This article is sponsored by JD Solutions. This article is based on a Senior Housing News discussion with Jennifer Dixon, Founder/CEO of JD Solutions Group and Trever Sweeney, Vice President of Asset Management at Ventas, Inc. The discussion took place on July 21, 2022 during the Senior Housing News BRAIN Conference in Chicago. The article below has been edited for length and clarity.
Senior Housing News: I’m joined by Jennifer Dixon. Jennifer started JD Solutions Group with a vision to align empathy, action, and purpose in senior living sales coaching, training and consulting. Among other roles, she previously served as Chief Sales Officer for Sherpa, VP of Sales for Benchmark Senior Living and was COO of Bild & Company.
I’m also joined by Trever Sweeney from Ventas, one of the largest owners of senior housing in the United States with a portfolio of more than 800 senior housing assets. Trever is Vice President of Seniors Housing Asset Management at Ventas. Jennifer, I want to start with you. You told me previously that memory care providers are bouncing back faster on occupancy. Do you really see them seeing things through a consumer lens? Can you explain what you mean by that?
Jennifer Dixon: Absolutely. I think that we have really seen a turn in the industry of how we look at our sales methodology, sales processes, and how we change that to fit it to the consumers, meaning the prospective families, the adult children, and we’re really turning it now to look at it through the lens, through their eyes. What that means is, meeting people where they are on the journey. We know that for family members who are really going through that process of trying to help a loved one who is struggling with memory loss, it’s an incredibly tough situation.
I think the pandemic showed us both through the use of technology and connection that we can meet people sooner in the process and begin educating them and talking to them about the challenges that they face. I think it’s an exciting opportunity for us.
SHN: Trever, turning to you, talk to us about Ventas, senior living communities and memory care specifically. Is there something you can share that you’ve observed that is particularly a high priority for consumers right now?
Trever Sweeney: Yes. We have in our operating portfolio, about 60,000 units, and 10% of those are from memory care. In memory care, what adult children really want to see is the person that’s caring for their loved one is consistent, is going to be there every day, and they know their name. What comes along with that is having consistent staff by limiting turnover and controlling contract labor. A couple things that operators really need to recruit and retain strong staff is investing in an applicant tracking system and identify opportunities to streamline and gain efficiencies in their end-to-end hiring process.
For example, is there anything in the hiring process that’s delaying getting consistent staff in the door? Are the drug tests taking too long? Are the background checks taking too long? Are you taking too long to get back to potential team members? Getting a handle on your labor and having a smooth hiring to onboarding process makes for happy staff; happy staff makes happy residents, and happy residents make happy staff, and so you have this virtuous cycle.
SHN: Are you seeing consumers aware that we’re in sort of this very tight labor market generally and so they’re asking more questions such as, “Is the staff strong here?” “Is there going to be consistent staffing?”
Sweeney: We definitely hear about family members asking questions about turnover when they see the different uniforms coming in from the contract labor agencies, that can be concerning to them and their loved one. Sometimes contract labor is necessary and I think they understand but when it’s pervasive and they are not seeing consistent care, that’s when there are questions.
SHN: Jennifer, I know in our past conversations, you’ve told me you’re concerned about memory care communities all trying to sell themselves the same way, the same old things. What do you think should be, or is the value proposition of memory care that providers need to do a better job of getting across? How can they differentiate themselves or not just be saying the same old things?
Dixon: I think it is something that people are looking for the answer to. It’s so interesting here that, on any given week, I’m listening to dozens and dozens of live calls that the communities are fielding from family members. What’s fascinating is that we’re all saying the same thing, which is essentially like a listing of features or amenities. I think when we begin talking about value propositions, we have to be really passionate about what the pain points are for prospective residents and their families.
I’ll give you an example. I was on the phone this weekend with an amazing sales director. She had a really difficult tour. The tour was with a husband, who was in his late 80s. He was touring for his wife for memory care and she was at home and he came to the community. He spent almost 45 minutes of the tour in tears and crying. His question to her was, “How do I know that you are going to be able to help keep her safe, the same way that I have for the last 10 years?” That’s a big, big question, and it’s not answered by a canned value proposition.
I think that we need to be more passionate about the challenges and the concerns that families are facing, and really hear questions that they have. We can be proactive to address this in our marketing and make sure that our sales process reflects their perspective. Then, we are going to be in a totally different situation, for the better.
