Debbie Stadtler: [00:00:00] Is your facility making the best impression possible on everyone who walks through the front door? Learn easy ways to boost your customer experience in this episode of Perspectives in Long Term Care. 
Hi, I'm Debbie Stadtler, editor-in-chief of Provider magazine, the flagship publication of the American Health care Association and the National Center for Assisted Living.

I'd like to welcome you to this episode of Perspectives in Long Term Care, a monthly podcast produced by AHCA and NCAL. Each month we'll talk with long term care and assisted living professionals about the opportunities and challenges impacting the long term and post-acute care profession. My guests today are Heather TerHark and Samantha Lawrence.

Heather is the chief strategy officer at Viva Senior Living and brings more than 27 years of experience to the table. Samantha is regional vice president of operations at Brightview Senior Living in New Jersey and has served seniors in various capacities for 26 [00:01:00] years. Heather and Samantha are the co-chairs of AHCA's Customer Experience Committee.

Welcome, Heather. Samantha. Thanks for being with us. 

Heather TerHark: Thank you for having us, Debbie. We're so excited to be here. 

Debbie Stadtler: We like to start at the beginning. So tell us a little bit about your personal journey, your career journey. How did you end up where you are now? What led you to get started in long term care?

Samantha, start with your journey. Tell us a little bit about it. 

Samantha Lawrence: So I was fortunate to know three great-grandparents and all of my grandparents and wow, when I was about 10 years old, my one great-grandfather had developed Alzheimer's. And at that time, communities like Heather and I had the opportunity to be engaged with didn't quite exist, so it was in a rural nursing home.

I went to visit my great-grandfather and a woman that was a patient/resident there grabbed my arm and said, honey, will you get me a laxative? I did not know what that was at the ripe old age of 10. But I knew she [00:02:00] needed something. So I went to the desk and I said, excuse me, this woman over there in blue, she needs a laxative and that nurse turned my career path.

Because she said, “Honey, she says that all the time. Just ignore her.” I didn't know what the right answer was, but I knew that didn't sound like the right answer. So I just went back and started talking to her and then you could not peel me out of there. I'm like, “Mom, this woman can't reach her cup. This woman is shaking and her food's falling off of her fork and we have to go.” Like I said, these people need help.

So volunteering closer to my home, playing the violin at dinner for a local nursing home, and they needed a part-time receptionist when I turned 16. I did a paper application. I called my mom on a payphone. I said I was really nervous about my big interview, and she said, “You are the only 16-year-old that is stoked about working in a nursing home. I think you'll get the job.”

And so then I never looked back. I grew my career in different frontline roles in reception activities, moved into management roles, got my administrator's license [00:03:00] in assisted living. Went into a subject matter expert role in dementia programming, but realized my heart was in operations, and been with Brightview now for the past 11 years, about six of those in a regional capacity, and was an executive director in Paramus, New Jersey, for them.
Opening that community actually prior to this role.

Debbie Stadtler: It's amazing how many people that I speak with that the beginning of their journey has some sort of family connection to how they start in this industry. So it's really interesting. Heather, tell us a little bit about your journey. 

Heather TerHark: Sure I wasn't quite as soon as Sam at the age of 10, but a woman in college. We all think we're going into college and we have this career path all mapped at, and I was working at a hospital as just more of that part-time job that you do in college and I got the opportunity to work with physicians, walking seniors on the track, some of them doing [00:04:00] stress testing. I got to teach water aerobics to seniors, and that was the start in college of my entire career because I knew right then and there, those were the people and I learned so much from a medical component being in the hospital going through surveys. So I got started right off at the age of 18. And I've been so blessed in my career to work post-acute rehab, skilled nursing, the entire senior living continuum, and also home health, hospice and pharmacy through just a few companies throughout my career, and my mother and my grandmother also passed away with Alzheimer's dementia.

So memory care communities have a very, very special place in my heart, and I'm so excited both Sam and I have the opportunity to have either memory care communities or memory care neighborhoods [00:05:00] and know that we do things to enhance the lives of those that live. And so it's a personal journey. I tell people I don't know what it's like to work outside of the health care field because I've never done anything that wasn't part of the world that we all live in today.

