ENGAGE Spring 2024

LEADERSHIP:

NEEDED NOW,

A MESSAGE FROM OUR Board Chair

joe jedlowski , mba/mha President, Distinctive Living

Welcome to the Spring issue of the Florida Senior Living Association’s (FSLA) premiere publication, ENGAGE!

As Chairman of the Board of Directors for FSLA, I am thrilled to connect with you, the honorable members of this prestigious association, through the pages of this magazine.

You will find this edition delves into many topics related to, and about, the theme of Leadership. It is important to always remind ourselves that in senior living, the theme of leadership is defined beyond the realm of managing budgets and staff. More importantly, Leadership is defined by building a team which empowers its’ employees and thus, facilitates a higher standard of quality of life for its’ residents. Not only does this contribute to long-term financial benefits (higher occupancy rates, facility reputation) but also contributes to residents receiving the adequate care they deserve. Without proper community leadership in place, it is unrealistic to assume that the senior living industry will be able to rise to future challenges without learning to develop and grow its leaders.

By investing in leadership development programs, continuing education, initiatives for mentorship, and team building, it is imperative to know that this will only result in a return for your own community and a fulfilled mission of enhancing well-being for residents.

Now, more than ever, it is essential that we continue to invest in staffing and training for the future of senior living.

Florida Senior Living Association offers a Leadership development program, as well as regular live and ondemand continuing education courses.

SPRING 2024

Gail Matillo, MPA

President & CEO

Jason Hand, Esq.

VP Public Policy and Legal Affairs

Kristin Quirk, MS

Membership & Partnership Director

Katherine Upton Education & Engagement Director

Executive Editor, ENGAGE Magazine

Meredith Van Valkenburgh, MSAFA, CGB, CPM Project Director

Jimmie Fay Griffin, LPN

Accounting & Membership Manager

FSLA EXECUTIVE BOARD OF DIRECTORS

Chair: Joe Jedlowski, MBA/MHA

President and CEO

Distinctive Living

Immediate Past Chair and Vice Chair: Shelley Esden

President and CEO

Lexor Senior Living

Past Chair: Melinda Skirvin

Vice President

Five Star Senior Living

Past Chair Emeritus: Mary Sue Patchett

Secretary: Page Ensor

Regional VP of Operations

Brookdale Senior Living

Treasurer: Lindsey Hacker

Parliamentarian: Robin Khanal, Esq.

Partner

Quintarios, Prieto, Wood & Boyer, P.A.

Industry Partner Committee Chair: Matt Depenbrock

Director of Business Development Guardian Pharmacy

Education Committee Chair: Marisa Strain Chief Clinical Officer

SRI Management

FSLI Chair: Gwen Thibault

Divisional VP of Operations

Legend Senior Living

Membership Committee Chairs:

Damon Thomas

Heidi Kuchenbacker

Legislative & Regulatory Committee Chairs:

Joe Signore

Tara Clayton

Editorial and Business Offices 2292 Wednesday St. Suite 1, Tallahassee, FL 32308 850-496-2562 | floridaseniorliving.org

Publisher: Gail Matillo gmatillo@floridaseniorliving.org

Executive Editor: Katherine Upton kupton@floridaseniorliving.org

Creative Director: Katie Truelove ktcreative@me.com

Advertising & Editorial Submissions engage@floridaseniorliving.org

ENGAGE is published quarterly by Florida Senior Living Association, 2292 Wednesday Street, Suite 1, Tallahassee, Florida, 32308. Florida Senior Living member companies receive subscriptions for communities as part of their membership. Free controlled subscriptions are also available to qualified individuals in the senior living business.

POSTMASTER, SEND ADDRESS CHANGES TO:

ENGAGE, 2292 Wednesday Street, Suite 1, Tallahassee, Florida, 32308. Printed in USA. Copyright 2022. ENGAGE will not be responsible for the return of any unsolicited manuscripts or photographs.

Copyright © 2024 Florida Senior Living Association. All rights reserved. No part of this publication may be reproduced or transmitted in any form – print, electronic, or otherwise – without written permission from Florida Senior Living Association. For media inquiries and advertising information, contact engage@floridaseniorliving.org.

Featured on the cover: 2024 FSLA Leadership Academy students (pictured on stairs), Facilitator

Velma Knowles, and Mentors Mary Sue Patchett and Heidi Kuchenbacker (pictured in front), at the second Academy meeting in March.

Photo Credit: Katie Truelove, ktcreative

AND WELLNESS

LEGISLATIVE POLICY & LEGAL AFFAIRS

OPERATIONS & REGULATORY

HUMAN RESOURCE INSIGHTS

cares

for your business

hr challenges

EDUCATION & EVENTS

MEMBERSHIP

the way: elevate senior living at clearwater

a new benchmark for excellence

member highlights

PAST FUTURE Know your to plan your

by gail matillo

AN INTERVIEW WITH KEREN BROWN WILSON, PH.D., FOUNDER AND CEO, AGE+ AND THE JESSIE F. RICHARDSON FOUNDATION

Have you ever wondered why assisted living is such a popular option for seniors who want to remain as independent as possible while enjoying the autonomy, dignity, choice, freedom, and camaraderie that comes with community living? For this article, we wanted to take a deep dive into where we’ve been to know where we’re going and what the future holds for it. Times are changing, assisted living is changing, and we all know the next 25 years will be a great baby boomer explosion of the 65+ population.

A HISTORICAL OVERVIEW

“Well, why aren’t you doing something to help people like me?”

This powerful question from Dr. Keren Brown Wilson’s mother, Jessie Richardson, turned out to be a defining moment for Dr. Wilson, who would eventually establish the assisted living model of long-term care in this country – and the world.

Dr. Wilson was a graduate student in gerontology when she heard her mother’s words of frustration, and Richardson was then a 65-year-old woman who had survived a stroke and was living in a nursing home.

“In the early days, nursing homes were stripped-down hospitals and people were in a ward. They were told when to go to bed. They were told when to get up. They were told what to eat,” explained Dr. Wilson. “My mother was unable to bathe herself, cut up her food or take her medication, but her focus was on having her own place so she could have a life.”

Since that question posed by her mother, Dr. Wilson has spent her entire professional career working with frail, low-income elders. She also founded the Jessie F. Richardson Foundation to focus on improving conditions for vulnerable older adults in developing areas and the communities in which they live.

gail matillo , mpa President/CEO Florida Senior Living Association

one could make her get up, turn off her favorite soaps or ruin her clothes. She could be Jessie again, a person living in an apartment instead of a patient in a bed.”

Authorities believed elderly residents would be unsafe if they had more control of their lives. But Wilson and her husband, gerontologist Michael DeShane, believed they could create a safe place for elders to live a life worth living with choice and independence.

“No one really believed we could give nursing care in a non-nursing setting,” remembers Wilson. “No one believed people would be safe. People were convinced we would kill residents.”

BIRTH OF A PARADIGM SHIFT EVOLUTION OF MODELS

ARGENTUM CREATED, FIRST EXECUTIVE DIRECTOR, CAROL FRASER FISK

GROWING PAINS: FROM MODEL TO INDUSTRY

After becoming a professor of gerontology at Portland State University, Dr. Wilson wanted to provide health care services to the elderly in low-income housing, allowing those seniors to remain at home. But the state of Oregon wouldn’t help pay for the services, and at that time, the only services Medicaid would cover were those provided in traditional nursing homes. This had the effect of medicalizing old age in the United States.

“In the nursing home, residents were told what they could and couldn’t do. They had no autonomy, which was very dehumanizing,” said Dr. Wilson. “My mother was poor – a Medicaid client – and there were not many choices for her. But she had a simple vision: a small place with a little kitchen, a bathroom, and a place for her favorite things. No

The couple borrowed several million dollars to build a facility, and against the odds, Wilson’s vision of assisted living was born. Not only did that early facility serve lower income people for a flat rate, but the pilot study also showed residents had better health outcomes than those who lived in nursing homes.

ASSISTED LIVING WORKGROUP REPORTS TO CONGRESS A CRISIS OF CONFIDENCE

This new model of care for the elderly earned significant national media coverage and Wilson was soon approached by Wall Street investors to take the idea public. For the next few years, she oversaw the building of hundreds of assisted living facilities across the US, with 3,000 employees in 18 states. Her original idea is now the model for assisted living worldwide.

