FSLA Engage Winter 2025

THE RIGHT THING

FLORIDA’S REGIONAL PREPARATIONS

Playbook A LEADER’S

KIM SMOAK ON VALUES, CHALLENGES, AND GROWTH IN PUBLIC SERVICE

Leadership C H AMP IONIN G EXCELLENCE IN SENIOR LIVING

ISSUE 11 | WINTER 2025

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A MESSAGE FROM FSLA'S

BOARD CHAIR

A

s leaders in the senior living industry, we understand the importance of thoughtful guidance and strategic decision-making. At the Florida Senior Living Association, leadership is not just a concept—it is embedded in every aspect of our organization.

Our Board of Directors, comprised of CEOs, COOs, and decision-makers with a wealth of proven experience, is a testament to this commitment. These individuals bring not only their expertise but also their passion for excellence to FSLA. Their collective vision and strategic insights ensure that we remain a trusted resource for our members and partners.

This leadership is the cornerstone of what makes FSLA unique. By having decision-makers at the helm, we are able to navigate the complexities of our industry with agility and confidence. Our members and partners benefit from this guidance, receiving advocacy, education, and resources that are both innovative and impactful.

We are proud to celebrate the success of FSLA’s Leadership Academy, which graduated its second class earlier this summer and welcomed its third class this fall. This program was developed specifically for staff employed in FSLA-member assisted living, memory

care, or independent living communities. Grounded in the conviction that individual leadership growth directly strengthens the communities they serve, the program delivers comprehensive training to build effective teams, enhance care initiatives, and cultivate character-driven leadership. By investing in our leaders, we are ensuring quality outcomes that benefit residents, staff, and communities alike.

We invite you to experience the strength of FSLA’s leadership firsthand by joining us at our upcoming events. Our Senior Leadership Retreat in February 2025 promises to be an inspiring and collaborative opportunity to connect with industry leaders. For more information, visit www.chartingthecourse2025. com. Additionally, our Advocacy Days in Tallahassee in March 2025 will provide a platform to engage with policymakers and champion the needs of our communities. Don’t miss these opportunities to be part of the conversation and shape the future of senior living.

As we continue to advance the future of senior living, let us recognize the power of leadership—not just as a title, but as a responsibility to inspire, empower, and elevate those we serve. Together, we will continue to build on our shared mission of enhancing the lives of seniors and their families throughout Florida.

joe jedlowski, mba/mha President, Distinctive Living

4|

BOLDLY DEFINING THE FUTURE OF SENIOR LIVING

LEADERSHIP AT THE HELM

Joe Jedlowski

Greg Roderick

Page Ensor

Board Chair Exec. Board Member Pres., Distinctive Living

Vice Chair Exec. Board Member CEO, Frontier Management, LLC

Secretary Exec. Board Member Regional VP Operations Brookdale Senior Living

Gwen Thibault

Gail Matillo

Matt Deponbrock

FSLI Chair Exec. Board Member Div. VP, Legend Senior Living

Ex-Officio Exec. Board Member Pres. & CEO, Florida Senior Living Association

Joe Signore

Mary Sue Patchett

Advocacy Committee Past Chair Emeritus Co-Chair; Board Member Advisory Board Member Pres. Tapestry Senior Living Strategic Advisor New Business, Patriot Angels

Javier Espinosa

Board Member Exec. Director Merrill Gardens at Solivita

Sevy Petras

Ben Gelhous

Board Member VP, Welltower Inc.

Jenny Phillips

IP Committee Chair Board Member Dir. Bus. Development Guardian Pharmacy

Justin Hutchens

Advisory Board Member Exec. VP, Sr. Housing and CIO, Ventas

Yunia Gonzalez Board Member RVP FL/GA/AL Atria Senior Living

Michelle Pierce

Lindsey Hacker

Treasurer Exec. Board Member EVP and CFO Inspired Living

Marisa Strain, RN

Ed. Committee Chair Board Member CCO, SRI Management

Krone Weidler

Damon Thomas

Steve Benjamin

Membership Committee Co-Chair; Board Member Honu Kai Consulting

Melissa Bonilla

Tara Clayton, J.D.

Advocacy Committee Board Member Co-Chair; Sr VP Marsh

Pilar Carvajal

Advisory Board Member Principal Cadre Healthcare Realty Advisors

Advisory Board Member CEO, Inspired Living

Alternate Board Member Community Relations Belmont Village Senior Living

Board Member CEO & Founder Innovation Senior Living

Erica Gullette

Jennifer MannPaguio, MHRM

John Moschner

David Nussbaum

Alternate Board Member, Sales Exec.

Propel Insurance

Dawn Platt

Alternate Board Member, Reg. HR Bus. Partner Brookdale Senior Living

Melissa Rogers

Board Member Principal, Providence One Partners

Alternate Board Member, National Dir. Memory Care Discovery Senior Living

Alternate Board Member, Reg. Dir. Clinical Services Discovery Senior Living

Susan Snyder

Doris Ellie Sullivan

J.D. Swanson

Michele Thompson

Veronica Yestrumskas

Board Member Propel Insurance

Heidi Kuchenbacker

Membership Committee Co-Chair; Board Member Sr. VP Operations Providence Senior Living

Alternate Board Member, Reg. Dir. Ops. & Sales Brookdale Senior Living

Board Member Pres./CEO, RUI

Melinda Skirvin

Past Chair Immediate Past Chair Parlimentarian Exec. Board Member Exec. Board Member Advisory & Exec. Board Member VP, Five Star Senior Living Exec.

VP and COO, Partner, QPW&B, P.A. Distinctive Living

Board Member CEO, Priority Life Care

Alternate Board Member Executive Director, Belmont Village Senior Living

Shelley Esden

Robin Khanal

Alternate Board Member, COO, RUI

Board Member CEO, Sencare/ Grand Villa Senior Living

Diana Saxton

Board Member Regional Director, Senior Lifestyle Corp.

Board Member Sr VP, Belmont Village Senior Living

Bill Sciortino

Board Member COO, Discovery Senior Living

Board Member; Area Mgr. Harbor Retirement Associates

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IN THIS ISSUE

FSLA STAFF

WINTER 2025

OPERATIONS & REGULATORY

LEADERSHIP

Doing the Right Thing

Building Connections, Driving Solutions 12

A Word from FSLA's CEO

Preventing Medication Errors in Senior Living 18

Kim Smoak on Values, Challenges, and Growth in Public Service

8 A Leader's Playbook 20 Building Resilience

Ask Monica 23

Leading through Challenges in Senior Living

Effective Ways to Maintain Updated Documentation 23

26 Your Leadership Voice It's Not Just What You Say, It's How You Say It

Mitigating Behavioral Issues

30 Leadership Through Service 33

in Memory Care through Design

24

Navigating Liability Challenges

in Florida's Senior Living Environment

28

Guardianship in the Long-Term Care Setting 36 LEGISLATIVE POLICY & LEGAL AFFAIRS

2025 Org. Session Update 10 Silver Tsunami

Florida's Regional Preparations

14

Leading the Way ON THE COVER

FSLA's President and CEO, Gail Matillo, alongside COO and General Counsel, Jason Hand, Esq., presented AHCA Deputy Secretary Kim Smoak with a Leadership Award.

Photo Credit: Millie Marky Videographer, Agency for Health Care Administration

Educating for Innovation in Assisted Living

37

Both Sides of the Fence 38 MEMBERSHIP

Member Highlights

Celebrating Our Communities

34

EDUCATION & EVENTS

Improving Care for Residents 13

Gail Matillo, MPA President & CEO Jason Hand, Esq. COO & General Counsel Kristin Quirk, MS Membership & Partnership Director Kelly Wilson Director of Medicaid & Health Services Jimmie Fay Griffin, LPN Accounting, Membership & Regulatory Manager

FSLA EXECUTIVE BOARD OF DIRECTORS Chair: Joe Jedlowski, MBA/MHA President and CEO Distinctive Living Vice Chair: Greg Roderick CEO, Frontier Management, LLC Past Chair: Shelley Esden Executive VP & Chief Operating Officer, Distinctive Living Past Chair Emeritus: Mary Sue Patchett Secretary: Page Ensor Regional VP of Operations.