Debbie Stadtler: It's amazing that passion and that connection with people with seniors is really just so evident in everyone who works in the industry. So I love how your journey really highlights that as well, Heather. I want to jump into our topic today, which is customer experience, which is a little bit different. I think a lot of people are used to hearing the term customer service, which I think is a little piece of it.

But start us off and get us all on the same page. What is customer experience and what is that encompass so that we know what that term really refers to? Heather, start us off.

Heather TerHark: Sure. So customer experience is everyone that comes into contact [00:06:00] with your community. It doesn't matter who it is, it could be a potential resident, a family member, a potential employee, but it also could be a fireman that comes in when there's 9-1-1 call. It could be the postman, the UPS that drops off. That is the experience because they're all our customers, because whether they're looking to work or to live in our community, they're part of that ecosystem that makes up that community and they form an impression and they have a feeling about that community of how the vibrancy or in the involvement or the heartbeat of that community. So truly that customer experience talks about anyone that interacts or has any kind of touchpoint with what we do. 

Debbie Stadtler: I think it's such a broad amount of people. I understand what you're saying, that it's really anyone who comes [00:07:00] into contact and has an experience with your organization, your facility, but that's a lot of different groups, potential residents, families, current residents. Those are all different groups with different needs. How do you serve each of those groups? How do you make sure this experience is consistent or excellent across all of these folks? Samantha, tell us more.

Samantha Lawrence: So the joy and the challenge of serving so many different customers, that the experience is unique to every single person.

Everybody comes to us with different emotions about being in that community or that facility. You've got prospective residents and families that are very apprehensive. This could symbolize to them a loss of independence. It could symbolize a big change. They live in the same home for 60 years. For that, maybe somebody that's a vendor or if the fireman, maybe this is their first day on the job, maybe they've never been to a community like ours before.

There's a combination of personalized and generic things that we all [00:08:00] need to do to make sure that we're giving a great customer experience when individuals come through our doors. When it comes to residents in particular and that kind of thought of. It's scary to transition into communal living after so many years just pretty much doing your own thing, really getting to know them as individuals from the prospect to moving in. We try to ask so many questions to get at the heart of their current situation, if they're a prospect or once they move into our doors.

What is it that brought them joy, brought them purpose in the real world, quote unquote, because this is their real world as well.

It's just going to feel maybe a little bit different, but how can we as an organization, focus on the possibilities, independence and choices that they still have, and really focus on those possibilities rather than the limitations they may be feeling? So it's really knowing them all as individuals as much as we can, and infusing resident centered hospitality along the way as much as we can throughout that experience.

Heather TerHark: Debbie, if I could add to [00:09:00] Sam's comment that when she talks about the hospitality, it's the really small details. How were they greeted the minute when they walked into the community? How were they greeted on the phone? Is there water out? Is there coffee? Is there someone saying, let me get someone for you? How do folks in the atmosphere feel when you walk through the community?

But the details are really important because you don't know. As you said earlier, who your customer is, so you have to embrace 'em and make them feel like this is just a great place to be, even if they're the postman who's dropping off the mail for the day.

Would you like some coffee? Can I help you somehow? All those things you're talked about, you and taught about with hospitality. [00:10:00] So I want to make sure that to everyone who's listening, it doesn't cost money, but it does take training. It does take time with the staff to really make sure that they know the ways to greet and welcome.

Debbie Stadtler: Speaking of staff, I think that is a big question because if your customer is everyone you're coming into contact with, then you know, making this excellent impression isn't just the responsibility of the front desk or the intake person who's meeting the potential residents. This is everyone on staff.

It's all the staff, it's the volunteers, it's the management. So how do you determine the skills or the roles that you're infusing into staff to support this customer experience? How do you teach or train some of this?

Samantha Lawrence: It starts, as you just said so beautifully, with [00:11:00] our associates. And at our organization, we firmly believe at the very foundation, if we're not as a company creating a great place for our associates to work, there's no way that they can in turn create a great place for our residents to live or all of those other vendors to walk through the door.

So it starts at the kind of lower level Maslow's hierarchy of making sure that as an organization we are thoughtfully caring for our associates. Making sure we have meaningful benefits and meaningful appreciation for everything that they do, so that they feel great about what they do when they come in the door.

