What Senior Living Providers Are Doing — And Could Be Doing Better — in Response to Black Lives Matter

Senior living providers — like many businesses across the United States — have been responding to the Black Lives Matter movement with a variety of messages and actions.

To get a sense of how providers are responding, I spoke with several CEOs and corresponded with many of the largest for-profit and nonprofit organizations in the country. And in an effort to better understand some of the racial justice issues at play, and best practices for addressing them, I spoke with Kyana Wheeler, deputy manager of Seattle’s Race and Social Justice Initiative, and a consultant who has worked with a variety of organizations to implement systemic changes as part of anti-racism efforts.

A clear consensus is that the senior living industry suffers from a lack of racial diversity, with few Black people among its corporate workforce and a sore lack of Black CEOs. This is an issue that has long been recognized but has not improved much over the years, several company leaders pointed out. 

“I look back 30-plus years ago, when I came into this industry, I’m 23 years old at a national conference; there’s a lot of white, gray-haired, older men, and I’m like, ‘Oh my, what did I just do?’” Asbury Communities CEO Doug Leidig told me on a recent episode of SHN TALKS. “I’ve seen some changes, but we still have an issue.”

A particularly troubling aspect of this situation is that about one in four frontline workers in long-term care is Black, according to a 2018 analysis from the Kaiser Family Foundation.

This type of racial imbalance within companies creates a “powder keg,” Wheeler warned, speaking from her own experience working with organizations that have had similarly skewed power structures.

So, reckoning with this disturbing racial dynamic of the senior living industry is overdue and should be seen as a top priority. But, it seems clear that changing this situation is dependent on providers making a broader commitment to becoming anti-racist — that is, an “active and conscious effort to work against multidimensional aspects of racism,” as Georgetown African American studies professor Robert J. Patterson put it.

Seriously reckoning with racism within a company means undertaking uncomfortable and even painful changes, but organizations that do so will ultimately be rewarded with increased business success, drive the sustainability of the industry as whole, and contribute to the creation of a more just society. On the other hand, senior living providers that ignore or merely pay lip-service to the Black Lives Matter movement could pay dearly down the line — they are adding to the “powder keg” that could ultimately destroy their enterprise, harm the industry, and set back the cause of racial justice.

Large providers respond

Senior living is an industry largely consisting of small or regional providers. Among these types of companies, there are some examples of organizations led by Black executives, as well as providers that have made racial equity a core goal for many years. But for this piece, I reached out to the five largest for-profit and five largest non-profit senior living providers in the nation, according to the 2019 rankings from Argentum and LeadingAge/Ziegler. My reasoning was that these companies make a particularly strong impact due to their size. (For an example of how a smaller provider has approached these issues and is responding to Black Lives Matter, I zero in on Presbyterian Villages of Michigan in a separate article.)

In particular, I asked for examples of actions that the largest senior living provider organizations are taking — not just statements they have released — in response to Black Lives Matter.

Some companies are introducing new training or education regarding race and racism. Catonsville, Maryland-based Erickson Living is adding required employee training on unconscious bias and workplace conduct. Des Moines, Iowa-based LCS is hosting a webinar open to all employees on the topic of injustice and systemic racism and offering additional learning experiences for associates, such as a session on unconscious bias.

Another common theme is that providers are creating new forums for communication and seeking to provide support to their associates.

For instance, McLean, Virginia-based Sunrise Senior Living hosted a call with geriatric psychiatrist Dr. Susan Wehry.

“Black team members spoke openly about their personal experiences, including losing a person close to them due to police violence,” Sunrise Chief Human Resources Officer Laurie Pack told SHN. Leaders within Sunrise were also directed to reach out to their teams to check in on how they’re doing and provide information about resources available to support emotional and mental health.

Many people in the workforce of Presbyterian Homes and Services live in the neighborhood where George Floyd was killed, because the nonprofit is based in nearby Roseville, Minnesota, and serves the Twin Cities, Senior Vice President-Employee Experience Traci Larson told SHN. Emotions are “raw,” she said. The company’s CEO Dan Lindh committed to “listening” as a primary response.