Brookdale Senior Living Treasurer: Lindsey Hacker Founder & CEO, ProVisio FSLI Chair: Gwen Thibault Divisional VP of Operations Legend Senior Living 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 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 Editor: Sandi Poreda sandi@bulldogstrategygroup.com 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 20224 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.

CHAMPIONING EXCELLENCE IN SENIOR LIVING | 7

LEADERSHIP

Doing the Right Thing How to Make Solid Leadership Decisions

By Gail Matillo

M

aking the right decision can be challenging for a number of reasons, especially when you’re in a leadership position. One of the best skills a leader can develop is the ability to assess a situation, weigh the options before them, and make a decision with clarity and purpose. However, just because a decision is right doesn’t mean it will be popular. It’s important for leaders to carefully consider the outcomes of their choices and prepare people as best as possible.

Do the right thing

Just recently, I had the opportunity to speak with an executive director who was struggling to make a decision about a necessary vendor change. This ED knew the vendor had served the community for years and members of his team might not be receptive to the change. But he also knew a change was necessary, even if it was hard for some people to understand.

As we were talking, I was reminded that FSLA’s very first goal was to “do the right thing.” After the ED and I talked through the options and reviewed all of the information, he made a statement that convinced me he was making the right decision. He said his goal was to treat each of his residents like they were his mother or father. That passion and dedication 8|

drove his decision-making process, which was ultimately successful.

Deliberating a hard decision

During Florida’s exceptionally active hurricane season, many decisions are made that directly impact the life and safety of residents and staff members. Our members spend countless hours deliberating these decisions before a storm is even identified, but once a natural disaster has a community in its crosshairs, the decision-making process intensifies.

In the days leading up to the landfall of Hurricane Milton, one of our members was carefully deliberating whether to evacuate their residents from a community in Fort Myers. The company set up a triage center in their corporate office to consider information from several sources, including the community’s architect, the builder, and FSLA staff members. They also took into consideration the potential evacuation destinations.

With as much information as possible, the company eventually decided to keep their residents in the new building built to withstand significant winds rather than to move them potentially closer to the predicted landfall. This decision was not made lightly and even after it was made, the company

BOLDLY DEFINING THE FUTURE OF SENIOR LIVING

LEADERSHIP continued to make contingency plans while monitoring the storm closely. Fortunately, they made the right call, and all their residents and staff members were safe.

A good ED and corporate structure = success

Making a tough decision can only be more challenging when the right people are not involved. Senior Living thought leader Steve Moran was recently quoted in Foresight as saying the two most important things to consider when evaluating any property are the the executive director and the team supporting the executive director. He believes a great executive director supported by a great corporate structure will lead to unbelievable success regardless of the position in the market.

A strong executive director without the support of a good team will not be empowered to make decisions that are in the best interests of the residents, the staff members and the community overall. Similarly, a good corporate structure without a competent and capable leader at the helm will be ultimately ineffective.

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!

GIVE TODAY

As an industry, senior living requires more than just a love for people and a caring heart. Our executives and leaders make challenging decisions every single day because of the immense responsibility resting on their shoulders. FSLA is proud of the leaders shaping our member communities by making those tough decisions with thought and purpose.

If your community is interested in investing in the leaders of tomorrow in the senior living industry, we encourage you to consider applying for or nominating someone for the next class of the FSLA Leadership Program. This 6-month program fosters thought leadership, mentorship and other opportunities to grow and develop professionally. For more information, please visit https://www.floridaseniorliving.org/ leadershipfsla.

gail matillo, mpa

President/CEO, Florida Senior Living Association

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LEGISLATIVE POLICY & LEGAL AFFAIRS

O

n Tuesday, November 19, 2024, the 2025 Florida Legislature convened its organization session with the primary focus on establishing the framework for the legislative session ahead. The proceedings included the swearing-in of new members, ensuring that all elected officials were officially recognized and ready to begin their legislative duties. This ceremony underscored the transition of power and responsibility to those chosen by the electorate to represent Florida's diverse interests. Key activities during this organizational session included:

2025 Organization Session Update

By Jason Hand, Esq.

Election of Leadership: The Senate and House of Representatives elected their presiding officers. The Senate chose President Ben Albritton (R-Bartow), while the House selected Speaker Daniel Perez (R-Miami). These roles are pivotal, as these leaders will steer the direction of legislative priorities, manage the floor, and influence the committee structure.

Select Comments from Senate President Albritton:

President Albritton spoke about the unrealized opportunity of Florida’s rural communities and asked the Senate to join him in the fight for a “rural renaissance” He also spoke about how the state must continue to develop and advance solutions to ride Florida’s waterways of excessive nutrients, and a desire to focus on leveraging data and technology to achieve more efficient and accountable outcomes.

Select Comments from House Speaker Perez:

jason hand, esq.

COO & General Counsel Florida Senior Living Association

Speaker Perez affirmed his priority to serve the people of Florida and to help ensure Floridians have the freedom to travel a path of their own choosing and at their own rate of speed without undue and unnecessary interference from big business and big government.

Interim Committee Meetings: Plans have also been made for interim committee work where members will delve into specific issues, gather public input, and prepare legislation for the regular session. This preparatory work is vital for informed decisionmaking.

• December 2-6, 2024 Committee Week 1 (House Only) • December 9-13, 2024 Committee Week 1

(Senate Only) • January 13-17, 2025 Committee Week 2 • January 21-24, 2025 Committee Week 3 • February 3-7, 2025 Committee Week 4 • February 10-14, 2025 Committee Week 5 • February 17-21, 2025 Committee Week 6 Now that the gears of Florida's legislative machinery are aligned, the state's lawmakers are ready to address the pressing issues facing Florida with efficiency and foresight.

10 |

BOLDLY DEFINING THE FUTURE OF SENIOR LIVING

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OPERATIONS & REGULATORY

I

n early November, I accepted the invitation to join FSLA’s staff as the new Director of Medicaid and Health Services. There is so much to say and do about this exciting new opportunity, but I would like to begin with my top priority, which is connecting with assisted living communities who are participating providers with one or more LTC managed care plans.

Building Connections, Driving Solutions

By Kelly Wilson

In 2000 when I was the administrative of a community, I participated with Amerigroup and Independent Living System as an executive director with residents enrolled in the pilot nursing home diversion / waiver program. Fortunately, we have come a long way since then and since the Agency for Health Care Administration first rolled out the privatized long-term care Medicaid program in 2013. Though assisted living is and has predominantly been a private pay model, there are many operators who recognize the need and relative value in long-term care Statewide Medicaid Managed Care (SMMC) program participation. However, because Florida’s Managed Medicaid program serves diverse populations under the larger Medicaid umbrella, there are often misconceptions and a stigma that is associated with the term “Medicaid.”

Nearly a decade ago, I authored an article highlighting the valuable role of assisted living under home and community-based services benefits (HCBS), the complexity of AHCA creating and implementing the managed care program, and the kinks identified early on. Some of these challenges included provider payment delays and challenges with communication and resolution. As many of us well know, these challenges and others are still present today.

In true grassroot fashion, FSLA will facilitate Managed Medicaid focus groups throughout the state beginning January 2025. This timeframe runs parallel to the rollout of AHCA’s SMMC 3.0, with newly negotiated plan contracts and changes to the statewide region map. We’re hoping most recipients and providers under HCBS with the assisted living benefit will see minimal impacts. Additionally, a new statutorily defined regional map for the Statewide Medicaid Managed Care Program will go into effect in January, condensing Florida’s 11 regions into nine. Moving from numbered regions 1 thru 11 to letters A thru I, the region breakdown is pictured at top left.

At the FSLA conference this summer, association leadership heard from members about their assisted living residents who have lost coverage; challenges and delays with processing and approvals

by DCF; and reimbursement issues with some managed care plans. This conversation really hit home and became the impetus in developing a position with a laser focus on the LTC SMMC program impact and challenges for providers.

kelly wilson

Director of Medicaid and Health Services Florida Senior Living Association

12 |

I have had a front row seat to the birth and growth of our statewide Medicaid managed care plan and know these are not new or isolated incidents. I look forward to meeting with many of you in the coming months, gathering information, and organizing data to develop actionable strategies for improvement. Please do not hesitate to call or email me with any questions. We have a lot of ground to cover statewide, and I am eager to speak with anyone interested and able to assist with locations and dates for a focus group meeting!