About the same time (1981) Paul and Terry Klaassen were dissatisfied with the American options for senior care and were searching for an alternative to the sterile, hospitallike environment of a nursing home. They founded Sunrise Senior Living to pioneer a new residentcentered model of elder care based on an assisted living model in the Netherlands where Paul Klaassen’s grandmother lived. Their community opened in Virginia and was based on a simple but innovative vision: to create alternative living options for seniors that emphasize quality of life and envisioned a loving, warm community filled with compassionate caregivers and happy residents.

THE EVOLUTION OF ASSISTED LIVING

For nearly 30 years, assisted living has grown to serve more than 1.2 million older adults. Half of assisted living residents are at least 85 years old, and about 70 percent of assisted living residents are female while the remaining 30 percent are male.

INTERVIEW WITH OREGON TRAILBLAZER "ALFS HAVE MORE OPTIONS FOR CARE AND SERVICES"

Dr. Keren Brown Wilson, generally reported as the founder of today’s assisted living communities, recently spoke with FSLA staff about her philosophy. She created the ALF model because she wanted to create a new way for seniors to remain independent and respected while also being able to receive the level of care they required.

Her first ALF community, Park Place in Portland, OR, opened in 1981 and is considered the first modern assisted living facility. It offered residents private rooms with doors that locked, 24-hour staffing for medical emergencies and community areas for social interaction.

Dr. Wilson believes it takes three important elements to build a successful community – environment, service, and philosophy. Her approach was driven by an early sociologist

"THE BEST SENIOR LIVING HAS YET TO BE INVENTED"

- PAUL KLAASEN, SUNRISE FOUNDER

who studied the competence environmental press theory, a model that explains how the interaction between an individual’s level of competence and the demands of their environment can affect residents’ behavior, well-being and overall health. The theory suggests that when the level of environmental demand exceeds an individual’s level of competence, they may experience stress, anxiety and difficulty adapting to their surroundings. On the other hand, when the level of demand in the environment matches an individual’s level of competence, they may experience a sense of accomplishment and fulfillment.

According to Dr. Wilson, if ALFs create an environment that supports people’s ability to function, they will thrive in that environment. For example, when pets are allowed in a facility, this environmental change will increase a resident’s functionality because they will have to care for the pet.

The same is true for the overall philosophy of assisted living: when a resident has greater control of their space, including which services are received, when and how, the resident is more motivated to use their space with greater functionality. The environment is premised on being the most supportive and adaptable for the highest level of function at the highest level, in contrast to the more medically oriented model where the resident is a patient, being cared for according to an institutional schedule.

“In the future, residents will want more freedom to organize their services differently and demand more choices,” said Dr. Wilson. “I used to hear people say they’d rather be dead than living in a nursing home, and that feeling of dread means we must do a better job with education and a demonstration of normalcy.”

There is still confusion today about the differences between nursing homes and assisted living because originally, nursing home providers

were the only options. They would take a wing of the facility and call it assisted living. In some cases, nursing home providers would also create independent living, home care, hospice, and pharmacies. This structure allowed them more control over the market area and allowed them to avoid talking about how most states didn’t allow any model considered to be assisted living.

“The difference between nursing homes and assisted living, to me, is clear: assisted living must have space shared only by choice,” explained Dr. Brown. “It must have variable service delivery and it must have a philosophy that is resident centered –resident choice – resident control.”

The concept of managed risk or negotiated risk in assisted living was designed to allow people to participate in decisions about how much risk they wanted in their daily lives. However, this concept isn’t widely accepted by the industry, regulators, and the public at large.

Robert Applebaum, a professor at Scripps Gerontology Center at the University of Miami, succinctly explained that what people want for themselves is autonomy, but what they want for those they love is safety.

This safety-based motivation is a significant influence over the people who are charged with making sure residents are safe, and the industry doesn’t accept much ambiguity about

what’s okay and what’s not okay, even when the person is fully cognizant. This struggle will likely continue to be present at some level in the longterm care industry for the foreseeable future.

Another challenge facing the industry in the next decade is transition. There are very few options for seniors between the ages of 50 and 80 who may need assistance but aren’t quite ready to move into a facility. While more technology may be an answer, a proactive transition earlier in life may also be preferable, rather than waiting for a person’s health to decline and their circumstances to dictate the decision.

Dr. Wilson suggested another option might be for states to invest in assisted living, using state bonds with returns to attract investors instead of a Medicaid model.

This would potentially create new models of care that recognize many people will not qualify for Medicaid but are not able to cover services and care out of pocket. Something between these two settings will likely attract boomers, and collaboration with regulators and advocacy for residents is key to further progress.

“I never want to fully retire. I plan to cut back somewhat, but I plan to work as long as I can,” said Dr. Wilson. “In the end, I’d like to be remembered as someone who cared about those who had less than they needed to live comfortably."

“I believe much is expected of those to whom much is given,” she continued.

“We always are able to do more than we think we can. And I just want to do as much as I can.”

Forbes, https://www.forbes.com/health/senior-living/assisted-living-statistics/; Historical Evolution of Assisted Living in the United States, 1979 to the Present | The Gerontologist | Oxford Academic (oup.com); https://doi.org/10.1093/geront/47.Supplement_1.8; Keren Brown Wilson, Historical Evolution of Assisted Living in the United States, 1979 to the Present, The Gerontologist, Volume 47, Issue suppl_1, December 2007, Pages 8–22, https://doi.org/10.1093/geront/47.Supplement_1.8; www.sunriseseniorliving.com

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ASSISTED LIVING COMMUNITY

by julie ann kemman , cpco

AHCA dictates the basic Medicaid benefits each State Medicaid Managed Care (SMMC) Medicaid Medical Assistance (MMA) and Long-Term Care (LTC) plans must include in their coverage based on each type of Medicaid provider. The required benefits for Assisted Living include but are not limited to assistive care services, personal care services, medication administration, and transportation. At the same time, Statewide Medicaid Managed Care plans can offer additional benefits that are outlined by each plan and often differ. This may include the ALF community transfer reimbursement fee. This additional reimbursement is for the ALF move-in or transfer fee that is labeled as unique and additional benefits. The amount varies by plan and is typically advertised in their brochure. It is important to become familiar with the amount and criteria to be met for the Medicaid plans your community is contracted with.

Some of the SMMC plans require a qualified resident to be labeled as a transitional community resident. This means that the

resident is transferring for the first time into an Assisted Living Facility. It is also customary that residents reside in SNF for 60 consecutive days and 1 custodial day (non-skilled level of care) to qualify. The plans also outline that the resident must reside in the ALF community for a designated period to receive the additional reimbursement or transfer fee payment.

The amount to be reimbursed by the SMMC plan may vary based on the availability or difficulty of the ALF placement of the resident for example. The reimbursement for the transfer fee may be paid

julie ann kemman , cpco President, Health Care Professional Consulting Services, Inc.

over a specific period and usually, a future date based on criteria. In addition, the payment may go to the responsible party instead of being assigned to the ALF community.

Before admission, the ALF needs to coordinate with the Medicaid Managed Care plan and have the confirmation as well as requirements in writing which outline when payment will be expected, and who payment will be assigned to. The SMMC plan coordinator may assist in understanding all criteria. Because the transfer is labeled as an additional benefit, each Medicaid plan has different criteria to understand and guidelines to follow. It is recommended to know the terms of your SMMC plan contract and refer to their provider manual for specific details as well as communicating with the care coordinator in advance.

LEADING THE WAY:

by katherine upton

The National Council on Aging recently found that 80%, or 47 million, adults aged 60 and older lack the financial resources to cover four years in an ALF community. Additionally, 60% of adults aged 60 and older do not have the funds to pay for in-home long-term care. This highlights the necessity and promise of the newly opened Elevate Senior Living Community. Elevate offers a truly unique and innovative Independent Living, Assisted Living, and Memory Care lifestyle option to middle-income seniors.

Elevate celebrated its 55,000-square-foot Clearwater

katherine upton Director of Education & Engagement, Executive Editor of ENGAGE Florida Senior Living Association

location during a groundbreaking opening on Thursday, January 13, attracting a crowd of about 1,000 Pinellas County residents to the celebration. In an equally memorable event, the Elevate hosted Session Two of the 2024 FSLA Leadership Academy and provided the Academy students with a community tour that displayed thoughtful design in every inch of the community.

