June 16, 2020 / Senior Housing News — As a longtime leader in senior living — both for her company, Brandywine Living, and as a past board chairman for industry association Argentum — Brenda Bacon has experienced a lot of change. She’s also been at the helm of that change and has learned a lot in the process.
With roughly 30 communities in seven eastern states, Brandywine has evolved under Bacon’s leadership to develop a culture around embracing change, whether that means exploring and developing new technologies, being on the forefront of wage increases, or making tough business decisions for the safety of employees and residents during the 2020 COVID-19 pandemic.
As a Changemaker, Bacon shares her thoughts with SHN on how to broach those difficult decisions, what it means to gain buy-in for change, and where she sees change coming down the pike for senior living.
Senior Housing News: Are there any changes that you’ve led — ways that you’ve changed Brandywine or the industry overall — that you’re especially proud of?
Brenda Bacon: There are, in both of those arenas, things that are especially meaningful to me, and only others can judge whether they’ve been successful or otherwise. Many of us came out of the nursing home industry or the hospital industry or some kind of caring industry. The thing that’s always intrigued me about our industry is we never really declared ourselves an industry; are we health care or hospitality?
If COVID has taught us anything, it has taught us that we are health care, but it doesn’t mean that we have to be health care in the traditional sense of a hospital or a nursing home.
At Brandywine, we always can provide that service that you need, but it doesn’t have to be in-your-face health care. The approach really needs to be around the guest experience — like all day dining, where you eat when you want to eat.
There’s a 24-hour nurse onsite, and she’s not walking around in scrubs saying, “It’s time for you to take your medicine.” That nurse is in that building at three o’clock in the morning. It’s not about when she wants to do something or needs to do something or check a box for you, it’s more like when you need her, she’s there.
I’d like to think that Brandywine has tried to develop a culture that says, “We’re here to make that customer happy in the senior living business, which is health care and hospitality and fun.”
I hope what we’re going through now as an industry puts an end to the, “Are we health care, are we a hospitality [industry debate].” We’re both. We don’t have to be a junior version of the hotel industry or a junior version of the health care industry. We can be our own industry because it is a unique product.
How has COVID-19 changed your thinking about the future or how the industry might need to adapt?
I would say that it has brought in new dimensions that we didn’t think about before.
Before, we were thinking about how to get baby boomers interested in our product. I think we’re going to come out of this with a whole different set of challenges due to the headlines, and the fact that COVID is hitting the nursing homes and senior living communities at a much greater rate. Who could have ever imagined this scenario?
If we think about coming out of the other side of this and what does that look like, people are going to ask themselves the fundamental question: Is my loved one safe and secure in senior living ,or am I making the best decision I can make under the circumstances by keeping them home and isolated even though they may be bored and with health deteriorating?
We have to be able to convince the public or customers that their loved one will be safe and secure in addition to being happy. That’s a new challenge. We may have hit upon those things before, but there’s a whole new dimension to it right now.
What needs to be done to achieve that safety and security you’re thinking about? Any operational changes you’re implementing at Brandywine?
On April 4th, we instituted a rule that says that says “one job only.” In the healthcare industry, employees traditionally work in two or three different healthcare institutions; they’ll work a shift at a skilled nursing and then they’ll go to an assisted living or the hospital, the doctor’s office. Nurses and care managers tend to have several different jobs.
In our communities, when we were looking at the surrounding nursing homes and some senior living, they had several cases of COVID before we did. Before our building started to get hit, I got all of our executive directors on a Zoom call and I said, “I’m going to send out a letter to all staff that says that you will work one place only. You can only work for Brandywine. You cannot work for other healthcare facilities during the duration of this COVID crisis.”
Our team was obviously concerned, as I was. They were saying, “We’re going to lose half our staff.” I said, “I know this is going to be hard, but they’re going to have to choose … Our residents are too much in danger from that [practice], as are our team members.” Each team member had to sign … that they were going to do that, and we verified it. We lost people, but I still feel like we were better off. Our job is to keep people as safe as we can.
I have to tell you, I think we’re going to stay in that position, [with the flu season ahead and possible second wave in the fall].
I’ve heard that from other people that if staff work one job only, employers might have to pay them more. Does this mean senior living is becoming a lower margin business going forward?
Thankfully, we adjusted all of our wages a year and a half ago for our frontline staff. I like to try to get ahead of things, instead of chasing them … The fact that Amazon, Target, ShopRite!, Dunkin’ Donuts, and everybody else has hired people at $14 to $15 an hour at a starting wage … you can’t operate in these markets and get the quality of person that you want if you’re going to be paying $12 an hour.
We don’t have to be a junior version of the hotel industry or a junior version of the health care industry.
By the way, all those other jobs are easier than the job they’re working for us. So we made that change and it’s been, probably, an easier transition for us than others. It wasn’t easy to do. We had to take a big gulp when we did it, but it was done before, so it’s not so bad now.
We have pretty good margins. Our margins are ahead of the industry and it’s partly because of the markets we’re in and the type of product that we provide, but I think of it as an investment. It’s an investment in being able to make that message to your customer that, yes, we may cost a little more, but we provide so much more.
Our first COVID case came in the middle of the night, and we all were awakened, and we all were up all night long. It felt like it was a gut punch. It just was awful. You get on your feet, you do what you need to do to protect a lot of people, and we’re doing very well, in terms of what’s going on.
