Association Bi-Monthly Magazine

ADAPTING MENUS TO CHANGING PREFERENCES p.6

11 TRENDS IN DINING DESIGN p.12

SENIOR LIVING

THE DINING & NUTRITION ISSUE Emerging trends and practical tips for the evolving senior living dining landscape

2018 SENIOR LIVING EXECUTIVE CONFERENCE EXPERIENCE p.20

MAY/JUNE 2018

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EDITOR'S LETTER

PRESIDENT & CEO James Balda jbalda@argentum.org

Perfecting the Recipe for an Exceptional Dining Experience Renowned American food writer M.F.K. Fisher wrote, “First we eat, then we do everything else.” Dining is an important and deeply personal experience for each of us—one that depends on a variety of factors from taste to environment to nutrition. In senior living, dining is also part of the personcentered care and service promised to residents, so it requires a thoughtful approach that evolves with residents’ changing needs and desires.

In this issue of Senior Living Executive, The Dining & Nutrition Issue, we explore developing trends and review tips and tricks for staying ahead of evolutions within senior living dining. As the resident landscape changes, so do dining preferences when it comes to style and cuisine. We look at what tools and techniques are available to culinary executives as well as community chefs to track trends, manage associated costs, and produce exciting menus (p.6).

We also address dining design trends across the industry (p.12). Choice and variety, versatility and transparency, engagement and collaboration—these are all demands driving an overhaul of dining environments and service standards across senior living. With the next generation of residents moving to senior living, community leaders are seeing both challenges and opportunities when reimagining design spaces.

But serving residents in senior living isn’t just about offering eclectic cuisine and engaging spaces; it requires attention to the unique nutritional and dietary needs of an aging population. With that in mind, we review best practices for serving those with specialized diets and how having a dietitian on staff may provide added support at your community (p.42).

Additionally, we share some of the latest innovations in memory care dining (p.52), ideas for engaging and retaining a young dining workforce (p.34), and principles to follow to ensure food safety and a safe working environment for dining staff (p.46).

We hope you were able to join us at the 2018 Argentum Senior Living Executive Conference in San Diego in May. In this issue, we’ve also shared sights and sounds from the event, which convened more than 2,600 leaders and professionals in senior living (p.20). Be sure to save the date for the 2019 conference, taking place April 15-17 in San Antonio, Texas.

– Jessica McKay Editor

CHIEF OPERATING OFFICER Maribeth Bersani mbersani@argentum.org CHIEF FINANCIAL OFFICER Gina Mamone gmamone@argentum.org VP, QUALITY IMPROVEMENT John Schulte jschulte@argentum.org VP, MARKETING Jaclyn Vann jvann@argentum.org VP, WORKFORCE DEVELOPMENT Brent Weil bweil@argentum.org VP, BUSINESS DEVELOPMENT Brad Williams bwilliams@argentum.org VP, GOVERNMENT RELATIONS Paul Williams pwilliams@argentum.org DIRECTOR, GOVERNMENT RELATIONS Alexis de Armas adearmas@argentum.org DIRECTOR, GOVERNMENT RELATIONS Neil Cohen ncohen@argentum.org DIRECTOR, CONFERENCE & EVENTS Ellen Drudy edrudy@argentum.org DIRECTOR, MEMBER SERVICES & DATA Kari Horesky khoresky@argentum.org OFFICE MANAGER/ EXEC. ASSISTANT Rosa Montgomery rmontgomery@argentum.org

PROFESSIONAL DEVELOPMENT & EDUCATION MANAGER Robert Oliveri roliveri@argentum.org PROGRAM COORDINATOR Kayla McAlindin kmcalindin@argentum.org ACCOUNT COORDINATOR Tiffany Crawford tcrawford@argentum.org STAFF ACCOUNTANT Olivia Wilson owilson@argentum.org

EDITORIAL EDITOR Jessica McKay jmckay@argentum.org SENIOR MANAGER, PROGRAMS & RESEARCH Sharon Cohen scohen@argentum.org PUBLICATIONS MANAGER Vatrice Chestnut vchestnut@argentum.org ART DIRECTOR Rose Thai rthai@argentum.org

ADVERTISING DIRECTOR OF SALES Katherine Madison kmadison@argentum.org SENIOR ACCOUNT EXECUTIVE, SALES Jim Owens jowens@argentum.org SUBSCRIPTIONS 703.562.1179

Senior Living Executive, Volume 25, Number 3 (print ISSN 21616698, online ISSN 2161-671X) is published bimonthly by Argentum, 1650 King Street, Suite 602, Alexandria, VA. Periodicals postage paid at Alexandria, VA and additional mailing offices. Argentum member companies receive subscriptions for staff as part of their membership. Free controlled subscriptions are also available to qualified individuals in the senior living business.

POSTMASTER: SEND ADDRESS CHANGES TO Senior Living Executive, 1650 King Street, Suite 602, Alexandria, Virginia 22314 703.894.1805. Printed in USA. Copyright 2017.

Prior to photocopying items for educational classroom, internal, or personal use, please contact the Copyright Clearance Center, Customer Service, 978.750.8400, 222 Rosewood Dr., Danvers, MA 01923 or check CCC Online at www.copyright.com. Senior Living Executive will not be responsible for the return of any unsolicited manuscripts or photographs.

Copyright ©2018 Argentum. All rights reserved. No part of this publication may be reproduced or transmitted in any form—print, electronic, or otherwise—without written permission from Argentum.

Correction: In the article “Securing the Right Training Opportunities for Sales Staff,” in the previous issue of Senior Living Executive (The Workforce Issue), Senior Lifestyle’s Janine Witte’s name was incorrectly reported as Janine White.

MAY/JUNE 2018 ARGENTUM.ORG 3

VOLUME 25, NUMBER 3

CONTENTS

12

11 TRENDS IN DINING DESIGN FOR THE NEXT GENERATION Senior living communities are transforming to cater to baby boomers’ dining habits. Learn about the keys to designing venues that will give new residents the experiences they seek.

20

SIGHTS AND SOUNDS FROM THE 2018 ARGENTUM SENIOR LIVING EXECUTIVE CONFERENCE

6 ADAPTING MENUS TO CHANGING RESIDENT PREFERENCES See what’s trending and what evolutions are taking place within senior dining. Learn about the tools available to help culinary executives track the trends that matter and explore kitchen management techniques that are helping chefs meet changing tastes cost effectively.

Read about the attendee experience at the annual Argentum conference in San Diego, which convened over 2,600 senior living executives, professionals, and solutions experts.

DEPARTMENTS WORKFORCE DEVELOPMENT

34 Building a Strong Dining Workforce 36 Thought Leader Profile: Lynne Eddy, The Culinary Institute of America 38 Change Agent Profile: Dawn Sweeney, National Restaurant Association

QUALITY IMPROVEMENT

42 Serving the Dietary and Nutritional Needs of Older Adults 46 Food Safety and Worker Training: A Strategic Imperative

MEMORY CARE

52 Innovations in Memory Care Dining and Services

3 A NOTE FROM ARGENTUM 55 FROM THE EXECUTIVE DIRECTOR'S DESK

56 THE HEART OF SENIOR LIVING 57 A RGENTUM ADVOCATES FOR YOU

60 PEOPLE AND PLACES

CONNECT WITH ARGENTUM Be sure to visit argentum.org and subscribe to receive Argentum Daily, our daily e-newsletter, for access to the latest news, research, and initiatives related to senior living. argentum.org/facebook

argentum.org/twitter

argentum.org/linkedin

MAY/JUNE 2018 ARGENTUM.ORG 5

ADAPTING MENUS TO CHANGING

Resident Preferences

BY ADAM STONE

6 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

At Brandywine Living, Sean Keating wants to stay on the cutting edge of culinary trends—but he also wants to tread with caution.

As corporate director of culinary innovation, he recently launched a steakhouse, of sorts. It’s only open on Saturdays and only at one property. Residents can pick from three steaks, three sauces, two veggies, and two sides. “I’ll try it in one community, maybe 10 residents, and if it flops I can cut ties without getting too hurt,” Keating said.

The steakhouse taps into emerging trends in senior dining: Fresh foods, made to order. Like many in senior dining, Keating is looking to follow trends without being trendy. It can be hard to strike that balance, to deliver seniors the comfort food they want while offering paleo/vegan/gluten-free options.

In this article we’ll take a look at what’s legitimately trending and the large-scale evolutions within senior dining. We’ll consider the tools available to help culinary executives track the trends that really matter, take a deep dive into the how-to’s of small batch service, and explore the kitchen management techniques that are helping chefs meet changing tastes cost effectively.

What’s hot?

In recent years, pickle-flavored foods like ice pops and candy canes had their 15 minutes of fame, and sous vide was briefly, wildly popular, until it wasn’t anymore. Kobe sliders came and went. Food trends can be a trap. Just when you’ve found the right use for kale, this (actual) headline appears: “Kale is dead. Long live watercress.”

That being said, there are some big picture evolutions underway that are going to prove real and lasting, and that senior dining executives need to be taking into account.

Sodexo Seniors vice president of marketing Thandi Baxter-Magro paints this picture: “We are seeing more of a focus on plant-based foods versus the more traditional meat and potatoes. With that comes an openness to more variety and more options. We see a continued emphasis on eating healthy, but an unwillingness to trim back on taste. So we need to find ways to be flavorful and to provide nutrition in healthier ways.”

Variety lies at the core of the movement. “You can call it a marketplace or a food court: It’s about having multiple venues as a way to offer more choices. It’s like a cruise ship model where there are lots of dining rooms and you can pick and choose. Or it’s kiosks, like in the mall model,” said Harris Ader, CEO of the Senior Dining Association.

In broad terms chefs are also hearing a call for foods that are locally grown, that go beyond mere calories to offer nutrition; foods that seem—in some vague and

A steak entrée served by Brandywine Living.

yet important way—more real. At Allegro Senior Living, vice president of dining services Mark Krystopa talks about this as a trend toward nurturing the body.

That can mean avocados and heirloom greens, and it can also mean a breakfast bowl with cage-free eggs and steel-cut oatmeal.

“We are trying to build a core menu of foods that would benefit you,” he said. “It’s a belief in a dining experience that nurtures your body.”

Baxter-Magro echoes this theme. “Fresh, local, seasonal, sustainable are all key areas. They want wild caught salmon. They want to know how much of their fruits and veggies come from local sources. They want things that are made from scratch,” she said.

This trend can have serious consequences in the kitchen, where the old routines and even old equipment may need to be reconsidered. Keating has pulled the fryers out of five buildings and started air-baking French fries. He talks about “brain foods” and “power foods” like spinach and blueberries.

Some of-the-moment trends may be a part of this: It speaks to vegan and vegetarian sensibilities and can play to a gluten-free diet as well. But the trend writ large is bigger than those trendier expressions. It’s a lifting up of the culinary experience overall. Seniors who cut their teeth on canned peas during the Depression are making way for a new generation with a broader, more complicated set of expectations. It isn’t necessarily expressed in terms of specific ingredients and recipes, but rather in broader notions of “quality” and “variety.”

It takes some finesse to understand just how this broad movement will play out at any given senior community, where residents will likely have their own unique spin on the emerging gastronomy.

MAY/JUNE 2018 ARGENTUM.ORG 7

ADAPTING MENUS TO CHANGING RESIDENT PREFERENCES

Testing the waters

Baxter-Magro enlists “dining ambassadors” to help her determine what direction the menu ought to go. Her volunteer tasters help her to keep in touch with the trends without leaving resident preference in the dust.

“It’s about sampling,” she said. “Before you make something a staple on the menu it’s really important to try these things out, to provide tasting events and other ways for people to sample these dishes. If it’s a vegan dish, the tasting might appeal to vegans but it also works as a way to excite the general population. Maybe they are not interested in vegetarian choices at first, but if they sample it, they develop some interest.”

At The LaSalle Group, director of culinary operations Jose Fernandez said a personal touch is required in order to move a menu in the right direction and at the proper speed. His chefs meet frequently with residents, “and we also meet with the families to learn their preferences and habits. We have a family night once a month where the chefs interact with families and residents in order to personalize that experience,” he said.

Some training often is needed in order to make this approach effective. “If chefs come from restaurants and hotels, they aren’t used to interacting with the guests. It can be strange at first,” he said. “But once they meet the families and the residents it becomes a very positive thing for the chef.

They come to feel like a part of the community, a part of the resident’s home.”

Keating calls this “touching tables,” and while it is a key component in his effort to stay current, he likes to start those conversations before residents even sit down in the dining room—before they even move in, in fact. “Typically, it starts with the marketing team. They will collect information during the tour and they will share that with corporate,” he said. “Then as soon as they walk in I get out and talk to that resident about their likes and dislikes, and we start to build that relationship and have that conversation.”

Ideally, a senior living culinary executive won’t just be building the menu in response to what today’s residents want. The chef needs to be looking forward, planning for the emerging tastes of residents who may still be five or 10 years away from their move-in. Ader urges senior living communities to conduct focus groups not just among today’s seniors but among those who may be coming down the line.

8 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

At Sodexo, wok stations are popular, giving residents more individualized meal options.

“When they go to dinner, where do they go? What kinds of foods do they like? The people who have been in your community can tell you what they like today, but you want to talk to the slightly younger people too, the people who are going to be your customers. If they are eating in local restaurants, maybe you want to go to those restaurants to see what they like, because that is who you are building for,” he said.

Do that, and you’ll likely start to hear discussions about quality and service, about local produce and healthy dining. The trend is perhaps most noticeable when it comes to the style of meal preparation. Senior living is in the midst of a sea change with restaurant-style service and individual preparation. That’s a whole new paradigm and it’s a high bar to meet.

“Owners and operators have to be really conscientious about the cost of a per-resident day. The costs are the guard rails that are put around innovation,” said Krystopa.

Fresh, local ingredients may cost more, and a strategy of individual meal prep can require more hands on deck. “Labor also comes into it, not just having more people but being able to afford someone who is skilled enough to purchase wisely and stay within those costs.”

Small-batch strategies

It’s no small trick to deliver on-demand cuisine on a large scale and still keep costs under control. The task is made doubly complicated when the prevailing winds

blow in favor of fresh (i.e. perishable) foods and locally-sourced produce obtained from small suppliers. It sounds like a perfect storm for blowing apart a culinary budget, but experts in senior dining say it is possible to meet the call for personalized preparation without busting the bank.

• Wok this way. At Sodexo, Baxter-Magro encourages senior dining providers to experiment with formats that highlight freshness and personalization. She’s a big fan of the wok station, where residents can choose the proteins, veggies, and sauces to suit their tastes. “It’s very visual and it gives people the opportunity to literally point to ingredients that they want.

It’s customized to their individual tastes on that day, in that moment,” she said.

• Cook ahead. Retail-inspired service trends sound like an easy way to crank up labor costs but Bill Lutz, president of Optimum Solutions & Strategies, said there are ways around that. A culinary consultant with a background in fine dining, he encourages senior living chefs to experiment with partial cooking as a way to individualize effectively.

“Every community has chicken on their menu, so you put it on the grill, put on the grill marks and seal the outside, then you take it off the heat. You put it in the refrigerator and when it’s ordered you put it in a 500-degree convection oven and it will come up to temperature in two minutes,” he said. “Now everything is served fresh and hot and you don’t have

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ADAPTING MENUS TO CHANGING RESIDENT PREFERENCES

to climb Mount Everest every time you go to service. It’s a way to distribute the work more evenly.”

• Go pro. In order to contain costs in a customized culinary environment, you need to hire and train at a higher level than in the past. “You can’t just hire a cook,” Keating said. “You need chefs who have restaurant experience, who are culinary grads. They have the mentality, the training. I don’t want someone who used to be a car salesman. I want someone who has been in restaurants their whole life.”

(Yes, you will pay more for that kind of experience, but Keating insists it will save you money in the long run.)

Once a senior living community decides to step up into the world of restaurant-quality cuisine and service, interesting things start to happen. Some dining executives say a move in this direction has freed them to be more creative in their presentation.

At FLIK Lifestyles, senior corporate executive chef Adam Grafton has become a fan of pop-up culinary experiences—microtasting events to bring a newfound sense of fun to the dining experience.

“The element of surprise is much more accepted in our communities today. Ten years ago, residents had to have the whole month planned out. Now they are more accepting of having some surprise, some spontaneity,” he said. “We might do a popup display in the afternoon, something as simple as avocado toast or a fun popcorn break in the hallway.”

