March 27, 2024 • 23 mins
Live from the 2024 NIC Spring Conference, listen in as Lisa McCracken, Head of Research & Analytics at NIC, sits down with Brett Landrum, Procare HR Founder and Co-CEO. Landrum expands on the capabilities that allow Procare HR to help operators deliver better quality of care, resident satisfaction, and financial results. Joining the discussion was Susie Koenig, Founder & CEO of healthcare management and consulting services firm SAK Healthcare. In today’s environment, with some senior housing and care companies facing distress situations, Koenig shares how SAK Healthcare has found success partnering with Procare HR as they work to shore up communities in distress.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Lisa McCracken (00:05):
Welcome to the NIC Chat's podcast, and we're
happy to be On the Road todaylive in Dallas at the NIC
Spring Conference. My name isLisa McCracken, I serve as the
Head of Research and Analyticswith NIC. So excited to be here
today with two guests, and Iwill introduce the two of you,
and I'll let you then telleverybody a little bit more
(00:27):
about you. But we're excitedtoday because we actually have
a repeat guest, Brett Landrum ,and he's gonna tell a little
bit more about his organization, and what they provide to many
of you who may be listening.
And then we have a guest ,Susie Koenig, who many of you
may know, Susie, with SAKManagement Services. So before
(00:48):
we dive into the conversation,we got about 20 minutes here
today to cover a lot ofdifferent interesting hot
topics that I think many ofyou'll be interested in
learning more about. But forthose of you who didn't see us
in the fall when we weretogether at the Fall
Conference, Brett, give alittle background on you, P
roCare, HR, and w hat would behelpful for those to know about
you. And then we'll go to you,Susie.
Brett Landrum (01:07):
Absolutely. When we think about ProCare HR and
the vision for ourorganization, we've built a
senior living optimized HRfoundation, delivering
comprehensive HR services fromtalent acquisition coaching,
etcetera. And we really believethat that foundational kind of
(01:30):
HR platform is an opportunityto really build and drive
better quality of care,resident satisfaction and
financial results for ouroperators. And so, for ProCare
we've been working the lasteight years to really refine
and understand the industry andbuild this comprehensive HR
(01:51):
services. And now we get to dothe fun stuff, which is really
to sit back and say, okay, howdoes this platform we've built
enable us to build and buy kindof in industry leading
solutions that can really movethe needle again in quality
care and financial results andresident satisfaction.
Lisa McCracken (02:08):
Right. And we're definitely gonna talk
about some of the workforce,obviously that's a hot topic
and I appreciate you commentingon workforce being related to
resident satisfaction,financial performance. It's all
interconnected. So we're gonnacome back to that and hit some
other topics as well. Susie, doyou wanna tell the listeners
about you?
Susie Koenig (02:25):
Of course. So I am Susie Koenig and we're with
SAK Healthcare. We'verebranded, so we've been in the
business as we were talking alittle bit earlier for a long
time. I've been doing this forover 30 years without giving
you exactly my age. However ,we come in and we're healthcare
(02:48):
turnaround company, and weprovide kind of the whole
interdisciplinary healthcaregroup that would come in and
almost be like a SWAT team tohelp providers and to assist
landlords, assist REITs, assistlenders to come in and to
(03:11):
provide management services orhealthcare consulting when
needed by many groups as well.
We have a third partymanagement arm as well as a
consulting arm. And we get veryinvolved in court proceedings,
court appointments,receiverships examiners,
(03:34):
chapter 11, trustees. And I'velearned without having the
legal degree , a little bitabout restructuring. And so
been very involved in thatprobably for about the past 20
years. But started originallyas a social service admission
director in a facility andlearned from the bottom up. And
(03:56):
became an administrator andworked through, and now we
operate portfolios and alldifferent types of cases that
need assistance and providingimprovement, mostly, and in
quality as well, clinical,financial , and the whole
(04:18):
gamut.
Lisa McCracken (04:19):
Your SWAT team depiction, that's an
interesting way to put it,right? Because your engagements
and management situations, arethere with organizations that
are in distress. And we'regonna get back to that. because
I think that's one of thereasons why we wanted the two
of you here today because weare in a situation in the
senior housing and care spacewhere there is that element of
distress. So , the two of youare often partners in these
(04:43):
situations. So , you get the,let's say the mayday call or
whatever it may be, and you'vegot a team and from my
perspective that's smart,obviously saying, okay, where
do we have expertise? Where dowe bring in others that can
bring some really solidsupport? So, Brett, talk to me
a little bit about what thatpartnership looks like and what
(05:03):
would be helpful for thelisteners to learn about?
Brett Landrum (05:06):
We've been very fortunate. I think we, Susie
and I met a couple of years agoand they were contemplating do
we build an in-house model forHR. Do we look for a partner?