And then when it comes to the skillset, before they even get to us, we're doing behavioral-based interviewing. We can teach them how to answer a phone or what they should say, or how they can take an order at the dining room table. But I can't teach them to have heart and passion for what they do.

So we start out with a group interview process that tries to get at the heart of some of these customer experience or service types of questions to get a [00:12:00] feel for if there's an innateness in them in that regard. And if we can start there, then we can interview to the scale on a one-on-one basis and move on from there.

And really make sure we actually have developed specific hospitality training to make sure that some of the things that Heather mentioned about answering a phone, eye contact. Making sure that if you don't know the answer, you don't end it there. You go and get somebody for you. And actually one of the things our committee did this past year for our members is develop some customer experience training with different scenarios that could pop up in different departments so that people have a resource to utilize for a quick hit in dining, in maintenance, and care with common situations that come up.

And I think that was a great deliverable last year. That can just be a small touch if folks might not have some of those resources independently. 

Heather TerHark: And I would just add exactly what Sam said. When someone walks in for an interview, whether it's an individual hiring manager or it's a group, if they [00:13:00] have passion, if they have heart, if they are there for the right reason and then you can train the rest of it.

Yes, they may have to have their med tech or their LPN license or certain things. But you can have two people with the exact same resume and the exact same certification or degrees. But it's how they respond. Do you watch them before the interview sitting in the lobby? Do they interact with the residents?

When you take them on a tour to the community, how does that potential associate employee, how do they interact with the residents? How do they talk to them when the residents talk to them? Because those are the folks that we want in our industry, because you can have a job description. But it doesn't really always encompass no job description.

ay you have to turn the remote on for the resident. No job. [00:14:00] Best description says we, how many times are we going to look for the eyeglasses and the dentures kind of things that we do without thinking, because that's what's important to that resident that lives there and all the much more complicated things that they've made with the TVs and all of that.

Now, who's going to do those extra little things when you talk to them? 

Debbie Stadtler: Absolutely. You can definitely sense that sort of connection and heart. I think that's really a great way of putting it, of someone who wants to be of service and hospitable to folks. Sam, you mentioned scenario-based training as one way to help folks develop these skills.

Tell us a little more about different types of training or different ways that facilities can help their staff be a little more open to this type of customer service and experience.

Samantha Lawrence: Sure. I think that one of the hardest things when you try to train to hospitality is it [00:15:00] often makes people feel they have to say yes to everything, and that's not necessarily a great thing either.

So, it's important to communicate that a “yes mentality” is important. But as a team, we all need to set expectations of what is reasonable to expect and what's not reasonable to expect. And if somebody has something that they would like to do or there's always that one-off transportation request, I think we can all empathize with, or that one-off extra time with care or a dining request or something that we unfortunately just can't accommodate that day.

So how do we say no without saying no? It's just as important as saying yes. Just saying, “You know what? While that's not something that's possible, I'd like to offer you this alternative, or maybe we can do this instead.” So just really having that yes mindset, but knowing that it might not always mean saying yes, and it's about offering some alternatives based on the expectations that we've all set forth from the beginning in a consistent way.

Also, we talked [00:16:00] earlier about focusing on relationship-building with our residents and knowing their preferences, but also understanding that knowing those preferences is not, does not mean making assumptions. For example, if Mrs. Jones always loves her orange juice every single morning. While some might think, oh look, they have the orange juice preset, maybe today she feels like cranberry juice. But how do you show that you still know her and know her preferences and respect them, but give choice. You walk up and say, “Mrs. Jones, is it an orange juice kind of morning, or are we feeling like something different today?” Because maybe she'll say, “You know what? I'm tired of orange juice.” And maybe she's too polite to say no. And so there's a way you can confuse the world of choice, but also showing that our residents well, and it's just really continuing to focus on all of your interactions are based in that foundational relationship because if there's trust that you are able to build through that relationship development.

Customer experience just gets that much easier. It all starts with relationships and trust. [00:17:00] 

Heather TerHark: I absolutely agree. The other thing I would add is teaching our associates, our employees, that they have the ability to problem solve, that they have vision. To solve a problem that it doesn't have to go to a department head or the nursing home administrator or the executive director that they've been caught.

