Being selected for the American Seniors Housing Association (ASHA) Senior Living Hall of Fame prompted Belmont Village Co-Founder and CEO Patricia Will to reflect — not so much on all she has already accomplished in her career, but on what comes next.
“It enabled me to reflect on the innovation that I want to continue to engender,” she told Senior Housing News in an interview last month shortly after the Hall of Fame induction ceremony, at the ASHA Mid-Year Meeting in Lake Tahoe.
Will dedicated her Hall of Fame honor to the industry’s workforce, and labor challenges and practices are at the top of her list in terms of future innovations.
“I think we are missing something big there, if we just keep stealing the same people from each other,” she said. “We need to see real changes.”
Will is also focused on pushing forward with innovations in areas where Belmont Village has been an industry pioneer, such as in working with top academicians and researchers to drive resident wellbeing, and bringing new developments to market that push the envelope on design and programming.
Overall, the consumer is changing as a new generation begins to seek senior living options, and providers must be cognizant that “they are going to perceive things differently,” Will said.
The ‘No. 1 key issue’
Recruitment and retention have been perennial challenges for senior living providers, but the workforce crisis has reached a new level of intensity due in large part to the Covid-19 pandemic.
Employers across a wide swatch of industries — including senior living — are experiencing worker shortages. They point to public policies related to the pandemic, notably enhanced unemployment benefits, as underlying causes of these shortages.
At the same time, senior living workers have endured extraordinary risks and often performed heroically during the pandemic, but these efforts have taken a toll.
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“The workforce that we have today is just extraordinary, but the pressures are also pretty extraordinary,” Will said. “We’re seeing some dislocations today that are not typical.”
Among those atypical dislocations: hospitality, not clinical roles, are currently the most difficult positions to fill across the Belmont Village portfolio of 30-plus communities nationwide.
This issue should ease in the coming months as hotels and restaurants staff up and the competition for hospitality workers abates, Will believes. In the long-term, she is acutely concerned about the caregiving workforce.
“On the care and clinical side, this can hit a crisis unless we as a company, we as an industry and we as a country do something materially different,” she said.
In terms of how Belmont Village as a company is responding, the organization is “taking it so seriously” that it is mimicking its pandemic response practices to tackle the issue.
“Just as we dedicated a think tank led by one of our top executives to deal with vaccinations, deal with the pandemic, we’re doing it today for workforce development,” Will said. “It is the No. 1 key issue for us.”
This internal think tank is taking on some of the most persistent and multifaceted challenges facing Belmont Village and the industry as a whole.
“We need to as a company, as an industry, do a much better job of recruiting people into our industry, training people for our industry, keeping people for longer, figuring out what makes them tick … and frankly, in a lot of instances, paying more,” Will said. “It’s all those things.”
Belmont Village has been an industry leader in certain workforce practices, including through providing profit-sharing incentives and opportunities for direct equity investment in the company for various workers in various roles throughout the org chart — “certainly to the executive director level,” Will said.
She does not believe this is a common industry practice, but signs are emerging that employee ownership and profit-sharing could be on the rise — including, just last week, the news that Canadian operator Sienna Senior Living is launching an employee stock ownership program.
Belmont Village also has pursued workforce development through innovative partnerships, such as with nonprofit JVS SoCal, which provides job training and experience to individuals from disadvantaged communities. Belmont Village makes financial contributions to JVS SoCal’s HealthWorks program and hires from the program’s talent pool.
But solving senior living’s workforce challenges also demands public policy changes at the national level, Will believes, and described immigration reform as “something that I believe in very strongly.”
“We have to advocate as an industry for a relaxation in immigration laws for people who are plentiful outside our country and very scarce inside the country — nurses, for example,” she said. “I think that’s possible but … you need to do it quickly.”
A new period of innovation
Over the last year, the Covid-19 pandemic spurred some innovations that will be lasting. For example, Belmont Village invested in a telehealth platform, and Will sees enormous promise in the ability of this technology to improve the resident experience while diminishing hospitalizations and emergency room visits.