They had kind of, I thinklooked, and kind of evaluated a
handful of different HRpartners. And ultimately as we
got in there and they got toknow us, I think,
(05:29):
philosophically we're verysimilar around pace. When Susie
calls, she may have somethingthat's like, Hey, I need you
guys in two or three weeks. Andyou gotta plug your whole HR
infrastructure and understandwhat's happening today.
Susie Koenig (05:43):
Sometimes I say, I need you tomorrow.
Brett Landrum (05:45):
And you never know what you're taking over.
Sometimes we have wonderfuldata and information and
access, and time, and there'sother scenarios where you have
nothing and you're rebuildingeverything from scratch, from
employee files to how they dopay, and everything else. And I
(06:05):
think for us as organizationsto partner quite frequently on
these, being able tocommunicate really well and the
pace at which bothorganizations. Operate at is
really important to the successof these.
Lisa McCracken (06:21):
Because not all those partnerships work out.
And to the whole point, I mean,as you explored, okay, do we
build this expertise because HRhas gotten a lot more
complicated in recent years.
Susie Koenig (06:33):
I can tell you it's the best thing, one of the
best decisions I've done in thepast year or so. We did explore
other groups and we foundProCare to be incredibly
responsive , and also havingthe full boat of services that
(06:55):
we needed. And , I'll tell you,I don't hesitate, I used to
freak out. We'd walk in with ,the first thing we'd have to
worry about is employee healthinsurance. We'd have to worry
about payroll, we'd have toworry about all these issues
that are big issues coming in,especially with the employee
crisis coming up now. And thankgoodness for ProCare, they
(07:20):
really, we pulled them into oneand then we pulled them into a
second, and then we said, okay,you are our partner now here on
out to come into thesefacilities. And we're getting
more and more all the time.
Lisa McCracken (07:35):
And I do wanna talk about that we were
chatting earlier about, whatthis time period looks like,
maybe compared to some othersort of challenging periods
that our sector has gonethrough. But, so I would
imagine those first couple daysand initial time period pretty
critical. So obviously you'vegot organizations that you work
with that are in a degree offinancial distress, pretty
(07:56):
significant in many instances.
But the employee, there'ssensitivities with the staffing
stuff because it's challengingenough. But that could also
really snowball and get evenworse in those first couple
days. So I would think thatthere's some really initial
things that are reallyimportant to do on the employee
side. So what do those firstcouple days look like? Maybe
(08:16):
Brett , you can comment andthen Susie add on.
Brett Landrum (08:18):
Yeah, to me there's an operational
leadership element, which iswhat Susie's team takes on. And
that's reassuring theadministrator, the executive
director, it's coming in and Iguess I won't steal her thunder
on some of the operationalthings they do, but when we're
on site with them, we're veryfamiliar with kind of their
(08:39):
workflows. But then, on the HRside of things, oftentimes
you're coming in and the twomajor questions, maybe three
that everybody has out of thegates is, am I gonna have my
job still? Is my pay gonna beright and do I have benefits?
And what happened with mybenefits? And, I mean, that's
it. And those are the three.
Sometimes there is moredistress if there's, they had
(09:03):
issues with employee engagementor relations or etcetera. But
typically, even despite thosetypes of scenarios, it's
generally those threequestions. And that's that
first week you're trying to getthe leadership team comfortable
with, at least from an HRperspective, the basics of the
technology, to be able to getpayroll process for us to get
data 'cause again, like a lotof the work that Susie's team
(09:25):
needs to do is , they need tohave access to information,
understand labor costs andstaffing and things like that.
So it's really, getting thattechnology infrastructure in
place right away, and I thinkkind of getting that first
payroll clean and doing areally good job on benefits is
important.
Lisa McCracken (09:44):
How would you respond to that, Susie ?
Susie Koenig (09:45):
And it's true, we take over facilities and we
have no idea until we walk inthe door what the issues are.
Lisa McCracken (09:54):
How much advance notice do you usually
have when you need to go in?
What does that look like? Isthere a typical?
Susie Koenig (09:58):
So there , like right now, I'm supposed to
maybe go into a place tomorrowin California. I have no idea
yet, because the judge, we haveto wait to get the approval if
the judge approves thereceivership. So we never know.
Lisa McCracken (10:13):
You need to be in the ready position.
Susie Koenig (10:14):
And so I never have an idea of really what is
going on. Sometimes I'll havenotice where maybe two or three
weeks we'll talk about it,we'll work with some of the
lawyers. This is all the courtappointments, in the regular
management engagements that wejust come into, it's not, we
usually will say a 30 daysnotice, 60 days notice, and
(10:38):
then we can get the informationthat Brett's team needs. But
oftentimes we'll walk in and wehave to immediately figure out
how payrolls are gonna be met,and then we have to bring
Brett's team in to the transferover. And then some of the
previous payroll companieshaven't been paid, and they say
they don't like, we had aninstance over the last few
(11:02):
months where we weretransitioning a facility in
December and January, and thenew payroll company didn't
wanna do the last payroll, andthey didn't wanna do the
payroll. What do you callit?Quarterly, the quarterlies
and the whole , and I was like,are you kidding me? But then I
(11:23):
said, you know what, I don'teven want them to touch it. I
knew that Brett's team would doit right, and it was more work
for them but Brett's teamimmediately got in there, dug
their heels in . The beauty isthat they will work with us
with whatever we have.