These are things you can solve that are simple types of things, because a lot of times it can just be taken care of right there at that moment. To Sam's example of the transportation, you know, “Debbie, we cannot catch you up for transportation this afternoon. What does tomorrow morning look like for you? I see we already have some openings for that.” 

Instead of saying, oh, no, I'm sorry, and just leaving it there. How can we train them to take the next step? How can we also train them to actively listen? It's something that all of us, no matter where we're at in our [00:18:00] profession, we think, “Oh, we're in a hurry. We're really going to move fast”. How do we make them take a breath and to see that this resident needs something and how do we help them? And sometimes that's so much harder than that sounds because there's another call light going off. Or they know that this resident, they're supposed to be in their room at this time to give them a shower and really, okay, let me repeat.

Now, Debbie, is that what you said to me that you need, let me figure out how we do this. Let's go look for what's missing, whatever the case may be. And then just truly teaching them some emotional intelligence if they say something's wrong, not to take it personally. There's a lot that goes into what a family member says.

That's because of guilt. It has nothing to do. But we sometimes take it personally because we have pride, we have passion, and we're doing the best we can. We're working as hard. How many times have we had to [00:19:00] teach them don't take anything personally, but we're here to solve that. We're here to create that best customer experience without worrying about what the issue is, how it reflects on anyone.

And sometimes teaching them that empathy doesn't mean to Sam's point that we're going to solve all of the problems, because some of it we can't solve what they're emotionally going through. 

Debbie Stadtler: I think those are such big pieces that you guys mentioned. Trust, relationship building, empathy, listening.

Not to solve necessarily, but really to hear a person out in a lot of situations. Those are such important skills in work like this where it's so human-focused and so person centered to be able to bring those types of skills. 

We all know that long term care has changed so much over the past five years, 10 years, 20 years, and [00:20:00] with the baby boomers and the silver tsunami, there are expectations.

How have the expectations around customer experience changed? What are some of the things that baby boomers are really focused on and look for as they have these experiences with our communities? Heather, what do you think? 

Heather TerHark: Oh my gosh, Debbie. It has changed so, so much. Just as our worlds have changed with Amazon and Uber and Netflix and all their expectations changed.

They're used to right-on-demand delivery. They're used to personalization. They are used to that responsiveness and. Going back to where we talked about earlier, hospitality, and whether it's post-acute rehab or it's senior living, they expect almost a lifestyle to it. Yes, they [00:21:00] need medical care, but they expect more than just good medical care now.

They expect so much more and it's going to just continue to shift and evolve even more. And so how do we step up as organizations to serve today's customer is really, I think, a conversation that continues because the expectations aren't going to get less.

Samantha Lawrence: That's a really great point, and I think when you think about just our industry, and Heather and I have been in it for about the same amount of time.

The nursing home residents that I started with back in the day is today's assisted living resident. And today's assisted living resident is the independent living resident. People are coming to us, often at a later phase of their journey, but they're still expecting that lifestyle that Heather described and we've created as a society, a very on-demand culture.

So going back to that transportation example earlier, they're [00:22:00] used to going on their phone maybe and having themselves or their adult child or somebody help them get an Uber instantly or order. A meal on DoorDash or delivery with food, or I want to watch this TV show right now. I can turn on Netflix or what if they can’t work the remote?

I'll get there. And so it's how do we find ways to anticipate needs so that we can try to get ahead of some of those demands or requests or desires or needs at the end of the day? I think one of the questions we get a lot is how are you evolving as a business? What are new tools, processes, services, programs?

People want to know that you're thinking ahead and sometimes aren't even always interested in what you're doing today. They want to know where you're going with some of the offerings because the consumers at all ages are very well educated now about what it is that we do, and they very much want to continue their existing independent lifestyle [00:23:00] within our communities.

Debbie Stadtler: I think that idea of evolution is so interesting and so much of what has changed in the world in general revolves around technology and the strides that it's made. So you know, what is the role of technology in this customer experience, hospitality service world. And how do you balance it with the things that are so human with that empathy and relationship building and things like that?

What's the balance between the technology and the human touch? Samantha, tell us more. 