BOLDLY DEFINING THE FUTURE OF SENIOR LIVING

EDUCATION

Improving Care for Residents

R

By Lori Barnes, PhD, APRN, ANP-BC

esident aides are essential to ensure elderly residents receive the care they need in assisted living facilities.

Good leadership helps these staff members feel supported, motivated and able to do their best work. Leadership can improve the work environment for aides in a few key ways, which in turn benefits residents.

Supporting Staff Health and Work-Life Balance

Resident aides often feel stress from their demanding jobs, which can lead to burnout and affect the care they provide.

Leaders can help by offering flexible scheduling options, allowing aides to swap shifts, and keeping shifts to manageable lengths. Studies show that flexible scheduling can reduce staff fatigue and improve the quality of care they provide (Peršolja, 2023). By focusing on ways to improve schedules, leaders create a better work-life balance for staff members and healthier outcomes for residents.

Leaders can and should also use Quality Improvement (QI) strategies to see whether these changes are helping. For example, tracking staff turnover rates or evaluating resident feedback can show whether flexible scheduling is making a positive difference.

Encouraging Open Communication

Good communication is essential in assisted living facilities. When aides feel comfortable sharing their thoughts and concerns, they feel more supported and can perform their jobs better. Leaders should create open communication

channels, such as regular check-ins, where aides can discuss any issues. This helps build a positive team environment in which everyone works together for the residents' well-being.

Leaders acting as Change Agents/ Advocates are key in creating this environment. They listen to staff concerns, support their needs, and work to make the workplace as positive as possible. This kind of leadership improves staff morale and helps aides feel valued.

Providing Opportunities for Learning and Growth

Offering aides opportunities for training and development benefits both the staff and the residents. When staff members can learn new skills or grow professionally, they feel more fulfilled and are likely to stay longer in their roles. Leaders can support aides by organizing skill-building workshops or providing pathways for career growth. Mentoring and other peer support programs may also prove beneficial to further the professional development of staff members.

Implementing good leadership practices in assisted living facilities helps both staff and residents. By supporting flexible scheduling, encouraging open communication, and providing growth opportunities, leaders make it easier for aides to provide excellent care. This approach reduces burnout, improves staff satisfaction, and creates a more positive experience for residents.

Peršolja, M. (2023). Effects of nurses' schedule characteristics on fatigue: An integrative review. Nursing Management, 54(4), 28-37. doi: 10.1097/01.NUMA.0000921904.11222.11

lori barnes, phd, aprn, anp-bc

Director of Nursing Education, Veritas Nursing Academy FSLI Trainer CHAMPIONING EXCELLENCE IN SENIOR LIVING | 13

LEGISLATIVE POLICY & LEGAL AFFAIRS

Silver Tsunami: Florida's Regional Preparations

By Jason Hand, Esq.

F

lorida is on the cusp of a significant demographic shift in which the state's population of seniors is expected to surge dramatically. This phenomenon, often referred to as the “Silver Tsunami,” presents both challenges and opportunities, requiring innovative approaches in healthcare, housing, community services and economic planning.

In mid-November, the Treasure Coast Regional Planning Council and the South Florida Regional Planning Council held a joint meeting titled “Preparing for the Silver Tsunami – Planning and Policy Solutions for Southeast Florida’s Communities.”

The event included panel discussions on: •

•

14 |

Regional Outlook on Aging in South Florida and the Treasure Coast: An in-depth look at the demographic shifts, and the unique challenges and opportunities facing South Florida and the Treasure Coast as the population ages.

Responding to an Aging Population – Programs and Policies: State, local, private and non-profit responses

•

•

•

to the economic, financial, service delivery and other challenges of aging in our communities.

Housing and Land Use Planning Solutions for an Aging Population: Exploration of aging supportive land use and zoning, development options, and the role of local government and non-traditional partners.

Transportation Solutions for Seniors: Leading experts discuss the adaptations needed in transportation services and infrastructure to meet the needs of an aging population, including paratransit and transit adaptations.

Healthcare and Supportive Services for an Aging America: Discussion on housing and healthcare challenges for older adults, including accessibility, longterm care, and community support systems.

As FSLA’s Chief Operating Officer & General Counsel, I had the opportunity to speak on behalf of Florida’s assisted living facilities. The main message I sought to deliver to participants was the importance of government officials keeping ALFs in mind when crafting solutions. This is critical because of the often misunderstood differences between ALFs, nursing homes and home health agencies, including the following:

BOLDLY DEFINING THE FUTURE OF SENIOR LIVING

LEGISLATIVE POLICY & LEGAL AFFAIRS • • •

ALFs cater to individuals who need help with daily activities but do not require the intensive medical care provided in nursing homes.

ALFs strive to provide a home-like setting and often feature apartment-style living or private rooms, communal dining areas, and spaces for social interaction.

ALFs are based upon a private pay model, as compared to nursing homes which are regulated by the federal government and are embedded in Medicaid funding.

In Florida, ALFs save the state $9 billion annually in Medicaid costs alone.

Also critically important to note is the shift currently occurring in the long-term care industry due to seniors delaying entering ALFs. By the time these individuals do move into such facilities, they are older and potentially in much greater need of medical and personal care. This often correlates with more complex health conditions that might be present upon entry, resulting in a higher cost of care. This affects not only the individual's finances but also the pricing models of ALFs. Just prior to my remarks, Senator Gayle Harrell presented on Florida’s Live Health Legislation. Signed into law in March 2024, the legislation is a comprehensive initiative to enhance the state's healthcare landscape amidst its rapidly growing senior population. This legislative package, championed by Senate President Kathleen Passidomo, includes measures to expand the healthcare workforce by increasing medical residency slots, creating a streamlined licensure pathway for out-of-state and foreign-trained physicians, and fostering innovation through a Health Care Innovation Council. It also allocates significant funds to improve access to care, particularly for rural and underserved areas, by increasing Medicaid reimbursement rates for preventive care and services like dental, nursing and therapy. The Live Healthy Act seeks to address the challenges posed by the "Silver Tsunami," ensuring Florida's healthcare system can accommodate an aging demographic while promoting health care innovation and access.

This phenomenon.... presents both challenges and opportunities, requiring innovative approaches in healthcare, housing, community services and economic planning.

Overall, the joint meeting convened a significant number of thought leaders and interested parties in senior living, and encouraged the sharing of diverse perspectives. Florida Senior Living was honored to participate, and we encourage other regions in the state to host similar conversations.

jason hand, esq.

COO & General Counsel Florida Senior Living Association

CHAMPIONING EXCELLENCE IN SENIOR LIVING | 15

LEADERSHIP

16 |

BOLDLY DEFINING THE FUTURE OF SENIOR LIVING

CHAMPIONING EXCELLENCE IN SENIOR LIVING | 17

OPERATIONS & REGULATORY

Preventing Medication Errors in Assisted Living Collaborative Approaches for Better Outcomes

By Wendy Kallaher, RN

E

nsuring resident safety is the top priority for assisted living operators and their care teams. While medication errors remain a persistent challenge across all healthcare settings, operators can prevent many of these errors by implementing proactive strategies and collaborative efforts with their long-term care (LTC) pharmacy partner. With a focus on training, innovation and a culture of vigilance, operators can significantly reduce error rates and improve clinical outcomes, ensuring residents receive the highest available quality of care.

Medication Error Prevalence

Estimates indicate between 16–27% of LTC residents experience medication errors. These errors can have serious outcomes, and up to one in 10 medication errors result in serious medical complications. Each year, there are approximately 800,000 preventable medication-related injuries in LTC communities. The good news is that about 40% of adverse medication events are potentially preventable. This highlights an opportunity for improvements in medication management practices and enhanced collaboration with the healthcare team.

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The Impact of Medication Errors

The effects of medication errors are far-reaching, extending beyond individual residents to affect care teams, families, organizations, and the broader healthcare community. For residents, these errors can lead to adverse drug reactions, falls, treatment failures, exacerbation of medical conditions, hospitalizations, disabilities, and even fatalities. The emotional and psychological impact on residents, families and caregivers cannot be overstated.