I believe that value proposition is about really listening to what the families are saying, answering their questions, and probably a later discussion is addressing service outcomes of our residents when they move into our communities and being able to communicate that.
SHN: I guess I need to follow up on that, because it strikes me that you say you need to listen and respond to the prospective customer. That seems so basic to me, yet I’ve also done mystery shops where I call and get just the laundry list of amenities. Why is that still happening?
Dixon: I think a lot of it is rooted in the sales methodology that you are using. By methodology I mean, how you are selling, why you are selling. That should be deeply rooted and aligned with your organization’s mission and vision. You have to look at the methodology and separately, you have to look at the process- that’s how you are selling and the steps that you’re taking. We can’t say that we value empathy, and we value connection, and listening, and then we’ve got a script of the same ten questions to ask all families. There’s a dissonance there.
I think what we’re seeing change is that sales directors need to be coached to think critically, to problem-solve and to go deeper and ask deeper questions of the families and the adult children that they’re working with. It’s so frustrating, because it sounds like such a simple thing. If you ask anyone in Senior Living Sales, they will say, “Yes, I listen all the time. My discovery is great”. But the live call reviews and mystery shop studies show there are less than two open-ended questions on average asked during most inquiry calls. We’ve got some work to do, but I think we’re heading in the right direction.
SHN: Let’s talk a little bit about technology. What are you seeing out there in terms of technology? Do you think consumer expectations are different, especially coming out of COVID maybe, about what technology they expect to see or want to see in the memory care community?
Dixon: I think we’re seeing two sides of the technology. Above everything else, families want communication. They want to know what’s happening. We’ve seen the relationships between family members becoming very fragmented. They don’t know how to have a relationship with their mother or their father who’s been struggling with memory loss. There are so many things, so many wonderful things that I know you all do in your communities to be able to foster and rebuild that connection. How do we share that, and what technologies enable us to share that and share the positive things that are happening?
On the front end of sales, we are completely reevaluating the marketing messaging strategy and the technology on our websites. There’s still a lot of our websites that just have basic boilerplate information, very little information about pricing or the why behind pricing. The more that we can use technology to be able to interact with families and give them education and content and ask their questions before they ever even identify themselves to us, the more we can build that trust.
SHN: Trever, any thoughts on that technology question?
Sweeney: There is a lot of interesting technology out there. We talk to a lot of interesting vendors. I love talking to them and I evaluate them sometimes the same way that I evaluate operating partners. What’s your philosophy? What’s your mission statement? Where have you been? Where are you going? That kind of thing. There’s a lot to wade through, but there’s some gems out there. One thing that we’ve been spending a lot of time on is proficiency in your digital marketing. I just think that is so important.
Echoing Jennifer, having a strong website and a strong web presence is really a big key to success. At Ventas, one component of our proprietary Operating Insights platform is engaging with our operators on their website and digital strategy. Part of this is performing a website code audit. Another is executing user experience testing to see, what is the experience of navigating your website, how interactive and informative it is, and we benchmark compared to other industry operators. Is it easy to schedule a tour? Is it easy to see what units are available? Can I see pricing that’s available for the units in your building? If you are locked in your digital strategy, you can really be successful.
SHN: That’s really interesting. You mentioned pricing availability, are you seeing that as something that is becoming more standard or should be?
Sweeney: I think it needs to be. I think you’re seeing more and more operators doing it, a lot are really thinking about it. I would certainly advocate for it. You look at other industries in hospitality, there’s full pricing transparency. Think of a world where someone can go on your website, they can look at pricing, they can pick out their unit, and they show up to your door with a residency agreement and say, “I just want to go look at Unit 201 and just take one more look, and then I’ll move in.” It takes a lot of burden off your salespeople. It’d be really nice to end up there in the future.
SHN: I feel like that’s something we’ve been hearing about for years and years too. I guess if the Ventas’s of the world are pushing things in that direction, maybe we’ll see more progress. As we’re thinking about elevating the value, proper memory care, and reaching consumers in more ways, I’m thinking partnerships are increasingly important, whether that’s with home health providers, primary care groups, adult day programs, community groups doing, arts and culture, the list of potential partners seems really long. Jennifer, is that correct? Do you have thoughts on the value of partnerships and do you see that increasing in memory care?