“We certainly don’t have all the answers but we are asking meaningful questions which we intend to pursue by listening to people of color and minorities among our employees, customers and the communities in which we serve and to which hold ourselves accountable,” he wrote in a statement to employees.

Cindy Baier, CEO of Brentwood, Tennessee-based Brookdale Senior Living (NYSE: BKD), also emphasized emotion and listening in a public statement that she released.

“As we all process our own thoughts and feelings regarding the racial injustice and social unrest, I encourage all of us to see how we can help each other,” she wrote. “I believe that our commitment to listening, growing, and understanding our differences will help us continue building an inclusive culture in which people can be themselves and feel wholly part of Brookdale and are able to thrive.”

I have to admit, I rolled my eyes when I read Baier’s statement. In this piece, I wanted to report that companies are taking concrete steps to change policies, or that they are hiring chief diversity officers or securing the help of outside consultants to drive change, or that they are otherwise putting their money where their mouth is when it comes to combating racism. The intention to “listen” struck me as weak.

So, I was surprised when Kyana Wheeler told me that she considered Brookdale’s statement to be among the best that were released by these large providers. She singled out Brookdale’s statement as being “human.”

“It was honest and directly talked about emotions, the pain, and it brought that back around to how we are in this together,” Wheeler said. “Our communities and the people in our communities need each other, and they are committed to that. Not committed to some action that makes them feel good, but committed to how the people feel.”

Wheeler’s point made me realize that with all the recent attention that has been focused — rightly — on structures of oppression and the need for systemic change, I had lost sight of the fact that racism is experienced at the individual level, and any response has to address each person’s pain, as well as their other emotions and reactions. “Listening” — emphasized not only by Brookdale but Sunrise, Presbyterian Homes and Services, and several other providers — is not only crucial, but difficult.

“Open up with real dialogue about recognizing the pain and humanity of what Black mothers, Black families, Black people must be feeling,” Wheeler advised, regarding how companies should be responding to this moment.

But while Wheeler found aspects to praise in Brookdale’s response and those of some other companies, she was not truly impressed by any of the statements from this group of large senior living providers. Here are just two of her points on how senior living companies — or businesses of any kind — can improve:

— Specifically address Black workers and the Black community. Black Lives Matter has opened up discussions about racism of various kinds, but as its name makes clear, this movement is about a particular group and a form of racism with especially deep roots in this country. Corporate statements that speak generally about racism or diversity, or that fail to distinguish racism against Black people from racism against other groups, are perpetuating long-standing problems. “Something that we as individuals, as institutions, as a country need to face head-on is our inability to center Black people without having to connect Black trauma to some other more understood or more recognized trauma,” Wheeler said. “… If you are reaching out to your internal staff, you must recognize that the Black staff is actually most harmed in this BLM moment and investment needs to look like you value that.”

— “Don’t act like you’ve been here with me the whole time.” An organization might have had “diversity” listed as a value in the mission statement for a long time, and many of the 10 largest providers shared information about their efforts to build greater diversity and inclusiveness over the years. However, if employees have not received a communication specifically about Black Lives Matter since the movement began when Trayvon Martin was killed in 2012 — or if they have never received a message from leadership about BLM — then assertions that the company has been a champion for anti-racism will seem transactional at best. When leaders acknowledge a company’s problematic silence, that is meaningful, versus messages that primarily convey why “this is a nice, not-racist institution,” Wheeler said.

Defusing the powder keg

As for the generally observed racial inequality between senior living leaders and frontline workers, Wheeler shared particular words of warning.

If an organization espouses diversity and inclusiveness as values, but leadership is predominantly white and the workforce is largely Black, unrest and resentment tend to build until an incident leads workers to call out the organization’s hypocrisy, she said. A crisis then ensues that could threaten the viability of the company going forward, particularly if marginalized workers are holding up the enterprise.