From a financial perspective, medication errors contribute to rising costs of care. Additional medical interventions, prolonged treatments, hospitalizations and legal expenses all add to the financial burden. Operators may also face legal liabilities, regulatory sanctions and reputational damage, further straining resources and diverting attention from the high-quality care residents deserve.

Strategies for Prevention

To mitigate the risk of medication errors, care teams must adhere to the fundamental "Rights of Medication"—Right Resident, Right Medication, Right Dose, Right Route and Right Time. Furthermore, ensuring the Right Reason for use

BOLDLY DEFINING THE FUTURE OF SENIOR LIVING

OPERATIONS & REGULATORY and the Right Documentation are crucial to preventing errors. However, these basic principles must be supported by robust processes and systems that ensure accuracy at every step of the medication pathway.

•

Addressing Systemic Issues

•

Beyond individual vigilance, addressing systemic issues is vital for reducing medication errors in LTC and assisted living communities. Operators must provide ongoing training and education for staff members, particularly in the use of technology and medication management systems. Operators should consider fully embracing newer medication management technology that facilitates closer community-pharmacy collaboration, such as electronic health records (EHR) integrated with the LTC pharmacy system and realtime pharmacy communication via mobile applications. Additionally, fostering a culture of open communication and continuous learning can help identify potential risks before they lead to errors.

Staffing shortages, high resident volumes and increased workloads are significant challenges that can contribute to errors.

LTC and assisted living operators should prioritize adequate staffing and support for care teams to ensure they can perform their duties effectively and safely.

How an LTC Pharmacy Can Help

LTC pharmacies employ experienced pharmacists, pharmacy technicians and nurses who can provide training, guidance and resources to community staff and prescribers on medication managementrelated topics including:

•

•

The “rights” of medication administration, including how to verify the resident's identity, check medication labels for accuracy, measure the correct dosage and administer medications at the appropriate time and route Performing quality control audits, such as medication storage area audits and “MAR to cart” audits Use of high-risk medications, e.g., hypoglycemic agents, antibiotics, opioids and naloxone, as well as issues like fall prevention and infection control Deprescribing and other strategies to reduce the incidence of polypharmacy, which contributes to medication errors

“While the challenges are significant, the potential to save lives and improve resident outcomes makes the effort worthwhile."

LTC pharmacies can further offer direct access to a consultant pharmacist and nurse account manager to assist with policies, procedures and recommendations to maintain safety and compliance. Operators should also expect their pharmacy partner to provide data and analytics on clinical interventions performed by their pharmacists, such as interventions for inappropriate doses or drug interactions, to protect residents from medication harm.

Preventing medication errors requires a multifaceted and collaborative approach that includes adherence to established protocols, continuous education, embracing advancements in technology, and systemic improvements. While the challenges are significant, the potential to save lives and improve resident outcomes makes the effort worthwhile. By working together with their LTC pharmacy partners and remaining vigilant, operators can minimize the risk of medication errors and ensure resident safety remains at the forefront of care.

References: Ferrah N, Lovell JJ, Ibrahim JE. Systematic review of the prevalence of medication errors resulting in hospitalization and death of nursing home residents [published online November 21, 2016]. J Am Geriatr Soc. 2016. DOI: 10.1111/jgs.14683

wendy kallaher, rn Sr. Director, Account Mannagement, Guardian Pharmacy Services

Wendy received her Bachelor of Science Degree in Nursing from U.A.B in 1996. An experienced registered nurse, she began her career with Guardian in 2006 when she joined the Birmingham pharmacy. In 2021, she transitioned to Guardian’s support services team. She currently serves as the Senior Director of Account Management where she leads Guardian’s client engagement initiatives and provides support for national client partnerships.

CHAMPIONING EXCELLENCE IN SENIOR LIVING | 19

LEADERSHIP

A Leader's Playbook Kim Smoak on Values, Challenges, and Growth in Public Service

By Gail Matillo

K

im Smoak, the Deputy Secretary for the Division of Health Quality Assurance at the Agency for Health Care Administration (AHCA), has been with the agency since 1995. She is responsible for ensuring both federal and state survey work is completed in a timely manner, monitoring quality improvement/quality assurance activities, and training of survey staff and other division staff. She oversees eight field offices, the complaint administration unit and the survey and certification branch within the division, in addition to the Office of Plans and Construction. Kim is also the State Survey Agency Director for the State of Florida. In these roles, she often works closely with the Florida Senior Living Association, and the working relationship is marked by open communication and mutual respect.

It took me years to finally accept the fact that I couldn’t control everything in your line of authority as a leader. But these challenges have helped me continue to grow, and I hope they will help to fine-tune my leadership skills.

FSLA recently asked Kim to talk a little bit about her experience and her thoughts on leadership.

What I learned from playing sports, especially team sports, has positively impacted how I lead. I believe in working together as a team; you always need someone to lead and be in charge, but it takes everyone working together to be successful. It's not about just one person.

Q: What have been the most significant influences on your development as a leader? How do you continue to grow in your role?

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Q: What personal values do you bring to your leadership, and how do these values influence the vision you have for your Agency?

When I was growing up, my parents always pushed me to do my best and give 100%, no matter what I was involved in, which for me was sports. As an athlete, I learned early in my life that you don’t always win or get what you want, but you must put in the hard work every day.

BOLDLY DEFINING THE FUTURE OF SENIOR LIVING

LEADERSHIP Q: Describe your process for making tough decisions. How do you balance data, intuition, and stakeholder input?

Q: What was your first job, and how did it set the tone for your career in public service or leadership?

As a leader, you must be willing to make tough decisions and know that not everyone will be happy with them.

However, you must stand behind your decisions, even if not everyone agrees they are the best. It is also about learning from the decisions that do not always turn out well.

My first job out of college was working in a facility for the developmentally disabled. After a few years, I worked as a social worker in a nursing home, and then I started as a surveyor at the Agency in 1995. Although being a public servant never crossed my mind, I find it to be very rewarding. Being a leader came naturally to me, and while this isn’t the career I envisioned when I was growing up, I feel it is what I was meant to do.

I often rely heavily on intuition or that gut instinct when making tough decisions.

Data is also a valuable tool, as long as you use it correctly. And naturally, I always believe in getting input from those stakeholders or others who are impacted by changes in our processes.

Q: Can you identify three or four pivotal moments in your career that significantly influenced your professional growth?

Q: Who has been the most influential mentor in your life, and what specific advice or lessons from them do you still apply today?

There have been many moments in my career that impacted my professional growth, but I’ll try to narrow it down to a few.

I’ve been fortunate to be mentored or influenced by many people in my life, from my parents to coaches and even supervisors in my career. The interesting thing about mentors is that you learn what to do, how to do it, and what not to do.

I often mention how proud I am of the work we do in Florida. This is all possible under the leadership of Governor DeSantis; Florida truly stands out in how we handle disasters. The impact of multiple hurricanes over the years and other emergencies, such as the public health emergencies, has required me to be more involved in emergency management and step up as a healthcare leader representing our agency.

One valuable piece of advice I received was not to be so quick to say no to an idea.

There are always ways to make it work – maybe not exactly as presented to you, but offering a compromise may be acceptable.

Q: Conflict is inevitable in any organization. Can you describe how you manage and resolve conflicts within your team?

I work hard to be respectful of others' opinions and thoughts on a subject, and I have always tried to find common ground.

We don’t all think the same way, so that conflict will happen, but being able to find common ground or agree to disagree is what matters. It is always best to maintain professionalism, no matter how hard it may be.

Taking on the role of a Deputy Secretary was something I never envisioned for myself, but it has caused me to grow in many ways and strengthen my leadership skills. I am honored I was able to step into this role during this administration.

Implementing major changes to survey processes and regulations has caused me to learn how to stay focused and maintain professionalism.

Taking on the role of a Deputy Secretary was something I never envisioned for myself, but it has caused me to grow in many ways and strengthen my leadership skills. I am honored I was able to step into this role during this administration.

CHAMPIONING EXCELLENCE IN SENIOR LIVING | 21

LEADERSHIP Q: How would you describe your management style, particularly in terms of fostering accountability and empowerment among your staff?