Dixon: When we’re talking about partnerships on the sales and marketing side, this is reflected in market-specific business and referral development. This is something that isn’t just needed in memory care, it’s vital to the success of any senior living operation. We’ve seen historically in senior living where the role of the sales director has been to focus mainly on internal sales. When they have some time, you should go out and build those relationships. The catch is, they never have that time, so it doesn’t happen consistently, if at all.
What I’m seeing is a much more strategic approach to partnerships and business development. I’m seeing a lot of investors and operators looking at making sure that they are funding business development roles in the community, meaning people who are very focused on working with partnerships, whether it’s with hospitals, health systems, Parkinson’s Specialty Groups, the Alzheimer’s Association, churches or local businesses. These relationships, just like the relationships we have with adult children and family members, need cultivating, but it’s very difficult sometimes to have the time to get out of the building and dedicate the time to do that.
We’re seeing more operators looking at, how do we do this? How do we invest in that role, perhaps at the corporate level to look at much larger partnerships, and then at the community level, how do we drive that connection? Even something as simple as making sure that every single community and sales director has a LinkedIn profile, are you connected with all of the people in your community who are passionate about memory care and passionate about aging in some way? There’s so many ways, again, technology that we’re able to interact with one another, but I see this as a great big, blue ocean for us to explore and forward here.
SHN: Trever, on this note, you’ve told me that business development efforts and partnerships actually can help memory care providers show up higher in internet searches. Can you explain that?
Sweeney: The good thing is that Google actually rewards old-fashioned business development, but what you need to do is build your partnerships with the Alzheimer’s Association, with different physicians out there, and then to formalize those relationships online. Google determines relevance by looking at other websites that reference you, and rewards you through a number of metrics but a simple one is called the“domain authority” and you should know what the domain authority of your website is.
The more that you can take those partnerships that you already have and formalize them online and get people to mention you, get the Alzheimer’s Association to link to your website, get more people to click on your website, then the higher you’ll show up organically in search, and then just naturally the more people will end up going to your website.
SHN: That’s great. All right, Trever, I’ll stay with you for this one. I want to open up the can of worms, the perpetual debate, standalone memory care versus part of continuum. I think there is lots to be said here and has been said here, but do you see one model versus the other may be resonating more with consumers right now or do you see one as a preferred model as we look to the future?
Sweeney: Great question. The typical response might be that a standalone memory care could have an issue because there can be in theory a dearth of leads, I hear people mention that and they can say that the margins will be tight. But I see a lot of different communities. And the other side of the argument is you can take an assisted living memory care community that doesn’t have good leadership, doesn’t have a good online marketing strategy. They’re 60% occupied because they’re not differentiated in doing a good job. How do you think those margins compare to almost full memory care that really knows what their strategy is and can really stand out in the market, and they’re 90% full?
In some cases, the standalone memory care is doing a lot better. It always depends on their leadership and execution. At Ventas, we have this right asset, right market, right operator strategy that sums up my sentiment on this one; it’s more than just what’s the footprint of the building, but what’s your strategy, what operators are there, what training are they providing, and how can they stand out in their individual market?
SHN: Jennifer, any thoughts to add to that standalone versus continuum?
Dixon: Now, I think there’s great opportunities for both. I think it’s just very important to be able to communicate clearly what it is that you do uniquely, what you do very well, and how do you help? How do you help families understand what the value is? Because they really don’t understand when they come in. I think that that comes across in the sales process too. If the majority of your building is assisted living and you only have a few units dedicated to memory care, does your sales team know specifically what to talk about? How is the caregiving training different? How is the programming different? Are they even comfortable giving tours and visits in the memory care program? I see a lot of, I’d say, nervousness sometimes from salespeople about not being comfortable going into the memory care part of the building.
When you have both levels of care, I think it’s important to differentiate them and make sure that your team is very comfortable with that. Ultimately, you want to be able to position yourself as the resource in the community. I think there’s pros and cons for both.
SHN: All right. I want to talk about specializations a little bit. It occurs to me that this is one way to be differentiated in your market if you’re a memory care provider and you have specialized programs for particular diagnoses or early stage say. Jennifer, is that true? Do you see this happening? Should it happen more? I’ve also heard on the flip side it can be hard to fill those programs actually if you limit yourself.