Lisa McCracken (11:40):
And that's hard because a lot of organizations
can't pivot and respond. Imean, knowing tomorrow that you
may or may not go into a placethat that's, can operationally
be a little challenging toexecute. So , often there's the
term, the low hanging fruit.
So, when you think around aboutsome of the fixes that need to
(12:00):
be made, I would suspect aboveand beyond keeping the wheels
turning, you gotta get peoplepaid and so forth. And maybe
some of your answers to thismight be around accessing data
and so forth, but are theresome initial, like, these are
the three common things we seeand maybe you can comment on
some of the HR workforce stuffand maybe operationally above
and beyond that, Susie. So a rethere some just general common
(12:20):
mistakes that people are makingt hat really they're just maybe
a re keeping their eyes off thewheel or taking their eyes off
the wheel?
Brett Landrum (12:26):
So if you start with labor, right? That's the
big one. And it's generally twothings. There's the talent
acquisition, so how are wegetting folks in, and
particularly how are we gettingour frontline team members into
the community? And then thesecond is, how are we actually,
what are we doing with the teamthat we have? How are we
staffing, how are we thinkingabout staffing? And oftentimes
(12:48):
I'd say what we see is there'sno system or discipline around
talent acquisition. So, it'sgreat that we post on Indeed,
but what are our expectations.
What are the cis tools we'reusing to measure how quickly
people are responding. Ourteam, as do we have supervisors
that are actually schedulinginterviews or applicants
(13:10):
waiting for two weeks andwhatnot. There's a lot of, I
think, low hanging fruit aroundthe talent acquisition process
and execution. And then on thelabor side, it's making sure we
have the right systems in placethat the data's credible 'cause
we can be looking at a lot ofthe labor management data, but
(13:33):
if it's not good, we're kindof, we're falling in the dark.
Those are two kind of immediatethings that we typically see as
opportunities.
Lisa McCracken (13:44):
You're probably getting into the forensic HR
stuff sometimes too, trying tofigure out, alright , unravel
some of these things, notknowing certain things you're
getting into. What do youobserve? Are there, your
situations are obviouslycomplex and you said there's
variability, but are therecommon things? Like these are
the top.
Susie Koenig (13:59):
Every situation is different, but there's
staffing issues and every,every building. And listen, you
wanna do the best thing, youwanna give orientation, right?
You wanna do all those things,right? But sometimes you just
can't do that. So we talk tofacilities, we say get them in
the door. Do we'll do amentoring program where we'll
(14:21):
do buddy systems where we willhave a new CNA. We won't wait a
week until they get into theorientation pool and sit down
with a group. We will have themimmediately go to the floor,
work with some mentors on thefloor, try to understand what's
going on. Especially if you'rehiring people that have
experience. Right now, ifyou're hiring people without
(14:42):
experience, that's a little bitdifferent. But we see, I think
the most part, facilities justdon't take their time to teach
and to train the employees todo the right thing. And I'm not
just talking about CNAs andnurses. I mean, I am talking
about the whole workforce andwhen we come in, we teach and
(15:06):
we train and we even go intothe dietary department and show
them how to do portion control,show them how to cook, how to
make things from scratchinstead of going in and using
all this frozen food, types ofthings and the recipes to
really look at it and not have,and the CRCs and in the LFS
(15:28):
numerous different, like fouror five different health . You
can't do that. You can have thealways available, right? You
can have, a substitute and thenmaybe a special. But you just,
maybe years ago that was okay,but now , times that you've got
to watch your food costs .
You've got to watch yourstaffing, you've got to watch
(15:51):
everything. I pulled themedical supplies while I was
here yesterday from buildings,and I said, why are we using
these expensive incontinencesupplies when this facility, I
can compare across the board.
Lisa McCracken (16:05):
And that's where you've got that
perspective too, right ? Youcan go in and say, well , that
is not normal. That's outtawhack. Or you're , it's, you
have a low spend here, but areally high spend here.
Susie Koenig (16:14):
We had one group that was buying all these pull
ups in extra large sizes thatare more expensive and they
didn't even fit the residents.
So of course they had skinissues. Of course, there's all
because of the lack of trueknowledge and training. And the
(16:37):
problem is you can't even getgood managers nowadays. Forget
about the people to work thefloor. You can't get DLN's,
executive directors,administrators. After C ovid,
even during C ovid, we had goodpeople. People were there, but
I think Covid shot something inpeople's brain where they said,
you know what? We don't need todo this anymore. And there's a
(17:00):
l ot of healthcare burnout.