I expect my team to do their jobs; I don’t feel the need to be a micro-manager. If a staff member makes a mistake or misses a timeframe, we discuss it and determine how to improve or implement measures to ensure it doesn’t happen again. As a manager, you can't sweat the small stuff. Staff will make mistakes; how you and your team react to those mistakes is what matters the most.

Q: Which skills or competencies have been most crucial for your career advancement, and how did you develop them?

I think one of the most important skills is the ability to get along with others, even when we completely disagree, and how to find a middle ground. Respecting a decision you don’t agree with is also critical. And maintaining a sense of humor and humility have kept me grounded.

Q: In your role, you have to make tough decisions. How have the last few years changed in terms of things you’ve seen in your career?

What I think about most is that nothing really surprises me anymore. No matter what is thrown my way, I try to find a way to make it work, whether or not I agree professionally.

We have faced many challenges in the past few years, from multiple hurricanes to public health emergencies, which factored into many of the changes and challenges to health care in our state.

Working in this administration under Governor DeSantis’s leadership, even when preparing for and responding to the multiple hurricanes and other disasters. Florida continues to stay strong and surge forward in the field of health care. While there have been challenges, it has been exciting to be part of this administration and experience how Florida stands out as forward-thinking regarding health care services and initiatives.

gail matillo, mpa

President/CEO, Florida Senior Living Association

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BOLDLY DEFINING THE FUTURE OF SENIOR LIVING

OPERATIONS & REGULATORY

monica wilson, ms ICEBridge, LLC

Have a question about assisted living operations?

Ask Monica: Monica@icebridgetraining.com

Does Florida have reciprocity with other states for Assisted Living Administrator Certification?

Florida does not recognize Assisted Living Administrator Certification or licensure from any other states. To become certified as an assisted living administrator in Florida, you must: • Take a 26-hour course (ALF Core training) from a trainer registered with the AHCA; and • Pass a state competency exam.

Effortless Ways to Maintain Updated Documentation

How do I renew my ALF Administrator certification?

To maintain a valid ALF administrator certification, you must complete 12 hours of continuing education in topics related to assisted living every two years. The certification does not expire, but if you cannot document 12 hours of continuing education for every 2-year period since certification, you will be required to repeat the ALF Core training and retake the state competency exam.

Keep copies of your own records and back them up to the cloud.

These should include: 

Your ALF Core training certificate of completion



Certification card from the testing entity (The MacDonald Research Institute)

Continuing education certificates with all of the required



monica wilson, ms ICEBridge, LLC

The good news is that you do not report the continuing education anywhere.

When you are an administrator of record for an assisted living community, all the documentation should be included in your personnel file. This is the documentation surveyors will ask to see when they visit your community.

• • • • • •

information, including:

The title of the training program The subject matter of the training program The training program agenda The number of hours of the training program The trainee’s name, dates of participation, and location of the training program The training provider’s name, dated signature and credentials, and professional license number, if applicable.

CHAMPIONING EXCELLENCE IN SENIOR LIVING | 23

OPERATIONS & REGULATORY

Mitigating Behavioral Health Issues in Memory Care Through Design

T

By Becky Trybus, CHID, EDAC, RID, IIDA and Dawn Platt, National Director Memory Care Services, Discovery Senior Living

his summer, I had the opportunity to attend the Florida Senior Living Association ENGAGE 2024 conference with two colleagues. The conference was a high-spirited success as we met many new people, connected with familiar clients, attended sessions, and exhibited. One of the sessions I attended, Untangling the Vines: Managing Behavioral Health Challenges in Memory Care Units, was especially interesting as behavioral health is not typically considered a programming component of senior living design. It should be, though, particularly with memory care. Because dementia causes a decline in cognitive functioning, it stands to reason this will affect someone’s behavior. According to a 2020 study cited on healthline.com, “90% of people with dementia have some kind of behavioral and psychological symptoms, including psychosis, agitation, aggression, and depression.”

To understand how design responds to these behaviors, we need to know what behavioral health challenges exist in today’s memory care communities. One of the session presenters, Dawn Platt, National Director of Memory Care Programs for Discovery Senior Living, discussed the top five behavioral health challenges surfacing in today’s memory care. I’ll briefly explain these and suggest ways the built environment as a nonpharmacological approach can help safely support residents and staff while mitigating further issues.

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Alzheimer’s Disease and Related Disorders (ADRD)

According to the National Institute of Neurological Disorders and Stroke, Alzheimer’s disease is the most common cause of dementia, accounting for at least two-thirds of dementia cases in patients 65 and older.

Design Intervention: Two ways to lessen resident stress through design are improving mobility and wayfinding.

Creating ample clear floor space and consistent, low-pattern, neutral flooring with minimal transitions and contrast between the floor and wall boundaries will help support aging eyes and mobility. Wayfinding with feature walls, art, and other visual cues will also help offset common behavioral symptoms and encourage independence.

Mixed Dementias with Psychosis

One complication of dementia is psychosis, a mental state that includes paranoia, delusions and hallucinations.

Design Intervention: Design can help provide residents calm and safety in two ways. The first is offering an accessible courtyard with access to nature, sunshine and physical activity.

The other option is providing a quiet room. This environment is visually low-pattern with soothing color, lower ceilings, softtouch finishes and natural light.

BOLDLY DEFINING THE FUTURE OF SENIOR LIVING

OPERATIONS & REGULATORY Alcohol-Induced Dementia

Damage can occur to the brain from excessive, long-term alcohol use. The effects can cause problems with short-term memory issues, language impairment, spatial cognition and everyday tasks. It can also damage nerves in the arms and legs, which can also lead to an increased risk of stroke.

Design Intervention: A broad spectrum of universal design applications can profoundly impact people with cognitive disabilities, regardless of the cause. Universal design considers the diverse abilities of all individuals by creating products and environments that are flexible, simple and intuitive. Some examples in public spaces include anti-skid floor surfaces, handrails, wide corridors and much more.

Veterans with Trauma History

In a study of more than 180,000 older veterans cited on Todaysgeriatricmedicine.com, researchers found veterans who experienced traumatic brain injury had a 60% higher risk of developing dementia compared with veterans who hadn’t experienced traumatic brain injury.

Design Intervention: Providing a calm, safe environment is key. This includes using a quiet room, offering common spaces for social support, and providing access to the outdoors to allow for physical activity, sunshine and fresh air to naturally offset sleep disturbances and deprivation.

Sexual Disinhibition and Other Persistent Behavior Patterns

Dementia-related changes in the brain can lead to confusion, disorientation, misinterpretation. and a lack of impulse control. In these situations, inappropriate sexual behaviors can occur.

Design Intervention: One of the best ways to lessen the chances of this behavior causing harm is through the built environment.

Memory care wings or neighborhoods specifically for women can provide an environment for female residents to feel safer among their peers. This also allows for purposeful aesthetics geared toward more feminine sensibilities.

To understand how design responds to these behaviors, we need to know what behavioral health challenges exist in today’s memory care communities.

Overall, a community’s design and physical structure are only two components available to senior living professionals who are working to mitigate behavioral issues in memory care communities, but they can certainly be important components. If your community is considering renovations or design updates, ask your memory care managers to weigh in on what they would like to see included or excluded from the final designs. And if your company is considering a new build, ask to include input from your memory care leadership team. These could be valuable suggestions that will ultimately improve the environment for your memory care residents.

becky trybus, chid, edac, rid, iida

Senior Interior Designer, Forum Architecture and Interior Design Inc.

dawn platt

National Director of Memory Care Programs Discovery Senior Living CHAMPIONING EXCELLENCE IN SENIOR LIVING | 25

LEADERSHIP

Building Resilience

Leading Through Challenges in Senior Living

By Damon Thomas, Senior Vice President, Providence Senior Living

L

eadership in the senior living industry is not for the faint of heart. Every day presents unique challenges, from navigating natural disasters like hurricanes and managing health outbreaks to addressing staffing shortages and ensuring compliance with ever-evolving regulatory demands. These obstacles require a steady hand, a clear vision, and — most importantly — resilience. Resilience is not merely a trait but a critical leadership skill that enables senior living leaders to guide their teams and communities through uncertain times. Here, we explore strategies for staying calm under pressure, fostering a supportive environment for staff, and guiding a team effectively.