The community campus consisted of six “neighborhoods”, each housing eight Independent Living Suites and 16 Assisted Living and Memory Care suites, as well as its own unique and intentional

kitchen and meeting spaces to encourage movement and socialization between households. From a thoughtful figure-eight design of the walkways in the outdoor space to support its’ memory care residents, to a first-of-its-kind oxygen bath available to all, the Elevate has truly set a new standard. Elevate at Clearwater Executive Director, Charlie Dierke, spoke of the community’s mission, naming it, “a low-cost project in a high-cost town”. Prioritizing affordability and fostering social engagement, Elevate Senior Living is redefining what senior living can be- a vibrant lifestyle without the high price tag.

https://www.mcknightsseniorliving.com/home/news/up-to-80-percent-of-older-adults-unable-to-afford-4-years-of-assisted-living-study/;

https://nypost.com/2023/04/27/most-senior-citizens-in-america-cant-afford-nursing-homes/

Effective Advocacy

Why Contribute to FSLA’s PC

by jason hand jason hand VP of Public Policy & Legal Affairs Florida Senior Living Association

After the senior living industry was caught off-guard by the Miami Herald’s “Neglected to Death” Pulitzer Prize-winning series, which spawned subsequent policy recommendations from the Governor and Legislature, FSLA was created with the marching orders to effectively advocate before the legislature. FSLA quickly became a well-regarded advocacy association with a long string of impressive legislative victories.

As a member of FSLA, you can expect us to continually advocate on your behalf, supporting and protecting the profession, and continuously working to achieve positive changes in the industry.

One of the ways we do that is via campaign and political contributions.

Our Political Committee, Florida Senior Living PC, is an essential tool to:

• Educate legislators and other key leaders about the benefits and issues facing Florida’s senior living industry.

• Build and strengthen relationships with candidates and elected officials who help advance FSLA’s advocacy agenda.

If you want Florida’s assisted living industry to be an effective advocate in Tallahassee,

contributions to the Florida Senior Living PC must be one of the first things on your mind.

Florida’s senior living industry is faced with ever-increasing issues in the coming years. It is critical that our membership and other stakeholders not only continue to provide political contributions to the Florida Senior Living PC – but also increase that support to ensure continued effective advocacy!

FSLA cannot be an effective advocacy association without your continued financial support. Every contribution is an investment in your career, your association, and the future success of our industry.

OUR INDUSTRY WINS WHEN WE WORK TOGETHER

We work hard for Providers, Staff and Residents! With your support and membership, together we can continue making an impact!

LEGISLATIVE AND REGULATORY

by sandi poreda

As leaders, we spend an inordinate amount of time communicating with the people around us, particularly with the people we supervise. And while some leaders are excellent communicators, many others leave much to be desired. And it’s not exactly an option to forgo communication if it’s not one of your strong suits.

If you’re not sure whether you’re an effective communicator with the people you lead, ask your reports whether they remember any recent important messages you conveyed. Ask them to summarize something you spoke about to determine whether what you’re saying and what they’re hearing are consistent. If they can’t recall or didn’t hear what you needed them to take away, your communication skills need improvement.

Unfortunately, there’s no silver bullet to becoming a better communicator. There are several strategies, factors, and challenges to evaluate in each specific situation. However, there are a few things just about every leader can implement to make significant improvements fairly quickly.

Be efficient. This is just another way to say don’t talk too much. Just like many meetings could have been emails, many long conversations could be significantly shorter. Everyone is busy, and everyone has too many demands on their time. When

someone takes up too much time communicating something because they can’t be bothered to be brief, this tells the recipient of the message that their time isn’t perceived as valuable.

Try organizing your message into main points in the order of priority and organizing support for each point. This will help you stay focused when providing the information, reducing, or eliminating the need to ramble, lose your place, or talk in circles while trying to bring a point home. Implementing this tactic will also help you solidify the support for your message so you can make a stronger case.

In other words, say less. Be respectful. Be brief.

Be effective.

There’s a difference between talking to someone and talking at them. People will remember more of a conversation they actually participated in rather than a lecture they merely received. Ask yourself the following questions as you prepare a message for your team members:

1. Is this the right time? Catch people at the beginning of their day or their shift. You don’t want to be the person keeping them from their break or from clocking out.

2. Is this the right place? Communicate in a setting with

as few distractions as possible. And have conversations that should be private in a setting where they can’t be overheard.

3. Is this the right method? Think about what motivates your team to buy into an idea and frame your conversation with this in mind. Conversely, think about what will almost certainly cause them to tune you out and avoid that at all costs.

Be quiet.

A frequent complaint from employees is that they don’t feel heard. Communication often comes from the top down, and if supervisors and bosses would take some time to listen, they would gather valuable information.

It’s also not enough to ask for feedback and then listen simply to refute or move on. Active listening asks us to really listen for content, context, and intent. Taking the time to stop talking and start actively listening to the people you lead will not only improve the understanding you have with your team, but it will also help them feel more respected.

Communicating can be tricky, but it's not impossible. With consistent practice of the principles above, your communication with your team members will undoubtedly improve and your leadership position will only strengthen.

sandi poreda , apr Bulldog Strategy Group, FSLA PR Conultant

by jimmie fay griffin , lpn

Many of our assisted living and memory care residents do not have local family and/or friends to visit them. Instead, many residents only have the staff at the communities as a support network while living in assisted living. The staff’s faces are the ones that they know. Take a moment to imagine being a memory-deficient person who has been moved out of their home. Living in unfamiliar surroundings, being cared for by strangerssuddenly life is full of new, unknown people, and then they are again in the same situation at a hospital.

While I am confident that this is being done by member communities, let me still remind you that as a community leader, we should be checking on residents while they are hospitalized. I have seen comments noted in these situations, such as “attempted to reach daughter- had to leave a message.”

Please, take the time to talk with someone no matter the number of calls that need to be made. Stop by the hospital, visit the resident, and check in with the staff. When you take this time to communicate, you are showing your true concern for that individual. Don’t let a busy schedule cause a negative perception. I recall once during my time as an Executive Director, following a resident who was transported via ambulance to the emergency room because her family was 8 hours away. The E.R. doctor said, “Well, this is a first!”

When I asked what he meant, he simply said that he had never had a staff member, especially the director, go with their resident to the hospital. I didn’t feel I did anything special; I simply knew that my resident couldn’t communicate well and needed someone to help verify clear communication with the doctors. She had delayed responses to questions. When I walked into her room, the hospital

jimmie fay griffin , lpn Clinical Advisor, Accounting & Membership Manager Florida Senior Living Association

staff had already decided she had dementia and were managing her based on that. When I intervened, asking them to repeat their questions and give her a moment to answer, they were dramatically surprised by the difference in response.

A truly caring leader will also be certain to show their staff compassion and concern as well. In employee culture, the staff’s behavior is often a mirror of how they feel they are being treated. It is important to show that you care about them as well; Give them praise when earned; When a situation requires critiquing be sure the criticism is constructive, in a manner that encourages learning rather than a shutdown in communication. Remember, that criticism can come across as finger-pointing rather than help with positive personal growth. Proving you can lead is really only accomplished by truly caring.

What is the difference between a power of attorney and a guardian?

Both a guardian and a power of attorney are involved in situations where someone needs help making decisions. However, they differ in who gets to choose the decisionmaker and when that power comes into effect.

Power of Attorney (POA): An individual chooses a trusted person to act on their behalf for financial matters, healthcare choices, or both. This is set up in advance, through a legal document. As long as one is mentally competent, they can still make their own decisions, even with a POA in place.

monica wilson , ms ICEBridge, LLC

Have a question about assisted living operations? Ask Monica: Monica@icebridgetraining.com

Monica Wilson is registered with the Florida Agency for Health Care Administration (AHCA) as an Assisted Living Core training provider and with the Florida Department of Elder Affairs as an Alzheimer’s disease and related disorders training provider. She is an experienced administrator, trainer, facilitator, and educator with a passion for older adults, technology and connecting people and processes.

Guardian: A court appoints a guardian to make decisions for someone who has been deemed incapacitated (unable to make their own choices.) The guardian can be granted authority over finances, healthcare, or personal care. The court decides who is best suited for the role of guardian, considering factors like the incapacitated person’s wishes (if known) and the potential guardian’s qualifications.

In assisted living, does a nurse need an order to assist with over-thecounter medications?

Yes. The rule is clear about this. The rule also states that unlicensed staff trained to assist with the self-administration of medication

do not need an order to assist with over-the-counter medications.

However, as a best practice, it is recommended that if unlicensed staff are assisting with the selfadministration of medications, they obtain orders to do so.

EMPOWERING LEADERS:

YOUR POTENTIAL WITH THE CAREER CONFIDENCE BLUEPRINT

by jill j . johnson , mba

For leaders, confidence is an essential trait that will allow you to fully unlock your potential and impact. Yet confidence can be an elusive trait. Doubt, low self-esteem, and the inability to deal with setbacks undermine confidence. Most people believe you are born with confidence –either you have it or you don’t. This self-limiting belief holds many people back from ever reaching their true potential.