Sometimes fun comes in the form of hydration. “I’ve got some watermelon and some fresh basil, that will be my aqua fresca today. It gives the kitchen folks a chance to be creative and it adds that element of surprise,” Grafton said. “It takes having an on-site team with a willingness to experiment. Maybe you do one of these a month, so it’s not overwhelming, but it adds an element of fun.”

Once you’re over the idea that all cooking has to happen in the kitchen, it becomes possible to take personalization down to the residence care level. Lutz has seen communities open successful mini-kitchens in memory care, as a way to bring fresher offerings to those who can’t make it to a dining room. All it takes is a mini-fridge and a high-volume convection oven.

“We’ll teach the front-line staff some basic things. Dietary aides can learn to do this,” he said. “Now you get those smells, 10 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

which is really important to stimulate appetite. Three times a day you have food being prepared and being served locally.

If you just plate it in the kitchen and bring it to the residents, that kills choice and it kills quality. It’s hard to keep food hot and fresh. We want people to have choice at the point of service—and the aides often like to serve the residents. They want to be part of the process.”

Pop-up stations? Mini-kitchens? Cooking to order? It’s hard to imagine going this direction without adding substantially to the labor cost. Yet those who urge this approach say the numbers can work.

First, cooking to order means less waste, so you’re saving money up front. Then there are techniques for making it work cost-effectively.

“It’s all in how you set it up in advance,” Ader said. “You look at a kitchen operation and see how production flows. You maximize your labor by doing the prep at the right time. You cross-utilize, making sure that the garlic, onions, pepper, rice can be used across the menu, and then you have those things ready on the line. That’s how you make it efficient. And the executive chef has to work through the recipes with the cooks. You don’t just hand them the recipe.

You walk them through and show them how it’s done. That makes it more efficient and it also gives you the consistency that is so important to the operation.”

Kitchen equipment factors in as well.

Krystopa designed a model for all Allegro communities to follow, one that lends itself to customized prep. “We build a standardized line, with a prototype that includes a gas range, a broiler, a conventional oven, and a hot holding cabinet that can be transported to memory care,” he said. “We lose the steam table, the scoop-and-serve, and that enables us to cook it à la carte as the order comes in.”

He’s also rearranged the kitchen workflow in order to more effectively produce meals under the higher-end model of service. “You are not adding bodies. It has to do with multitasking the kitchen assistant. You add versatility within your labor structure to maximize what people do in the kitchen,” he said. “So when we introduced the salad bar, the front of house staff now introduces all those ingredients. Bartenders and servers are in charge of executing on that. It’s about using the staff you have effectively.”

All these strategies can help a senior living community deliver a more personalized experience, but there’s a lot more to current dining trends than just personalization. Residents want variety, freshness, local sourcing, and a range of other enhancements. Here’s how to deliver on those emerging culinary cravings:

Tips and tricks

To meet the demand for fresh, local produce, Baxter-Magro said senior living leaders need to maintain close communications with their providers, including both large-scale distributors and more locally-based purveyors who may have ties to local or regional producers.

“When we ran a plant-based burger we had conversations very early on in order to have those ingredients available to us,” she said. “With senior living communities, the partnership is important, having that regular communication so that we can understand how they are going to be refreshing the menus. Do they want to source new items locally? How will we set up the supplies for that? The sooner you can start planning it, the better we can line up those things and negotiate best costs.”

Conversations with suppliers are key. At the same time, there are in-house strategies a savvy chef can employ.

• Finger foods. For residents who crave variety, Fernandez likes to whip up small, easily-held tidbits. These are especially helpful as a way to bring variety to memory care, when some residents wander as they eat. “It’s the same meal everyone else is having but they can hold it in their hands. The food is formed into shapes that are easy to hold and it’s not too hot.

We have a whole menu of foods that people can pick up, and we know beforehand which residents need this, so we make those meals especially for them,” he said.

• What’s growing? Lutz looks to seasonality as a way to keep meals both fresh and local. He’ll change up the menu every four to five weeks in order to achieve this.

“Your purveyors need to let you know what is available and you build the menu around that,” he said. “You look for the items that aren’t moving well and you change those out first. Then you look at what is seasonal, and what is more attractive in terms of pricing. Your purveyor’s hot sheet should tell you what’s a good bargain and then you shape the menu around those seasonal items.”

• Share the burden. Suppose it does cost a little more to go with a meal service that is fresh, local, wholesome, and high-end.

There’s no reason the weight of that should fall solely on the shoulders of the culinary budget. “Maybe I find other ways to cut costs, maybe not even in my department. Maybe we find that savings in nursing or in another department,” Keating said. “You want to look at the big picture, the overall costs of things beyond just the kitchen. It’s about being a team. We’re all working for one common goal.”

This notion of shared responsibility goes beyond just questions of budgeting. As senior dining takes a more sophisticated turn, some see a growing need for food service to evolve into a more broadly shared responsibility.

Chefs can’t create “quality” all on their own.

“We have front-line caregivers who have to be brought into the loop. There has to be an all-team approach,” Lutz said. “In the culinary world there is production, execution, and delivery, and if that third piece is out of whack, the whole thing falls apart.

The interaction between the server and the customer is extremely important. There’s a sales piece, a sense that this person is there to take care of you. There needs to be a detailed level of service, not just order-taking.

You’d like a hamburger? What would you like on it? May I suggest you try this? Everyone needs to be trained to do that and to bring that mindset to the dining room.”

That level of service hasn’t always been the norm in senior living, any more than cooked-toorder has been the driving force in the kitchen.

As a more personalized prep style emerges, service will need to step up its game accordingly.

This speaks to an overall theme that many senior living leaders voice when asked about emerging culinary trends. While it’s important to stay current, they said, chasing the latest trend must always take a back seat to basic block and tackle.

“You need to learn to drive well before you worry about buying a new car. You need solid production criteria, you need a solid infrastructure,” Lutz said. “The boomers are coming? Okay. But you first have to get good at what you are doing. You have to do good, solid, homecooked food. That’s what residents want. Then if someone is a vegetarian or needs it gluten-free, you can do that without sweating bullets. Chefs can do all that stuff, if they are doing the fundamentals correctly.”

THE NEW CUISINE Kisco Senior Living recently held its first nationwide culinary contest as a way to highlight some of the most creative work happening in the kitchens of its senior living communities.

Winning entries included miso tofu stuffed beet dumplings, blackened white fish with pumpkin seed succotash and tomato essence, and this recipe:

PAN SEARED TRIPLETAIL AND GULF SHRIMP WITH CURRY MANGO SAUCE Yield: 4 Plates INGREDIENTS 16 oz.

Tripletail, 4 oz. portions

4 oz.

Gulf shrimp

To taste

Salt and pepper

As needed

Canola oil (for searing)

1 cup

Curry sauce

4 each

Scallion basmati rice

4 cups

Roasted zucchini and butternut squash

20 each

Zucchini slices, paper thin for plating

2 oz.

Curry oil

1 oz.

Thyme and scallion flowers (for garnish)

METHOD Season tripletail with salt and pepper. Heat sauté pan over medium high heat.

Coat with canola oil and sear for approximately two minutes per side. Reserve.

Season shrimp with salt and pepper. Heat sauté pan over medium high heat.

Coat with canola oil and sear for approximately one minute per side. Reserve.

MAY/JUNE 2018 ARGENTUM.ORG 11

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A casual restaurant at The Carillon at Boulder Creek in Boulder, Colo.

MY

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CMY

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BY TOM GRESHAM

IN DINING DESIGN FOR THE NEXT GENERATION 12 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

For decades, the senior living dining experience was marked by capacious formal dining rooms with banquet-style seating, white tablecloths, and little palpable difference in atmosphere from one meal to the next. The result was something consistent and pleasant but static, limited, and predictable. Then came the baby boomers.

The arrival of a new generation of residents with much different dining expectations than their predecessors has changed the way senior living communities design their dining venues. No longer is safe and familiar the preferred path.

“They want choice, they want independence, and they don’t want to be told when to eat, where to eat, and what time to eat,” said Gottfried Ernst, vice president of hospitality for Harbor Retirement Associates (HRA). “Baby boomers want you to mold their dining experience to their lifestyle.”

Randy Bremhorst, vice president of design for Hoffman Planning, Design & Construction, Inc., said members of the baby boomer generation do not expect to alter their habits when they move to a senior living community.

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11 TRENDS IN DINING DESIGN FOR THE NEXT GENERATION

“Boomers want the lifestyle they are used to,” Bremhorst said. “The mentality is, ‘Why should I compromise any of my current experience if or when I move into a senior living community?’”

This shift in preferences has created design challenges and opportunities for communities. As communities begin to more closely follow dining design trends in other hospitality-related industries, such as hotels and restaurants, they are emphasizing variety, choice, and the casual and placing less importance on the formal and tightly scheduled.

Philip Dopson, vice president of design and retail for Morrison Community Living, said the senior living industry has been aware of the pending shift in preferences likely to arrive with boomers, but some communities have been slow to act.

“It’s a conversation that has reached a lot of people in senior living, but it hasn’t reached everyone,” Dopson said. “I think some people are still thinking, ‘That’s still 10 years down the road, and I’m not going to mess with what we’ve got right now.’ But that’s a mistake. It’s time to do something now.”

In light of this shift, experts reflected on 11 design keys to the new senior living dining climate.

More venues, more choices

The most impactful design change that the boomers have wrought is the need to offer multiple venues of varying styles and atmospheres. Senior living communities across the industry are creating new venues to ensure a diversity of choices for residents. These new venues tend most often to adopt the casual atmospheres of bars, cafés, pubs, taverns, grills, and coffee shops, but communities are also looking at trends such as clusters of micro-restaurants, upscale culinary shops, food courts, marketplace-style venues, and fast-casual offerings, Bremhorst said. Many of these new venues feature extended hours so residents are no longer locked into set dining schedules.

“We’re seeing communities push more toward casual or interactive experiential dining,” said Julia Bailey, senior interior designer with OZ Architecture. “Residents are wanting to be able to treat their community dining as they would going into a restaurant, making it more entertainmentbased and making a priority of experience over function.”

14 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

Harbor Retirement Associates has adopted exhibition kitchens to allow residents to watch as their food is being prepared.

Jami Mohlenkamp, principal with OZ Architecture, said providing casual restaurant climates that do not require rigid schedules helps residents stay positive about the transition to senior living.

“It helps create that feeling that you’re still living the life you’ve always lived,” Mohlenkamp said.

In the past, Erickson Living, which operates senior living communities in 11 states, might have three or four restaurants on one of its large campuses, said Patrick Plumadore, the company’s vice president of dining services. Today, those same campuses are more likely to be home to up to 12 restaurants, ranging from formal dining to graband-go fare. Historically, the main dining room at an Erickson Living campus could seat 250 people. That main dining room is much more likely to have half that capacity today, Plumadore said.

“We know that baby boomers don’t want to just have that same experience,” Plumadore said. “They want to be flexible, so we’ve got to be flexible enough with our designs to accommodate those different experiences.”

Previously, when designing a new senior living community, the dining experience could be simply centered around a large, main dining room. Now, designing dining venues takes more planning and care, particularly to identify the mix of venues that will be a hit with a particular population of residents.

For existing campuses, it can be difficult to carve out new spaces to accommodate the desire for more casual venues, particularly at those communities constructed with the old dining style guiding the design. When done right, though, the rewards are apparent. For instance, Ernst said HRA renovated an existing community in Coral Springs, Fla. by lowering the seating capacity in the main restaurant and transferring it to a new café and bar nearby. Part of the lobby also was converted to accommodate the new dining space. The effort was worth it.

“Our residents loved having that new dining venue—that extra choice for them to go somewhere if they didn’t want a four-course meal,” Ernst said. “It’s really added a lot to the community.”

Creative division

Often, creating brand-new venues from scratch on a campus is not a viable option. However, Dean Maddalena, president of studioSIX5, said creative ways of breaking up a space can transform a single venue into multiple venues, even when they’re all served by the same kitchen.

“We break up the spaces with screens, and we’ve even made it where we create different rooms within a room, each with a different personality,” Maddalena said. “You might have one that’s a bit more formal, another one that’s more casual, another one that’s more like a bar. And then you can change them out.”

David Fik, principal of Lantz-Boggio Architects, said savvy uses of partitions can give residents starkly different settings right next to each other, so that one group of diners is watching their food get prepared in a bustling open kitchen while behind a screen another group looks out upon a serene pond.

“You might get a pod of five tables that feels very different from the five tables next to it,” Fik said. “It’s a great way for residents to feel like they’re not going into the same dining venue every day and giving them some variety in the same space.”

StudioSIX5 also developed a product called Collage that helps one space do the work of multiple spaces. Collage is a monitor that displays images, such as artwork.

“So, if you have an Italian dining theme one night, then you can put up images of Italy or maybe like a spaghetti western,” Maddalena said. “So, it can create a different personality in the same space from night to night to match your food offerings.”

Versatile venues

In the new, swiftly evolving world of dining, experts say designing with the future in mind is essential. Today will be tomorrow very soon.

“Dining preferences change so rapidly now that we’re trying to design spaces that are flexible,” Plumadore said. “The infrastructure has to last 15 to 20 years, but the facade or decor may change every three to five years based on the preferences of the residents that are moving in. So, we’re spending a lot of time getting the infrastructure right so that there’s flexibility. The front of the house may be a Tex-Mex restaurant and then five years later it becomes Mediterranean style. The motif and decor and the seating styles may all change in the front of the house, but the kitchen infrastructure can stay the same to support it.”

In addition to considering flexibility over the long term, Fik said designing flexibility into spaces can allow for short-term versatility. For instance, a single space can serve to house a sort of rotating restaurant with proper planning and initiative. One of Lantz-Boggio’s clients has adopted a plan that transforms a dining venue every few months. For a period, the space may be an Italian restaurant with Italian columns, artwork, custom lighting, wall finishes, and other features. Then, the restaurant can

be transformed with new features into a completely different restaurant, such as an American pub, with corresponding design flourishes. It’s like opening a new restaurant on campus a few times a year.

“Residents love that kind of variety,” Fik said.

Similarly, Fik said a single space can seem like a different venue to residents depending on the time of day. A bistro, for instance, can house multiple shades of casual over the course of 12 hours—ranging from a self-serve continental breakfast spot in the morning to a grill or cold sandwich place at lunch and a lively bar in the evening.

The formal dining room remains as a steadfast presence as communities evolve, but as it takes on less of a daily destination for residents it also can become more versatile. As part of that evolution, Fik said the dining room can be partitioned to set aside a designated upscale area within the venue.

That area can be home to a more private space that hosts themed nights with premium menus. Mohlenkamp said private dining spaces also can be designed to host date nights that help both new and old couples enjoy a romantic atmosphere.

food,” Dopson said. “They want to know where it’s coming from.”

Plumadore said Erickson Living has implemented many open kitchens in its venues.

“Sometimes it could be a bar, sometimes it could be more of a sit-down restaurant because each will bring a different feel to the residents, but will allow them to talk to the staff and see what they’re doing when they’re cooking,” Plumadore said.

The Food Network and the popularity of cooking shows, particularly those that put the chef in the spotlight, are an integral part of the boomers’ keen interest in the making of their food. Also, in that vein, some senior living communities are implementing demonstration kitchens that can host cooking classes for residents.

“The opportunity to learn how to cook new things really reinforces residents’ independence,” Bailey said.

Access and acoustics

Even as senior living communities strive to create more casual, restaurantlike atmospheres, they also must take care to accommodate the unique needs and preferences of the population they serve. That

“Dining preferences change so rapidly now that we’re trying to design spaces that are flexible,” Plumadore said.

“The infrastructure has to last 15 to 20 years, but the facade or decor may change every three to five years based on the preferences of the residents that are moving in.”

Opening up the kitchen

One of the more popular modern restaurant design features in new senior living dining spaces is the open or exhibition kitchen.

“It’s such an appealing feature for residents to see their food being made,” Ernst said. “It elevates the experience.”

Dopson said the rise of open kitchens stems from a focus on transparency in food preparation and diners’ devotion to fresh, local ingredients and made-to-order cooking.

Dopson also said the open kitchen creates a more “home-like environment” for diners.

“People want to get more engaged with

means paying attention to the details in new designs—simply replicating a contemporary casual eatery can create an unpleasant climate for some seniors.

“Design for senior ergonomics is a key consideration in all aspects of senior living,” Bremhorst said.

