Trinity Health Senior Communities CEO: Our Future Hinges on Closer Health System Alignment

When Jan Hamilton-Crawford took the reins as CEO of Trinity Health Senior Communities earlier this year, she vowed to implement some “bold changes.” For the Livonia, Michigan-based senior living organization, those changes will likely include much closer alignment with its parent organization, Trinity Health.

As she surveys the senior living industry, Hamilton-Crawford sees a big opportunity for operators to coordinate and arrange more care in residents’ homes, no matter the care setting. And in the future, she sees senior living communities serving a dual role as a hub for both hospitality and health care.

“[I can picture] a model whereby it’s more like a spa-like resort,” she said during a recent appearance on the Senior Housing News podcast, Transform. “But yet, the urgent care clinic is right there on the campus and the home care services are right there.”

What Hamilton-Crawford is describing is part of a larger trend in senior living to better manage residents’ wellbeing and general health, not just their acute care needs. And she is not the only industry leader who thinks that is the way of the future.

With one of the largest non-profit Catholic health systems in the U.S. behind it, Trinity Health Senior Communities and its 40 communities are well-positioned to make good on Hamilton-Crawford’s vision.

At the same time, the organization is also looking to expand its resident base, including by more closely interacting with Black churches and other previously underserved markets.

Highlights of Hamilton-Crawford’s podcast interview are below, edited for length and clarity. Subscribe to Transform via Apple Podcasts and SoundCloud.

On transformation underway at Trinity Health Senior Communities

Like so many healthcare systems, Trinity Health learned important lessons during the global pandemic.

We’re changing things up in skilled nursing homes. Infection control has been tested and enhanced, and we’re focusing much more on integrating with our acute care partners within our system. In both assisted living and independent living, we’re laser-focused on providing high-quality housing, hospitality, holistic wellness and health care services.

So many older adults have a lot more choices now. And as they look toward retirement and life after retirement, there are just a lot more choices they have, as well as a lot more of their children are becoming more involved. So our teams are committed to bring in their very best every day so that the residents feel reassured that they’re getting the experiences they deserve when it comes to dining, when it comes to safety, when it comes to more modern amenities, when it comes to programs, when it comes to activities.

As we talk to the children and the children are satisfied, and see different things for their parents and their older loved ones — that’s the transformation we’re looking at.

On the “bold changes” Hamilton-Crawford wants to make:

Moving away from the traditional, institutional-like environments and making them more like home environments for our residents — I believe that’s what more people are looking at. More people are looking to that and to an emphasis on wellness versus healthcare, although we’re seeing people come into the industry much later now than they once did.

So for example, many individuals are not looking to go into senior living until they’re 80. So with that, [we are] making the communities more of a destination point, making them more fun, making them have more luxury apartments, making sure that it’s a place that their friends will come — and where people will connect more together, versus just a place where people go and live and possibly get care in the future.

And then, certainly recruitment and retention of our colleagues. It’s important to have the right people there to serve these individuals. And what does that look like? You know, how do we recruit people? How do we retain people? How do we make sure that we’re getting the best of the best with people that really, really, really have a passion for caring for our aging population? They’re our most vulnerable population, but they’re also you have to have a real passion to want to do this and work with these individuals on a day-to-day basis.

On how Trinity Health Senior Communities can work more closely with its health system parent company:

Certainly by leveraging the expertise, among the leadership team and among the individuals that are working there. For example, leveraging the [expertise of] nursing staff at an acute care hospital.

I remember almost 15 years ago when a former organization was talking about the hospital without walls. Now, it’s like doing more at home, wherever home is. It’s not necessarily that three bedroom two bath anymore, it might be a skilled nursing bed. But wherever that is, that’s where the care is delivered. That’s where we make sure that it’s an environment that’s more around everyday living, and again, [making sure it’s] not so institutional. Also with discharge planning, also with having more comprehensive settings for our rehab patients as well as for the patients that don’t need that. So, it’s really bridging all that together.

Also, the Trinity brand is huge. How can we leverage that so that anyone that’s associated with a Trinity service, whether it’s an acute-care hospital, where they it’s in senior living, whether it’s in urgent care, whether it’s home care, PACE — wherever they are served, it all just ties in together and connects together?

[I can picture] a model whereby it’s more like a spa-like resort that people go to. But yet the urgent care clinic is right there on the campus and the home care services are right there on the campus so people don’t have to seek out anything.