Unleashing Your Potential Confidence is the fuel leaders need to leverage their talents, seek out new challenges, and make a lasting

impact. It is also the gap between your biggest career dreams and actually achieving them. While you must take personal responsibility for building your confidence and your career.

As an award-winning mentor, I designed the Career Confidence Blueprint Course to equip leaders just like you with proven strategies to systematically build your confidence through deliberate focus and practice. You no longer have to white-knuckle it alone. I will be your personal mentor.

Transform Your Leadership Confidence

You won’t need to fake it until you make it. Through this step-by-step process, you will gain the clarity and self-awareness you need to understand exactly where you are on your leadership journey and how to elevate from there. I pull the curtain back to be your mentor guiding you to create your own confidence plan. I’ve seen firsthand the impact that implementing this approach to career planning has on creating breakthrough results.

This powerful online course provides you with a comprehensive roadmap using short videos, critical questions for reflection, and tons of bonus material. This insight will help you build unshakable confidence as you reach for progressively higher rungs of success.

• Foundations of Confidence – Discover the three pillars essential for nurturing lasting confidence and maximizing your leadership capabilities.

• The Power of Practice – Gain insights into how to use deliberate practice to gain mastery of your leadership skills.

jill j . johnson , mba President and Founder Johnson Consulting Services

Jill J. Johnson, MBA, President and Founder of Johnson Consulting Services, is a management consultant, accomplished speaker, award-winning author, and two-time Business Hall of Fame inductee. She helps senior living clients make critical business decisions and develop plans for turnarounds or growth. Jill’s consulting work has impacted over $4 billion worth of decisions. She has a proven track record of dealing with complex business issues and getting results. For more information, visit www.jcs-usa.com.

• Tailor Your Confidence Plan –Think through critical questions to develop a career that aligns with your values and goals.

• Use Confidence Boosters –Learn about the invaluable role of mentors and coaches. Master more effective communication strategies to turbocharge your confidence.

• Take Action – Decide what you want to achieve in your leadership journey and then follow through to implement it.

With the Career Confidence Blueprint Course, you’ll learn how small, consistent efforts can have a compounding effect in transforming your mindset over time:

Achieve Your Career Vision with Unshakable Confidence

Ultimately, expanding your confidence allows you to have vastly more impact than you ever thought possible - whether driving initiatives, inspiring teams, or influencing stakeholders. You’ll discover a clear path to make your desired future a reality.

The Career Confidence Blueprint is designed for busy leaders like yourself. The course breaks down the robust curriculum into bitesized chunks that you can easily fit into your schedule. This allows you to thoroughly anchor these confidence-building lessons at your own pace alongside all of your other priorities.

Your daily choices build the

“This course is amazing! So professional, and just the right time per module! I love the handout materials.”

- Gail Matillo, President and CEO, Florida Senior Living Association

POWERED BY

foundation for your confidence journey. Maintaining momentum requires trusting your abilities through inevitable setbacks. No one can predict the future, but if you own it, act on it purposefully, and apply these proven strategies, you will continue to elevate your confidence and leadership skills.

Final Thoughts

Take control today by visiting the QR code below and unlock the Career Confidence Blueprint to get a 10% discount! Don’t hold yourself back any longer. Imagine having the tools to bolster your self-assurance, to harness your skills and talents for impactful leadership. The Career Confidence Blueprint isn’t just a course; it’s a pathway to unlocking your potential and achieving the success you deserve.

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RSVP ON OUR WEBSITE FOR FUTURE EVENTS: FLORIDASENIORLIVING.ORG

WHAT IS AID AND ATTENDANCE?

Aid and Attendance is a VA pension program designed to help supplement the cost of long-term care for Veterans and their spouses that meet specific VA requirements. This pension can be used to offset the cost of long-term care and make senior care more affordable than ever!

WHO ARE PATRIOT ANGELS?

Our team of advocates are devoted to helping Veterans and their Surviving Spouses. We have developed a process that cuts through the VA’s red tape in order to help Veterans and their loved ones receive the VA’s Aid and Attendance benefit. Under the supervision of a VA accredited attorney, our Veterans are provided with quality guidance throughout the application process.

MONTHLY BENEFIT AMOUNTS

SINGLE VETERAN ............................................................... $2,300.00

MARRIED VETERAN ............................................................ $2,727.00

SURVIVING SPOUSE ........................................................... $1,478.00

VETERAN MARRIED TO VETERAN ............................... $3,649.00

EXCELLENCE

by kristin quirk

On March 7, 2024, FSLA’s team - Gail Matillo, President and CEO; Kristin Quirk, Director of Membership & Partners; and Jimmie Fay Griffin, Accounting & Membership Manager attended the grand opening of Providence Living at Pembroke Pines in support of FSLA’s Board Members, Damon Thomas and Michelle Pierce.

The event was very well attended, and it was clear this was a momentous occasion for the Providence Senior Living team. Undoubtedly, tremendous dedication, detail, and hard work will ensure the success of this beautiful community. The FSLA team can’t wait to watch them thrive. This success was led by CEO Tom Green and COO Michelle Pierce, whose leadership, dedication, and unwavering commitment to excellence have set the standard for Providence Senior Living and the senior living industry.

In his opening speech, Damon pointed out how Michelle’s expertise and passion have

reshaped industry standards, setting a new benchmark for excellence. Her visionary approach has not only elevated the community but is also an inspiration to strive for greater heights. Whether it was a beautiful painting or a unique piece of art, Michelle’s special touch was felt throughout the community and brought a truly unparalleled uniqueness. She was never alone in such great efforts though as she worked closely with CEO Tom Green who not only steered the company through challenges but also nurtured a culture of innovation, collaboration, and excellence.

Providence Living expressed their excitement about the positive impact that this new community will have on the local broader community. This vibrant community will allow for the residents and families to thrive. Providence Living at Pembroke Pines will be more than just a place to live; it will serve as a cornerstone of support and vital services for its residents and families.

In Damon’s speech, he stated, “Our top priority will always be our residents, they are the heartbeat of our community.” This statement resonates with FSLA’s team because everything we do is to beneficially impact the residents and ensure that they can live their lives safely and beautifully. Providence Living is deeply committed to ensuring that every resident feels valued, respected, and empowered, and will provide them with an unparalleled level of support and attention.

FSLA is so excited to support Providence Living at Pembroke Pines in its efforts to support and empower its staff, residents, and families. Our team enjoyed the delicious food, prepared by FSLA 2023 Industry Partner of the Year, Aaron Fish, Founder, Trestle Hospitality Concepts, the amazing company of new and familiar faces, and the jaw-dropping entertainment throughout. It was truly a phenomenal event!

kristin quirk , ms Director of Membership & Partnership Florida Senior Living Association

STRATEGIC LEADERSHIP

by kelly m . smith

Strategic leaders are intentional and purposeful and possess key characteristics that enable them to effectively envision, shape, and execute strategies that align an organization with its long-term goals and objectives. While some individuals may naturally possess such qualities, many aspects of what it takes to lead strategically can be acquired through a combination of educational and professional development training as well as coaching and mentoring.

Strategic leadership begins with a visionary outlook that extends beyond immediate challenges and includes the ability to link longterm goals to the organization’s mission, vision, and values. Additionally, strategic leaders must have the ability to proactively plan for the future while remaining adaptable to change. Leaders must anticipate and balance shifts in operational needs, the market, and customer expectations and make

kelly m . smith , phd , clssbb , cphq Q3 Healthcare Consulting, LLC

key decisions based upon input from others. Therefore, strategic leaders should be proficient in building strong, cohesive teams which are essential to promote a positive culture, improve productivity, and inspire creativity and innovation. As a result, team members are more satisfied, engaged, and less likely to turnover.

In order to develop strategic leaders within an organization, competencies must be defined to meet the organization’s needs. Examples may include skills such as critical thinking, decision-making, effective communication, adaptability, and a global mindset. Next, an assessment of the organization’s current leadership should be conducted to evaluate existing strengths as well as opportunities for improvement. Findings from the evaluation can then be used to tailor development programs to address specific improvement

needs. A comprehensive leadership development plan should be crafted outlining the specific steps and initiatives to meet the desired competencies through formal training programs or workshops focused on strategic leadership skills.