Dixon: I think that we’ve got a lot of growing to do to be able to measure outcomes that are specific to a diagnosis, to specialize in that way. I think that where we have a lot of runway and a lot of good direction to go in, is looking at what the families experience every day as caregivers. You have these different diagnoses, but there are some very similar behavior challenges that we see in our residents that families don’t understand. There’s a lot of embarrassment that comes with it for family members.
Again, if we are specializing in something specific, we have to address those issues and how are we helping with that, and ultimately how do you help change that resident’s life for the better? How do we help families understand that “behaviors” are sometimes the only means of communicating a frustration and sign for us to learn more? Whether you do that through a specialized program or in general, I think we’ve got opportunity for both.
SHN: Trever, any thoughts on that specialization question?
Sweeney: We’ve seen operators offer some specializations. The important thing is you don’t need to put up a banner that says this specialization only. Most communities are going to have maybe one or two people with Parkinson’s, but if you can offer additional training via university partnership or have a certain physician that you partner with and then you can talk about that in your tours and then have that physician refer to you and have a monopoly over that referral partner, that can certainly be beneficial.
The important thing is, don’t shy away residents that don’t have that specific diagnosis and just meet residents where they’re at. At any good memory care community, you’re going to have to offer separate programming for individual residents. Some residents want to listen to music, some residents want to color, all residents want to do different things. You just have to meet residents where they’re at.
Dixon: We heard even earlier this morning about just the confusion over terms and language, so dementia versus mild cognitive impairment versus Alzheimer’s, and then you throw in things like Lewy body and Pick’s disease. There’s a lot, and there’s a good chance for us to help educate families and our potential partnerships, referral partners in the community about this, because again, most people don’t understand this, they don’t understand the terminology and when they’re exposed to it, it’s already a crisis situation.
We heard the comments earlier about the early stage of mild cognitive impairment, it’s so important to have a diagnosis then, to begin treatment then. As a senior living community, are you bringing experts in from the surrounding community, the medical community, the colleges and universities, to speak about these topics, to educate families? All of that builds trust and continues to position yourself as a real trusted resource.
SHN: I know Ventas got out of the skilled nursing space a few years ago. Within the context of memory care, I’m curious if you have any thoughts about the role of the nursing home and how that intersects or doesn’t with private pay memory care. Is it something that you are not paying any attention to? Is it something that’s on your radar at all?
Sweeney: One thing that is really fun about Ventas is, we have such a great team of people that, one, love to collaborate, and two, just love to learn and remain industry experts in healthcare real estate and operations. We pay close attention to what’s going on in skilled nursing as part of our understanding of the broader macro environment. I don’t want to comment on our philosophy, but we’re paying close attention.
SHN: Trever, I want to zoom out a little bit. As you’re traveling around and on the phone, interacting with all of these communities in the mental health portfolio, how do you know when you’re dealing with, or you’ve stepped into a really great memory care community that’s really fulfilling the value prop that we’ve talked about today? What are some things you look for or see or hear or experience?
Sweeney: Prior to Ventas, I was in the military. In the military, a big thing is leadership. If you have a strong executive director leader that takes pride in themselves, takes pride in the community, can collaborate with the rest of their team, that shines through in things like, are they doing daily walks with the maintenance director? Looking at the temperature of the lights, are there boxes in the hallway? Just general cleanliness of the facility.
Then, are staff members taking pride in their work? Are they standing around on the phone or are they rushing into problems in the building? It starts with a leader in the building. It’s hard out there to get strong executive director leaders, but if you have a good company culture and a good philosophy and your corporate team is getting out and visiting buildings and making sure that folks in the field are supported, then you can find and maintain those strong leaders.
SHN: Jennifer, any final words to help providers in their efforts to understand and reimagine that journey?
Dixon: Yes, final answer. I think that what we are selling is change. This isn’t about selling memory care. This is about selling change. When you are selling something as monumental and huge as what we are doing in the senior living industry, we have to recognize that this is not about us. We have so many amazing things in our communities, but it’s not about us. It’s about the families. It’s about the residents. We are selling a major life change and we have to meet people where they are. We need to go to them. That is what should influence how we market and how we sell. I think when we get to that point in senior living and in memory care, it’s going to be a beautiful thing.
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