Staying Calm Under Pressure

In times of crisis, the leader’s demeanor sets the tone for the entire team. Calmness under pressure is not about suppressing emotions but about managing them effectively. Here are key strategies to maintain composure: • Prioritize Communication: In the face of uncertainty, clear and consistent communication is essential. Keep your team informed about the situation, action plans and expectations. Transparency builds trust and reduces anxiety.

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•

•

Focus on What You Can Control: Instead of fixating on uncontrollable factors, channel energy into actionable steps. For example, during a hurricane, concentrate on evacuation plans, securing resources and keeping residents safe.

Practice Mindfulness: Techniques like deep breathing, meditation or even brief moments of reflection can help leaders manage stress and maintain focus.

Fostering a Supportive Environment for Staff

A resilient team is built on a foundation of support, empathy and empowerment. Staff in senior living communities often face emotional and physical challenges, making it crucial for leaders to create a nurturing environment: • Recognize and Appreciate Efforts: Regularly acknowledge the hard work and dedication of your team.

Simple gestures like thank you notes, public recognition or staff celebrations can boost morale.

• Encourage Open Dialogue: Foster an environment where staff feel safe to voice concerns, ask questions and share ideas. Open communication not only resolves issues promptly but also enhances team cohesion.

BOLDLY DEFINING THE FUTURE OF SENIOR LIVING

LEADERSHIP •

Provide Resources and Training: Equip your team with the tools and knowledge needed to handle crises effectively. Ongoing training sessions on emergency preparedness, stress management and conflict resolution can build their confidence and competence.

Guiding a Team Through Uncertain Times

Leadership in uncertainty requires vision, adaptability and a strong sense of purpose. Here’s how leaders can guide their teams effectively: • Lead by Example: Demonstrate resilience through your actions. Show your team challenges are opportunities for growth and learning.

• Empower Decision-Making: Trust your team to make informed decisions within their areas of responsibility.

This not only alleviates the burden on leadership on a few key people but also fosters a sense of ownership and accountability.

• Maintain a Forward-Thinking Mindset: While addressing immediate concerns, keep an eye on long-term goals. For instance, during staffing shortages, focus on immediate recruitment while also implementing retention strategies to prevent future challenges.

The Bigger Picture: Resilience as a Culture

Resilience is not just an individual attribute but a cultural value that can be cultivated within a senior living community.

Leaders can: • Build Strong Relationships: Foster a culture of mutual respect and collaboration among staff, residents and families. Strong relationships create a support system that helps everyone weather storms — literally and figuratively — together.

• Celebrate Resilience: Share stories of overcoming challenges within the community to inspire and motivate.

Highlighting moments of triumph reinforces the collective strength of the team.

• Evaluate and Adapt: After every challenge, conduct a debrief to assess what worked and what didn’t. Use these insights to refine processes and prepare for future challenges.

Conclusion

Building resilience as a leader in senior living is a continuous journey. It requires self-awareness, a commitment to your team and an unwavering dedication to the residents and families you serve. By staying calm under pressure, fostering a supportive environment, and guiding your team with clarity and purpose, you can not only navigate challenges effectively but also create a legacy of strength and stability. In the face of adversity, resilience isn’t just about surviving—it’s about thriving and emerging stronger as a leader and as a community.

damon thomas

Senior Vice President, Providence Senior Living Damon Thomas is a 30-year veteran of the senior living industry, with leadership experience at some of the nation’s largest senior living companies. He is currently the Senior Vice President at Providence Senior Living, an Ambassador for Bridge the Gap, and a Founding Member and Board Member of the Florida Senior Living Association.

CHAMPIONING EXCELLENCE IN SENIOR LIVING | 27

OPERATIONS & REGULATORY

Navigating Liability Challenges in Florida's Senior Living Environment

By Tara Clayton, J.D. and Patrick O'Rourke, FCAS, MAAA

A

s a leading retirement destination for American seniors, Florida is also facing significant challenges that demand strong leadership within the senior living industry. A recent 2024 study by Oliver Wyman Actuarial and Marsh’s Senior Living & Long-Term Care Industry Practice highlights a concerning trend: general liability and professional liability claim costs continue to rise, with an anticipated 4.4% nationwide increase in 2024 for senior living providers.

In Florida, the situation is particularly pressing. The state’s estimated loss rate – the average amount of insurance related loss per unit – stands at $1,610 per occupied senior living unit, significantly higher than the national average of $760.

This disparity underscores the need for proactive leadership to address the high frequency of claims that have plagued Florida’s senior living sector in recent years. As the senior population in Florida continues to grow, so does the demand for quality senior living services, which in turn heightens scrutiny regarding liability risks. These rising liability costs can impact economic viability and influence future industry investment or expansion.

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One of the most pressing issues facing senior living providers is the prevalence of resident falls, which account for more than 70% of all loss-related incidents. Falls are a leading cause of injury among seniors, often resulting in severe events such as fractures, head injuries and even fatalities. Senior living leaders understand that prioritizing the implementation of a comprehensive fall mitigation program is important for enhancing a safer environment. However, it’s also important to include a diverse array of tools in a larger program and not rely too heavily on any one solution, such as technology and the use of artificial intelligence.

While falls represent the most significant risk, other issues such as skin and wound injuries, fractures and even elopements also pose challenges, with average country-wide claims costs ranging from $200,000 to $300,000. Claims related to abuse – whether staff-on-resident or resident-on-resident – and choking incidents are particularly concerning, with average estimated claim costs reaching up to $370,000. As residents face conditions that can impair their swallowing abilities, such as dementia or Parkinson’s disease, it is important for leaders to conduct periodic re-assessments and adopt responsive protocols and training to mitigate these risks.

BOLDLY DEFINING THE FUTURE OF SENIOR LIVING

OPERATIONS & REGULATORY In light of these challenges, Florida's senior care providers are increasingly focused on enhancing safety procedures and risk management practices. By prioritizing fall prevention and choking hazard mitigation, providers can protect residents while also reducing liability exposure. Senior living safety programs play a vital role in expanding quality of life while also minimizing incidents. Foundational risk management practices – such as thorough assessments, robust documentation, and transparent communication with residents and families – also remain essential.

As the landscape of senior care evolves, leaders in the industry must continue to focus on resident safety and ensuring the sustainability of their organizations. By fostering a culture of safety and accountability, senior living providers can navigate these challenges effectively and continue to promote innovation.

Access the 2024 study by Oliver Wyman Actuarial and Marsh’s Senior Living & Long-Term Care Industry Practice by scanning this code:

This disparity underscores the need for proactive leadership to address the high frequency of claims that have plagued Florida’s senior living sector in recent years.

tara clayton, j.d.

Managing Director, Marsh Senior Living & LTC Industry Practice Tara is a risk advisor and attorney with a proven track record in the senior living, long-term care, and health care industries, serving as a risk advisor, operations counsel, and defense litigation counsel. As a Managing Director in Marsh's Senior Living & LTC Industry Practice, she provides clients with strategic and tactical guidance on general and professional liability claim resolution, risk management, and strategies to maximize insurance coverage across multiple lines. Known for expertise in complex litigation and innovative risk management initiatives, Tara helps clients reduce costs, enhance value, and gain greater control over their programs.

patrick o'rourke, fcas, maaa

Senior Principal and Consulting Actuary, Oliver Wyman Actuarial Patrick is a Principal in the Philadelphia office of Oliver Wyman Actuarial Consulting. Patrick has experience in estimating unpaid liabilities and funding levels for self-insurance programs and captive companies for workers’ compensation, medical professional liability, general liability and commercial automobile liability. He has performed rate analyses for many lines of insurance, including workers’ compensation, medical professional liability and most major liability coverages. His clients included competitive insurance companies, joint underwriting associations, state regulators, captive insurance companies and various other corporations.

CHAMPIONING EXCELLENCE IN SENIOR LIVING | 29

LEADERSHIP

I

magine this: You're leading a team meeting, talking about an exciting new project. You’ve got your words ready, but something feels off. Your team seems disengaged, distracted, and not as energized as you’d expect. You’ve just given a great pitch, so why the disconnect?