While regulatory complexities and rising costs are beyond the control of operators, workforce challenges can be overcome by investing in talent development and succession planning. By fostering a culture of continuous learning, providing leadership training, and identifying high-potential individuals, we can ensure a pipeline of skilled professionals ready to take on key roles in our organization.

If you are interested in fostering strategic leaders, the Q3 Strategic Leadership Collaborative can help. By aligning Q3 Healthcare Consulting’s unwavering commitment to quality, rooted in the Malcolm Baldridge Framework for Performance Excellence and the Tresane Model, we deliver a revolutionary program that produces leaders inspired to create an environment for success. Through a combination of educational training and coaching, our collaboration is designed to foster cohesive team building beginning from the top down to promote performance excellence. For more information, please contact us at info@q3hc.com.

LEADERSHIP ACADEMY 2024

The senior living industry is experiencing unprecedented transformation and growth. As the aging population grows, the demand for high-quality resident-centered care has never been greater. To meet this challenge, we need a new generation of leaders: individuals equipped with the vision, skills, and ambition to navigate this evolving landscape. This is why Florida Senior Living Association developed the FSLA Leadership Academy in 2023. This program was designed for staff employed in member communities and is based on the targeted growth of individual leaders with the conviction and belief that communities will also benefit from comprehensive leadership training.

The FSLA Leadership Academy employs a variety of learning methods and tools, combining selfawareness, other awareness, and the application of principles of leadership and observable benefits to the organization in which the leader leads. Leading the 2024 Leadership Academy is Facilitator Velma Knowles, Certified Leadership Coach, best-selling author, and host of her own video/podcast show, “Your

Leadership Chat”. Velma believes that everyone can be a valuable leader and empowers leaders to use their presence and strengths to communicate and lead with purpose. The 2024 Academy curriculum is accompanied by Velma’s best-selling book, “The Valuable Leader: Seven Steps to Greater Growth, Value, and Influence”.

In addition to being a motivating and charismatic Facilitator who is an outstanding Leader herself, the FSLA Academy students are also guided by three group mentors: FSLA Board Members Mary Sue Patchett, Gwen Thibault, and Heidi Kuchenbacker. All as seasoned leaders in the senior living industry, the Academy mentors share their stories in senior living and work alongside the students providing virtual mentorship calls and guidance. This ensures the students' success up to the final session where the students present a leadership project completed within their community. Finally, the students will walk across the stage at the annual FSLA Conference to graduate.

Kylee Hanson, Executive Director of the HarborChase at Stuart, and a

katherine upton Director of Education & Engagement, Executive Editor of ENGAGE Florida Senior Living Association

graduate of the Inaugural Leadership Academy, stated “Working with veteran leaders in the industry gave me insight and a role model that has allowed me to make a big impact at my community and establish growth in my personal career”.

Wendy Smith, Executive Director of Brookdale Senior Living Stuart, Graduate of the Inaugural Leadership Academy stated, “The interaction with fellow professionals and mentors enabled me to gain additional knowledge, support, and ideas to continue to enhance not only my professional development but my personal goals as well. The monthly meetings with our assignments helped push the comfort zone one may have at times, however, that is a good aspect as I grew in areas I did not expect. The opportunity to go to the capital and lobby was priceless. Meeting and collaborating with support agencies and government officials is not always possible at the community level and this opportunity did not only provide that but also provided more learning on my behalf as well.”

At the most recent Leadership session in March, the new

Elevate at Clearwater community generously hosted the Academy as well as provided a guided tour of the innovative and first-ever purposefully designed senior living community option for middlemarket seniors. Students of the Academy, which includes Assistant Executive Directors, Business Office Managers, Sales Directors, Culinary Directors, and Resident Directors, seemed to take in every innovative element of this new community and were able to ask questions and receive in-depth explanations from the opening Leadership team of the Elevate at Clearwater- Charles Dierke, Executive Director, and Erika Boyd, Director of Sales & Marketing. FSLA is proud to Congratulate the Elevate at Clearwater Community and Leadership for a DeficiencyFree state survey, which is truly an accomplishment

Throughout the 6-month Leadership Academy, alongside developing a plan to improve a leadership issue within their community, students are in the pursuit of defining their own Legacy. At the January session, students began thinking about what they wanted their legacy to be, and at the March session, they presented a slide of only pictures to portray this and explained them to the group. few students' legacies are included here.

“In my 13 years of experience in the community of culinary and hospitality, I have learned from every role and from many leaders which has allowed me to understand the great responsibility that comes with being a leader. When you manage a team, you become in charge of shaping how your team works: how they think, and how they problem-solve. I believe that challenging my team will harness motivation and that doing so while being kind and genuine will teach resilience. Cultivating resilience is crucial as it brings confidence in adapting and adjusting when things get intense, which it does in the kitchen. Through this resilience will come the availability to bring creativity and innovation, which is the pillar of bringing that fun, curious side to any job you have. Being a leader and leaving a legacy is an honor and ultimately, I hope to shape whoever I work with to feel confident and joyful in what they do, every day.”

Stephanie Torres, Culinary Director

“At the age of 18 I graduated as a Certified Nursing Assistant, my nursing teacher Sharleen Scarafia gave me the opportunity to care for her mom. I cared for Darleen Nybozny for almost two years. Darleen was loving, gracious, funny, and truly inspiring with her positive outlook on life. Darleen was patient to teach me sign language and shared her love for the outdoors. We became a family. Caring for Darleen gave me a different understanding of senior living and dementia. My first goal was to attend nursing school, but I kept finding that Memory Care was where my heart was. I continued my education to become a Certified Dementia Practitioner and studied Healthcare Business Administration to continue caring for more seniors. Now as an Associate Executive Director I feel grateful to Darleen for allowing me to care for her and her daughter Sharleen for her endless mentorship in the healthcare field. My daily goal is to enrich the lives of those I serve through compassion and providing quality of life.

Daniella

Gonzalez- Aguilar, Associate Executive Director Brookdale Palm Beach Gardens, 2024 Leadership Academy Student

The Fairway at Naples, 2024 Leadership Academy Student

“I knew I wanted to work with the senior population in some capacity from a very young age. I have been serving our seniors since 2005. I started as a Resident Assistant, then became a Lead Med-Tech. I have been a Business Office Manager since 2017. One of my favorite memories is assisting a resident that loved gardening but was no longer able to because of dexterity limitations. He would often tell me about the vegetables and fruits that he and his wife would grow and how much he missed that. So, one year on “Earth Day” I bought some pepper plants and asked if he would like to go out to our courtyard and plant them. The joy on his face was everything to me! I assisted him and heard his stories as we planted. He was so happy when we were done. I believe I got more joy and fulfillment out of that day than he did. He diligently checked on his peppers everyday then came to my office and gave me updates.

My most important role is to make people feel safe, cared for, encouraged and nurtured. I strive to make a difference in the quality of life of those around me for the better. I truly love this field I’m in and believe the smallest difference makes the biggest impact!

Linda Cintron, Business Office Manager Brookdale Altamonte Springs,

LEADERSH IP ACADEMY

Whether you are an aspiring administrator, a seasoned caregiver, or someone seeking a fulfilling career shift, the FSLA Leadership Academy is the key to unlocking your full potential whilst shaping the future of senior care. The Fall 2024 Leadership Academy will kick off in September and nominations are accepted until July 15th, 2024!

Scan the QR code below for free access to Velma Knowles bestselling book, “The Valuable Leader: Seven Steps to Greater Growth, Value, and Influence”.

Now Accepting Applications for the Fall 2024 Senior Living Leadership Academy!

Nominations for the Fall class will be accepted until July 15 Class is limited to 20 participants

www.floridaseniorliving.org/leadershipfsla

FSLA is the premiere association exclusively representing assisted living, memory care, and independent living communities that provide the best choices, options, and quality care to thousands of seniors daily in Florida.

Each issue of ENGAGE goes out to our exclusive member and partnership list statewide!

Advertise with us!

floridaseniorliving.org/engage

2024 Leadership Academy Student

Is Leadership an Inside Job?

by velma knowles

“Give me six hours to chop down a tree and I will spend the first four sharpening the axe.” – Abraham Lincoln

You most likely know Abraham Lincoln as the former president of the United States. But what you might not know is, Lincoln was also well-known for his productivity. In fact, Lincoln was a skilled woodcutter before he became president and firmly believed that you should use the best tools to get the job done.

As a leader, you constantly juggle demanding priorities, busy schedules, and unforeseen challenges. Yet, sometimes, you can get so busy that you lose sight of what it takes to truly be productive.