Such pandemic-related changes will be a net positive for the industry, in her view, but Covid-19 generally created impediments to innovation.
“I think to a very large extent, all of us that are more typically engines of innovation got sucked into a maelstrom,” she said.
Now, while the delta variant does introduce uncertainty, Will is eager to again pursue changemaking efforts.
Some of those efforts involve new developments. Belmont Village forged a joint venture with Greystar, ushering the multifamily giant into higher-acuity senior living for the first time. Will is bullish on that relationship and the first project in La Jolla, California (see featured image above). She teased further announcements that likely will be forthcoming “in the not too distant future.”
Another innovative partnership involves a first-of-its-kind development JV with health system Baptist Health South Florida. The first project in that pipeline is set to break ground next month.
Through the Baptist Health partnership, Belmont Village is poised to raise the game on health and wellness through new programs and other collaborations, including an onsite “healthy living center.” Elsewhere in the country, Belmont Village has partnered with other organizations, including leading medical, academic and research institutions, to create cutting-edge clinical programs. For instance, the provider gained fame for its “Circle of Friends” approach to mild cognitive impairment.
Going forward, Belmont Village and other providers must continue to forge and strengthen these types of partnerships, Will said. That includes focusing on the neurological and psychological health and wellbeing of residents who are not experiencing cognitive impairment.
“I’m really excited about pushing the ball forward there,” Will said.
In looking back over her senior living career, Will joked that she was not able to balance her checkbook when she entered Harvard Business School — but, she emerged with a strong financial skillset and, from the start, determined that Belmont Village would be both a partner and a manager in its communities. In this manner, the company has maintained strong alignment with its capital partners, she said.
Such alignment is hard to achieve in a typical third-party management model, and Will believes that industry stakeholders are now “coming to grips with that” and will need to innovate with new capital structures.
“I think that we mimicked, in our industry, the structures of the real estate industry, whereby the operators simply take a fee on the revenues,” she said. “Inherently, there’s some misalignment there … because you have to make a bottom line [but] you’re getting paid off the top line.”
In these areas and others, Will believes that the need to innovate across the industry is particularly pressing, in light of how the Covid-19 pandemic has created new challenges and altered the market. In particular, providers need to move quickly in this environment, as the delta variant demonstrates.
Providers that have high resident and staff vaccination rates should be relatively well-insulated from serious delta-related setbacks, in Will’s view. While resident vaccination rates are high across the industry, staff vaccination rates have lagged and vary among providers. Belmont Village pushed hard to encourage staff to be vaccinated, and had achieved a high level of participation prior to recently introducing a vaccine mandate.
“What we did is work day and night, a million touch points, to get as many people vaccinated as we could without a mandate, and in the process, you de-risk the loss of people as a result of imposing the mandate,” Will said.
Providers that were not as proactive now are in a very tough position; with low staff vaccination rates, they risk having their workforce seriously affected by Covid-19 outbreaks.
“I’d be scared to death,” Will said, of being a provider in that situation.
Despite the spread of the delta variant and the pressing need for industry-wide innovation, Will is optimistic about the future, even on solving the thorny workforce problems. She is “really excited about young people coming into the industry” and believes that the sector offers variety and opportunity to assume a “seat at the table” that promising talent will recognize.
That belief is reflected in the experience of her own sons, Aron Will and Adam Will.
“I would never have imagined that my boys would be in the seniors housing industry,” she said.
She believes that both Aron and Adam recognized that the industry offered unique paths for each of them. Aron went into the financial side and is now a vice chairman with CBRE, while Adam transitioned from a career in show business to become director of communications at Belmont Village.
When it came time to induct Will into the Hall of Fame, both Aron and Adam introduced her to the stage. Their speeches added even more resonance to an honor that Will described as particularly meaningful after the travails of the pandemic.
“Particularly this year, it was very sweet,” she said.