Lisa McCracken (17:01):
So you live in the world of distress from any
of that . That's the nature ofyour business. You see
obviously a lot of that. Andyou have perspective over
different cycles and we've beenthrough different cycles in
senior housing. The greatfinancial crisis was the last
one we had the pandemic and soforth. How is this time
(17:22):
different? Maybe? I mean, whatyou're seeing?
Susie Koenig (17:26):
So I think from my perspective, I'm older,
which gives me a little bitmore perspective and more
experience. And I can look atthings now and really get it
where, when I was working witholder guys, because when I
originally started in thisindustry, I was working with
(17:47):
people that were 30 years mysenior because I was moving up
the trajectory. And I was like,how do you know that? How do
they. And you know what? Age,experience. But it is so
different. People don't talk topeople.
Lisa McCracken (18:04):
So it's largely the staffing and people part of
it, you think , I mean theregulatory environment, all
that stuff's different.
Obviously economics.
Susie Koenig (18:10):
I think social media has really made it so
crazy in a good way and in abad way. I n a good way. We can
go out there and post jobs andgo on Facebook and do tiktoks
and do all this fun stuff toget staff. And there's a lot of
facilities that are doing thatkind of thing. But then, you
(18:31):
also have people in theretalking about negative things
that are going on w ith mymother, my father, my this, my
that. And some of these peopleare doing it because, there's
no tort reform in certainstates. And to sue, they know
if they're gonna sue, they'rego nna g et a n insurance
company to settle no matterwhat. So they're just, so
(18:52):
they'll go on social media, andsay things that are not even
true. And how do you controlthat?
Lisa McCracken (18:58):
Your brand is being defined by other people
in many respects too. And Ithink we would all agree that
it is a more complicatedbusiness these days. You gotta
understand and have thatexpertise.
Susie Koenig (19:08):
The supply chain.
Who would've thought we'd havethings sitting in the ocean on
pallets not being able to getin? 'cause we don't have enough
people to unpack. That neverhappened. People used to love
getting jobs, but we don't havepeople that wanna work. People
don't. I don't understand it.
When I was young , had to havemy family, I I had to be out
(19:31):
there working, but now peoplewanna work from home. How do
you take care of people fromhome?
Lisa McCracken (19:35):
That's tough in our business unless you're at
the back office. So we've eventalking a lot about some of the
headwinds and the stress andyou do noble work really for
stepping in those difficultsituations to really rightsize
and turn the ship around. Iwanna end on a positive note.
Okay, let's dig deep here. Sowhat are you most optimistic
(19:55):
about? I mean, so there'sheadwinds, but there's some
really significant tailwindsand opportunities. What are you
optimistic about, Brett?
Brett Landrum (20:02):
When I think about the staffing shortage and
crisis right now, it's notgonna end, it's gonna continue.
But I think it's gonna force usto change how we think about
the work that our frontline,our frontline team members do.
I think we're gonna have to getmore creative. I think we're
(20:22):
gonna have to find ways to makeit for them to perform more of
the fulfilling, residentinteraction and engagement. I
think that the crunch is goingto, while painful in the short
term , like I think it's gonnaprovide some really good
innovation, make us better andevolution of the industry. And
(20:43):
I think it's gonna , there aresolutions. I don't think we've
figured out exactly what theyare yet. But if we keep trying
and failing at some point, Ithink we'll get the bullseye
and I think the industry willbe better off for it.
Lisa McCracken (20:58):
Okay . Put on your rose colored glasses,
Susie. Let's hear it.
Susie Koenig (21:00):
Well, I think those , that's a great comment
that you have to say becausehonestly, we've taken over now
in the past three weeks,several large facilities and
communities that are beloved inthe community. And they just
can't make a go at it. So whatI've done is I've gotten out
there and done a bunch of townmeetings with the community and
(21:22):
with families and withresidents, and I never would've
gotten people together. And Isaid, I need your help. And I
made residents in charge , Imean, they love it. They want
to belong. And it's gotten themmore involved and it's gotten
them to become more of a partof the community. And I
(21:44):
would've never done that 10years ago. But now we're trying
to save them and I tell them, Ineed your help. And families,
people are saying, what can wedo? We just had this burger
night at the Moose Lodge andthey sold more . It was a
not-for-profit that I justcame, they sold more burgers
(22:05):
than they've ever sold becausethere's also kids, this
facility had an orphanage. Andnow there's a kids program
there and everybody wants tohelp. Charity is important.
And, and coming close to homeis what's important. So we're
seeing that we're looking atdifferent ways to get people
(22:28):
involved and bring in more of acommunity type of a thing. And
getting our employees to bemore vested too.
Lisa McCracken (22:36):
Right , right.
I think at the end of the day,particularly in these difficult
situations, the residents wantto see the community succeed.
The family certainly does, andthe staff. So I think if you
can harness that and maybe thenext time we do this, we'll
have , we'll meet at BurgerNight at the Moose Lodge, NIC
Chat's podcast On the Road atthe Moose Lodge. So, we
appreciate everyone tuning in.