So, let me ask you: Are you the kind of leader who takes the time to ‘sharpen your axe’?

Sharpening your axe can be a metaphor for training and development.

Let’s consider the story of the Woodcutter.

Now, if you are like me, you don’t know much about woodcutting. You most likely don’t go into the forest to cut down trees –and neither do I. But this is not the case with the heroes in our story, Jack, and Bill.

Here is the story in my own words.

Jack is a very talented woodcutter who went to work with Bill, the owner of a nearby Trees R Us Company. Jack could not wait to get to work because he loved woodcutting, and he was so thankful for the opportunity to work with a great leader like Bill.

On his first day at work, Jack chopped down 18 trees.

"Woo Hoo! Bill could not believe it. “Jack, you knocked it out of the park.

Way to go! Keep up the great work.” Jack was smiling from ear to ear. (You know how that feels when your leader is so pleased with you for doing a great job.)

On his second day, Jack tried harder than the day before. Unfortunately, he was only able to chop down 15 trees. Yikes!

By the third day, Jack only cut down 10 trees. Oh no!

Heartbroken and discouraged, with each day that passed, Jack chopped down fewer trees. He began to think it might be time for him to find another job. (Have you ever felt that way before?)

But Jack did not want to disappoint his leader. Yet the harder he tried the less productive he became. Jack was at a loss. “I don’t know what else to do. I must be losing my touch because I’m failing at this job.”

With sincerity in his voice, Jack decided to speak with his leader and apologize for his lack of productivity. “I’m so sorry Bill, I don’t understand why, as hard as I try, I can’t seem to chop down more trees like I did the first day on the job.”

Listening with great empathy, Bill asked Jack the question all leaders need to ask their employees: "When was the last time you sharpened your axe?" Jack thought for a moment and then he said what you as a leader might have said before to yourself: "Sharpen my axe? I don’t have time to sharpen my axe. I don’t have time to stop and get better tools or learn something new. I have to keep working. No time to slow down or stop, I’m already behind.”

Are you or your employees too busy to get better?

I tell you this story because all great leaders take the time to sharpen their axe. They take the time to

velma knowles Certified Leadership Coasch

constantly invest in the growth and development of their employees and themselves.

When was the last time you invested in the training and development of your employees? How about the last time you invested in your own training and development?

Leaders have a responsibility to grow and develop those that they lead. But leaders also have a greater responsibility to grow and develop themselves.

Imagine what would happen when you and your team members take the time to learn new skills in areas like communication, conflict resolution, and active listening.

Imagine achieving higher levels of employee retention, engagement, collaboration, and productivity.

All of these and more are possible for you.

So start today!

Invest in the training and growth of yourself and those you lead because as a great leader, you know this to be true: Leadership is an Inside Job.

ADVERSE INCIDENTS

by jimmie fay griffin , lpn

Q: Should I do an adverse incident report to AHCA?

A: FSLA received an inquiry this past month with regards to a resident who was ambulatory and fell entering the dining room. The resident was sent to the hospital due to complaining of hip and leg pain. Seventeen days later, he died in the hospital. An adverse incident report was not submitted initially and there was concern that this was an error on the director’s part. In accordance with 429.23(2) (a), this wouldn’t be considered adverse since the incident was not one over which the facility personnel could exercise control rather than because of the resident’s condition. Make certain you have a clear understanding of Chapter 429.23.

However, there are times when an incident cannot be determined immediately as to whether it

needs to be reported as an adverse incident report until a thorough investigation is done. That requires the 1-Day Report to be done “within 1 business day.” Then within 15 days, the final report must be submitted. Both reports require online reporting. Keep in mind that you can do the final report as soon as you have completed a thorough investigation. Remember that you are not claiming that the incident could have been avoided by submitting the 1-Day Report. It appears that many individuals do not fully understand this. But also, remember that if it is certain to not be an adverse incident, you are not required to submit the report.

However, be certain that there is clear and concise documentation on record in case there should be any further issues. Be able to show why an adverse incident was not done.

Also, realize that an incident could be considered adverse based on documentation on file in a resident’s file. If a resident has had a change in condition and requires increased observation (particularly at night) be cautious of how this is worded. For example, if you have on file that the resident is to be checked on every two hours then you must show that is what is done.

A better choice of language might be to say that the resident will be checked on three times during the night. Don’t say midnight, 2 a.m., and 4 a.m. There may at some point be an event preventing the staff from checking at that exact time. If the documentation says they will be checked on at 2:00 a.m. and then they fall at 2:00 a.m., this quickly becomes a situation that would be considered an incident that could have been controlled by staff being present.

jimmie fay griffin , lpn Clinical Advisor, Accounting & Membership Manager Florida Senior Living Association

WE TURN IDEAS INTO WORKS OF PEOPLE AND PURPOSE.

For clients who seek a service-oriented design partner, our purpose-driven culture has lived strong for more than 30 years, resulting in facilities and communities that serve more than 100,000 patients and residents each week.

Highlights Member

Sodalis Tallahassee

With FSLA’s office based in Tallahassee, I recently visited a local member community, the Sodalis of Tallahassee. At FSLA, I love going out to visit our members and the FSLA team is always looking for new ways in which we can support the residents of the community and staff. For this visit, I had the pleasure of meeting

Patriot Angels

FSLA’s Industry Partner, Patriot Angels, is celebrating 20,000 approvals for the Aid and Attendance Benefit. This milestone reflects their commitment to supporting our nation’s heroes and their surviving spouses in accessing affordable, quality care they deserve.

FSLA is extremely proud of Suzette Graham, CEO & Founder, and all

Aisha Thompkins, Sodalis’ Executive Director since August of 2023. She was so kind and excited to learn about FSLA and the ways we can support her. During this visit, she and the staff expressed their excitement about the community’s re-grand opening on March 28, 2024.

the Patriot Angels’ team for their unwavering dedication to serving veterans.

We are excited to continue supporting Patriot Angels as they continue to make a difference in the lives of Veterans, their widows, and their families.

HarborChase of Tallahassee

Another local community that I had a wonderful time visiting is the HarborChase of Tallahassee. I had the pleasure of meeting front community members Mya and Riley who enjoyed learning about FSLA’s CNA Program and browsing recent issues of ENGAGE magazine.

I also met Sheila R. Sabin, the art teacher at HarborChase Tallahassee, who oversees the creation of all the beautiful art that the residents create. In the art room, the residents’ art decorates the walls, creating a whimsical space for all to enjoy. The

(4,5,6)

pictures are all sketched by Sheila and have a varying range of fun themes that the residents thoroughly enjoy. Talking with Sheila, it was apparent that her passion for seniors and art is meaningful to both her and the community. The residents made each of the sketches come to life and I admired their beautiful paintings in their bright art room.

When I asked Sheila how she originally became involved with directing the art program at HarborChase Tallahassee, she expressed the true fulfillment and joy she receives from it. (1, 2)

1

I recently had the pleasure of visiting an FSLA member, Cherry Laurel, located in Tallahassee.

The residents were gearing up for the St. Patrick’s Day Bash. I could tell all the staff, residents, and their families were looking forward to partaking in some shenanigans! The spirit of the community was festive, fun, and inviting for all.

While admiring the beautiful community, I met a kind resident named Robin. Robin expressed her love

Cherry Laurel

for the staff at Cherry Laurel, especially Valier Walker, the General Manager. She stated, “This is where all my friends are. Ever since I have been here everyone has been so welcoming with warm hugs. I love my home.”

This kind resident even introduced me to her two cats and was incredibly grateful for the staff’s great care of them, as well. It is apparent that the community truly ensures great attention, care, and support for its residents.

HarborChase of Daytona

It was "Surfs Up" for the Grand Opening of HarborChase of Daytona!

The FSLA team hit the road and attended the Grand Opening of HarborChase of Daytona Beach, the newest Luxury Assisted Living and Memory Care community in Daytona Beach.

(10,11,12)

Our team enjoyed celebrating senior living and the exceptional coastal cuisine that was prepared by their talented culinary team. Everyone had such a wonderful time celebrating the grand opening and the event was filled with great e energy and true excitement from all in attendance.

Promoting a Culture of Deprescribing to Enhance Resident Well-being

by michael samarkos

michael samarkos , pharmd , cph Regional Director of Clinical and Consultant Services, Guardian Pharmacy

Older adults living in senior living settings often take many medications each day –sometimes, this polypharmacy is not necessary and can even be harmful. Decisions about the most appropriate medication regimen are best made when everyone – including the resident, family, community staff, pharmacist, and healthcare providers – works together. Everyone on the resident’s care team can help make medicationrelated care safer and more effective.

