together?
Cecil: Absolutely. Absolutely.
Mike: Crazy. Well, lastly, since you are a genie, let’s say–
Mike: Let’s say that you could grant three wishes to listeners. What can they do to start today that would make a difference in the communities and the lives of their residents? What should they wish for?
Mike: Three wishes to improve the lives.
Cecil: Three wishes to improve the lives. I think that the first wish would be to be able to connect with every employee. Every person who is working in your organization should feel a connection from the top. They should feel like they are a part of the company and I would wish that employers could find a way to bridge that gap.
Two, another wish. My wish for communities is to place as much emphasis on their independent living residents as they place on their assisted living residents as they place on their memory care residents. We have to meet people where they’re at. I think that we have, for a long time in this industry, wanted the sexy senior to be living in independent living and we want to put them out on parade. But the fact of the matter is, there’s a lot more going on in retirement community than just independent living residents who just got rid of their home and don’t want to mow their yard anymore. Yes, they make brochure covers but, the reality is, that’s not everyone who is living with you. I would wish that we could take a look and see how we connect with each resident and make sure that their experiences are similar in the way that they’re being met for the goals that they have for themselves.
Three wishes, gosh, I mean, you know what? I might be coming up short as a genie.
Cecil: My third wish would be that communities can do a better job. No, let me take that back. That the industry can do a better job at showing how wonderful this industry is to work in, how much fulfillment you can get by serving others and helping others, and showing that this is not only a viable career path, but it’s a field that’s wide open. Senior housing is here to stay. My wish would be that we can find a way to attract younger people to join our industry and to find fulfillment in a career in senior housing.
Mike: To change the perception of what it means to be in this industry.
Cecil: Absolutely. Absolutely.
Mike: Those are three awesome things as a genie that I would hope your wishers would wish for. That’s pretty epic. Cecil, thanks for hanging out today and sharing your wisdom and your insight. I’m glad that we were able to do this today. I know that we’re on different time zones and things are kind of crazy, but this has been absolutely unbelievably awesome, and it’s always a pleasure to talk to you.
Cecil: Thank you, Mike. It’s always a pleasure to talk to you too.
Mike: Thanks to all of you for listening and hanging out with us on this crazy journey. We definitely appreciate it. If you like what we’re doing here and you want to stay up to date on what’s going on in the industry, please subscribe to the show on all the platforms: iTunes, Google Podcast, Spotify, iHeartRadio, you name it. Don’t forget to send us your questions and comments to firstname.lastname@example.org. We’ll address them in our upcoming mailbag episodes because, really, this show is about helping you. Once again, thanks for hanging out with us today and we will talk to you next time on Cosmic Soup.