For instance, Bremhorst said bar tops must be lower than at a typical bar so that seniors can sit rather than “perch” at the bar. Bremhorst also notes that the spacing and layout of furniture must make moving around a space comfortable for seniors, including those who need the support of mobility devices.

MAY/JUNE 2018 ARGENTUM.ORG 15

11 TRENDS IN DINING DESIGN FOR THE NEXT GENERATION

One of the advantages of the move toward smaller venues is improved acoustics for older diners, Mohlenkamp said.

“There’s an acoustical benefit to breaking down some of those larger spaces, especially when we can use some sort of banquette or furniture components or vertical wall components,” Mohlenkamp said. “When you start to create spaces within a larger space, sound doesn’t travel as much as it does in a wide-open dining space. From a comfort standpoint, that’s beneficial for an older adult.”

Dopson said even kitchen equipment must be considered when designing a dining space, particularly with an open kitchen setup. For instance, loud equipment that might get absorbed into the noisy environments common to busy restaurants “won’t translate to senior living,” Dopson said, where more diners might have hearing issues and could struggle to carry on a conversation if the kitchen is too loud.

“That’s why it’s very important to partner with the right kitchen food service specialist to get those components correct,” he said.

Getting the light right

Lighting design serves a critical role in creating the mood and atmosphere in a venue. For instance, Plumadore said, a bar should be lit brighter during the day and darker in the evening to create the appropriate aura. Ernst said integrating natural light into dining spaces has become a point of emphasis for HRA because of the unique way it can bring a bright, cheery atmosphere to a room.

Bailey said specialty lighting and window treatments can be adjusted during the day, even with preset settings, so that the shades are drawn and the lights dimmed for dinner, and the shades are up and the lights turned up for breakfast. In this way, the proper lighting design and management can make one venue feel like multiple venues.

“Lighting is really important,” Bailey said. “A lot of times there isn't a lot of attention to decorative lighting or the way that you're integrating dimming systems, but that definitely helps set the mood and can establish the kind of restaurant or atmosphere you want to create.”

relates to a diner’s surroundings. Mohlenkamp said communities can take advantage of their environment to give residents a vibrant setting for meals that embraces the world around them.

For example, urban locations allow for the prospect of offering a dining venue on the top floor and giving residents a striking view while they eat. Mohlenkamp said top-floor dining creates challenges related to transporting supplies and waste up and down, but “you can really capture some amazing views for all residents versus making that space a penthouse [residences] for a very small group of people.”

Mohlenkamp said OZ Architecture is a proponent of offering outside dining spaces when possible to help residents connect to the outdoors. The trick, of course, is making sure that the surroundings are a good fit for meal time. A garden, yes. An alley with a dumpster, no. Also, Mohlenkamp said, the area should have a good mix of sun and shade to help for both warm and cooler days.

“There are some site planning considerations,” Mohlenkamp said. “You definitely need to be in the right place for it.”

Ernst said HRA has made a push to create more outdoor dining spaces.

“We’re trying to make a point of providing some great outside seating with umbrellas overlooking a park or some sort of greenery, so residents can choose to get some fresh air while they eat,” Ernst said.

Inviting the community

Senior living communities are not only integrating the design lessons of the larger community—they are reaching out to welcome the larger community into their new venues. Boomers crave that engagement.

“We believe that intergenerational interactivity is important,” Fik said. “It makes everybody feel younger.”

In urban areas, Maddalena said he has seen senior living communities with restaurants or bars located on the street and at least occasionally open to the public. One community, he said, holds a weekly happy hour for millennials. Others are looking at inviting food trucks for special public events.

“I think that’s going to be more and more of a trend moving forward,” Maddalena said.

Mohlenkamp said OZ Architecture is designing a community in Cincinnati that will feature a café on the front of the campus. The community is located in a mixeduse neighborhood with an office building on one side and a multifamily residence on another, and a conversation developed about whether the café should be open to the public.

“There’s this discussion about making some amenities that draw people into a community in a secure way,” Mohlenkamp said.

“Not giving them free rein but encouraging some social interaction between members of the outside community and the residents.”

Finding a view

The move toward restaurant-style dining also has shed a new light on where dining venues are located, particularly as it 16 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

A bistro bar at a Harbor Retirement Associates community.

11 TRENDS IN DINING DESIGN FOR THE NEXT GENERATION

Embracing the community also means embracing residents’ families. Previously, family members tended to come take residents out to eat off campus. However, Plumadore said, one effect of new, more attractive food service options is that family members are more likely to visit and eat with residents because the atmosphere more resembles the world they live in and they see no need to leave.

“Now you can come see Mom and Dad and have a great meal, and our prices are very reasonable, if not less than our competitors,” Plumadore said. “They’re opting to come here.”

Assuming an identity

Dopson said a natural result of moving away from a central dining room and moving toward restaurant concepts is giving these new dining spaces specific identities with unique names, brands, and logos.

“Treating them this way gives them a more complete feel of a true dining experience,” Dopson said.

Maddalena said creating an identity and brand for a restaurant often is the initial step in planning a new venue and that identity can guide the design process. An identity helps residents form attachments to a venue.

“For residents, it becomes instead of just ‘Let’s meet in the restaurant’ to the restaurant actually having a name that means something,” Maddalena said.

Bremhorst said incorporating local elements such as artifacts and photography can give venues a unique personality that appeals to locals.

“We do research on popular local restaurants and country clubs and the type of local dining venues that a lot of people are familiar with and have an attachment to,” Maddalena said. “And then we design with that place in mind.”

New technology

The integration of new technology into senior living dining design has been largely unambitious so far, experts say, but some initial steps are apparent.

Plumadore said Erickson Living has been piloting the use of handheld ordering devices in some of its venues and has seen improved efficiency, including better accuracy in ordering and service time improvements of between six and 11 minutes. In the pilot, residents use tablets that are at the 18 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

The exhibition kitchen designed by Hoffman Planning, Design & Construction at The Arlington of Naples in Naples, Fla.

table to order. The improved time efficiency in restaurants that could serve 350 to 400 residents in a three-hour time span is huge, Plumadore said.

“The tablets become helpful in managing wait times,” Plumadore said. “It doesn’t prohibit residents who want to stay longer, but anytime we can reduce service time the better off we are, and the better our residents’ satisfaction is.”

Ernst said HRA also has implemented the use of tablets for ordering in its main restaurants, where a server takes the order at the table with a tablet and those orders are printed in the proper areas of the kitchen. In addition, HRA has started to use digital media displays in place of paper menus.

Eventually, Ernst said, residents will be able to order directly from the digital displays.

Maddalena said some communities offer an app for residents that provides them with a notice for special dining events and daily menus.

Plumadore and others say they expect technology to play an increasingly central role in dining design and service in the future.

For instance, Plumadore would like to develop a program one day that allows residents to view wait times at a campus’ various venues on their phone before deciding where to eat.

Working with residents

No matter the new offerings a senior living community offers, experts say working with residents throughout the process is essential.

“Every single community is different and who knows that better than the residents,” Fik said.

Designers and administrators say they use open meetings for residents, collaboration with resident design committees, and focus groups, among other tactics for learning residents’ preferences. Some seek input from older adults in the local market who might be bound for senior living one day.

Then, once the new venues are in place, Ernst said it can take encouragement to get residents, particularly long-time ones, to use them. HRA has used a variety of incentives and special programming, such as happy hour specials and trivia nights, to get residents in the doors.

“Sometimes, you have to work to get residents to taste all of the new products and understand the features of the new venues—to get them introduced to it,” Ernst said.

Plumadore said taking current residents’ preferences seriously is essential but so is considering the prospective residents and the residents of the future.

“We have a kind of symbiotic relationship with residents and make sure we understand what they want and what they see happening, but we also want to consider what’s going on outside that they may not know that they want yet,” Plumadore said. “It’s kind of a balance of hearing feedback from current and future residents and then also saying, ‘Where do we think the industry’s going next?’”

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Sights and Sounds from the 2018 Argentum Senior Living Executive Conference

More than 2,600 professionals across senior living convened for the 2018 Argentum Senior Living Executive Conference May 14-16 in San Diego. This year, a redesigned format empowered attendees to create individualized learning experiences with two new unique paths through the Mainstage and the Hive. The new format allowed attendees to gather ideas and strategies from dynamic speakers or engage with peers in solutions-oriented discussions. An industry expo also showcased nearly 300 exhibitors sharing the latest in service and product innovations. Here, you’ll see select highlights from the conference:

“#Argentum18 was a tremendous opportunity to learn from, network with, and be motivated by the best of the best!”

—Julie Podewitz, CMO, Traditions Senior Living

20 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

MAINSTAGE INSPIRATION More than one dozen speakers took to the Mainstage at the conference, which hosted several of the world’s leading experts in workforce development, gerontology, resident programming, branding, building design, technology, and artificial intelligence.

“Most people are way more focused on the weaknesses and identifying flaws and fixing them. It has a lot to do with fear. We should be honoring strengths.”

— Marcus Buckingham

Among the speaker lineup was Marcus Buckingham, who guides the vision of ADP Research Institute as co-head and talent expert.

He also founded The Marcus Buckingham Company in 2006 with a clear mission: to instigate a “strengths revolution.” Buckingham spoke on opportunities to cultivate employees’ strengths to create a winning environment for staff and the organizations they serve.

Conference attendees had the opportunity to meet Buckingham at the Expo following his presentation, where he signed copies of his “Standing Up 2.0” book.

Former Airbnb chief marketing officer Jonathan Mildenhall also took to the Mainstage. Mildenhall, who previously led The Coca-Cola Company’s marketing initiatives as vice president of global advertising strategy and content excellence, shared his perspective on helping companies define their purpose and translate it into effective marketing.

Thanks to sponsor Enlivant.

Thanks to sponsor OnShift.

Tying the Mainstage story together was Nina Easton, a long-time journalist and entrepreneur who served as the program emcee. Easton helps clients find the narrative of their life’s work and connects those stories with audiences through SellersEaston Media, a storytelling service that she co-founded in 2016.

“Storytelling is critical in a digital era where people crave (more than ever) authenticity and connectedness.”

— Nina Easton

This year, conference attendees had the unique opportunity to meet Sophia, the world’s very first humanoid celebrity, created by Hanson Robotics. Attendees were also able to pose for a selfie with Sophia at the Expo following her Mainstage appearance.

MAY/JUNE 2018 ARGENTUM.ORG 21

SIGHTS AND SOUNDS FROM THE 2018 ARGENTUM SENIOR LIVING EXECUTIVE CONFERENCE

BUZZING ABOUT THE HIVE Dozens of peer-to-peer topical discussions took place within the Hive facilitated by the leading minds across senior living.

From conversations on reducing risk by resolving family conflicts, to driving occupancy in crowded markets, to identifying solutions for social isolation, discussions in the Hive produced thoughtful insights and actionable takeaways for participants.

“There are millions of people who rely on our industry to innovate to best serve our residents, and no individual company can do it alone. We need collaborative environments like the Hive to have real, meaningful, solution-oriented discussions.”

— Tom Croal, CFO, Silverado

DINING CONVERSATIONS FROM THE HIVE: TRAIN FOR EXCELLENCE Dining is one of the most visible and challenging aspects of senior living communities, and training is crucial to operational excellence. In a Hive discussion on staff training and engagement, Senior Dining Association founder and conversation facilitator Harris Ader asked food service executives to share successful practices.

Most dining workers have little work experience when they join the company, participants noted; much of the waitstaff may still be in high school. “We’re one of the only industries with such a large age gap between those providing the service and those receiving it,” Ader said, “so training has to be consistent.”

IntegraCare focuses on front-of-house service with weekly lectures, and reinforces the teachings. “Then we have a weekly huddle in the kitchen, with gifts and awards for top performers—fun stuff that keeps them engaged,” said Doug McAnlis, regional director of food service for IntegraCare.

Another engagement strategy is to take waitstaff to a restaurant offering service the community wants to emulate.

“There’s no better way to show them what can be done, and how it’s done,” said Marjan Kodric, vice president of dining services for Brookdale.

Kitchen staff also can benefit from engagement-building activities. One company invites cooks to put their own creative spin on staple dishes such as meatloaf. Another stages a contest: “Have the culinary staff create a tasting plate and vote on the best every month,” said Gottfried Ernst, vice president of hospitality for Harbor Retirement Associates. “The best gets a $1,000 gift certificate.”

For the staff who see a career path in senior living, professional development is crucial to continuity. One company offers assistance in achieving ServSafe® certification, and another offers internal career fairs. IntegraCare has a director assistant training program that gives entry-level workers a clear path to management, according to McAnlis.

Suppliers can be a resource too. For example, a frozen-food supplier might be happy to help chefs trial new recipes.

“Maximize your resources—ask manufacturers for help,” Ader suggested.

Resident and family input is important, too. Resident ambassadors or committees can offer feedback on new dishes or take a behind-the-scenes tour. “Training goes both ways,” Ader said. “Residents want to have a purpose. Get them involved.”

22 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

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MAY/JUNE 2018 ARGENTUM.ORG 23

SIGHTS AND SOUNDS FROM THE 2018 ARGENTUM SENIOR LIVING EXECUTIVE CONFERENCE

INTRODUCING NEW INITIATIVES The conference served as a launching pad for two new Argentum initiatives: Senior Living Works and Senior Living IQ.

Argentum’s Senior Living Works initiative is intended to mobilize the senior living industry and increase awareness of the senior living career field, while supporting the retention and advancement of current employees. At seniorliving.works, you’ll find the tools and resources to support your recruitment campaigns. The initiative will continue to evolve, providing expanded information on educational and growth opportunities for current employees and future job seekers.

“Senior Living Works promises to be a great tool for operators seeking to recruit new talent or bring best in class training to existing team members. The timing could not be better.”

— Bill Pettit, R.D. Merrill Company president & COO, and chair of Argentum’s workforce development committee

Sign up to be a Senior Living Works Ambassador at seniorliving.works. @SrLivingWorks

The Senior Living IQ initiative, led by Argentum, is focused on supporting the ongoing investment in quality of life for residents of senior living communities. Senior Living IQ offers an informational website at seniorlivingiq.org with industry best practices and resources for the first phase of the initiative, which focuses on resident safety. As the scope expands, other high-risk areas will be addressed including emergency preparedness, medication management, and memory care.

“Through this project, Argentum and it members are leading the way and the outcome will be better care of seniors and a better seniors housing industry over the long term.”

— John Moore, Atria Senior Living chairman and CEO, and chair or Argentum's quality improvement commitee

24 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

Visit seniorlivingiq.org and commit to investing in quality. @SeniorLivingIQ

SHARING SOLUTIONS AT THE EXPO The Expo proved to be a showcase of leading technology, products, and services across senior living.

Nearly 300 industry suppliers filled the exhibit hall with solutions-based innovations including over 40 new products such as: • Tempo from CarePredict, a comprehensive solution combining wearable technology, indoor location tracking, and predictive analytics; • HeartLegacy® App for Families from HeartLegacy, allowing family members to exchange video greetings with loved ones in senior care and stay up-to-date on community events and activities; and • HUR SmartBalance from HUR USA, a tool for assessing balance, accurately identifying users with a high risk for falling, and implementing results-based fall prevention and balance training programs.

This year, new Lunch and Learn Sessions at the Expo also drew a crowd hoping to learn about the latest and greatest product offerings in the senior living space.

THE EXPO SHOWCASED: 290+ solutions providers 44 companies displaying new products/ technology 70+ show specials offered to those sourcing products and services

“We found this to be an excellent event in all aspects, but most importantly due to the outstanding attendees, who fit our market and business partner profile perfectly.”

— Clayton Mitchell Garrett, vice president-energy services Specialty Lighting Group

MAY/JUNE 2018 ARGENTUM.ORG 25

SIGHTS AND SOUNDS FROM THE 2018 ARGENTUM SENIOR LIVING EXECUTIVE CONFERENCE

HONORING SENIOR LIVING HEROES

Argentum recognized four extraordinary senior living employees at the 2018 Argentum Senior Living Executive Conference. They are recipients of the 2018 Argentum Hero Awards, honoring employees who represent the highest levels of excellence, caring, and dedication across the industry, and the 2018 Argentum Senior Living Community Leadership Award, recognizing exemplary leadership in senior living community management. Award-winning journalist Joan Lunden helped to present the awards to each of the deserving individuals.

Thanks to presenting sponsor Benchmark.

2018 Argentum Hero Nkeiru Uzegbu

Active Living Program Director Merrill Gardens at Lafayette Lafayette, Calif.