After a pause during the pandemic, the approach to medication management in longterm care and senior living is once again undergoing a significant shift towards deprescribing, the process of thoughtfully reducing and discontinuing medications that may no longer be beneficial or have the potential to cause harm. It is a nuanced practice aimed at ensuring each resident's medication regimen is optimized for their current health status, mitigating the potential for adverse drug reactions,

polypharmacy, and inappropriate use. Deprescribing is foundational to good prescribing – backing down when doses are too high, or discontinuing medications that may no longer be necessary.

As a regional director of clinical and consultant services, I have witnessed firsthand the profound impact deprescribing can have on the quality of life for residents while also reducing the burden on community staff.

The Impact of Deprescribing on Resident Outcomes

Reducing the medications a resident takes, where possible, often boosts their overall well-being, underscoring the importance of quality over quantity in medication management. Eliminating

Michael Samarkos, PharmD, CPh, is the regional director of clinical and consultant services for Guardian Pharmacy of Orlando and Tampa. Guardian Pharmacy Services is one of the nation’s largest, most trusted long-term care pharmacy services companies with 43 pharmacies serving more than 6,000 communities and organizations nationwide.

any duplicate or unnecessary therapies improves medication adherence—a proven strategy to improve outcomes and reduce hospitalizations—while minimizing the risk of medication errors and reducing out-of-pocket costs for residents.

Added Benefits to Senior Living Providers

Deprescribing also benefits the community and its care staff by streamlining operations and simplifying the med pass, decreasing the chances of medication errors, and minimizing transcription errors during transitions of care.

While the advantages are numerous, overzealous deprescribing can result in adverse drug withdrawal reactions. It requires a careful, individualized assessment of each resident's medication needs and close monitoring throughout the deprescribing process to ensure the medical conditions remain well managed.

The deprescribing initiative is not a new concept. The pandemic briefly stalled the momentum toward deprescribing, as communities faced the daunting task of adjusting to COVID-19 restrictions while addressing the mental health challenges of residents, including isolation, depression, and anxiety. This period made reducing medications particularly difficult. However, post-pandemic, the engagement of family members and caregivers in residents’

healthcare has been instrumental in helping communities revive deprescribing.

Creating a Culture of Deprescribing

In senior living settings, there are four key behaviors that, when adopted, can foster a culture of deprescribing.1

1. Keep deprescribing top of mind. Every member of the healthcare team should participate in conversations about deprescribing and look for opportunities to deprescribe during routine visits.

2. Embrace shared decisionmaking. Residents and their families or caregivers should participate in shared decisionmaking with their healthcare providers and pharmacists to establish goals of care, evaluate the effectiveness and safety of medication use, and consider non-drug alternatives, when available.

3. Adopt an all-hands-on-deck approach. Each member of the community staff and all healthcare providers should observe for signs and symptoms and report changes that occur as a result of medication adjustments, or any change in condition that might warrant a review for deprescribing.

4. Know the reason for the use of each medication. For each medication a resident receives, the prescriber should document the reason for use, the goals of therapy, and the

expected duration of use.

The active participation of family members and caregivers in healthcare discussions and medication management is crucial to sustaining the momentum. Their involvement leads to a more judicious approach to prescribing, with a greater emphasis on monitoring and evaluating the impacts of medication adjustments. This collaboration between healthcare professionals, residents, and their families is key to advancing deprescribing practices.

As healthcare professionals, our goal is to provide safe and effective patient-centered care. Deprescribing is a vital tool in achieving this goal. Deprescribing ultimately benefits the resident and their quality of life—and whenever we can enhance the quality of life for any of our residents, it is most certainly the right choice.

Fostering a culture of deprescribing through collaborative efforts among healthcare professionals, residents, families, and their care team not only promotes safer medication management in the community but also prioritizes the well-being and quality of life of older adults in long-term care and senior living settings.

Tools are resources to support community staff, pharmacists, families, and prescribers are available at deprescribing.org

1Deprescribing in Long-Term Care. Deprescribing.org Accessed on February 26, 2004

from: https://deprescribing.org/resources/deprescribing-in-ltc-framework/

The ripple effect of mentorship can be extraordinary. It can empower an individual, shape a career, and leave a legacy.

I recently spoke with a few senior living leaders about informal mentoring: Randy Romroth, Executive Director of Tuscan Gardens, Delray Beach; Heidi Kuchenbacker, Honu Kai Consulting, and FSLA Board Member; and Tim Pierelli, Executive Director, The Heritage. They were generous with their time and the stories they shared. A few themes quickly emerged from our conversations.

Mentoring helps create a pipeline of strong leaders who carry on

by monica wilson monica wilson , ms ICEBridge, LLC

your values and culture within an organization. But, at its core, mentorship is about fostering the holistic growth of an individual. While career development is a significant aspect, a truly impactful mentorship extends beyond the confines of the workplace. A great mentor recognizes the interconnectedness of personal and professional lives and can help an individual thrive in all aspects of their life.

Mentors help individuals understand their value. Sometimes, individuals underestimate their own capabilities. A skilled mentor can help someone discover talents and potential they may not have

recognized before. This can be a turning point in a mentee’s career and personal journey.

“When you see talent, you help them along and the next thing you know, doors are opening, and they do things greater than you can imagine.” –Randy Romroth, Executive Director of Tuscan Gardens, Delray Beach

Mentoring is rewarding. But, mentoring also requires time, energy, and effort. It is no surprise then, that mentors want to invest in individuals who are eager to learn and grow and who are also committed to putting forth their best effort.

The mentees caught the attention

“When mentorship is really amazing, it goes beyond the workplace. It includes personal and professional goals.”

– Heidi Kuchenbacker, Honu Kai Consulting, FSLA Board Member

of their mentors when they exhibited specific attributes: strong people skills, a desire to learn, initiative, and work ethic. A passion for seniors and integrity were also valued attributes.

The mentors all mentioned the need to build trust and to have honest, straightforward communication and sometimes difficult conversations. “Sometimes the person has to soul search to see if they have the compassion and passion to continue and to evaluate if this is something they really want to do going forward.” – Tim

Pierelli, Executive Director, The Heritage

Whether you are a seasoned mentor or just starting, here are some ways to hone your skills and ensure that both you and your mentees get the most out of the relationship:

• Create a safe space where your mentee feels comfortable sharing their challenges and concerns without fear of criticism.

• Respect your mentee’s privacy and keep discussions confidential unless they give you explicit permission to share something.

• Emulate the values and behaviors you want to see in your mentee. Your actions speak louder than words.

• Offer constructive feedback that is specific, actionable, and focused on helping your mentee improve.

• Offer guidance and suggest resources but recognize the most impactful goals are those that the mentee defines for her/his self.

• Work with your mentee to set Specific, Measurable, Achievable, Relevant, and Time-bound goals. (SMART) This helps them visualize success and track their progress.

• Be prepared to adapt your approach based on your mentee’s individual needs and learning style.

• Offer encouragement and celebrate your mentee’s achievements, big or small. This positive reinforcement helps them stay motivated on their journey.

• Mentorship is a two-way street. Be open to learning from your mentee’s fresh perspectives and experiences.

Advocacy

by jason hand

jason hand VP of Public Policy & Legal Affairs Florida Senior Living Association

The Power from Below: Why Grassroots Advocacy Matters

Grassroots advocacy, the act of ordinary citizens coming together to influence change, is often underestimated. Yet, this collective action holds immense power to shape our communities, states, and even the nation. By amplifying the voices of everyday people, grassroots movements can address critical issues, influence policy decisions, and create a more just and equitable society.

Empowering Individuals, Shaping Communities:

Grassroots advocacy fosters a sense of agency and empowerment among individuals. It allows people to move beyond feeling like bystanders and actively participate in shaping their environment. Through community organizing, individuals connect with others who share their concerns, fostering a sense of solidarity and purpose. This collective energy can then be channeled into concrete actions, such as contacting elected officials, organizing rallies, or raising awareness through educational campaigns.

Building a Groundswell for Change: The beauty of grassroots advocacy lies in its ability to build momentum and influence policy decisions. By mobilizing large numbers of concerned citizens, grassroots movements can capture the attention of policymakers and decision-makers. Through coordinated efforts, such as letter-writing campaigns, phone calls, and public demonstrations, they can effectively communicate the needs and perspectives of the

community. This collective voice can hold significant weight, pressuring policymakers to consider the potential impact of their decisions on the lives of real people.