(22:56):
Thank you so much. This was areally good conversation. I'm
glad we did this tag team. Thank y ou.
Susie Koenig (23:00):
There's so much more we could talk.
Lisa McCracken (23:00):
We could keep going, but we're limited. So
thank you so much. You cancheck out this podcast on
nic.org and enjoy the rest ofthe conference and thank you
again very much. Thank you.
Welcome to the NIC Chat's podcast, and we're
happy to be On the Road todaylive in Dallas at the NIC
Spring Conference. My name isLisa McCracken, I serve as the
Head of Research and Analyticswith NIC. So excited to be here
today with two guests, and Iwill introduce the two of you,
and I'll let you then telleverybody a little bit more
(00:27):
about you. But we're excitedtoday because we actually have
a repeat guest, Brett Landrum ,and he's gonna tell a little
bit more about his organization, and what they provide to many
of you who may be listening.
And then we have a guest ,Susie Koenig, who many of you
may know, Susie, with SAKManagement Services. So before
(00:48):
we dive into the conversation,we got about 20 minutes here
today to cover a lot ofdifferent interesting hot
topics that I think many ofyou'll be interested in
learning more about. But forthose of you who didn't see us
in the fall when we weretogether at the Fall
Conference, Brett, give alittle background on you, P
roCare, HR, and w hat would behelpful for those to know about
you. And then we'll go to you,Susie.
Brett Landrum (01:07):
Absolutely. When we think about ProCare HR and
the vision for ourorganization, we've built a
senior living optimized HRfoundation, delivering
comprehensive HR services fromtalent acquisition coaching,
etcetera. And we really believethat that foundational kind of
(01:30):
HR platform is an opportunityto really build and drive
better quality of care,resident satisfaction and
financial results for ouroperators. And so, for ProCare
we've been working the lasteight years to really refine
and understand the industry andbuild this comprehensive HR
(01:51):
services. And now we get to dothe fun stuff, which is really
to sit back and say, okay, howdoes this platform we've built
enable us to build and buy kindof in industry leading
solutions that can really movethe needle again in quality
care and financial results andresident satisfaction.
Lisa McCracken (02:08):
Right. And we're definitely gonna talk
about some of the workforce,obviously that's a hot topic
and I appreciate you commentingon workforce being related to
resident satisfaction,financial performance. It's all
interconnected. So we're gonnacome back to that and hit some
other topics as well. Susie, doyou wanna tell the listeners
about you?
Susie Koenig (02:25):
Of course. So I am Susie Koenig and we're with
SAK Healthcare. We'verebranded, so we've been in the
business as we were talking alittle bit earlier for a long
time. I've been doing this forover 30 years without giving
you exactly my age. However ,we come in and we're healthcare
(02:48):
turnaround company, and weprovide kind of the whole
interdisciplinary healthcaregroup that would come in and
almost be like a SWAT team tohelp providers and to assist
landlords, assist REITs, assistlenders to come in and to
(03:11):
provide management services orhealthcare consulting when
needed by many groups as well.
We have a third partymanagement arm as well as a
consulting arm. And we get veryinvolved in court proceedings,
court appointments,receiverships examiners,
(03:34):
chapter 11, trustees. And I'velearned without having the
legal degree , a little bitabout restructuring. And so
been very involved in thatprobably for about the past 20
years. But started originallyas a social service admission
director in a facility andlearned from the bottom up. And
(03:56):
became an administrator andworked through, and now we
operate portfolios and alldifferent types of cases that
need assistance and providingimprovement, mostly, and in
quality as well, clinical,financial , and the whole
(04:18):
gamut.
Lisa McCracken (04:19):
Your SWAT team depiction, that's an
interesting way to put it,right? Because your engagements
and management situations, arethere with organizations that
are in distress. And we'regonna get back to that. because
I think that's one of thereasons why we wanted the two
of you here today because weare in a situation in the
senior housing and care spacewhere there is that element of
distress. So , the two of youare often partners in these
(04:43):
situations. So , you get the,let's say the mayday call or
whatever it may be, and you'vegot a team and from my
perspective that's smart,obviously saying, okay, where
do we have expertise? Where dowe bring in others that can
bring some really solidsupport? So, Brett, talk to me
a little bit about what thatpartnership looks like and what
(05:03):
would be helpful for thelisteners to learn about?
Brett Landrum (05:06):
We've been very fortunate. I think we, Susie
and I met a couple of years agoand they were contemplating do
we build an in-house model forHR. Do we look for a partner?
They had kind of, I thinklooked, and kind of evaluated a
handful of different HRpartners. And ultimately as we
got in there and they got toknow us, I think,
(05:29):
philosophically we're verysimilar around pace. When Susie
calls, she may have somethingthat's like, Hey, I need you
guys in two or three weeks. Andyou gotta plug your whole HR
infrastructure and understandwhat's happening today.
Susie Koenig (05:43):
Sometimes I say, I need you tomorrow.
Brett Landrum (05:45):
And you never know what you're taking over.