The states are making all kinds of requirements, but we decided to be very transparent with our employees and our families, getting ahead of it. At the end of the day, if you’re going to make the case that your loved one is safe and secure in a senior living environment, more safe and secure than they are at home, you have to knock out some statistics that back that up.
We don’t know where this data is going to end. If you can say, 98%-99% of our residents lived through COVID with our help, 99% of everybody was okay … if you can show pictures, or have a group of people that are COVID survivors, and they’re in their 90s, that gives me hope. It should say something to our public, our customers out there.
I’ve heard Brandywine has a great asset management system, “Alvin.” Can you talk about your approach to technology and how you created that platform?
Brenda: The people in the company will tell you that the platform was created because I had issues with command and control, and applications [laughs].
I need data now, I need to know what’s going on in the buildings. I was frustrated all the time about waiting until the end of the month; the accountants added up everything, two weeks later they got the books closed, everything done, and they said, “This is what happened last month.” By that time, if I see something that needs to be corrected, I’m already two weeks into the next month. To me, that is not the way you run a business, you need real information immediately.
We built our Alvin system from an operator’s standpoint, from the ground up. It certainly has the financial system in it, and we built our own HR system and clinical data. The main thing is, I can see in any given building who’s moving out, when, I can see the projections, who’s moving in, at what price, I can slice and dice, whether the cohort of people that moved out last month or even yesterday were paying a higher price than the cohort of people that moved in that same day.
We can look at our collections, we can look at our acuity, we can look at our staffing by hour every time someone sticks their hand into the scanner to clock in. We capture that. So we know exactly who’s working, who’s on the floor, how many bodies are in the building, what their rate is, how much money we’re spending per hour at any given building, or anywhere in the portfolio.
It gives you very real information, and it’s live. I think it gives you a lot of power, in terms of running your business day to day.
Everybody uses it. Our executive directors use it, our dining services people use it, our wellness directors use it, our salespeople use it. Everybody’s information goes in there.
You’ll hear people in other companies, sometimes, talk about being on these endless conference calls, or that they have three or four systems that don’t talk to each other. You put the information in one time, and it populates everything in our system. The information is actionable.
What year did you launch the system?
We started building Alvin when before we sold our nursing home [portfolio], so it had to be before 2006.
This might be a difficult question to ask in the midst of COVID, but do you think senior living as a whole is changing fast enough?
I think if it wasn’t, it will now.
I think the people will come out of this and everybody is under extreme business pressure, but a lease is a lease … I think there will be so much distress in the business that people are going to have to move fast.
Some people are going to learn and embrace new skills, other people are going to be kind of curled up and frozen.
I think those who are just putting a little bit of investment here and there and thinking that you just need to fill the pretty building are going to reassess that, because there is risk here and you’ve got to know what you’re doing.
Some people are going to learn and embrace new skills, other people are going to be kind of curled up and frozen. Some people are going to be able to make changes, and other people, like in any situation, are going to say, “I wish it was just like it was.” And it’s never going to be like it was.
Can you describe a time when you tried to create a change and it didn’t go well?
Around 2013, 2014, we looked at the several trade organizations that we were all paying dues to — Argentum, which was ALFA at the time, ASHA, LeadingAge, and NIC, and NCAL or AHCA, so you had five or six. But the two predominant ones, I would say, in our sector were ASHA and ALFA, now known as Argentum.
Several of us in the industry got together and we met for around nine months. We sat down and tried — with representatives from ASHA and Argentum — to put together a roadmap for the industry to come together, have a stronger voice, speak with one voice, get more power and recognition for the industry, use our resources better, and help to lead the industry as it grows and goes into change.
That turned out to not work. Probably right now, during the COVID crisis, you have more coordination between the industry associations than you have ever had, but it’s still awkward. It’s still two different organizations that say, “We think we want to do this. What do you think?” and then negotiating among themselves before they can present a united front. I would say that that was something that I regret we were not able to do.
Did you learn anything from that experience about yourself or what it takes to lead change?
It is always important to get buy-in. Timing is everything in many, many things, in whatever you do. The time wasn’t right, and if the time is not right, you can’t force it.
You have to be able to show how everyone benefits. There were things that we could have done better to have made that work.
Are there Brandywine initiatives that you’re changing or pausing because of COVID-19?
Well, everything has been paused now because of COVID-19, because we’re in hand-to-hand combat until we get past this stage and figure out what’s next.
I think how buildings open back up is going to be really important. It’s going to be definitional in terms of how you and your team think through precautions. “Okay, we’ve had this happen to us now. What did we learn? What are we going to do to make sure that we don’t throw the baby out with the bathwater in terms of all of the wonderful things that were going on before? How do we take those extra steps so that we can stop, drop and roll immediately if we see the first sign of this virus or some other coming back?”
We get lots of wonderful letters from our families and our residents. Those give you energy, and that’s a good thing. For those who don’t know us or know the industry, and if all they know of the industry right now is what they’re reading in the headlines where we’re being lumped into the long-term care situation, not that we don’t have cases in assisted living but certainly not to the degree … if that’s people’s headline definition, we’ve got a lot of work to do.
As an industry, as individual companies, we’ve got a lot of work to do to make sure that we protect our brand, to make sure that we change that narrative, to make sure we understand what it is that people need to hear from us. I think that is that your mom is going to be safe and secure with us. They’ll have a whole lot of fun too. They’ll have a lot of new friends and be able to order wonderful food and go on trips. They’re going to have all of that going on, but the top headline message is your mom is going to be safe and secure with us.