Addressing Local and National Concerns:

Grassroots advocacy tackles issues at all levels, from local concerns like environmental protection or educational opportunities to national issues like healthcare reform or social justice. This adaptability allows communities to address their specific needs and priorities. Additionally, successful local movements can inspire and inform national efforts, creating a ripple effect of positive change across the country.

The Importance of Participation: While individual action is important, it is the collective power of a community that truly makes a difference in grassroots advocacy. By participating in marches, signing petitions, or simply attending informational meetings, individuals contribute to a larger movement, demonstrating widespread support for a cause. This collective participation sends a clear message to those in power that the community is invested in seeing change.

In conclusion, grassroots advocacy is a powerful tool for positive change. By empowering individuals, fostering community engagement, and influencing policy decisions, it plays a critical role in shaping a better future for all. So, the next time you feel passionate about an issue, remember the power you hold as an

individual and the immense potential of collective action. Get involved, raise your voice, and be part of the positive change you want to see in the world.

Q&A:

Q: What is grassroots advocacy?

A: Grassroots advocacy is a form of activism that empowers ordinary citizens to influence issues they care about. Unlike traditional lobbying conducted by professional groups, it focuses on mobilizing local communities to directly communicate with decision-makers.

Q: Why is grassroots advocacy important?

A: Lots of reasons. For example, the use of grassroots advocacy accomplished the following:

• Empowering individuals: It provides everyday people with a powerful tool to make their voices heard and shape policies that affect their lives.

• Building community: Grassroots efforts often bring together diverse individuals with a shared passion, fostering collaboration and a sense of shared purpose.

• Influencing policy: By collectively expressing their concerns and perspectives, grassroots movements can pressure policymakers to consider the needs and experiences of the public they represent.

• Raising awareness: Grassroots campaigns can educate the general public about important issues, sparking dialogue and inspiring others to get involved.

• Promoting accountability: By holding elected officials

accountable for their actions, grassroots advocacy can strengthen democracy and ensure that policies are made in the best interests of the people.

• Overall, grassroots advocacy is a vital tool for promoting citizen engagement and shaping a more responsive and equitable society.

Q: Who can be an advocate?

A: Everyone. The beauty of grassroots advocacy lies in its inclusiveness. Anyone with a passion for change and a desire to make their voice heard can become a grassroots advocate! Here are some examples:

• Individuals directly impacted by an issue: People who personally experience the effects of a policy or lack thereof can be powerful advocates, sharing their unique stories and shedding light on the human element of an issue.

• Community leaders: Those with established connections within their communities can be instrumental in mobilizing others and raising awareness.

• Professionals and experts: Individuals with specialized knowledge relevant to the issue can provide valuable insight and expertise to support advocacy efforts.

• Existing organizations: Established non-profit organizations, advocacy groups, and professional associations often play key roles in leading and coordinating grassroots efforts.

Ultimately, who can be a grassroots advocate depends on the specific issue and the needs of the campaign. What matters most is your passion for the cause, willingness to learn and contribute, and capacity to engage with others respectfully and constructively.

Q: I don’t have time to create a new event, how can I help?

A: One great example of how to leverage multiple approaches is when your ALF has an event (grand opening, special occasion, etc.), you can engage by identifying key stakeholders and decision-makers

(elected officials, community leaders, media outlets). Use this opportunity to brag about your community and educate key government officials. For example, consider inviting:

• State Senators and Representatives

• Executive Branch Officials (Governor, AHCA, DOH, DEM, DBPR, State Fire Marshall)

• County Officials (Commissioners, key staff (e.g., zoning), Fire Marshall,

• Other Officials (Special Districts, City officials, etc.)

• Other Associations (Local Chamber of Commerce, AIF, Hospice, Home Health, Alz. Assn., AARP, etc.)

Q: What do I say?

A: Crafting clear, concise, and compelling talking points is crucial for effective communication in any advocacy effort – FSLA can help.

Here’s a step-by-step guide to help you:

• Define your key message. What is the single most important idea you want your audience to remember? Keep it focused and specific.

• Know your audience. Who are you speaking to? Tailor your language, examples, and framing to resonate with their interests and concerns. Choose a frame that aligns with your audience’s values and beliefs. For example, if you are advocating for environmental protection to a health-conscious audience, frame it as a way to ensure clean air and healthy living. Consider common frame formats of economic, moral, and security.

• Keep it simple and concise. Aim for 3-5 key points delivered using short, clear sentences. Avoid jargon and complex terms.

• Focus on benefits, not just features. Explain how your issue affects your audience and what positive outcomes can be achieved. Present clear and actionable solutions your audience can support.

• Use powerful language (but avoid sensationalism). Employ strong

verbs, vivid imagery, and personal anecdotes to capture attention and connect emotionally. Facts and figures are important, but emotions connect with people on a deeper level. Use stories, anecdotes, and imagery to evoke empathy and understanding. Avoid overly negative or fearmongering tactics.

• Use data and evidence. Back your claims with credible sources and data. This strengthens your argument and builds trust. Be transparent and truthful: Avoid misleading information or exaggerated claims.

Respect diverse perspectives: Acknowledge different viewpoints, even if you disagree, and focus on finding common ground. Use personal stories and data to support your arguments.

Here are some additional tips:

• Start with a strong hook: Grab attention with a thoughtprovoking question, a surprising statistic, or a compelling story.

• Use data and evidence: Support your claims with credible facts and figures sourced from reliable institutions.

• Anticipate potential objections: Be prepared to address common concerns or arguments opposing your position.

• End with a call to action: Clearly state what you want your audience to do, whether it’s contacting their representative, signing a petition, or attending a rally.

By following these steps and practicing consistently, you can develop clear, concise, and compelling talking points that will empower your advocacy efforts and leave a lasting impression on your audience.

Elevating the Resident and Team Member

by jennifer fitzpatrick

Covid-19 and its accompanying policies disrupted senior living and healthcare and there’s no going back to how it once was. Before the pandemic, burnout and compassion fatigue were at epic levels; over the last few years, they’ve only gotten worse. We all know resident, family, and staff satisfaction are interrelated, so how do we elevate everyone’s experience without increasing our stress as a leader?

Embrace the three R’s!

Recognize your existing team. Revisit your hiring non-negotiables. Reimagine what great resident/ family service is.

1. Recognize your team. Never forget that in our current job seeker’s environment, our staff has lots of options. Are you thanking them for coming in every day? Do you compliment them when you see them handling a task or resident problem well? When they call out sick, does your mind immediately wonder how you

will fill their shift, or do you take a second to tell them you hope they feel better? Yes, money and benefits matter but your team also cares deeply about feeling appreciated.

Also, ensure you recognize your team by insisting they take breaks and time off. Not only will this boost loyalty to your organization, but you will also reduce the incidence of burnout and compassion fatigue. If you need help with filling in staffing gaps, check out resources like KARE and Connect RN.

2. Revisit your hiring nonnegotiables.

Narrow it down to three qualities that are essential for a job you are hiring for. This does not include credentials like a nursing license. Obviously, if you are hiring nurses, they must be licensed and pass a criminal background check, but what three qualities are essential beyond that? Maybe

jennifer l . fitzpatrick , msw , lcsw - c , csp Founder, Jenerations Health Education, Inc.

compassionate, smart, and reliable? Stop expecting perfect candidates in this job seeker’s environment.

3. Reimagine what great resident service is.

Allow the resident and family to share what’s most important to them. Frequently we are so focused on what we think they care about that we overlook what’s most important to them. Consider this example I recently heard from a senior living executive. One resident’s family was very focused on Mom needing to drink more water, and the most important aspect of great service to them was that staff cue her to drink a bottle of water each morning. When hydration for that resident became a priority, complaints decreased, and satisfaction soared. Consider the individual needs and desires of your residents and their families rather than what you believe the most attractive aspects of your community are.

Jennifer L. FitzPatrick, MSW, LCSW-C, CSP (Certified Speaking Professional) is a speaker, consultant, author, and founder of Jenerations Health Education, Inc. One of less than 800 Certified Speaking Professionals worldwide, Jennifer is the author of Reimagining Customer Service in Healthcare and Cruising Through Caregiving: Reducing the Stress of Caring for Your Loved One. She was a gerontology instructor at Johns Hopkins University’s Certificate on Aging program for over a decade and has been featured on ABC, CBS, Sirius XM, and in Forbes, U.S. News & World Report, Redbook, Fast Company, and countless other media outlets.

For more information please go to: www.jenerationshealth.com

Email: contact@jenerationshealth.com | Phone: 443-416-7710