Merrill Gardens

2018 Argentum Hero Emily Horne

Life Engagement Manager Autumn Leaves of Towne Lake, Woodstock, Ga. The LaSalle Group

2018 Argentum Hero: Leadership in the Face of a Natural Disaster Lisa Thomas Life Enrichment Coordinator Sabine Place, Orange, Texas Enlivant

2018 Senior Living Community Leadership Award James Arp

Executive Director Belmont Village Westwood, Los Angeles, Calif.

Belmont Village Senior Living

SHARPENING SKILLS AT THE EXECUTIVE DIRECTOR LEADERSHIP INSTITUTE During the conference, more than 80 senior living community leaders participated in the seventh annual Executive Director Leadership Institute (EDLI). The three-day training and professional development program focused on critical areas such as operations management, leadership, human resources, sales and marketing, clinical oversight, and risk management. Led by facilitators Tana Gall, CEO of Blue Harbor Senior Living, and Chris Guay, president and CEO of Vitality Senior Living, attendees heard from a variety of thought leaders; among them was Bruce Tulgan, founder of Rainmaker Thinking, who has spent decades tracking profound changes in the workforce and the workplace, and who spoke on human capital management strategies.

Thanks to co-sponsors Insight Worldwide and Medline.

26 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

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SIGHTS AND SOUNDS FROM THE 2018 ARGENTUM SENIOR LIVING EXECUTIVE CONFERENCE

CATCHING UP WITH THE C-SUITE Leaders from across senior living participated in two C-Suite panels focused on Women Leadership in Senior Living and Cultivating an Engaging Workforce Culture. Topics addressed included maintaining work-life balance, advice for ambitious female leaders, and best practices in hiring, onboarding, and retaining a professional, caring staff.

Thanks to Sodexo for sponsoring the workforce panel.

The Women Leadership in Senior Living panel included Michelle Hamilton, senior vice president of operations, The Arbor Company; Brenda Bacon, president & CEO, Brandywine Living; Patricia Will, president & CEO, Belmont Village Senior Living; and Shamim Wu, COO, Elmcroft.

WELCOMING A NEW ARGENTUM BOARD CHAIRMAN Tim Buchanan, president and CEO of Legend Senior Living, was elected to serve as the new chairman of the Argentum Board of Directors. Most recently, he served as the vice chairman on the board. Considered a pioneer in the industry, Buchanan also served as the first chairman of the Senior Living Certification Commission, an independent, nonprofit organization committed to establishing credentialing programs for professionals working in senior living.

See p.59 for a full list of the 2018-2019 Argentum Board of Directors.

“Argentum will continue working to innovate and educate the public about what we do and how we can help. We must continue to lead public policy and regulation conversations happening in the states and in Washington. We will continue to work to attract an increasing number of professional, caring workers to serve our nation’s older adults. I want to thank the board for entrusting me with this responsibility.”

—Tim Buchanan, Legend Senior Living president and CEO and Argentum Board of Directors chairman

28 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

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ARGENTUM POST-CONFERENCE RECAP

TEAM BUILDING AT THE BALLPARK Hundreds of conference attendees joined together at Petco Park, home of the San Diego Padres, to celebrate Opening Night at the Ballpark.

The Padres faced off against the Colorado Rockies and attendees enjoyed the action from a sold-out private venue in center field.

Thanks to sponsor HD Supply.

DRIVING SUCCESS AT THE ADVOCACY FUND GOLF CLASSIC The conference kicked off with the annual Argentum Advocacy Fund Golf Classic at Maderas Golf Club in Poway, Calif. Nearly 100 golfers took to the course in support of the fund and its mission to support the senior living industry at the state and federal levels.

Thanks to presenting sponsor Welltower.

Congratulations to the 2018 golf classic winners: First place foursome: Thomas Masiello, Josh Davis, Frank Russo, Michael Pokora Second place foursome: Ed Scott, Rich Kortum, Doug Peterson, Joe Weisenburger Third place foursome: Geoff Ebner, Brian Cloch, Andrew Huber, Steve Taylor Closest to the pin: Kai Nielsen and Danielle Lansberry Long drive: Kai Nielsen and Erin Hayes

32 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

ARGENTUM SENIOR LIVING EXECUTIVE CONFERENCE

SAVE THE DATE

APRIL 15 -17, 2019 San Antonio Convention Center, San Antonio, TX

WORKFORCE DEVELOPMENT

Building a Strong Dining Workforce One Student at a Time

By Kenya McCullum

A

rgentum research shows that employees between the ages of 16 and 24 make up about 25 percent of the workforce in the dining sector of the senior living industry. This is great news for the profession as a whole: Not only do younger workers bring an infectious enthusiasm to their job that can be felt by staff members and residents alike, they also represent the senior living workforce of the future.

But senior living companies have to snag them first.

“We have so many people that have come to us and they thought they were just getting a summer job or a job after school—and they come in thinking, ‘Hey, I need some money’—but they fall in love with the industry or with the residents or with cooking,” said Tracy Newcomer, vice president of human resources at Country Meadows Retirement Communities.

Making these young people fall in love with senior living is not necessarily easy—especially when they had plans to pursue other career options—but when organizations make a concerted effort to reach them during the recruitment process and keep them engaged after being hired, they can reap the rewards of gaining long-term employees that dedicate their entire careers to the profession.

Meeting students where they are

As with other groups of workers, recruiters need to find the younger generation where they are and then spark their interest. The following are some ways that senior living communities can find potential dining staff and capture their attention, so they consider working in the industry on a long-term basis:

School recruiting. High school or college students who are not aware of job opportunities can get their first exposure to the industry when senior living recruiters 34 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

Garrett Kistler started working with Country Meadows as a dishwasher when he was in high school. Working part-time for Country Meadows through high school and college, Garrett realized that he wanted a career working with seniors. He quickly moved up to dining room associate, then to director of independent living, and is now a marketing director.

make presentations at their schools. This can help to generate initial interest in working for a community, as well as give recruiters the opportunity to discuss the industry and the different roles available in dining.

Word of mouth. Current employees can be a

community’s best ambassadors because they will tell their friends about their job and get other students interested in working there, too.

“If staff members are happy in their position, they’re more inclined to encourage their friends to apply,” said Devon Fassanella, dining services director at Cloverwood, a Friendly Senior Living community.

Organizations can increase the likelihood of students bringing their friends on board by offering a referral bonus for their effort—a selling point that workers will be sure to mention as they discuss what they love about their job.

Get students through the door. Telling

students about how great it is to work at a senior living community is a solid start, but showing them what it’s like is even better, said Newcomer. When talking to students about jobs at Country Meadows, she will invite them to visit the community to see what it’s like, as well as encourage them to participate in the shadow program that allows them to get a firsthand look at what workers do. By doing this, the community sells itself to prospective workers.

“I always say, if I can get them to my [community], they will want to work for me,” she said. “It’s a pretty easy sell if you can get them here.”

Demonstrate potential for growth. More so than generations past, young workers today want to know that there is room for advancement within an organization.

In order to attract employees in this age group and keep them, communities should let students know during the recruitment process that they can start as a dining assistant and over time advance into other roles, such as a chef, executive chef, dining services manager, and director of dining—or even jobs in the industry not related to food service, like human resources, nursing, or marketing. When these kinds of possibilities are highlighted, students start thinking about how working for a senior living community can be part of their future.

“People want to see what opportunity is available down the road, not just the job that’s available,” said employee retention expert Cara Silletto of Crescendo Strategies, which helps senior living organizations around the country reduce employee turnover. “We no longer see many of the roles within our [communities] as a career job where people stay in that one role forever.

Instead, a lot of our new hires see it as a stepping stone and they want to see what the next stepping stones are.”

Engaging a young dining workforce

Attracting young employees to a senior living community is only the first step toward building the industry’s future workforce.

Organizations must also engage these workers in such a way that will inspire them to stay in the profession long-term, rather than leaving as soon as they graduate. The following are some ideas for nurturing this important group of employees:

seniority, but on their competencies, what can they perform in their job duties, and even what soft skills they have.”

Silletto warned that not doing this can quickly lead to dissatisfaction among young employees. When they feel like they’re ready to level up, they’re not going to wait if there’s no clear opportunity available to them.

“If you don’t give them opportunities to bounce internally, they will bounce outside of the organization,” she said. “Young people today do get bored easily because we live in a fast-paced world with access to information and entertainment at our fingertips, so we just don’t have a workforce today that is patient and tolerant for waiting.

And that’s not a bad thing because they are often driven to do better.”

Offer relevant perks. Large perks like tuition assistance can be especially attractive to students, so some senior living organizations provide this benefit to help their workers advance their job skills, as well as their knowledge of gerontology.

But communities that do not provide help paying tuition can still offer a valuable perk

AGE OF SENIOR LIVING WORKERS IN FOOD SERVICE 46%

Younger than 30 Years 30 to 49 Years

Provide immediate opportunities to advance.

Younger workers won’t stay in the industry, or even at a specific community, if they don’t see a clear—and immediate—opportunity for growth. In order to meet this need, employers can create levels for their entry-level workers based on their performance, so students can start to see the possibilities for growth within months of entering their jobs, instead of waiting for years.

“If you’re going to have a server, for example, it should not just be a server is a server is a server. Instead there should be what we call competency levels—so there should be a Server Level 1, Server Level 2, and Server Level 3,” said Silletto. “These levels should not be based on tenure or

50 to 60 Years 65 Years and Older

27% 22%

5%

Food Service

Source: Argentum Quarterly Issue 1 2018, “The Senior Living Employee.”

by compiling a list of local scholarships and grants available to college students.

That way, young employees who are busy juggling work and school can have financial aid information at their fingertips.

Also, smaller perks can go a long way toward building employee loyalty and making students feel appreciated. Organizations can offer discounts on movie and event tickets, gas, and oil changes, as well as the opportunity to earn extra time off.

Workers will value these kinds of perks and will remember them when weighing their employment options.

No matter what perks organizations offer, leaders should remember that in order for them to seen be as a benefit, they should have continued relevance—which requires knowledge of what workers want.

“Especially with this group of 16-to-24year-olds, we cannot assume we know what they want. You have to ask them what they want and probably one size doesn’t fit all,” Silletto said. “You can create some standard perks, but the more flexibility and choice you can offer people, the better.”

Promote work-life balance. One of the most

appealing things about working in senior living dining compared to the restaurant industry is the flexibility. Employers should promote this benefit by showing students they can work flexible shifts that allow them to have time for their studies, as well as their recreational activities.

Get to know employees. Just like older employees, members of the younger generation want to know that their employers care about them. Asking students about what’s going on in their lives—from big exams to college applications to prom— as well as their concerns about work can help demonstrate that they’re important.

“I think it’s very important for managers, supervisors, and directors to get to know their employees. You need to know a little about them on a personal level to see what their issues and concerns are every single day,” said Eugenia Capobianco, assistant director at Friendly Home, a Friendly Senior Living community. “It shows them that you care and you build a relationship—and it’s all about relationships.”

MAY/JUNE 2018 ARGENTUM.ORG 35

WORKFORCE DEVELOPMENT

Setting Top Chefs on a Senior Living Career Course

By Sara Wildberger

E

njoying a meal from a chef trained at The Culinary Institute of America (CIA), the Ivy League–level college of the culinary arts, is a peak dining experience. But these top chefs aren’t headed only to New York and Paris to practice their expertise after they graduate. Thanks to a program designed by Lynne Eddy, CIA associate professor and registered dietitian, more grads are aware of—and choosing— careers at senior living communities.

Eight years ago, Eddy proposed a 15-week course, “Foodservice Management in Health Care,” as an elective for the CIA bachelor’s program. The course covers topics ranging from nutrition principles to confidentiality to purchasing. A capstone project requires students to visit, evaluate, and report on the foodservice operations of a local hospital or a CCRC. Here, Eddy shares some of the concepts behind the course, what makes senior living dining different from a workforce perspective, and ways to help raise awareness about these careers.

First: The news is good

Many student chefs are greeting the prospect of a career in senior living or health care dining with enthusiasm. The course is

a hit: Eddy offers it only once a year—and it always has a waiting list.

Eddy had anticipated having to counter stereotypes about green Jell-O and bland purees. CIA chefs, after all, are training for the Ritz-Carltons of the world. But this is “the same audience for today’s CCRCs,” Eddy pointed out. Their global, sophisticated palates welcome the work of great chefs: “The residents may have eaten Peking duck in Asia, and they can tell you if the flavors are right.”

Challenges: Vive la différence

Restaurant work makes big demands: You must work long and unpredictable shifts and thrive on tension. In a senior living culinary program, the hours are more predictable.

The degree of planning and exactitude required in senior living dining can also be a change from restaurant work. “We in health care are very rigid—it’s more like baking, or pastry; it’s more like a laboratory,” Eddy said.

“You can’t have too much potassium, for instance. You can’t just use your own recipe.”

Eddy said her students learn to regard those limitations as creative challenges.

Making the case for careers

Finding work after graduation is a top concern to all students—so when grads who took

Thought Leader Profile Lynne Eddy

RND, FAND Associate Professor, The Culinary Institute of America the class were getting internships and several job offers, it attracted attention. Through a career fair, field trips, guest speakers, and Eddy’s own efforts, students get ample connections and real-world information on careers in health care and senior living.

Eddy counsels some students to go out and learn in the hectic hotel and restaurant world for their early career, before they have families—then come to health care. For later-career chefs, who may themselves be facing physical limitations, the benefits of working in a senior living culinary program “really hit home,” Eddy said. “In health care, you can have phenomenal benefits, great work conditions, and good quality of life. You can have a personal life—you might even work a Monday to Friday schedule, or alternate weekends.”

WHAT’S THE RECIPE FOR SENIOR LIVING LEADERS? • Allow for culinary inspiration. “Don’t get stuck in a three-week repeating menu groove,” Eddy said. “You’ve got to keep it seasonal, cost-efficient, and international.”

• Keep supporting a good work-life balance for your chefs and foodservice professionals. It’s a major draw. “Continue offering those great benefits. It’s reasonable to work 40 to 50 hours a week—not 60.”

36 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

• Partner with a local culinary college and support its career fairs and internship programs. School is expensive; a scholarship program can create a lasting relationship and pipeline of highly qualified workers.

• Start early: Raise awareness—and offer work—to high schoolers, too. They’re already planning their college course and their careers.

Looking for passionate and dedicated employees?

We can help.

We’re taking recruiting to a whole new level and want you to be part of the movement. From PowerPoint presentations to career posters, Senior Living Works provides the tools and tips you need to recruit and retain talented employees.

Visit seniorliving.works to download our toolkit and become a Senior Living Works Ambassador. Together, we will recruit a passionate and dedicated workforce.

WORKFORCE DEVELOPMENT

Cultivating Women’s Leadership in Food Service

By Sara Wildberger

F

ood service is one of the top employers of women. Yet how many of these women are leaders in this industry?

A 2017 McKinsey & Company study of the industry reports that while women make up 49 percent of employees at the entry level, women represent only 23 percent of the food industry’s C-Suite executives.

Understanding and addressing that gap is the goal of Lead the Way, an initiative launched in March 2018 by the Women’s Foodservice Forum (WFF), which for nearly 30 years has advanced women leaders in the foodservice industry by offering products, services, insights, and information for emerging and existing leaders.

With their goals to raise up new leaders, both WFF and the Lead the Way initiative have the potential to introduce research and solutions to help avert rising senior living workforce challenges.

One of the forces behind Lead the Way on the WFF board is Dawn Sweeney, president and CEO of the National Restaurant Association. Here, she offers information on the initiative, its importance to the industry, and how senior living leaders can support women’s advancement in food service.

Accelerated change needed

An impetus for Lead the Way was the numbers revealed in the 2017 Women in the Workplace study by McKinsey & Company. The study, Sweeney said, “reported it will take at least 100 years at the current pace of change to reach gender equality in the C-Suite.”

And the industry can’t wait that long.

“The Lead the Way program is committed to accelerating change in the food industry and reducing that timeline,” Sweeney said.

To that end, the initiative aims to close the gap by 2025.

Other McKinsey research, Sweeney pointed out, “reveals that 90 percent of 38 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

organizations say they prioritize gender diversity because it leads to better business results.” In addition to creating industry best practices to help close the gender gap and open the path and prepare women leaders for success in the food industry, the initiative plans to create a Gender Equity Index to track and encourage progress.