Here’s the thing—your leadership voice isn’t just in the words you speak. It’s also in your body language, and if that doesn’t align with your message, it can send mixed signals.

Let’s take a look at a quick story to see how body language can make or break your leadership communication:

The Story of John’s Body Language Breakdown

Your Leadership Voice: It's Not Just What You Say, It's How You Say It

By Velma Knowles

John, a leader at a growing assisted living community, was in the middle of an important presentation to his leadership team. He was talking about a new project that he was excited about. But no matter how much enthusiasm he put into his words, his body didn’t quite back it up.

John stood stiffly at the front of the room, glued to his notes. His arms were crossed, and his gaze often wandered away from the team. He looked about as excited as someone watching paint dry. He spoke about his excitement, but his body said otherwise.

By the end of the presentation, his team didn’t share his enthusiasm. In fact, they felt uninspired and disconnected.

Later, one of John’s staff members, brave enough to offer feedback, said: “John, I know you’re excited, but your body language made it seem like you weren’t.”

This moment was a turning point for John. He started consciously aligning his body language with his words. He began leaning into conversations, making eye contact, and using open gestures. The change was immediate… his team felt his passion and commitment, and their productivity soared.

The Takeaways: How Body Language Shapes Your Leadership Voice

What can you learn from John’s experience?

Here are three simple and actionable tips for making sure your body language matches the message you’re trying to send as a leader: 1. Lean In to Show Engagement Leaning in slightly during conversations tells others you’re genuinely interested and present. When you 30 |

BOLDLY DEFINING THE FUTURE OF SENIOR LIVING

LEADERSHIP physically show engagement, your team will feel heard and respected, making them more likely to open up and trust you.

2. Tilt Your Head to Show Active Listening A subtle tilt of your head while listening can indicate curiosity and understanding. This small gesture makes it clear you’re not just hearing their words… you’re processing them. It shows you value what’s being said and are fully present in the moment.

3. Maintain Steady Eye Contact to Show Confidence Eye contact is one of the most powerful nonverbal tools in your leadership toolkit. It signals confidence, attentiveness, and trustworthiness. When you make eye contact with your team, they’ll feel your commitment to them and the project at hand.

But don’t overdo it… avoid staring at them intensely. Aim for natural, comfortable eye contact rather than a laser-focused stare.

Why This Matters to You

Your body language isn’t just a personal habit; it’s a reflection of your leadership brand. Whether you’re in a one-on-one conversation or addressing the entire team, your body language speaks volumes. And when it aligns with your verbal message, you’ll be perceived as a leader who is clear, committed, and trustworthy.

Remember: the next time you walk into a room, your body is already communicating long before you say a word. Make sure it’s saying what you want it to say.

Are You Ready to Fine-Tune Your Leadership Voice?

Are you curious about how other hidden communication blind spots might be impacting your leadership? Download our free checklist on “Reveal Hidden Communication Blind Spots” to discover easy-to-apply tweaks that’ll help you connect, engage, and lead with confidence.

Aligning Words and Body Language for Maximum Impact

Start today—because the way you show up matters.

In John’s case, when he matched his words with purposeful body language, his leadership voice became more compelling.

His team could feel his enthusiasm… not just through his words but through his actions. And that made all the difference.

v e l m a k n ow l e s

Effective communication as a leader requires more than just speaking clearly. It’s about ensuring your words match your body’s message. When your nonverbal cues align with your verbal communication, you’ll be seen as a leader who’s confident, authentic, and deeply engaged.

Certified Leadership Coach FSLA Leadership Academy Facilitator

Retreat to the white sands and relaxing atmosphere of the Henderson Beach Resort in Destin, Florida and join your C-Suite, Executive, and Senior Leadership colleagues from around the southeast at the Third Annual Strategic Leadership Retreat for Senior Living Professionals.

CHAMPIONING EXCELLENCE IN SENIOR LIVING | 31

MEMBERSHIP

Serving Senior Living With Care.

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We are proud to offer tailored solutions for senior living communities with industry-leading accuracy, fast results, and dedicated support for your residents and staff.

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386.965.9003 | NonaScientific.com arocco@NonaScientific.com | Fax: 352.561.2950

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Leadership Through Service

S

By Sandi Poreda, APR

ometimes a funny thing happens when you start calling someone a leader. All of a sudden, there might be more meetings, or longer meetings, or meetings that feel more tense. Maybe that person starts making a bigger deal about the size of their office, or the location, or the view. Perhaps people might start avoiding the new leader because they seem less approachable or less interested in the bigger picture than in their own new position.

It’s possible this happens because leadership means different things to different people. Some people think of control when they think of leadership, as in they have more control over more things or more people. Other people think a leadership position means they have an elevated status, useful for continuing a professional climb or even looking down on subordinates.

Here’s what I think leadership really is: leading from a position of service rather than one of power. True leadership happens when someone with a position of legitimate authority uses that authority to support his or her team, organization or community.

Talking about servant leadership is easy, even trendy. But what happens when you look past the buzzwords and start looking at how to implement this concept? What does it actually mean to be someone who uses their leadership as a platform for service, and what might that mean for the organization being led?

First, servant leadership should come from a place of quiet humility. An act of service loses its impact when the motivation is recognition. An executive director who jumps in to help bus tables in the dining room will win more support from their team if they’re not simultaneously calling attention to what they’re doing. Otherwise, the people on the receiving end of the assistance may feel as though they’re being called out for not doing something well enough or fast enough.

Second, servant leadership has to be consistent. Helping the maintenance team take out the trash once won’t cover you for the rest of the quarter. To build a reputation as a true servant leader, these acts of service should be carried out whenever the opportunity arises and in as many diverse situations as possible.

A leader can’t risk alienating parts of their team by solely focusing on helping a single person or activity.

Last but not least, servant leadership should happen without any expectation of reciprocity. This can be a delicate balance, however, because leaders should lead by example and encourage

Ask yourself whether you’re willing to commit to or elevate your own servant leadership, and keep track of the positive changes that follow.

their team to follow these same principles of service. The key is ensuring team members understand the acts of service should be implemented on an outward-facing basis, not responsively toward the original leader.

When an organization is led by someone who truly embraces the concept of servant leadership, an environmental shift occurs. People are more likely to be loyal to a strong servant leader, which means turnover rates will drop along with the expenses of constantly training new staff members.

The organization is likely to be seen as more stable, both internally and externally, which will benefit the bottom line.

Leaders who invest their time and attention into their team should be able to build a sustainable leadership culture, helping those team members in management positions grow their own leadership potential.

Leading from a position of service may be a difficult skill to master. However, there are clear benefits to embracing this concept and avoiding the traditional pitfalls that often accompany someone who is elevated to a position of authority. Ask yourself whether you’re willing to commit to or elevate your own servant leadership, and keep track of the positive changes that follow. The results will be nothing short of spectacular.

sandi poreda, apr

Bulldog Strategy Group, FSLA Public Relations Conultant CHAMPIONING EXCELLENCE IN SENIOR LIVING | 33

MEMBERSHIP

Member Highlights

CELEBRATING OUR COMMUNITIES

St. Augustine Plantation Tour with AHCA’s Legislative Affairs Team On November 7, St. Augustine Plantation in Tallahassee hosted a tour of its assisted living community for FSLA, ACHA’s Legislative Affairs Director, Jim Browne, and AHCA’s Deputy Legislative Affairs Director, Emily Reeves. The purpose of this tour was to highlight and explain the distinct differences between assisted living communities and skilled nursing facilities.

As a recent addition to AHCA’s Legislative Affairs team, Emily was able to see firsthand just how assisted living communities operate and the activities the residents engage in. The tour emphasized the personalized care, vibrant social environment, and supportive services provided in assisted living, contrasting with the higher medical care focus of skilled nursing.

St. Augustine Plantation provides its residents and families with excellent care, and we were thrilled to be able to showcase it. As we walked around to tour the beautiful community it was apparent it felt like home to the residents and that they are surrounded by loving staff in a delightful, supportive environment.