Sometimes we have wonderfuldata and information and
access, and time, and there'sother scenarios where you have
nothing and you're rebuildingeverything from scratch, from
employee files to how they dopay, and everything else. And I
(06:05):
think for us as organizationsto partner quite frequently on
these, being able tocommunicate really well and the
pace at which bothorganizations. Operate at is
really important to the successof these.
Lisa McCracken (06:21):
Because not all those partnerships work out.
And to the whole point, I mean,as you explored, okay, do we
build this expertise because HRhas gotten a lot more
complicated in recent years.
Susie Koenig (06:33):
I can tell you it's the best thing, one of the
best decisions I've done in thepast year or so. We did explore
other groups and we foundProCare to be incredibly
responsive , and also havingthe full boat of services that
(06:55):
we needed. And , I'll tell you,I don't hesitate, I used to
freak out. We'd walk in with ,the first thing we'd have to
worry about is employee healthinsurance. We'd have to worry
about payroll, we'd have toworry about all these issues
that are big issues coming in,especially with the employee
crisis coming up now. And thankgoodness for ProCare, they
(07:20):
really, we pulled them into oneand then we pulled them into a
second, and then we said, okay,you are our partner now here on
out to come into thesefacilities. And we're getting
more and more all the time.
Lisa McCracken (07:35):
And I do wanna talk about that we were
chatting earlier about, whatthis time period looks like,
maybe compared to some othersort of challenging periods
that our sector has gonethrough. But, so I would
imagine those first couple daysand initial time period pretty
critical. So obviously you'vegot organizations that you work
with that are in a degree offinancial distress, pretty
(07:56):
significant in many instances.
But the employee, there'ssensitivities with the staffing
stuff because it's challengingenough. But that could also
really snowball and get evenworse in those first couple
days. So I would think thatthere's some really initial
things that are reallyimportant to do on the employee
side. So what do those firstcouple days look like? Maybe
(08:16):
Brett , you can comment andthen Susie add on.
Brett Landrum (08:18):
Yeah, to me there's an operational
leadership element, which iswhat Susie's team takes on. And
that's reassuring theadministrator, the executive
director, it's coming in and Iguess I won't steal her thunder
on some of the operationalthings they do, but when we're
on site with them, we're veryfamiliar with kind of their
(08:39):
workflows. But then, on the HRside of things, oftentimes
you're coming in and the twomajor questions, maybe three
that everybody has out of thegates is, am I gonna have my
job still? Is my pay gonna beright and do I have benefits?
And what happened with mybenefits? And, I mean, that's
it. And those are the three.
Sometimes there is moredistress if there's, they had
(09:03):
issues with employee engagementor relations or etcetera. But
typically, even despite thosetypes of scenarios, it's
generally those threequestions. And that's that
first week you're trying to getthe leadership team comfortable
with, at least from an HRperspective, the basics of the
technology, to be able to getpayroll process for us to get
data 'cause again, like a lotof the work that Susie's team
(09:25):
needs to do is , they need tohave access to information,
understand labor costs andstaffing and things like that.
So it's really, getting thattechnology infrastructure in
place right away, and I thinkkind of getting that first
payroll clean and doing areally good job on benefits is
important.
Lisa McCracken (09:44):
How would you respond to that, Susie ?
Susie Koenig (09:45):
And it's true, we take over facilities and we
have no idea until we walk inthe door what the issues are.
Lisa McCracken (09:54):
How much advance notice do you usually
have when you need to go in?
What does that look like? Isthere a typical?
Susie Koenig (09:58):
So there , like right now, I'm supposed to
maybe go into a place tomorrowin California. I have no idea
yet, because the judge, we haveto wait to get the approval if
the judge approves thereceivership. So we never know.
Lisa McCracken (10:13):
You need to be in the ready position.
Susie Koenig (10:14):
And so I never have an idea of really what is
going on. Sometimes I'll havenotice where maybe two or three
weeks we'll talk about it,we'll work with some of the
lawyers. This is all the courtappointments, in the regular
management engagements that wejust come into, it's not, we
usually will say a 30 daysnotice, 60 days notice, and
(10:38):
then we can get the informationthat Brett's team needs. But
oftentimes we'll walk in and wehave to immediately figure out
how payrolls are gonna be met,and then we have to bring
Brett's team in to the transferover. And then some of the
previous payroll companieshaven't been paid, and they say
they don't like, we had aninstance over the last few
(11:02):
months where we weretransitioning a facility in
December and January, and thenew payroll company didn't
wanna do the last payroll, andthey didn't wanna do the
payroll. What do you callit?Quarterly, the quarterlies
and the whole , and I was like,are you kidding me? But then I
(11:23):
said, you know what, I don'teven want them to touch it. I
knew that Brett's team would doit right, and it was more work
for them but Brett's teamimmediately got in there, dug
their heels in . The beauty isthat they will work with us
with whatever we have.