Partnerships and collaboration

Lead the Way is a joint initiative, supported by several groups, including the International Food Manufacturers Association and the International Food Distributors Association.

“Through the Lead the Way initiative, WFF is working with partner companies as well as research alliances and trade associations to establish industry metrics and benchmarks, implement best practices, and measure year-over-year gender equality progress for the industry.”

And, of course, another major partner is the National Restaurant Association. “Working with groups such as the Women’s Foodservice Forum, we have an opportunity to engage with those who share the goal of promoting gender equality in the workplace,” Sweeney said.

“The restaurant industry is the nation’s second-largest private sector employer, and if we continue to offer opportunities for success for every employee, we can affect positive change across the entire industry.”

Getting on board

“Senior living organizations can join the Lead the Way initiative by partnering with WFF to

Change Agent Profile Dawn Sweeney

President and CEO, National Restaurant Association, Board Member, Women's Foodservice Forum

support the mission,” Sweeney said. Among the more than 150 WFF partners are companies familiar to senior living and health care leaders, such as Sysco and Aramark.

To learn about the extent of the challenge and start implementing solutions, senior living leaders “can leverage WFF’s extensive learning and development portfolio of events, programs, networking opportunities, and products tailored to suit the needs of all career levels,” Sweeney said.

The WFF holds an annual executive summit with programming designed for executives on rising trends and topics such as developing mentors to build the next generation and best practices to close the gender equality gap. The group also holds an annual leadership development conference as well as leadership development workshops at multiple locations. WFF members can take webinars and courses and join communities of interest, such as for women of color or working mothers.

WOMEN IN THE FOOD INDUSTRY Data from the 2017 Women in the Workplace Study shows: • Women account for 49 percent of employees at the entry level, but represent only 23 percent of the food industry’s C-Suite

• Women of color account for 14 percent of employees at the entry level and hold only 3 percent of C-Suite positions

Argentum Events: A Look Ahead | WASHINGTON, D.C. | ARGENTUM.ORG/SYMPOSIUM SENIOR LIVING SYMPOSIUM NOVEMBER 8–10, 2018

Take advantage of an intimate experience to be educated and inspired.

November 8 Argentum Executive Roundtable Meetings ✪

November 9 Concurrent Tracks: • Sales, Marketing & Occupancy • Workforce Development (sponsored by OnShift) • Quality & Operational Efficiency (sponsored by HCP) Silver PAC Trustee & Silver Circle Donor Appreciation Event ✪

November 10 Public Policy Breakfast and Midterm Election Debrief ✪

| WASHINGTON, D.C. | ARGENTUM.ORG/PPI ARGENTUM PUBLIC POLICY INSTITUTE & FLY-IN MARCH 5-6, 2019

Advocate for critical senior living issues and stay informed on the most important state and federal legislative and regulatory trends.

| SAN ANTONIO, TX | ARGENTUM.ORG/CONFERENCE ARGENTUM 2019 SENIOR LIVING EXECUTIVE CONFERENCE APRIL 15–17, 2019

Join 2,500 executives from over 750 companies to advance excellence in senior living.

Visit argentum.org/events for the full events schedule including: ARGENTUM CHIEF EXECUTIVE SUMMIT ✪ September 12-13, Boston, MA | argentum.org/summit SENIOR LIVING LEADERSHIP RECEPTION October 16, Chicago, IL

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WORKFORCE DEVELOPMENT

3 Key Questions To Combat Turnover Mark Woodka, CEO, OnShift

T

his year’s Argentum Senior Living Executive Conference in San Diego was another five-star event.

The keynote speakers, sessions, and networking events were insightful, productive, and fun, too. As always, it was great to catch up with so many people, while opening doors with the newest member of the OnShift team, Lisa Fordyce, a widely recognized leader in senior living.

Workforce issues rang through as one of the biggest themes of the conference. Time and again, the topic of employee turnover came up and truly to no one’s surprise. With high competition, unemployment rates under 4 percent and a growing workforce shortage, this is nothing short of a crisis.

Fortunately, one of the greatest benefits of getting together at the event is that we can exchange ideas and collectively work together to solve these problems.

Here are three important questions to ask of your organization as you work to address employee turnover:

What is your turnover rate and how are you measuring it?

To successfully combat turnover challenges, you must first identify how big of an issue it is for your organization. This can be challenging as there is currently no standard for measuring turnover and retention in senior living. To remedy this, Argentum’s workforce development committee has been tasked with developing an industry-standard calculation for measuring turnover and retention in senior living. These metrics will allow providers to accurately benchmark and compare their organizations.

At the conference, Brent Weil, Argentum vice president of workforce development, and I took the stage during the opening

40 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

session to update attendees on this initiative, including the status of the pilot program. To date, turnover and retention data has been collected from approximately 325 senior living communities, consisting of nearly 80,000 employees in positions ranging from nursing to dining services. This data will be used to create a standard method of reporting. The pilot program is expanding so just let us know if you’re interested in participating.

How much does turnover cost your organization?

Determining the true cost of turnover may be easier said than done. As a best practice, work with your finance leaders to develop a model that works best for your organization.

Research estimates that the cost of a caregiver leaving is approximately $5,000. This estimate includes direct costs like recruiting, screening, and training. But, you may want to develop a model that is more holistic and includes additional costs such as the use of agency workers or overtime incurred as a result of filling vacant shifts.

In addition, staff instability negatively impacts quality of care and service, staff morale, and customer satisfaction. Consider correlating your turnover rates with additional operational and clinical measures for a more comprehensive view into the true cost of turnover.

What are you doing to prevent turnover?

Research shows that high employee engagement leads to higher profitability, productivity, and yes, less turnover. When employees are engaged, they have bought into your organization and are actively working to advance your mission. It’s no wonder then that employee engagement initiatives are one of the best ways to tackle turnover.

There are many ways senior living organizations can engage staff. Start by taking the temperature of your staff with pulse surveys that provide a quick and simple way to continuously gauge satisfaction. Conducting these brief surveys on a consistent basis, at least a few times a month, allows providers to capture feedback and act upon it in a timely fashion.

Recognizing and rewarding employees also goes a long way toward improving engagement. Systematic rewards programs are one of the best ways to fairly and consistently recognize employees for great performance and a job well done.

Employee engagement doesn’t have to be complex to be effective—but it does need to be consistent. OnShift’s newest offering, OnShift Engage, was developed specifically to help senior care providers systematize their engagement initiatives. Early adopters have reduced turnover by up to 67 percent and improved overall satisfaction. It’s this consistency that drives engagement and offers momentum in creating a workforce that is satisfied and dedicated to helping their organizations thrive.

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MAY/JUNE 2018 ARGENTUM.ORG 41

QUALITY IMPROVEMENT

Serving the Dietary and Nutritional Needs of Older Adults

By Cynthia Helzel

A

nutritious, flavorful diet is fundamental to health and quality of life for senior living residents.

However, older adults may face physical and cognitive challenges that make it difficult for them to gain adequate nutrition and satisfaction from their meals. How can providers meet these challenges to ensure optimum nutrition among a resident population with a wide spectrum of needs?

Fresh is best

Good food starts with good ingredients.

Using fresh, high-quality ingredients rather than canned or processed foods offers the best opportunity for creating healthful, tasty meals. Scratch cooking also reduces or eliminates the added sodium, fillers, and fats often present in premade convenience foods.

scratch at Sunrise Senior Living. “That’s really the biggest and best way to improve nutrition and to prepare things that are very flavorful—much more flavorful than you would get if you were opening up a can of something,” said Caitlin Rogers, vice president of dining and senior nutrition at Sunrise.

Rogers said that her team develops menus and recipes for nearly 30,000 residents in almost 300 communities. The menus are centrally planned at the corporate level, but communities can choose from nearly 30 different variations. Examples include a seafood-rich Coastal menu and a meat-and-potatoes comfort food menu called Heartland.

Each community can further customize its menus with chef specials.

want flexibility, and they want to have input about their menu.”

At Vi, chefs at each community create the menus, which are then approved by the corporate office. “We look to make sure that first of all the quality is there, that they’re using seasonal ingredients, and that there are enough choices, so it’s not repetitive,” said Steve Sandblom, corporate director of food and beverage. “At the very minimum we have a six-week menu cycle, but most of our communities are reinventing the menu every single month.”

Resident dining councils are a valuable tool for gathering feedback about a community’s menu. They provide an opportunity for residents to indicate the menu items they enjoy or dislike as well as requesting items they’d like to try. Residents can also ask to

“Any menu, no matter what it is, can quickly become stale if the dietary staff doesn’t have a constant focus on variety, color, and plate presentation,” said Cathy Mosley, manager for senior living at US Foods.

This is the principle used at Unidine, which provides food and dining management services to more than 160 senior living communities across the country. “Our foundation is our Fresh Food Pledge, which is fundamental in what we do,” said Tim Bouchard, senior vice president of operations at Unidine. “We don’t buy premade lasagna or premade meatballs. We make all of those types of things in-house.” Seasonal menus can be planned around produce available locally, such as ripe strawberries in the spring or tomatoes later in the summer.

Likewise, everything is cooked from 42 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

Resident satisfaction

Resident satisfaction is just as important as the nutritive attributes of the food itself. If residents don’t like the meals, they’ll eat less and could face a decline in their health as a result.

A major key to resident satisfaction is offering a variety of menu items and options.

“Any menu, no matter what it is, can quickly become stale if the dietary staff doesn’t have a constant focus on variety, color, and plate presentation,” said Cathy Mosley, manager for senior living at US Foods, which serves more than 10,000 health care customers nationwide. “Residents want choices, they

have their own recipes featured for a special occasion, for example.

Another key to resident satisfaction is the dining environment. “Part of providing care for people living in senior care is making sure that we respect residents’ food preferences, including the time of their meals and the environment of their meals,” said Sonal Patel, consultant dietitian/nutritionist and president of HealthyBite LLC. Her company provides medical nutrition therapy to residents in health care settings including senior living.

Residents should be encouraged to eat in a

communal setting, but if they insist on eating alone, staff should respect their wishes.

If residents are unable to articulate their preferences, staff should speak with family members to find out what the resident likes to eat, how, and when.

Special dietary concerns

For seniors with health challenges, the goal is to allow as liberal a diet as possible so they can enjoy the same food as everyone else.

Less restrictive diets tend to result in greater intake, which gives the resident more vitality and satisfaction and therefore promotes a greater quality of life.

When modifications must be made, they should be done in small increments. “The new thinking in long-term care is that we need to be the least restrictive when it comes to food,” said Patel. “Most [older adults] do not consume enough food to begin with, for several reasons.” Intake can be affected by factors including diseases, mobility issues, cognitive issues, dislike of the food, and some medications that suppress appetite.

“I would say probably at least 50 percent of residents don’t eat enough,” Patel added.

Restricting their diets further could lead to malnourishment.

Rogers said that at Sunrise, residents of skilled nursing have their diets closely monitored, while those residing in assisted living are given more liberal options. “In our assisted living environment, the residents are free to do as they wish. It’s their home, they should choose what they want to eat and we’re here to provide them with the choices to do that.”

At Vi, the culinary staff works in close coordination with the lifestyles department to plan menus. Eating well is a main component of the company’s Living Well program, but “eating well” does not necessarily mean being on a strict diet. “Eating well might mean having a cheeseburger today because you’ve been eating salads all week,” said Sandblom. The inclusion of occasional treats and indulgences in a resident’s diet helps to maintain the enthusiasm and enjoyment of food that is so important to overall well-being.

Unidine’s menus are supplemented with spreadsheets detailing modifications for special diets such as puréed, calorie control, or carb control. Even so, the renal, carb control, and sodium control diets are not strict.

“We generally like to liberalize the diets as much as possible,” said Bouchard.

When it comes to evaluating a resident’s food intake and planning a healthy diet, Patel trains her dietitians to look at many factors that affect nutrition. Those include the medications a resident is taking, what their usual diet is like, whether they are eating enough food overall, how much they weigh, and the results of any lab work. “We do take care of everybody on an individual basis,” she said. “That’s very important. There are no generalizations. Everybody is an individual and everybody needs to be treated as such.”

Dietitians will further consult with nursing staff and medical providers to create meal plans for residents with significant health challenges (see sidebar on p.46). Some of the more common special diets in senior living and their modifications include: • Diabetic/carb control. Since diet restrictions don’t often have a strong effect on the progression of diabetes, Patel found that it’s often better to adjust the medication as needed and allow residents to eat a nearly normal diet, especially for those whose lab work is within normal ranges.

“We keep their carbohydrates consistent for each meal, and we reduce the foods that are really high-glycemic-index or really high-sugar like fruit juice or desserts,” Patel said. Residents are advised to eat fresh fruit at breakfast rather than drink fruit juice. It’s also important to educate families to prevent them from bringing excessive amounts of sugary treats and desserts to the resident.

• Low sodium. By cooking meals from scratch and eliminating added salt, communities can ensure that most menu items are acceptable for those on low-sodium diets. Herbs, spices, and citrus juices can be used in place of added salt to enhance flavor.

• Renal diet. As with most medical challenges, the renal diet depends in part on

VEGAN CHOCOLATE MOUSSE Luc Buisson, pastry chef at Vi at Aventura, shared this recipe for a vegan dessert perfect for those residents who require or seek a dairy-free option.

Yield: 40 Servings INGREDIENTS 1.98 lb. Garbanzo bean brine 8.8 oz.

Sugar

10.6 oz.

Cocoa powder

Pinch Salt METHOD • Mix sugar, salt, and garbanzo brine with mixer on high speed for 15 minutes until emulsified (consistency must be dense).

• Gradually add cocoa powder, folding with a spatula.

• Fill up ramequin.

• Reserve three to four hours in cooler before serving.

• At the time of serving, dust with cocoa powder and top with chocolate tuiles.

MAY/JUNE 2018 ARGENTUM.ORG 43

QUALITY IMPROVEMENT

•

•

•

•

the severity of the disease. “In cases of kidney disease, we tend to restrict protein, but many [older adults] are protein-depleted to begin with,” Patel said. “So, we tend to work with them based on their disease progression and their lab work. If they’re on dialysis, they have no restrictions as far as food is concerned.” However, it is important to monitor intake of sodium and potassium, which could build up in the body of a renal patient.

Medication interactions. Grapefruit juice can cause interactions and changes in absorption rates with a wide range of medications, including statins, antihistamines, and blood pressure medications.

Natural black licorice can cause sodium retention, deplete potassium, and interfere with the effectiveness of the blood thinner Coumadin. Even leafy green vegetables can interfere with blood thinners when eaten in large amounts. Certain medications and medical treatments can also cause changes in the sense of taste or appetite that may interfere with healthy eating.

Modified texture/pureed. For residents who require pureed or mechanical soft foods, standard menu items can be altered to a suitable texture or thickness within the community kitchen or ordered in prepared versions. Mechanically altered foods are available in forms that closely mimic the shape and appearance of the original food, which helps make them more appetizing.

Food allergies/intolerances. Culinary staff should be made aware of residents’ food allergies or intolerances such as dairy or gluten. Since allergies can be immediately life-threatening, it’s imperative that residents with food allergies receive the proper diet always.

Other special needs. Numerous other factors can impact the ability of a resident to eat normally. These include issues such as reduced vision or hearing, problems with teeth or dentures, hand tremors, cognitive decline, depression, or even difficulty sitting up or reaching.

44 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

SHOULD YOU HAVE A DIETITIAN ON STAFF? Dietitians and certified nutrition specialists are indispensable members of corporate menu planning teams. They also provide valuable services at the community level, either as staff members or consultants. Whether an individual community needs one of these professionals on staff depends largely on the makeup of the resident population.

Registered dietitians are uniquely qualified to plan meals for residents with medical conditions. They are most often employed in skilled nursing and memory care environments. In those settings, the ongoing need for specialized dietary knowledge makes their presence imperative.

Vi employs dietitians and nutritionists on staff in its communities. “The advantage mostly is in our care center environment, where the residents may have more challenges and they may have more restrictions,” said Sandblom. “That’s where the registered dietitian or registered nutrition services manager would be involved to verify that the resident has the amount of calories they need and the food they’re supposed to be eating.”

In independent living and assisted living communities, dietitians can serve as consultants. The frequency of their visits would depend on the demand for their services.

Some residents will try to hide these issues rather than admit they’re having trouble. Residents should be thoroughly assessed when they move to a community and, if necessary, observed during mealtimes to determine the source of any difficulties. It can also be helpful to ask family members about any eating challenges they’ve noticed.