Many senior living executives and other leaders in the field tout the fact that frontline workers have an opportunity to rise through the ranks, but the racial imbalance in the industry suggests that there are systemic barriers preventing Black workers from attaining power — a point acknowledged by Presbyterian Homes and Services’ Larson.

“Our collective spiritual heritage and understanding can enable us to name and dismantle barriers that serve to prevent people of color from rising to the top levels and deny our sector the benefit of their unique perspective and experience,” Larson told SHN, referring to nonprofit providers in particular.

The road to achieving this particular goal — and building a more equitable, just, anti-racist version of senior living generally — will be long, Wheeler cautions. And, each organization has its own unique dynamics to assess and address. That said, here are a few overarching concepts that Wheeler singled out, that are crucial to dismantling barriers and achieving real change:

— Recognize white normativity. In the United States, power has historically rested with individuals who hold citizenship and are white, male, able-bodied, Christian and heterosexual. People who do not fit this mold have been socialized to “become more of the norm” — for example, Wheeler strove to attain multiple degrees, achieve a certain level of class and make sure she speaks “proper English.” Within organizations, corporate advancement is frequently contingent on meeting expectations and fitting within structures defined by white founders and leaders, and by larger societal values defined by white normativity.

To address this, Wheeler suggests doing root cause analysis — asking six times why a particular policy, system or structure is in place. That process of repeatedly asking “why” often leads to conversations about an organization’s core values. When leaders say they are committed to change, they usually mean they are committed to comfortable change, Wheeler noted. Recognizing white normativity and changing a company’s values and structures accordingly is not comfortable. For example, company policies might call for an employee to be fired for making racially offensive comments to coworkers. But such a “zero tolerance” policy involves the relatively easy exertion of firing power — often held by white leaders — versus going through a restorative process that might involve a dialogue between the employee, their Black colleagues, and others, which can reveal deeper issues within a company’s culture.

— Go beyond “diversity and inclusion.” The words diversity and inclusion sound good but have “little value to Black and Brown communities … the intention of diversity and inclusion is to maintain the status quo while seeming like one is invested,” Wheeler said. In other words, simply having people of color working at a company does not mean that the organization is striving to create an anti-racist and just workplace where white normativity does not rule.

Black business leaders have spoken out against the phrase “diversity and inclusion” recently.

“The reason why I personally have an issue with the term ‘diversity and inclusion’ is because we adopted it in corporate America to say ‘we’re trying,’ but the efforts didn’t really yield anything,” African American Real Estate Professionals D.C. President Carisa Stanley told Bisnow. In particular, she emphasized that companies need to evaluate how many Black workers they have in revenue-driving positions, which hold influence within a business.

— Involve outside experts and institutions. Organizations in the United States collude in unspoken ways to uphold white normativity, Wheeler said. So, a company will need to work with other businesses and institutions in the quest to become anti-racist. One example: Certain jobs might call for applicants to have a particular level of education or experience. Such requirements favor certain demographic groups. A 30-year-old white woman is likely to have finished college faster and with fewer loans than a person of color, Wheeler said. It’s obviously not feasible to simply scrap such job requirements. But a company can forge relationships with area schools and open up a dialogue about ways to collaborate on new approaches to access, funding, job preparation and applicant pipelines.

Finally, senior living providers should be realistic in their expectations. Data from organizations such as McKinsey and Altarum show that greater racial equity in business translates to improvement across a variety of domains, including financial performance and employee retention. However, these returns take years to achieve and demand investment of money and time, Wheeler emphasized.

A danger is that organizations become overwhelmed at the enormity of race-related problems, not only within their company but society as a whole. So, she advises starting now, aiming for achievable short-term wins, and valuing the journey’s complexity and challenges.

Quoting tennis great and civil rights icon Arthur Ashe, she said: “Start where you are and use what you have.”

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