Make Safety a Competitive Advantage

by Jeff Shaw

COVID-19 broke seniors’ trust, and successful communities must repair it.

By Raj Shah, CareSafely

Running a seniors housing business is an inherently risky proposition. As an operator, you are trusted with caring for residents and patients with complex and persistent medical, physical and psychological conditions.

Residents (current and future) and their families place significant trust in your organization to have appropriate safety processes and systems in place. In their minds, safety is non-negotiable. Food menus, building décor, amenities and social activities are all second-order priorities compared to basic safety.

The COVID-19 pandemic has fundamentally broken the trust that seniors and their families place with long-term care (LTC) organizations. According to a Qualtrics survey in August 2020, 44 percent of older seniors (75 and older) do not trust the level of safety at senior care facilities. Safety distrust is almost 50 percent among baby boomers.

Some may argue that COVID-19 is a black swan event that happens once in 100 years. Consumers may give a pass for the initial response to COVID-19 in early to mid-2020, but they are not likely to give a pass in 2021 and beyond. Depending on a variety of factors like COVID-19 mutations, vaccination rates and herd immunity, COVID-19 will continue to play a large role in the minds of residents and loved ones for the foreseeable future.

Extenuating structural challenges around staffing (shortages, turnover and rotations) have further strained the safety challenge. However, the staffing issues are unlikely to change anytime soon.

The bottom line is that the pandemic has broken safety trust and the ramifications are real. For LTC organizations that fail to act to restore trust, things will get worse.

Implications of Broken Safety Trust

Business performance will further decline. Census and occupancy rates have dropped dramatically across almost all service lines, especially in assisted living. Prospective residents are wary of moving into a community until they have a higher comfort level about safety and risks.

Legal liability is a very real threat. More than 55 COVID-19 negligence and wrongful death cases have already been filed against organizations and their leaders. Many more are in the process of being filed across the country.

Staffing shortages and low morale will continue. Staffing shortages have been a chronic issue for the LTC industry. COVID-19 has made the situation much more acute. Lack of safety is the key driver to the worsening staff shortage and higher turnover.

Worker injury rates were already two times higher than construction or coal mining industries. And now with COVID-19, the fatality rate is also higher than any other industry.

Brand reputation will suffer. COVID-19 has negatively impacted the overall brand of the seniors housing industry and of each operator as news organizations and social media have extensively covered the pandemic’s impact.

It is not clear how quickly the brand reputation will rebound. Or whether it will be across the board or specific to those operators that are able to differentiate their safety initiatives from their competitors (think Volvo for cars).

Government regulation and scrutiny will increase. State and Federal scrutiny around safety practices will likely increase as seniors and consumers press elected officials for tougher regulations and enforcement actions. The food industry is an example. After a spate of e. coli and salmonella illnesses and deaths, Congress passed the Food Safety Modernization Act.

Lessons from Other Safety-First Industries

The seniors housing industry is not the first to encounter safety challenges. Other industries like airlines, manufacturing and food processing have also experienced — and overcome — significant safety challenges. Adopting best practices from other safety-first industries can significantly improve safety.

To get started on the path to a safety-first culture, consider the following best practices.

  1. Make safety a top-three strategic priority

While safety has always been important to the seniors housing industry, it has not necessarily been considered a top-three strategic priority in the C-suite or governing board. For any safety program to work, it must be a strategic priority on par with financial performance and operational efficiency. Safety starts at the top. If it is important to the C-suite, it will be important to the rank and file.

  1. Avoid managing safety in silos

Safety must be managed holistically, not at the department/functional level. This means identifying risks facility-wide, building safety processes that span the entire operation, and deploying systems that monitor all safety processes and incidents. A 360-degree approach must consider all risk factors and be supported by a continual improvement process that drives higher levels of safety and lower levels of risk.

  1. Don’t limit safety risk assessments

Every safety program must start with a comprehensive assessment of risk factors. The process should be strategic, comprehensive and imaginative (i.e., consider black swan events).

Ideally, these assessments are built by safety experts, operations experts, government guidelines and industry recommendations, with input from frontline employees who are closest to the action. Assessments should be updated regularly as new risks emerge.

  1. Make safety training and coaching a priority

High staff turnover and urgency to get new hires on the floor quickly typically results in minimal safety training. A robust onboarding safety training program, coupled with ongoing coaching program, is critical. The goal should be that 100 percent of the staff has 100 percent of the knowledge and 100 percent of the confidence to make the right safety decision 100 percent of the time.

  1. Take a proactive, automated approach to safety

Most LTC organizations have made the digital transition to electronic health records (EHR) and financial management systems. Yet something as important as safety continues to be managed using a hodgepodge of paper, email, verbal conversations and spreadsheets. As a result, safety management is reactive and focused on “check the box” compliance rather than building a culture of safety.

Digital safety management tools simplify workflows and improve risk assessment, incident reporting, and action planning. These tools also make it easier to identify high-risk areas for proactive attention before an incident. For multi-facility operators, digitizing safety management is especially critical to ensure facility-wide consistency to safety standards.

Make safety a competitive advantage

COVID-19 will have a multi-year impact on business performance, staff recruiting/retention, and brand. A renewed and sustained focus on safety can be a true competitive advantage by rebuilding trust with seniors and their loved ones.

Other safety-first industries have learned and adopted best practices from their own industries and other sectors. Now is the time for the seniors housing community to do the same.


Raj Shah is the founder of CareSafely, a software platform for senior care safety, compliance and quality management.

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