Samantha Lawrence: Sure. I think one of the big things I know that we've done, going back to the pandemic, really leveraging some of the very basic tools that we have FaceTiming and not stopping FaceTiming at, okay, the pandemic's over, everybody's out.

But if there is somebody that needs some assistance with connecting with a loved one, there's a way that I've built that relationship with that resident helped me FaceTime my loved one, and that's a great [00:24:00] customer service, customer experience piece. But it's also a way to leverage a very basic piece of technology on a broader scale.

One of the things I'm really excited about is fall prevention or technology. I know our organization is in the process of rolling out safely you and our dementia care neighborhoods, and it's a fall detection software that detects fall motion and sends that alert immediately to our team. And our team is able to respond more quickly.

What's been the greatest gift of this software is not only does it prevent an unnecessary hospitalization because we didn't see what happened in a different scenario, and we might send someone out of an abundance of caution. It's detected injuries that we might not have known happened because the resident got themselves back into bed before we got there quickly.

But it's also been a great associate training tool because as we watched the video recording back of what happened, we are able to see body language and did we illustrate empathy in the way that we physically reacted to the [00:25:00] resident? And it's created great training tools, not necessarily that we even had to train to, but an associate watch it and says, “Oh my gosh, I would've gotten down at eye level next time I do that. I look like I was standing over that person.”

And so it's a great way to illustrate the strengths that we have, as well as the opportunity areas we might have. So it's a great way to leverage technology to help us, but not in a way that eliminates the human touch and actually really enhances the human touch.

Debbie Stadtler: I think that's a great point. Enhancing is really a keyword there, Heather, is that what you're seeing? 

Heather TerHark: Absolutely. And not only technology-enhancing, but I think that the technology, as Sam said, what are we doing as an organization next year in five years? AI is gonna play a big part in this too, as they scrub records, as they summarize things for us and [00:26:00] what we're so used to, okay, is it HIPAA compliant? Is making sure there's no security breaches? But the resident wants to know the highest wifi fastest speeds. How do we merge all of that together with the on demand, the great technology, not just fall detection, but also being able to know if they're restless at night, and what if they have had an accident from moisture being detected?

What ways for them to have more freedom, even if they do wander from a memory care standpoint and not feel like they just have small places to wait. All those things that technology helps us do to better care and provide a better customer experience. But how do we blend it all together as an organization from a security standpoint, from a cost standpoint.

Also, let's face it, [00:27:00] teaching staff how to use some of it only as good as what you use it or that you provide. The data comes from that technology. So it's a small shift that I think isn't going to stop right now. 
Because how many have walked into different buildings and we're like, we have great wifi, but then there's pockets that we still have to find in the buildings.

Buildings are big, so we haven't fully even got wifi where we want, in a lot of cases. What do our new policies and procedures look like when you start talking about fall detection or you start talking about families putting cameras in to monitor? What does this all mean to us? But we have to find a way to do it because that's what the customers expect.

And there's a ton of things I think all of us are working on, but I think this is just the very, very beginning and I really [00:28:00] believe AI is going to play a big part in it too. 

Debbie Stadtler: There's so much possibility. It's really amazing and a lot to try to integrate. Like you said, you really want everything integrated and working and all of that good data flowing and things like that.

So that's a really great point of not only using the technology, but making sure we're really executing well with it. This has been a great conversation. I have learned so many things about ways to enhance my experience with other people and have a better customer experience, so I appreciate your information and wisdom with us today.

Heather and Samantha, thank you so much for joining us. 

Samantha Lawrence: Thank you for having us. We had a great time. 

Heather TerHark: Yes, thank you. This, it's been great to speak to everyone at AHCA-NCAL and we always are looking for members for our customer experience committee in the next year. 

So please know we would love to have you be part and help [00:29:00] us expand the customer experience journey and we're working to just try resources for members. As Sam mentioned earlier, with different scripts and playbooks and things of that nature. 

Samantha Lawrence: Absolutely. 

Debbie Stadtler: Thanks to everyone for listening to this episode of Perspectives in Long Term Care. Join us each month as we discuss issues that impact the long term and post-acute care profession and be sure to subscribe to this podcast wherever you listen to your favorite podcasts.

Take care.