Sodalis Tallahassee All treats, no tricks! This Halloween, Director of Membership & Partnerships Kristin Quirk brought spooky fun and spirit to Sodalis Tallahassee with the delivery of a festive basket of Halloween candy and goodies for the residents and staff to enjoy. She enjoyed seeing the residents in their fun costumes with their joyous spirits. Kristin loves celebrating with members and creating memorable moments for the friendly residents and staff.

Coral Oaks Veterans Day Celebration Coral Oaks, a Five Star Senior Living Community in Palm Harbor, serves as a home for many veterans who made many significant sacrifices for our nation’s freedom. FSLA proudly supports veterans, so we loved seeing Coral Oaks honor these residents. On Veterans Day, Coral Oaks celebrated their veterans with a beautiful program and an exquisite luncheon.

FSLA expresses our deepest gratitude to the brave men and women who have served our country and to Coral Oaks, a Five Star Living Community, for celebrating them!

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MEMBERSHIP Discovery Village at Tampa Palms Celebrating 100% Capactiy!

FSLA congratulates Discovery Village at Tampa Palms for achieving 100% capacity! This achievement reflects your commitment to creating a warm and thriving environment for your residents. We wish you continued success and many more accomplishments in the future.

Discovery Village at Tampa Palms It’s a Zoo at Discovery Village at Tampa Palms Discovery Village at Tampa Palms had an unforgettable day as zoo animals paid a special visit to the community! Residents were thrilled to see the friendly animals and enjoyed getting the chance to pet and learn about them up close.

These furry friends brought smiles, laughter and joy to the residents and staff.

Industry Partner Spotlight Toi Labs – Recognized as one of TIME Magazine’s 2024 Best Inventions Congratulations to FSLA’s Industry Partner, Toi Labs, on the recognition of TrueLoo as one of TIME’s 2024 Best Inventions!

kristin quirk, ms

Director of Membership & Partnership Florida Senior Living Association

FSLA loves to visit our members! If you would like us to speak at or tour your community, please contact Kristin Quirk, Director of Membership & Partnership at membership@floridaseniorliving.org or (850)-708-4972.

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OPERATIONS & REGULATORY

Guardianship in the Long-Term Care Setting

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By Shawn Harrison

ecognize this scenario? Resident admits to your facility with family members assisting but with no formal Power of Attorney. Soon it becomes clear she lacks capacity to make health care or financial decisions. Family assistance is now nowhere to be found. With no Power of Attorney, what are your options?

A professional guardian may be the solution. The process is straightforward. You petition the court to appoint a guardian and to determine incapacity for your resident. Once the petitions are filed, the Court appoints a three-person examining committee and an attorney for the resident, who is now known as the Alleged Incapacitated Person or AIP. The exam committee members and court appointed attorney come to your facility to interview the AIP and make their recommendations on incapacity. A short 15-minute hearing then place on both petitions. At the hearing the Court will review the exam committee reports and the attorney’s recommendation as to whether a guardian is appropriate.

After the evidence is presented, the Court makes a finding of Incapacity and appoints the professional guardian.

Once the guardian and her attorney are appointed, she will coordinate with you visits to review health, treatment, etc., close all bank accounts and get all funds transferred into a guardianship account, and get a payor source established. If you have a balance hopefully it can be paid. Your resident is now known as the Ward, and her guardian is now acting fully on her behalf for all healthcare and financial decisions. If the Ward has assets, the guardian and her attorney are paid for their services using those assets. If not, you have the obligation to pay her and her attorney for their services for the rest of the guardianship case. That varies widely based on individual facts but in most cases won’t exceed a few thousand dollars per year and in all cases is a better option than continuing to provide lifetime care for a resident who cannot communicate with you or pay for your services.

Feel free to contact us for more information at sharrison@ sha-law.com.

shawn harrison

President, Shawn Harrison Associates, PLLC Shawn Harrison Associates, PLLC is a law firm located in Tampa, Florida practicing in the areas of commercial litigation, healthcare law, government relations, and strategic business consulting, primarily for the small business community.

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LEADERSHIP

Leading the Way

Educating for Innovation in Assisted Living

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By Monica L. Wilson, MS

enior living is still in the early stages of exploring how technologies like machine learning, predictive analytics and robotics can enhance care. These innovations hold great potential to improve the quality of care, making it more personalized, responsive and efficient for residents. But to realize that potential, we need to lead the conversation to overcome regulatory hurdles holding us back.

Institutional Inertia

I’ve been teaching an online Gerontology class at a local college for the past 13 years and I have witnessed the rapid evolution of the learning environment, especially with the increased accessibility and advancement of AI. Unfortunately, the college recently issued a policy prohibiting students from using AI tools to assist with their work, a policy I find problematic. Rather than banning AI, I believe we should be focusing on teaching students how to use it effectively and ethically. After all, students are already using AI, albeit sometimes with humorous or poor results.

This resistance to new technologies is something we’re also experiencing in the assisted living arena. Similar barriers are being erected by regulators who, even in the face of clear benefits, are reluctant to embrace emerging technologies. In both environments, those in authority often try to limit or prohibit the use of technology due to concerns about privacy, ethics or safety.

Fortunately, assisted living regulations do not ban the introduction of innovative technologies. Despite this, obstacles are sometimes arbitrarily imposed during the survey process. The senior living industry could greatly benefit from proactively addressing common concerns, like privacy, ethics, and the potential for over-reliance, by demonstrating how these issues are being effectively managed.

Conversations Should Address Common Concerns and Demonstrate Benefits

There are a number of steps the senior living industry can and should take to address some of these common concerns, including the following: • Educate all stakeholders about the benefits of the technology, including improved resident outcomes, increased efficiency, and enhanced safety.

• Ensure transparency and accountability in the deployment of technology solutions, and demonstrate how informed consent is being secured and autonomy supported.

• Demonstrate how resident data is being protected and adherence to privacy regulations is maintained.

• Share scenarios and stories from different stakeholders in creative ways so those who are unfamiliar with the technology are exposed to the excitement and satisfaction residents, family members and staff realize when benefiting from the technology.

monica wilson, ms ICEBridge, LLC

Technological advancements will continue to evolve, and for some institutions, the introduction of new technology can feel like a loss of control. This may be perceived as challenging established power structures, particularly if it alters decisionmaking processes or shifts oversight practices. Overcoming this resistance requires transparent communication about the benefits of the technology, along with clear demonstrations of how it is being implemented ethically and efficiently.

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LEADERSHIP

F

or many years, when I was the executive director of a community, I was lucky to be on the member side of the fence of the Florida Senior Living Association. Whenever I needed support and extra assistance, I knew I could count on FSLA and it only took a phone call or email to reach the team members there.

I also truly enjoyed the annual conferences, which provided me with a terrific opportunity for education, networking and taking time from the craziness of being an executive director. These events gave me a chance to let my hair down, relax and smile.

Both Sides of the Fence

By Jimmie Fay Griffin

What I did not realize was the effort, experience and expertise it takes to provide the services I enjoyed and benefited from. Now that I am on the association side of the fence, I am delighted to be a part of the team that works hard to meet the needs of the association members, no matter the challenges.

For example, the first conference I helped plan and prepare for took me by surprise with how much time, effort and many challenges it took to make certain the event was successful and the attendees’ expectations were met and even exceeded.

Our team wouldn’t be so successful without Gail Matillo at the helm. She is dedicated to leading her team in such a way that makes everyone willing to work to their greatest potential for the association to be successful. All of our team members, including Jason Hand, our COO and General Counsel; Kristin Quirk, our Director of Membership & Partners; Kelly Wilson, our Director of Medicaid and Health Services; James McFaddin, our contracted lobbyist; Katie Truelove, our contracted marketing and graphic design professional; and Sandi Poreda, our communications consultant, conference manager and ENGAGE Magazine editor, are dedicated to making the association successful and helping meet the needs of our members. Together, we truly are an incredible force for the good of our members.

jimmie fay griffin

Accounting, Membership and Regulatory Manager Florida Senior Living Association

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I am excited to be part of the new initiatives Florida Senior Living is planning for the future, and I hope all of our members will also appreciate and benefit from what we have to offer in the upcoming months. I know with all of our hard work, Florida’s senior communities will continue to be a point of pride for our FSLA team and everyone else in the industry.

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