Lisa McCracken (11:40):
And that's hard because a lot of organizations
can't pivot and respond. Imean, knowing tomorrow that you
may or may not go into a placethat that's, can operationally
be a little challenging toexecute. So , often there's the
term, the low hanging fruit.
So, when you think around aboutsome of the fixes that need to
(12:00):
be made, I would suspect aboveand beyond keeping the wheels
turning, you gotta get peoplepaid and so forth. And maybe
some of your answers to thismight be around accessing data
and so forth, but are theresome initial, like, these are
the three common things we seeand maybe you can comment on
some of the HR workforce stuffand maybe operationally above
and beyond that, Susie. So a rethere some just general common
(12:20):
mistakes that people are makingt hat really they're just maybe
a re keeping their eyes off thewheel or taking their eyes off
the wheel?
Brett Landrum (12:26):
So if you start with labor, right? That's the
big one. And it's generally twothings. There's the talent
acquisition, so how are wegetting folks in, and
particularly how are we gettingour frontline team members into
the community? And then thesecond is, how are we actually,
what are we doing with the teamthat we have? How are we
staffing, how are we thinkingabout staffing? And oftentimes
(12:48):
I'd say what we see is there'sno system or discipline around
talent acquisition. So, it'sgreat that we post on Indeed,
but what are our expectations.
What are the cis tools we'reusing to measure how quickly
people are responding. Ourteam, as do we have supervisors
that are actually schedulinginterviews or applicants
(13:10):
waiting for two weeks andwhatnot. There's a lot of, I
think, low hanging fruit aroundthe talent acquisition process
and execution. And then on thelabor side, it's making sure we
have the right systems in placethat the data's credible 'cause
we can be looking at a lot ofthe labor management data, but
(13:33):
if it's not good, we're kindof, we're falling in the dark.
Those are two kind of immediatethings that we typically see as
opportunities.
Lisa McCracken (13:44):
You're probably getting into the forensic HR
stuff sometimes too, trying tofigure out, alright , unravel
some of these things, notknowing certain things you're
getting into. What do youobserve? Are there, your
situations are obviouslycomplex and you said there's
variability, but are therecommon things? Like these are
the top.
Susie Koenig (13:59):
Every situation is different, but there's
staffing issues and every,every building. And listen, you
wanna do the best thing, youwanna give orientation, right?
You wanna do all those things,right? But sometimes you just
can't do that. So we talk tofacilities, we say get them in
the door. Do we'll do amentoring program where we'll
(14:21):
do buddy systems where we willhave a new CNA. We won't wait a
week until they get into theorientation pool and sit down
with a group. We will have themimmediately go to the floor,
work with some mentors on thefloor, try to understand what's
going on. Especially if you'rehiring people that have
experience. Right now, ifyou're hiring people without
(14:42):
experience, that's a little bitdifferent. But we see, I think
the most part, facilities justdon't take their time to teach
and to train the employees todo the right thing. And I'm not
just talking about CNAs andnurses. I mean, I am talking
about the whole workforce andwhen we come in, we teach and
(15:06):
we train and we even go intothe dietary department and show
them how to do portion control,show them how to cook, how to
make things from scratchinstead of going in and using
all this frozen food, types ofthings and the recipes to
really look at it and not have,and the CRCs and in the LFS
(15:28):
numerous different, like fouror five different health . You
can't do that. You can have thealways available, right? You
can have, a substitute and thenmaybe a special. But you just,
maybe years ago that was okay,but now , times that you've got
to watch your food costs .
You've got to watch yourstaffing, you've got to watch
(15:51):
everything. I pulled themedical supplies while I was
here yesterday from buildings,and I said, why are we using
these expensive incontinencesupplies when this facility, I
can compare across the board.
Lisa McCracken (16:05):
And that's where you've got that
perspective too, right ? Youcan go in and say, well , that
is not normal. That's outtawhack. Or you're , it's, you
have a low spend here, but areally high spend here.
Susie Koenig (16:14):
We had one group that was buying all these pull
ups in extra large sizes thatare more expensive and they
didn't even fit the residents.
So of course they had skinissues. Of course, there's all
because of the lack of trueknowledge and training. And the
(16:37):
problem is you can't even getgood managers nowadays. Forget
about the people to work thefloor. You can't get DLN's,
executive directors,administrators. After C ovid,
even during C ovid, we had goodpeople. People were there, but
I think Covid shot something inpeople's brain where they said,
you know what? We don't need todo this anymore. And there's a
(17:00):
l ot of healthcare burnout.
Lisa McCracken (17:01):
So you live in the world of distress from any
of that . That's the nature ofyour business. You see
obviously a lot of that. Andyou have perspective over
different cycles and we've beenthrough different cycles in
senior housing. The greatfinancial crisis was the last
one we had the pandemic and soforth. How is this time
(17:22):
different? Maybe? I mean, whatyou're seeing?
