Michele Holleran headshot
Michele Holleran
Michele Holleran

Overall resident satisfaction scores went up significantly during the COVID-19 pandemic, according to the national Holleran research benchmark. A comparison of scores between pre-pandemic and during the pandemic was conducted in a new analysis, showing that ratings increased across all levels of care at the nation’s leading life plan communities.

Although this finding may seem counterintuitive, there are plausible reasons for the positive scores.

First, residents believe their communities did everything possible to keep them safe during the pandemic. This belief is evident from the multitude of qualitative comments submitted on Holleran resident surveys from April 2020 through December 2021. Response to the pandemic was front and center in the minds of residents and likely was a top driver of resident satisfaction during this time period.

Second, although resident engagement mean ratings dropped overall, one domain of engagement increased: the voice domain, which measures how well a campus listens to residents, responds to concerns, is transparent and keeps residents informed. Campuses got creative with how they communicated with independent living residents and their families, and this creativity paid off, leading to significantly higher “voice” scores. Use of Zoom, apps, digital engagement platforms, personal phone calls, daily or weekly updates in newslettersall contributed to helping residents navigate the pandemic.

A written comment from one resident on the Holleran survey illustrates the appreciation for transparent communication during COVID: “The administration was really open with us about what was going on and some of the challenges they were facing with contradictory information from the [Centers for Disease Control and Prevention] and local government entities. They didn’t pretend to have all the answers, and when new recommended protocols emerged, they immediately shared those with us.”

In particular, voice domain scores were high at UPMC communities, the Emerald Communities, Sunnyside Village and Cedars View (Redeemer Health).

Lucia Maglio, manager of resident services at Cedar Views, based in Philadelphia, says the key to her campus’ high marks was partially due to the strong relationship between the administration and the community’s resident council, as well as monthly meetings with residents, where concerns are openly shared and follow-up happens in a timely fashion. Another key was the campus’ commitment to tell the residents why a certain decision has been made that affects their daily lives. “This is their home. They have a right to know,” Maglio said. “We take the time to give them detailed reasons for those decisions. And we are very careful to take a customized approach to each resident concern that is raised.”

But although the voice domain was higher during the pandemic, the three other engagement categories did not fare as well. The connection, fulfillment and well-being domains went down. These drops were expected and are a natural outcome of being isolated from others (including family), not being able to engage in normal activities, and feeling depressed or anxious.

When the pandemic hit, there was much more of a focus on the basic needs of residents, which is what is measured by satisfaction scores. Think about Maslow’s Hierarchy of Needs — the lower rungs of human need are about shelter, safety and food. Life plan communities overall did pretty well with meeting those basic needs.

Engagement scores, on the other hand, reflect how well campuses perform with higher level needs — helping people feel a sense of belonging, esteem and self-actualization. Those are challenging needs to meet during a pandemic when everyone essentially is on lock down.

What will be interesting, as we move forward with measuring both satisfaction and engagement, is the effect of staffing on the resident experience. One would expect the scores to decrease as the aftershocks of the “Great Resignation” take effect.

More than the buildings and amenities, the staff members on campus can make or break the resident experience. Once their favorite staff members leave, residents are bound to be affected, because some of those staff members are like family to them. States one life plan community resident in Virginia: “My wife and I are literally grieving the loss of some of our favorite employees who have left. These people were beloved by all the residents on campus, and now there’s just one big hole in our hearts.”

Highly engaged staff members are the key to a positive resident experience at all levels of care, even independent living. The Holleran benchmark reveals that the percentage of most highly engaged employees has dropped from 34.4% to 29.8% during COVID. The employee engagement mean score in the Holleran benchmark hit an all-time high of 4.05 in 2019 but dropped to 3.97 in 2021. Scores for “my opinions count” and “this organization cares for its employees” have both taken a hit.

And unlike resident satisfaction scores, employee satisfaction mean scores have slipped, signifying that life plan community campuses are not even meeting workers’ basic needs. This is a somewhat alarming decrease, although not unexpected. Burnout, stress and fatigue have affected the staff members on most campuses. The emotional and physical pressure at work has depleted and exhausted even the most loyal of staff members.

Because resident and employee engagement actually mirror one another over time on a campus, it is predicted that both stakeholder groups will be scoring their life plan communities more harshly in the future. And yet, there is hope. Getting turnover rates to go down and increasing engagement among staff members may not be as daunting as once thought.

An example: Those campuses that have a dedicated focus on diversity, equity and inclusion are beginning to attract workers who value feeling welcomed. Campuses that have changed their culture to reflect empathy toward those undergoing mental health challenges are seeing less turnover. Communities that have adopted the universal worker model, espoused by the Green House Project, are seeing much higher levels of engagement than those with traditional workforce models.

The common denominator of all those initiatives is their emphasis on seeing workers as holistic beings who have higher level needs around respect, appreciation and being understood as individuals. When campuses begin to see their employees in this light, not only will workforce engagement increase, but resident engagement will increase as well.

Michele Holleran is founder and CEO of Holleran, a provider of actionable engagement and satisfaction surveys for those who serve older adults.She also is a board chair of the Center for Innovation, the parent organization of the Green House Project.

The opinions expressed in each McKnight’s Senior Living marketplace column are those of the author and are not necessarily those of McKnight’s Senior Living.

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