What’s trending?

“The population is changing,” said Bouchard. “We’re getting a more sophisticated group that’s focused on health and wellness.” He added that residents are requesting more healthful options, including vegetarian entrees such as Unidine’s popular homemade veggie burger and a chocolate cake made with beets.

Technology is also enhancing senior living dining. The software application eMenuCHOICE presents diners with photographs of more than 600 menu items along with written and audio descriptions, which

can be recorded in any language. “What we like to say is that if you have a lot of options but the residents really don’t know what they are, then it’s not really true choice,” said Matt Stenerson, eMenuCHOICE cofounder and CTO. The program also stores individual dietary guidelines, allergy, and health information for each resident, and integrates with electronic health records for real-time updating. It further identifies each diner by billing category and generates an appropriate monthly bill. The customizable program runs on any platform and can use a community’s existing tablets, PCs, and Macs.

Senior nutrition is a complex process that requires the involvement of everyone in the community, from culinary staff and dietitians to aides, nurses, residents, and family members.

“Food service isn’t an island by itself,” Bouchard said. “We have to work with everybody within the [community] to meet the needs of the residents.”

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SENIOR LIVING SALES COUNSELOR

QUALITY IMPROVEMENT

Food Safety and Worker Training: A Strategic Imperative

By Karen Purze

F

ood service operations in senior living communities are increasingly getting attention as a source of competitive advantage. David Koelling, president of Strategic Dining Services, a dining service and hospitality management provider, knows the strategic importance of the dining operation. “For many operators, dining is the number one controllable expense, and the biggest driver of resident satisfaction. Increasingly, hospitality is what we do. Dining and hospitality needs to be part of the vision. It needs to match, fit, and in some cases lead an organization’s strategy,” he said. That strategy includes safety—food safety and worker safety in the kitchen.

Fresh food is safe food

At Market Street Memory Care Residences, a Watercrest Senior Living community in Viera, Fla., menu design goes beyond having a tailored, nutritionally-balanced, and dietary-compliant menu creation process.

The community offers a mostly Mediterranean diet, with a lot of fresh fish, chicken, and turkey. “Our freezers are really small,” said executive chef Ryan Gorsuch. High quality, fresh food improves the dining experience—and it’s also easier to manage from a food safety perspective.

In fact, Koelling makes a direct connection between quality ingredients and safe food handling. “When you have quality food, you handle it differently. You store it differently. You hold it for the shortest time possible. If you’re committed to fresh, great food, the handling looks very different—and so do the outcomes. Ninety percent of sanitation and health issues go away if you’re committed to quality food.”

While senior living communities are bound by the same laws and regulations that 46 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

Image courtesy of ServeSafe®

apply to restaurants, there are some special considerations that make it necessary to “take it up a notch above what you might see in a restaurant,” said Lynne Eddy, an associate professor of business management at The Culinary Institute of America. Eddy teaches students in her senior-level courses on human resource management and foodservice management in health care (see p.

38) to combine expert level culinary skills with the technical knowledge and cultural sensitivities they need in a health care or senior living setting.

Special safety considerations for senior living

Eddy reminds students that seniors may have compromised immune systems; this

means kitchen and dining areas must be extra clean, and special attention must be paid to food temperatures and food storage.

“Food poisoning can be devastating [in this population],” said Eddy.

William Weichelt, director of food safety and industry relations at the National Restaurant Association (NRA) agreed.

“This is more of an at-risk population; you want to make sure things aren’t undercooked, and that there are processes in place for monitoring [food temperatures].”

Special dietary requirements may also factor in to food safety in a senior living or health care setting. Gorsuch, who had extensive experience in restaurants, hotels, and country clubs prior to joining Market Street, needed onsite training in some of

the food preparations his residents required.

Eddy teaches her students both the “what” and the “why” of special dietary requirements. For example, she brings in speech pathologists to teach about swallowing mechanisms using medical terminology.

“This is how we teach about food consistencies and why it matters to someone with dysphagia,” she said.

Beyond the technical requirements of maintaining a healthy and safe kitchen and dining area, Eddy sensitizes students on resident privacy issues as they relate to diet. For example, “someone handling trays could be unaware that residents may not want to be acknowledged as having swallowing disorders, diabetes, or other conditions that affect what they eat or how their food is prepared.” Without this training, students (or staff) may not be cognizant that a resident’s diet is a confidential matter. “If you have food service experience in a restaurant, this may not be quite so obvious,” she explained.

Designing a food safety program

Weichelt, who was previously responsible for the ServSafe® Food Safety training programs offered by the NRA, said “don’t take what [food handlers] know or don’t know for granted” when designing a worker training program. Weichelt recommended ServSafe food managers be recertified every three to five years, with food handlers recertifying every two years or so.

Gorsuch uses the ServSafe curriculum to certify his staff, then supplements that training by regularly reinforcing safety and compliance topics with in-service meetings and on-the-spot coaching. Weichelt endorsed this approach: “Managers need to be observant and give immediate feedback and remedial training as and when they notice issues. Just training once and walking away isn’t ideal.”

A workplace training program should cover not just each person but also each piece of equipment at a community. Gorsuch tailors his training program by community, as each has different equipment.

Koelling noted that “in a kitchen, it’s the technical side of things that typically needs reinforcement. Like what’s going on inside

your ice machine? If not properly cleaned and inspected, it could be the single biggest risk in your community. There’s not much exposure to a topic like that outside of a health care or senior living community; it’s important to train.”

Staying inspection ready

According to Gorsuch, daily reinforcement is the key to the inspection success at his communities. “We know what to look for daily, and we stay inspection ready. We don’t have to worry about ‘getting’ ready for inspectors. That’s the way I was trained.”

Koelling uses a checklist “game” to introduce some fun into the process of getting and staying “inspection ready.”

Strategic Dining Services creates tailored checklists such that each piece of equipment gets inspected, and each employee gets a set of tasks to complete. The goal is that each checklist is completed without any issues found, in less than four minutes.

“When the four minutes are up, we look at the corrections needed. And we talk about not just ‘what’ needs to be corrected, but also ‘why’ and ‘how.’ So, we’re playing a game, but learning in the process.” They also use it to get others familiar with the inspection process and build an understanding across the entire team, by having an executive director or the maintenance director take a position in the drill. A nice side effect of the training is it can increase inspection scores by helping avoid minor findings, Koelling said.

Worker safety

Training and reinforcement of best practices and community-specific processes is critical to maintaining food safety. Training is also essential to worker safety. Weichelt noted that food service communities “are busy, very high pressure. Things get busy, there are many moving parts, and things can change rapidly.” If equipment is not working properly, or staff is not trained to use it correctly, injuries can occur. Beyond the increased workers’ compensation expense of injuries, workers have a legal right to a safe working environment. Koelling noted that keeping workers safe starts with the hiring process. “Are you hiring people that are equipped to be in a kitchen setting where things are hot, sharp, heavy, and fastpaced?” He noted worker shortages and difficulty in hiring can sometimes also rush the onboarding processes that are so critical to keeping dining staff safe.

Trust your instincts

If a senior living executive doesn’t have a food service background and isn’t sure where to start with improving a food service operation, Koelling offered this advice: “Start with your instincts. Those are going to be your best tool for evaluating what’s going on. What does it look like in the kitchen? Smell like? If the kitchen doesn’t seem right, trust me, it’s not right. Start with your instincts, and then work out a plan or get help to address the concerns.”

A SAFETY RESOURCE FOR YOUNG DINING WORKERS The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) cites that restaurants and other dining businesses in the United States employ 11.6 million people; of those, nearly 30 percent are under 20 years of age.

To assist those workers, OSHA has developed a special e-tool geared toward young workers in food service that describes common hazards and offers potential safety solutions. The e-tool includes information, quizzes, and posters on a variety of topics from serving and clean-up to cooking and food prep, and can be accessed at osha.gov/SLTC/youth/restaurant/index.html.

MAY/JUNE 2018 ARGENTUM.ORG 47

Attract More Residents and Promote Optimal Health:

The Importance of Person-Centered Nutrition and Dining in Senior Living A trend that is becoming increasingly apparent in longterm, post-acute care is person-centered care in senior living. This is largely being driven by the influx of baby boomers joining senior living facilities across the country.

At the forefront of this movement is a growing expectation that food and hospitality operations within senior living facilities will continue to evolve in response to this shift.

As mainstream dining trends gain a stronger influence over senior residents and their adult children, senior living facilities have begun to adopt different dining experiences like farm-to-table, grab-and-go, bar/buffet, and tapas/small plates dining.

Providers are discovering new ways to attract and accommodate baby-boomer residents, who are more accustomed to eating out at a higher frequency than the previous generation. In response to this, communities have also increased the quality of their venues, both in number and diversity. A recent MatrixCare dining study of 180 senior living food operators, found that the majority (63%) have two or more dining venues on their campus. This helps them cater to an audience whose experience has been heavily shaped by contemporary dining experiences.

As the restaurant approach to dining and hospitality in senior living communities becomes more of the norm, the challenge of balancing the evolution in dining culture with nutrition guidelines and internal facility capabilities becomes more difficult. These new trends in dining are required to attract new residents and keep them satisfied, yet regulatory requirements and dietary recommendations still must be adhered to.

Still Following the Rules As claims in public health continue to support nutritious eating for its role in maintaining overall wellness during the aging process, operators must ensure that perceptions match reality. Food Managers and Dietitians alike have already begun to visualize the importance of this process.

MatrixCare’s study found that providing considerations for special dietary needs is of great importance in an operation’s success, second only to the quality of overall dining service. Rating 4.41 out of 5, Managers and Registered Dieticians feel their dining program is more successful when focused on the therapeutic diet restrictions of their clients.

By working to reach the nutrition-centered goals of maintaining the health and quality of life of residents, facilities will be successful in supporting nutrition-related health. Also, actively seeking to accomplish these objectives not only improves customer satisfaction, it may also reduce medical expenses.

Providing menu items from a reputable, healthful diet can combat comorbidities and reduce side effects of disease. Medical conditions and diseases affected by nutritional status can be found in all care settings.

Osteoporosis, Heart Disease, Chronic Kidney Disease, Diabetes Mellitus, and Hypertension have proven to be better controlled with dietary consumption that is based on nutritional recommendations.

48 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

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RELATIVE IMPORTANCE OF DINING CONSIDERATIONS

Clinical Nutrition/Wellness Inclusion Considerations for Special Dietary Needs Capture of Non-Typical Meal Expenses (Guest/Employee Meals) Analytic Reporting Capabilities Technology Specific to Dietary Services for Staff Efficiencies Integrations or Interfaces from the Medical Record Incorporating Brand into Dining Regulatory Compliance Tools Menu Variety Quality of Dining Services Food Cost Control Number of respondents Very important

Somewhat important

0

A little important

10

20

30

Not very important

40

50

60

Not important

As person-centered care moves to the forefront, facilities are creating menus that meet preferences for food, dining atmosphere, cultural beliefs, and individual dietary therapeutic needs. How can kitchen operators move to accommodate nutrition needs across the entire spectrum of care? Creating a facility menu that meets the nutritional recommendations for overall health can support this initiative.

US News and World Report named the Mediterranean Diet #1 for diabetes control in its 2018 rankings, and it tied with the ever-popular DASH Diet (Dietary Approaches to Stop Hypertension) for #1 in benefitting overall health. The inclusion of more therapeutic nutrition styles such as these drives the success of Senior Living organizations in maintaining the wellness of residents.

It is estimated by The Journal of the Academy of Nutrition and Dietetics that 67 percent of adults with Type 2 Diabetes, do not have their blood pressure under control and therefore require medication management therapy. By incorporating recommendations from the DASH Diet, senior living providers can not only improve health, but possibly reduce medication needs.

This concept also supports the Academy of Nutrition and Dietetics’ idea that the quality of life and nutritional status of older adults in LTPAC settings can be enhanced by individualized nutrition approaches. By designing a facility-wide therapeutic menu that supports overall wellness, operators can be assured that they are taking steps forward to successfully meet the majority of residents’ individual needs.

MAY/JUNE 2018 ARGENTUM.ORG 49

Sponsored by ®

Integrated Care. Better Outcomes.

Moving Forward Focusing on the dining environment and experience will result in communities electing to add or repurpose some of their traditional dining settings to include: • Grab-and-go options, where residents can have soups, sandwiches and in some instances basic groceries (which could include eggs, milk, bread, cereals) and other convenience items.

• Bistro/Café, which offers a less formal setting and also encourages social interaction.

• Bar/Pub, which could include amenities for residents that range from large screen TVs to pool tables.

• Flexible access and dining hours are also a key component in addressing senior’s expectations.

As senior living providers begin to accommodate the dining preferences of younger residents, they may also find themselves serving people outside of their immediate community. Expanded menus, new and diverse venues, and more flexible hours will likely encourage residents to invite friends and family members to enjoy the facility’s dining experience with them. Being able to “entertain” in this way can boost residents’ mood immensely, which further supports the individual’s overall wellness.

In addition to including diverse dining options and flexible hours, it is important to understand that some seniors will be looking for menu offerings that are familiar and remind them of home, or growing up. As menus change and the selection of available meals widens, these should also be included— particularly the more healthy options.

This is increasingly important because, as seniors are living longer than ever before, they want to maintain a healthy lifestyle as they age.

Having the capability to customize each resident’s menu options to their personalized nutrition needs is of extreme value to senior living providers, according to the MatrixCare study. A nutrition management software program that allows you to build and adjust dietary options around individual resident needs, allows facilities to provide the highest level of person-centered care.

About the authors: Amy Wootton, RDN, Director of Nutrition Management and Mauricio Hermosillo, Director of RetailTracker, wrote this article based on MatrixCare research of its customers.

For more information on MatrixCare MealTracker or RetailTracker, contact MatrixCare at 866.469.3766.

50 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

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MEMORY CARE

Innovations in Memory Care Dining and Service

By Debbie Reslock

S

haring a meal can be one of life’s most gratifying moments, but the joy of dining can quickly be lost for those living with the challenges of Alzheimer’s or other dementias. The right setting and food structure can play a big role toward restoring self-confidence and quality of life.

In fact, the chance that a resident will continue to try and eat increases if mealtime is made easier and more pleasant. The National Institute on Aging (NIA) at the National Institutes of Health suggests the following six tips for making mealtime more enjoyable for those with dementia: • View mealtimes as opportunities for social interaction. A warm and happy tone of voice can set the mood; • Be patient and give the person enough time to finish the meal; • Respect personal, cultural, and religious food preferences; • If the person has always eaten meals at specific times, continue to serve meals at those times; • Serve meals in a consistent, familiar place and way whenever possible; and • Avoid new routines, such as serving breakfast to a person who has never routinely eaten breakfast.

Person-centered dining programs encourage participation by supporting independence, preferences, and the opportunity for social interaction.

Developed at Rush University Medical Center through a study funded by NIA, the MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay), was discovered to lower the risk of developing Alzheimer’s disease between 35 percent and 53 percent, depending on how closely it was followed. MIND diet fare includes leafy greens and other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil, and wine. Foods to be avoided or limited include red meats, butter and stick margarine, cheese, pastries and sweets, and fried or fast food. In the study, those who rigorously adhered to the MIND diet plan had the best outcomes, but individuals who only moderately followed the diet still saw significant results.

Meeting the challenges of dining and dementia

Of course, the right brain nutrition does little if it is not eaten. One of the bigger challenges for those with Alzheimer’s is

combating weight loss while maintaining independence and dignity while dining. Those managing the challenges of the disease can be overwhelmed with too many choices or distractions or find themselves unable to sit long enough to get through a meal.

Combining both the latest in nutrition and dining best practices, three senior living providers have shared their most innovative programs resulting in optimal dining experiences for residents with Alzheimer’s or other dementias:

Integrace

Copper Ridge, an Integrace community, serves those with Alzheimer’s and other dementias in Sykesville, Md. It includes an onsite neurocognitive clinic for diagnosis and treatment and an institute for research and education. It is also home to The Bistro, a restaurant adhering to the MIND diet that can help residents and their families rediscover the joys of mealtime, according to Rusty Mitchell, executive director at

What’s good for the heart is good for the brain

But what we eat also matters. When the heart-healthy Mediterranean diet was combined with the sodium-reducing DASH (Dietary Approaches to Stop Hypertension) diet, a hybrid was found to not only be good for the heart but for the brain as well.

52 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

Fresh Bites at The Bistro at Copper Ridge

MEMORY CARE

Copper Ridge. For their dining programs, Integrace partners with Unidine Senior Living Culinary Group.