And then there are programs that are associated with taking care of yourself. For example, through our insurance, we get points for having our teeth cleaned. So it’s going to the dentist, things of that nature.

You can work through those types of things within the senior community as well: “How many steps did you take today? Did you check your blood pressure today? Those are types of things where they can get points and we can put them in a drawing. Trinity has all of those services already. So it’s really tying those all together.

On what Hamilton-Crawford on her “listening tour” as new CEO at Trinity Health Senior Communities:

[I would ask], what do you see working in the future? What are your needs? How can we, as a system, as an office, support you more? And the same thing with the residents: What’s working, what’s not working? Mainly, what you hear from the resident, especially in this day and time, is they just want to be safe. Covid has shone the light on where we are, what we’re doing? Even if there is another pandemic, how can we be at a point that we don’t have to close down anymore? How can we move to models where buildings have porches so that people can make sure that they have visitors and not be isolated — things of that nature.

I’m also hearing from the residents that they want that nursing care available. They just want to know that it’s there, even though they may never use it or need it. I’m doing listening sessions with colleagues that will start in September. So, there will be more of that.

On staffing challenges and opportunities:

It’s not that hard, people would just really want to feel loved, valued and appreciated. And especially on our front lines, people did not feel like they were loved, valued and appreciated during the pandemic. And so my goal with the senior leadership team as well as all the [community] leaders is to get out there and assure people that they are valued, they are appreciated, and that we do see them as very integral in serving our seniors.

We’re also looking at, certainly, salaries; we’re looking at benefits, we’re looking at more flexibility. The leaders are accustomed to hiring someone for a 12-hour shift. And we may have to have three people for three or four-hour shifts … and it’s harder for us to manage that. But we have to be flexible as well in understanding what the needs are of the individual.

It’s a very hands-on environment. I’d love to say we’re going to get some robots and take care of the needs of the individual, but senior living is very, very up close and personal.

What do we need to do as leaders to assure that number one, we can recruit these people? And number two, that we retain them by really continuing to live out our mission by showing that these individuals are very much appreciated? Believe it or not, there are residents that can run staff off. In restaurants right now, you walk in and you see signs that say ‘Please be kind to our staff,’ and that they’re working as hard as they can.

We have to be mindful of that when we’re working with the senior communities as well, because people have chosen this and we need to keep them. And so it has to be very much a collaborative conversation, and a collaborative effort for us to retain the passionate staff that we’re looking for.

On being the first Black woman to lead a division at Trinity Health:

My parents instilled in me that I can do and I can be anything that I want it to be. They instilled in me the safe, the family and fun. And that’s what we did, and that’s what I’ve used throughout my leadership.

I have one daughter, and her name is Rea. And I have also instilled that in her. I wanted to make sure that throughout my career that things for her were limitless. And she’s also a CEO, as well as a trained lawyer. 

Being in this role is very fulfilling for me, I really want to be an example for other Black women and Black leaders that you, too, can do this. It takes a lot of hard work, it takes a lot of prayer, it takes a lot of perseverance. But you can do this, too. Surround yourself with strong mentors and people that believe in you, and learn from them and accept feedback. And they, too, can do this as well.

On having “uncomfortable conversations” about diversity:

I think the uncomfortable conversation is understanding and realizing that over almost 90% of the frontline individuals that work in senior communities don’t look like the residents and patients that we serve. And so, how can we have a conversation about having more exposure to the people that look like the frontline people to feel more comfortable moving into the residential communities that we serve?

I’ve heard throughout my career that sometimes it’s the price point. And I know many, many people that look like me that can afford to be in these communities. Well, they’ve never heard of them. They don’t even know that they exist, because they don’t have friends that can share this information with them.

So, I think a big part of what has to happen is the whole exposure piece. Have we presented to the Black churches? That might be uncomfortable, but have you gone to the mega churches, and done a presentation on your community? This is what you offer.

We tend to keep going to the places from which we’ve gotten a resident from, versus breaking into new grounds and saying, ‘Okay, no, I’m gonna go to the Potters House.’ Trust me, there are quite a few in there who can use our services and that could benefit from our services. But they don’t even think about it.

On what she would change about senior living if she had a magic wand:

Certainly making the choices of where people end up — making those choices broader and making sure that those choices are all consolidated into one place. So when a person chooses to leave their home after 30 or 40 years and they go to what we would call independent living or assisted living, that it’s all right there, and they never ever have to move. Even if they need skilled nursing, they don’t have to move, that all of these services come to them, including the hospitalization — it all comes to them at whatever location they live in.

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