Susie Koenig (17:26):
So I think from my perspective, I'm older,
which gives me a little bitmore perspective and more
experience. And I can look atthings now and really get it
where, when I was working witholder guys, because when I
originally started in thisindustry, I was working with
(17:47):
people that were 30 years mysenior because I was moving up
the trajectory. And I was like,how do you know that? How do
they. And you know what? Age,experience. But it is so
different. People don't talk topeople.
Lisa McCracken (18:04):
So it's largely the staffing and people part of
it, you think , I mean theregulatory environment, all
that stuff's different.
Obviously economics.
Susie Koenig (18:10):
I think social media has really made it so
crazy in a good way and in abad way. I n a good way. We can
go out there and post jobs andgo on Facebook and do tiktoks
and do all this fun stuff toget staff. And there's a lot of
facilities that are doing thatkind of thing. But then, you
(18:31):
also have people in theretalking about negative things
that are going on w ith mymother, my father, my this, my
that. And some of these peopleare doing it because, there's
no tort reform in certainstates. And to sue, they know
if they're gonna sue, they'rego nna g et a n insurance
company to settle no matterwhat. So they're just, so
(18:52):
they'll go on social media, andsay things that are not even
true. And how do you controlthat?
Lisa McCracken (18:58):
Your brand is being defined by other people
in many respects too. And Ithink we would all agree that
it is a more complicatedbusiness these days. You gotta
understand and have thatexpertise.
Susie Koenig (19:08):
The supply chain.
Who would've thought we'd havethings sitting in the ocean on
pallets not being able to getin? 'cause we don't have enough
people to unpack. That neverhappened. People used to love
getting jobs, but we don't havepeople that wanna work. People
don't. I don't understand it.
When I was young , had to havemy family, I I had to be out
(19:31):
there working, but now peoplewanna work from home. How do
you take care of people fromhome?
Lisa McCracken (19:35):
That's tough in our business unless you're at
the back office. So we've eventalking a lot about some of the
headwinds and the stress andyou do noble work really for
stepping in those difficultsituations to really rightsize
and turn the ship around. Iwanna end on a positive note.
Okay, let's dig deep here. Sowhat are you most optimistic
(19:55):
about? I mean, so there'sheadwinds, but there's some
really significant tailwindsand opportunities. What are you
optimistic about, Brett?
Brett Landrum (20:02):
When I think about the staffing shortage and
crisis right now, it's notgonna end, it's gonna continue.
But I think it's gonna force usto change how we think about
the work that our frontline,our frontline team members do.
I think we're gonna have to getmore creative. I think we're
(20:22):
gonna have to find ways to makeit for them to perform more of
the fulfilling, residentinteraction and engagement. I
think that the crunch is goingto, while painful in the short
term , like I think it's gonnaprovide some really good
innovation, make us better andevolution of the industry. And
(20:43):
I think it's gonna , there aresolutions. I don't think we've
figured out exactly what theyare yet. But if we keep trying
and failing at some point, Ithink we'll get the bullseye
and I think the industry willbe better off for it.
Lisa McCracken (20:58):
Okay . Put on your rose colored glasses,
Susie. Let's hear it.
Susie Koenig (21:00):
Well, I think those , that's a great comment
that you have to say becausehonestly, we've taken over now
in the past three weeks,several large facilities and
communities that are beloved inthe community. And they just
can't make a go at it. So whatI've done is I've gotten out
there and done a bunch of townmeetings with the community and
(21:22):
with families and withresidents, and I never would've
gotten people together. And Isaid, I need your help. And I
made residents in charge , Imean, they love it. They want
to belong. And it's gotten themmore involved and it's gotten
them to become more of a partof the community. And I
(21:44):
would've never done that 10years ago. But now we're trying
to save them and I tell them, Ineed your help. And families,
people are saying, what can wedo? We just had this burger
night at the Moose Lodge andthey sold more . It was a
not-for-profit that I justcame, they sold more burgers
(22:05):
than they've ever sold becausethere's also kids, this
facility had an orphanage. Andnow there's a kids program
there and everybody wants tohelp. Charity is important.
And, and coming close to homeis what's important. So we're
seeing that we're looking atdifferent ways to get people
(22:28):
involved and bring in more of acommunity type of a thing. And
getting our employees to bemore vested too.
Lisa McCracken (22:36):
Right , right.
I think at the end of the day,particularly in these difficult
situations, the residents wantto see the community succeed.
The family certainly does, andthe staff. So I think if you
can harness that and maybe thenext time we do this, we'll
have , we'll meet at BurgerNight at the Moose Lodge, NIC
Chat's podcast On the Road atthe Moose Lodge. So, we
appreciate everyone tuning in.
(22:56):
Thank you so much. This was areally good conversation. I'm
glad we did this tag team. Thank y ou.
Susie Koenig (23:00):
There's so much more we could talk.
Lisa McCracken (23:00):
We could keep going, but we're limited. So
thank you so much. You cancheck out this podcast on
nic.org and enjoy the rest ofthe conference and thank you
again very much. Thank you.
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