We eat first with our eyes and that may never be more important than to the resident who needs puréed food, said Bill Rodgers, general manager of Unidine Senior Living Culinary Group. So, at Copper Ridge, they thicken a resident’s meal to the right consistency and then pipe it out with pastry bags, so the plate of food actually looks like food. “If it looks like carrots, the brain will tell you it’s carrots. But if it looks like an orange ball on the plate, they may not even take the first bite,” he said.

Any opportunity to restore a resident’s independence should never be missed. The Bistro also offers “Fresh Bites” for those who have been prescribed finger foods or who may struggle to stay seated or hold utensils.

“If eating is hard, we know they can lose interest and then not eat at all,” Rodgers said. Using chicken salad sandwiches on small brioche buns as an example, he said those who can’t sit through a meal can pick up one to eat while walking and then get redirected back to the food to have another.

But one of the greatest benefits of The Bistro may be that it offers families and loved ones a chance to eat together again, like they once did. Going out to eat in a restaurant can be overwhelming and apprehensive for both, Mitchell said, but now they have the chance to enjoy this experience in a welcoming and understanding environment.

“The anxiety of cognitive challenges often causes people to stay at home but now they come here and find they are also forming social and support networks.”

Watermark Retirement Communities

Working with a grinding and food combination process developed by Grind Dining, Inc., Watermark Retirement Communities, headquartered in Tucson, Ariz., branded their program Thrive Dining™. The program supports those who have limited use of utensils and may have limited desire to eat with others.

Whether individuals have cognitive issues, Parkinson’s, or even dental problems, Thrive Dining offers a culinary solution

Thrive Dining pre-entree sorbet service at Watermark Retirement Communities

by serving a fully balanced meal with a program that also promotes dignity and independence, said Watermark’s national director of dining services, Rob Bobbitt. In fact, it’s the exact same food everyone else is eating; it’s just in finger food form.

“We take the same food and convert it to a Thrive Dining meal. In the past, finger friendly diets in senior living were usually fish sticks, chicken tenders, or sweet potato fries. But to have to eat that three times a day and for the rest of your life? Not at Watermark,” Bobbitt said. “Now you can have what’s on the menu just like everyone else.”

Bobbitt added that they plate each meal to look attractive. “Whenever we’re served a meal, we look at our plate first. The aroma comes second,” he said. “So we make sure to focus on the plate composition to be attractive and appealing [to the eye].”

According to Bobbitt, it’s a priority that what’s on the plate is a complete, balanced, and nutritional meal because if someone isn’t eating that, it leads to immediate health decline. But then Watermark takes it a few steps further.

They first give out warm hand towels scented in lavender, rosemary, or a citrus base. “It’s great to see residents put it up to their face because it feels and smells so nice,” said Bobbitt.

Next, they serve a citrus type of sorbet, but not as a palate cleanser. “It’s actually been proven to increase meal intake. It causes you to salivate and is similar to the response when you walk into a kitchen when someone’s cooking. It triggers the same sensation,” Bobbitt said. “It’s amazing to watch the residents light up.”

Dining is about much more than just nutrition. It invokes so many memories and coming together with family. But it’s not the same when everyone else has a complete meal with so many choices except for you. So, Thrive Dining is a game changer, Bobbitt said.

“We’re so excited to offer this. It’s not only great for the residents, but it pushes the culinary team to a higher level,” said Bobbitt. “And it’s not just in preparing the food, but plating, presentation, and service.

It also ups our game.”

MAY/JUNE 2018 ARGENTUM.ORG 53

MEMORY CARE

“At this stage of their life, we want to help them eat well but also enjoy what they eat,” said Giampietro.

Chefs preparing brain healthy ingredients at Silverado.

Silverado

Also focusing on prolonging their residents’ cognitive capabilities, Silverado, whose home office is in Irvine, Calif., incorporates the MIND diet components in their menu, said vice president of culinary services, Nick Giampietro. This includes using whole grains, fresh vegetables, berries, beans, and olive oil. But he said it’s not too far off from what they’ve always prepared for their senior population.

Giampietro cautioned that any change needs to be incorporated slowly. “You can’t eliminate everything they liked or are used to from their diets,” Giampietro said, “like all red meat or foods with saturated fats.” So, Silverado provides brain beneficial selections that offset the other choices. “This way they can still enjoy a dessert because they’re also getting other healthy foods.”

Balancing taste, nutrients, and preferences is also required, especially for those in memory care who struggle to keep weight on. Giampietro said they do make ice cream and desserts available. “At this stage of their life, we want to help them eat well but also enjoy what they eat.”

54 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

The goal at Silverado is to serve the same food no matter what a resident’s prescribed diet may be. If a resident requires finger food, they take the menu that day and transform it. “We believe this helps them maintain their independence by being able to feed themselves if they’re not able to use a fork. It’s respectful for them,” said Giampietro.

“If the menu includes meatloaf, mashed potatoes, and green beans, we would make the meatloaf into meatballs and the mashed potatoes may become a potato wedge to go along with the green beans that they can eat,” he said.

A brain healthy meal at Silverado

As far as following the MIND diet components, Giampietro said it’s easier to integrate into the menu than one might think.

“We changed our pasta and breads to be whole grain. We added quinoa. But for our population and their families, these may not be foods they grew up with so you need to educate and communicate with them. Have them try it and then adjust where needed.”

Silverado also goes to local senior centers and hospitals to do cooking demonstrations, as well as educate and share information on brain healthy cooking.

“Sometimes we host the public in our community and cook items right in front of them, so they can see how easy it is to incorporate into their daily menu at home,” Giampietro said.

Dining programs aren’t one-size-fits-all, according to Giampietro, and it doesn’t work to roll one out like it is. It needs to be case by case, he said, engaging and understanding resident behaviors that may affect mealtime. “It’s important to work with them and come up with an individual solution.”

Restoring dignity with dining

The struggle for those with cognitive issues only continues to worsen as the disease progresses, as does the loss of autonomy.

So any solution that can lessen the reliance on others shouldn’t be overlooked. And the results are real.

“Imagine seeing someone agitated at mealtime and 100 percent dependent on assistance who is now able to dine by themselves and who may even indicate that they want more,” said Bobbitt. “Families come up and hug the caregivers. They’ve never seen their loved one eat that much and now they have their dignity back at mealtime.”

FROM THE EXECUTIVE DIRECTOR'S DESK

Simple Steps to Creating a Fun and Healthy Nutrition Program

By Paula Moore, CDAL

T

he safety and well-being of our residents is always important, and that includes many aspects of resident care, including dining and nutrition.

With proper nutrition and hydration, residents have fewer medical issues, which means they can have healthier and more active lives.

Not only can a fall result in a life changing injury to a senior, it can also negatively impact your community occupancy and potentially your reputation.

At Five Star Senior Living, our service pillars are Dining & Nutrition, Health & Wellness, and Warmth & Hospitality. These pillars overlap as an excellent dining program encourages good nutrition, socialization, and a healthier, happier individual. With the help of celebrity chef Brad Miller, Five Star has incorporated the “Exceptional Dining” concept into the assisted living environment. We ask ourselves how we can make dining in the same

restaurant every day an enjoyable experience.

We accomplish this by eliminating institutional type meal planning, offering restaurant style dining with a variety of menu choices, using fresh produce, featuring regional cuisine, and learning our residents’ preferences. Creating a fun dining atmosphere through chef demonstrations, themed dinners, parties, and events, makes dining the highlight of the day.

Resident participation is a key to success.

At Morningside, we keep our residents excited about dining by involving them. We incorporate resident recipes into our menus, have group cooking activities, and hold regular food committee meetings so residents are part of the menu planning process.

Proper hydration is also very important.

Offering fluid options with meals and having a hospitality station that offers fruit flavored water, tea, coffee, and our signature cookies encourages drinking. Twice-daily hydration

rounds to each apartment—offering water and snacks, including fresh fruit—works well for us.

Mealtime provides that special “family time” for residents to socialize. As caregiv- Paula Moore, CDAL ers, it provides us with Executive Director Morningside of Fayetteville a venue where we can Five Star Senior Living visit with residents while they are all together and recognize potential nutritional changes that may develop.

As the leader of your community, be sure to “touch the tables” at mealtimes and demonstrate the importance of good nutrition and hydration. Pour the coffee or tea, pick up the plates, and you will learn all you need to know about each resident and the choices they are making.

“CDAL is a Differentiator” The Certified Director of Assisted Living (CDAL) credential demonstrates an executive director’s commitment to providing residents and their families with the highest standards of excellence in senior living.

Applications are required to verify eligibility.

Apply today slcccertification.org August 1 Registration Opens

September 17 Testing Period Opens

October 31 Registration Deadline

December 14 Examination Period Closes

MAY/JUNE 2018 ARGENTUM.ORG 55

SPOTLIGHT: THE HEART OF SENIOR LIVING

Chefs and Community Support San Francisco Seniors

By Leo Williams

T

he 31st Annual Star Chefs and Vintners Gala, held May 20, 2018, brought together 100 chefs, more than 100 vintners, and 900 attendees to benefit Meals on Wheels San Francisco (MOWSF), an organization that provides food and nourishment to 4,500 of the area’s homebound seniors.

Gala attendees enjoyed meals provided by stars of the San Francisco culinary world, such as Charles Phan, chef of the Slanted Door; Mourad Lahlou, chef of the eponymous Mourad; and Nancy Oakes, chef of Boulevard Restaurant and gala chair. Their offerings included delights such as California lamb, ricotta gnudi, ramps, morel, and crimini fricassee.

According to Karl Robillard, director of marketing and communications for MOWSF, the event brought in more than $3.3 million.

Those funds are well appreciated. Robillard said MOWSF’s 24 drivers serve about 6,000 meals on any given day, a number that has been climbing by more than 10 percent each year as the city’s older adult population grows. Nearly three-quarters of the seniors receiving service from MOWSF are at or below the federal poverty line.

“A lot of the reason is what you hear from anybody working with senior populations,” he said. “The demographics of this entire country—and certainly San Francisco—are changing rapidly. More people are living longer, and there are more seniors than ever before.”

MOWSF counts on the gala to provide about a quarter of its budget, he said. The agency brings in about $14 million annually, split between private and public sources.

The gala, in turn, is responsible for about half of its private income.

56 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

David Nayfeld, chef and co-owner of Che Fico and Nancy Oakes, chef of Boulevard Restaurant and MOWSF gala chair.

Robillard credits Oakes, the event chair, for maintaining enthusiasm for the gala within the city’s culinary community.

“Because she has really gone to bat for Meals on Wheels, many aspiring new chefs want to be part of this gala,” he said. “Many of the established chefs, like her, who have been around the city for years, are eager to be part of it every year.”

Attendees at the gala were treated to a three-hour experience; the first hour was dedicated to cocktails and hors d’oeuvres featuring cuisine from Spain to India to Japan.

To avoid having the untenable job of preparing meals for 900, the chefs divided into teams, with each team serving about 100 guests. As a result, there was a wide variety of dining experiences across the room.

“It is likely that the table next to you will be enjoying a different appetizer, main course, and dessert from your table,” Robillard said. “That’s how they keep the quality so high and how they keep the event so ex-

citing and unique. You never know exactly what you’re going to get.”

A live auction accompanied the meal, with people bidding for vacation packages and dinner parties at winning bidders’ homes.

“These are all things that you could never buy anywhere outside of the gala,” Robillard said. “You have to be in this room to have a chance to bid.”

Overall, the gala serves to bring the community together and provide help for those who might go hungry without this support.

“Honestly, it’s just an amazing event,” Robillard said. “There are really no words to accurately describe how beautiful it is, how incredibly important it is for seniors all throughout the city. If you apply the amount of money we raised this year to the cost of producing meals, we raised enough money to provide 660,000 meals to homebound seniors throughout San Francisco. That’s a lot of home delivered meals and safety checks for seniors!”

PUBLIC POLICY

Argentum

Advocates For You

The workforce shortage has long-plagued the senior living industry, creating frustration and concern for providers across the country. Recently, Congress has been addressing the workforce shortage crisis

example, Sen. Ron Johnson (R-WI) has introduced a state-based visa pilot program, with a plan to allow states to manage visas and allocate them to industries most in need of workers. According to analysis

by Brian Schaitkin, senior economist at the Conference Board, 26 percent of personal care aides and home health aides are foreign-born, and more than 20 percent of immigrants work in the food service industry. While it is unexpected for Congress to address immigration reform this year, the concern among health care and food service industries is only going to continue to grow, forcing them to put pressure on elected officials to make a change.

permeating across all business sectors, especially in health care. While there aren’t any one-size-fits-all solutions, there are legislative proposals being introduced that could help alleviate the workforce stress for many providers. Some members of Congress are considering workforce training proposals as an approach to mitigate staff shortages and improve quality of care.

These proposals focus on programs geared toward incentivizing individuals to obtain the proper training for high-demand jobs such as nursing and caregiving.

One unique approach circulating on Capitol Hill is merging immigration reform with workforce development. For

Immigrant clustering in the food services industry

Most workers are in low-skilled jobs such as cooks, cashiers and wait staff regardless of nativity. % of native-born in the food service sector working as...

% of foreign-born in the food service sector working as...

Cooks

Waiters and waitresses

24.5%

31.5% Waiters and waitresses

Cooks

15.7%

14.2%

Food service managers

Food service managers

10.6%

10.5%

Cashiers

Cashiers

9.3%

6.9% Food Preparation workers

First-line supervisors/managers

6.0%

6.0% Top 5 total:

Top 5 total:

64.6%

70.7%

Immigrant clustering in the healthcare industry

Among immigrants a higher share are working as doctors or lower-skilled nursing aides than among the native-born. % of foreign-born in the healthcare sector working as...

% of native-born in the healthcare sector working as...

Nursing, psychiatric, and home health aides

Registered nurses

16.4%

19.0% Registered nurses

Nursing, psychiatric, and home health aides

10.3%

16.0% Physicians and surgeons

Medical assistants and other healthcare support occupations

4.5%

7.7% Medical assistants and other healthcare support occupations

Physicians and surgeons

4.0%

5.0% Personal and home care aides

4.9% Top 5 total:

52.6%

Argentum has been working with organizations like the National Conference of State Legislatures to identify how immigration reform can impact the senior living workforce shortage. Argentum encourages their members to stay abreast of these issues and other legislative proposals that can impact business operations. To stay up to date on federal and state legislative and regulatory activity, you can visit argentum.org/advocacy.

Licensed practical and licensed vocational nurses

3.8% Top 5 total:

38.8%

Source: 2010 Current Populations Survey data accessed via IPUMS.org

You can help address workforce challenges by becoming a Senior Living Works Ambassador. Sign up today at seniorliving.works and receive access to educational webinars and practical resources to boost your recruitment campaigns and strategy.

MAY/JUNE 2018 ARGENTUM.ORG 57

ARGENTUM 2018 PREMIER MEMBERS

Member companies at the PREMIER level make a direct investment in advocating for and protecting the collective interests of the senior living profession. They enjoy the many expanded benefits of membership, like participation in the Executive Advisory Board and the exclusive Chief Executive Summit. For membership information, please visit argentum.org/ membership.

A Place for Mom aplaceformom.com Affinity Living Group affinitylivinggroup.com Allegro Senior Living allegroliving.com American House Senior Living Communities americanhouse.com Atria Senior Living atriaseniorliving.com Avanti Senior Living avanti-sl.com Belmont Village Senior Living belmontvillage.com Benchmark benchmarkquality.com Bickford Senior Living enrichinghappiness.com Blue Harbor Senior Living blueharborsl.com BPM bpmsl.com Brandywine Living brandycare.com Bridgestone Living bridgestoneliving.net

HHHunt Senior Living hhhunt.com

Sagora Senior Living sagora.com

Holiday Retirement holidaytouch.com

Senior Lifestyle seniorlifestyle.com

Insignia Senior Living Insigniaseniorliving.com

Senior Living Communities senior-living-communities.com

IntegraCare Corp integracare.com

Shepherd Senior Living liveshepherd.com

Integral Senior Living islllc.com

Silverado silveradocare.com

Kensington Senior Living kensingtonsl.com

Singh Senior Living singhweb.com

Knute Nelson knutenelson.com

Sunrise Senior Living sunriseseniorliving.com

Legend Senior Living hegendseniorliving.com

Swiss Re America swissre.com

Life Care Services lcsnet.com

Symerica Senior Living symphonyseniorliving.com

MatrixCare ★ matrixcare.com

The Arbor Company arborcompany.com

Direct Supply ★ directs.com

MBK Senior Living Communities mbk.com

The Garlands of Barrington thegarlands.com

Elmcroft Senior Living elmcroftseniorliving.com

Medline Industries ★ medline.com

Enlivant enlivant.com

Merrill Gardens merrillgardens.com

Era Living eraliving.com

Morrison Community Living compass-usa.com

Five Star Senior Living 5sqc.com

National Health Investors nhireit.com

FOX Rehabilitation foxrehab.org

New Perspective Senior Living npseniorliving.com

Greenfield Senior Living greenfieldseniorliving.com

OnShift ★ onshift.com

Harbor Retirement Associates hraonline.net

Pathway to Living PathwaySL.com

Brightview Senior Living (The Shelter Group) sheltergrp.com Brookdale brookdale.com Buron Healthcare buroninc.com Century Park Associates centurypa.com Chancellor Healthcare chancellorhealthcare.com Chelsea Senior Living chelseaseniorliving.com Civitas Senior Living csrliving.com Clearwater Living clearwaterliving.com Commonwealth Senior Living commonwealthsl.com Country Meadows countrymeadows.com

HCP ★ hcpi.com Hearth Management thehearthllc.net

Provision Living provisionliving.com RealPage Senior Living realpage.com

The LaSalle Group autumnleaves.com The Waters Senior Living thewaters.com Ventas ventasreit.com Vi Living viliving.com Vitality Senior Living vitalityseniorliving.com Welltower Inc. welltower.com Wentworth Senior Living wentworthseniorliving.com Willis Towers Watson ★ willistowerswatson.com Yardi Systems ★ yardi.com

★ CORPORATE PARTNER: Thank you to Argentum’s Corporate Partners whose annual financial support and resource commitment advance critical industry initiatives.

58 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

ARGENTUM 2018 EXECUTIVE MEMBERS

We would like to recognize the following EXECUTIVE members for their enhanced support of Argentum.

Arena arena.io GlynnDevins GlynnDevins.com

Gordon Food Service gfs.com

Kwalu kwalu.com

RCare rcareinc.com

Guardian Pharmacy guardianpharmacy.net

Lyft lyft.com

Sodexo sodexo.com

Hanson Bridgett hansonbridgett.com

Omnicare omnicare.com

Kindred Healthcare gentiva.com

PointClickCare pointclickcare.com

ARGENTUM BOARD OF DIRECTORS

CHAIRMAN Tim Buchanan, President & CEO Legend Senior Living

James Balda, (ex officio) President & CEO Argentum

Brad Klitsch, (ex officio) SVP of Market Development, Direct Supply

VICE CHAIRMAN Pat Mulloy

Scott Brinker, EVP & CIO HCP

VICE CHAIRMAN Randy Richardson, President Vi

Jack Callison, CEO Enlivant

Gayle Kvenvold, (ex officio) President & CEO, LeadingAge Minnesota

SECRETARY John Moore, Chairman & CEO Atria Senior Living TREASURER Bruce Mackey, President & CEO Five Star Senior Living PUBLIC POLICY COMMITTEE CHAIRMAN Ed Kenny, Chairman LCS IMMEDIATE PAST BOARD CHAIRMAN Loren Shook, President, Chairman & CEO Silverado

Kathy Fiery, (ex officio) Director, Division of Assisted Living/ Alterative Service, Health Care Association of New Jersey John Goodey, EVP & CFO Welltower Tom Grape, Chairman & CEO Benchmark Judd Harper, President The Arbor Company Kai Hsiao, CEO Elmcroft Senior Living Chris Hyatt, COO New Perspective Senior Living

Sally Michael, (ex officio) President California Assisted Living Association Mary Sue Patchett, EVP - Community and Field Operations Brookdale Bill Pettit, President & COO R.D. Merrill Company Robert Probst, EVP & CFO Ventas Collette Valentine-Gray, CEO & COO Integral Senior Living Patricia Will, Founder & President Belmont Village Senior Living Chris Winkle, CEO Sunrise Senior Living

MAY/JUNE 2018 ARGENTUM.ORG 59

PEOPLE AND PLACES

News, Sales & Developments Newton, Mass.-based Five Star Senior Living announced the completion of a renovation at Jefferson Manor, an independent living community in Kokomo, Ind. The renovation included a dining room expansion, furniture and fixture upgrades, and additions to the community’s beauty salon. The renovation was highlighted during a special celebration on April 12.

Harbor Retirement Associates, based in Vero Beach, Fla., celebrated the grand opening of HarborChase of Wildwood, a new assisted living and memory care community in Wildwood, Fla. The community includes 66 assisted living apartments and 26 memory care residences.

Pathway to Living, headquartered in Chicago, Ill., celebrated the opening of Heartis Village of Orland Park in Orland Park, Ill. The community offers 96 residences including 72 for assisted living and 24 for memory care. The community’s memory care residents will have access to A Knew Day®, Pathway to Living’s signature memory care program that provides rehabilitation for the brain by helping those with memory impairment become more engaged and communicative.

Atlanta, Ga.-based Guardian Pharmacy Services announced a new partnership with Mallatt’s Homecare Pharmacy, an employee-owned business in Wisconsin that has been serving the community for over 90 years.

The partnership grows Guardian’s footprint in the Midwest and marks its first venture in Wisconsin.

Columbia, Md.-based LifeSpan Network, an Argentum state partner serving Maryland and the District of Columbia, announced a partnership with Real Time Medical Systems aiming to reduce hospital readmissions and improve quality of care. The Real Time Clinical tool provides detailed clinical alerts and intervention recommendations to ensure appropriate care is administered at a community before a hospital admission is needed.

CarePredict, headquartered in Ft. Lauderdale, Fla., unveiled their Next Generation AI-Powered Elder Care Technology Platform 60 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

Terry Hornikel and Benchmark chairman and CEO Tom Grape

Waltham, Mass.-based Benchmark announced the appointment of Terry Hornikel as executive director for Sturges Ridge of Fairfield, a new assisted living and memory care community opening this fall in Fairfield, Conn. She has previously served as an executive director for Meridian Senior Living, Emeritus Senior Living, and Kindred Healthcare. Hornikel is a frequent speaker on topics from Medicare to long-term care insurance to Alzheimer’s and dementia. at the Argentum Senior Living Executive Conference in May. The solution combines a wearable sensor with machine-learning algorithms and smart location technology to measure activity and behavioral patterns of residents, allowing community staff to intervene before a health emergency.

Solvere Senior Living, based in Princeton, N.J., opened Tessera of Brandon, a new assisted living and memory care community in Brandon, Fla. The community includes 89 assisted living apartments and 49 memory care suites. A grand opening celebration was held on April 26.

Newton, Mass.-based VoiceFriend announced its automated notification solution is now Amazon Alexa-enabled. This new skill

allows residents to access and listen to daily schedules and menus, learn about upcoming events and activities, and receive notices and appointment reminders—all through voice-activated commands. It also allows family members to listen to information and alerts and allows administrators to easily communicate to staff members.

Watercrest Senior Living, based in Vero Beach, Fla., celebrated the groundbreaking of Watercrest Columbia Assisted Living and Memory Care located in Columbia, S.C. The community, currently under construction, will offer 107 residences, including 75 for assisted living and 32 for memory care.

Construction is planned for completion in late spring 2019.

Appointments, Promotions & Recognition The Arbor Company, based in Atlanta, Ga., named Michelle Hamilton senior vice president of operations. She joined the company from Country Meadows Retirement Communities where she served as senior vice president and chief of senior living operations.

Hamilton has served as an Argentum regional executive roundtable chair and as chair of the assisted living board of directors for the Pennsylvania Health Care Association.

Argentum, headquartered in Alexandria, Va., announced that Tim Buchanan, president and CEO at Legend Senior Living, was elected to TIM BUCHANAN serve as the new chairman of the Argentum Board of Directors.

Most recently, he served as the vice chairman on the board. Buchanan also served as the first chairman of the Senior Living Certification Commission, an independent, nonprofit organization committed to establishing credentialing programs for professionals working in senior living. Buchanan officially assumed the Argentum board chairman’s position at the Argentum Senior Living Executive Conference in May. Benchmark announced Jerry Kemper as the company’s senior vice president and CFO. He brings to Benchmark over 20 years of operaCORINA REBELLO tional and strategic experience in the health care and long-term care industries. Most recently, Kemper served as vice president and CFO for the nursing center division. Benchmark also promoted three community leaders: Chris Golen was promoted from campus executive director at The Commons in Lincoln in Lincoln, Mass. to regional director of operations for the company’s CCRCs. At The Commons in Lincoln, Reynaldo Leblanc was promoted from associate campus executive director to campus executive director, and Holly Dineen moved from director of sales and marketing

to associate campus executive director. The company also hired Rob Guinard as director of community relations for Benchmark Senior Living at Shrewsbury Crossings in Shrewsbury, Mass. Additionally, Corina Rebello, the director of dining services at Benchmark’s River Ridge at Avon in Avon, Conn., received a first-place win at the 2018 Chef Challenge hosted by the Connecticut Assisted Living Association, an Argentum state partner.

Brookdale Senior Living, headquartered in Brentwood, Tenn., hired Teresa Sparks as the company’s interim CFO. She is filling the vacancy left by Lucinda Baier, who became Brookdale’s new president and CEO earlier this year. Most recently, Sparks served as EVP and CFO of Surgery Center Holdings. Brookdale also announced that former CEO Bill Sheriff will rejoin the company as a consultant. Sheriff led Brookdale from 2006-2013.

Five Star Senior Living announced the election of Adam Portnoy to managing director, filling a vacancy on the board. He is the managing director, president, and CEO of The RMR Group Inc. and president and CEO of The RMR Group LLC. Portnoy also currently serves as the honorary consul general of the Republic of Bulgaria to the Commonwealth of Massachusetts.

HCP, based in Irvine, Calif., announced the appointment of Lydia Kennard and Kent Griffin to its Board of Directors. Kennard will serve as a member of the audit committee as well as the compensation and human capital committee. She has served as president and CEO of KDG Development Construction Consulting since 2011. Griffin will serve as a member of the audit committee and the investment and finance committee. He has served as managing director of PHICAS Investors since 2016. Additionally, HCP announced the appointment of Brian Cartwright as the new chairman of the board. He served as general counsel of the U.S. Securities and Exchange Commission from 2006 to 2009 and has served on the public company board of Investment Technology Group since 2016.

Carlsbad, Calif.-based Integral Senior Living (ISL) has named LaTanya Jules as senior executive director and Vera Steinmetz as director of sales LATANYA JULES and marketing at The Shores at Clear Lake Senior Living in Houston, Texas. Jules has 16 years of experience in senior living and has been with ISL since 2006. SteinVERA STEINMETZ metz brings to ISL 15 years of experience in the industry. Additionally, ISL named Allison Rodman as director of sales and marketing at The Point at Rockridge located ALLISON RODMAN in Oakland, Calif. Rodman most recently served as the community living specialist and outreach consultant for Alameda Elder Communities.

Irving, Texas-based The LaSalle Group, promoted Schekesia Meadough to vice president of health and wellness. She joined LaSalle in 2015 as a reSCHEKESIA MEADOUGH gional director of healthcare. In her new role, Meadough will continue to expand clinical education and quality initiatives at the company’s network of Autumn Leaves communities and will oversee compliance with state regulatory bodies.

MatrixCare, based on Bloomington, Minn., was recognized for its interoperability in a report from KLAS Research. The company was lauded for its strength in receiving and sending data. MatrixCare also announced a partnership with Attendance on Demand, a time and labor management solutions provider, furthering the company’s commitment to interoperability.

Seattle, Wash.-based Merrill Gardens is marking its 25th anniversary this year. To commemorate the anniversary, the company created a special video celebrating the beauty of human connection and inspiring reflections

MAY/JUNE 2018 ARGENTUM.ORG 61

PEOPLE AND PLACES

on thankfulness and gratitude. The messaging, branded Yes You Can, is being incorporated into programming across Merrill Gardens communities.

OnShift, based in Cleveland, Ohio, announced 10 winners of its annual Scheduler of the Year Awards. The program, in its seventh year, recognizes schedulers who demonstrate excellence in their scheduling and labor management responsibilities utilizing OnShift Schedule. The company also announced the addition of Lisa Fordyce to its executive team as EVP of enterprise development for senior living. She began her career in senior living as a caregiver and expanded her role into operations leadership, holding several senior executive positions at national senior housing organizations. Most recently, she served as COO at Senior Lifestyle Corp.

Ventas, headquartered in Chicago, Ill., appointed Peter Bulgarelli as EVP of office and president and CEO of Lillibridge Healthcare Services (LHS). LHS manages Ventas’ medical office building and university-based life science portfolio.

Guardian Pharmacy Services hired Larry Schifer as national sales manager.

In this role, he will be responsible for increasing Guardian’s overall cusLARRY SCHIFER tomer base through sales initiatives, assisting in the evaluation and development of local sales teams, and developing materials to support regional and national sales projects. Most recently, he served as district business manager at Purdue Pharma L.P. Waltham, Mass.-based Massachusetts Assisted Living Association (Mass-ALA), an Argentum state partner, announced the selection of Brian Doherty as president and CEO effective July 9, 2018. Doherty has spent the last five years leading two local Massachusetts associations within the health care and real estate space. He has also served as the chief executive of the Massachusetts Psychological Association and as CEO of the Northeast Association of Realtors.

62 SENIOR LIVING EXECUTIVE MAY/JUNE 2018

Balfour Senior Living, located in Louisville, Colo., hired Phill Barklow as the company’s first COO and Sara Thom as vice president of human resources. Barklow has over 20 years of experience in the senior living industry and served in leadership positions at communities across southern California.

Elder Care Alliance, headquartered in Alameda, Calif., named Dan Hadfield vice president of sales and marketing. He joined the company with DAN HADFIELD more than 20 years of experience in operations, management, and sales and marketing. Hadfield will oversee the company’s five communities in California located in San Mateo, San Francisco, Camarillo, Oakland, and San Rafael. Most recently, he served as a regional director of sales and marketing for Integral Senior Living. The company also appointed Eduardo Chavez as culinary director and executive chef at AlmaVia of San Francisco. He brings more than a decade of experience in restaurant service and large-scale catering to the company. Most recently, he served as the executive chef at Mira Vista Golf & Country Club.

Minnetonka, Minn.based Eldermark Software recently added Brad Fuqua as senior vice president of market development. His focus will be on BRAD FUQUA business development within Eldermark’s marketing division. Most recently, Fuqua served as vice president of SeniorHousingNet, part of the realtor. com network.

Heritage Senior Living, based in West Allis, Wis., hired Antonio Evans as regional director of hospitality and culinary. In this role, he will supervise ANTONIO EVANS Heritage’s hospitality offerings including culinary, lodging, entertainment/leisure, and wellness programs. Most recently, Evans worked as a restaurant head chef and general manager.

Burlington, Mass.-based Northbridge Companies appointed Maureen Gardner to executive director of Laurentide at Mashpee Commons in Mashpee, MAUREEN GARDNER Mass. She brings more than 25 years of experience in the senior living industry to Northbridge. Most recently, Gardner served as an executive director at Wingate Residences at Brewster Place.

Portland, Ore.-based Radiant Senior Living named Terri Stamsos director of operations for Baycrest Village in North Bend, Ore. Stamsos has spent TERRI STAMSOS the last 30 years working at Baycrest Village, starting in her junior year of high school working in dining services.

StudioSIX5, based in Austin, Texas, will celebrate its 15th anniversary this year. Part of their commemoration will include donating to Family Eldercare and participating in a donation drive for Meals on Wheels Central Texas PALS (Pets Assisting the Lives of Seniors) program.

The Waters Senior Living, located in Minneapolis, Minn., named Tami Kozikowski as COO. Most recently, she served as EVP and president of LifeSpa at LifeTime Fitness.

Watercrest Senior Living announced Jennifer Harris as executive director of Market Street Memory Care Residence in Palm Coast, Fla. Over the past JENNIFER HARRIS 20 years, Harris has served in independent, assisted living, and memory care communities.

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Visit argentum.org/membernews or email editor@argentum.org.

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Congratulations Ventas on your 20 year milestone as a premier capital provider in healthcare real estate.

Capital One Healthcare is pleased to celebrate this achievement, and to support our work with innovative companies like yours.

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