Tana Gall has been on a mission since returning to Merrill Gardens as president last November.

The groundwork for the Seattle-based owner-operator’s entry into the middle market was underway before the coronavirus pandemic shifted priorities to resident safety. However, the middle-market concept is still in the works and likely will be piloted in a handful of communities by the end of the year, Gall said July 23 during the latest installment of Senior Housing News “TALKS” series.

She also noted that Merrill Gardens’ experience as one of the few U.S. senior housing operators in China informed its response to the pandemic on these shores.

And a summer of unrest and protests for racial equality across the country led Gall to reassess Merrill Gardens’ efforts to mentor people of color for career paths in senior living, and to elevate them to leadership positions.

“I want to mentor people. I love this business. We need to be more cognizant of our great line staff who are of color and say, ‘This is a great industry for you. And we’re going to help you get to where you want to go,’” she said.

Middle-market plans moving forward

After returning to Merrill Gardens with the acquisition of Blue Harbor Senior Living, Gall hit the ground running researching a scalable middle-market model, and made significant progress that was slowed by the pandemic.

By January, Merrill Gardens established focus groups filled with people whose insight and advice would prove beneficial to the company in its quest. The operator is close to settling on a brand for its middle-market product, as well as an operational model.

Progress continues, even as Merrill Gardens’ priority is responding to the virus, and the company may be ready to pilot the concept in a handful of communities within a few months.

“By the end of the year, we should have that operating in some of our communities,” Gall said.

Gall is confident that Merrill Gardens’ middle-market brand will more than meet the growing demand among the fast-growing baby boomer cohort, but it will be a streamlined product. She envisions a middle-market brand with a high service component and fewer amenities than in the company’s market-rate segment. This should appeal to boomers whose retirement nest eggs have taken hits from the pandemic, in addition to future residents who cannot afford market-rate senior housing.

“A lot of people are going to think about the move to retirement in a more practical way. That’s how I see this middle-market model looking: a little more practical. It will certainly be a great thing to have in the market,” she said.

Versatile staff — or “universal workers” — will play a role in Merrill Gardens’ middle-market model. Gall indicated that the operator is looking to recruit workers that can be trained in a variety of capacities, which she sees as a way to keep staffing costs in check while also laying the foundation for employees to launch a career path in senior living.

“Our vision is that we’ll still advertise to get a server, so we get the right people applying. But when they come in, we want to talk to them about other things that we’re going to cross-train them to do, so that they have a career path in this industry. Maybe you’ll want to be a med tech someday or maybe you want to get into programming or activities,” she said.

The former Blue Harbor communities will account for a significant part of the middle-market brand. The portfolio age averages 26 years, but Gall believes that the plants and buildings are suited to meet future demand. There will be some retrofitting to do, notably an upgrade of WiFi systems to better handle resident demand, as well as because Merrill Gardens’ care platform runs through these systems.

“In the next couple years, I believe all the buildings will be good to go with WiFi, and will certainly make the technology advances much easier because it has been challenging in buildings where we don’t have WiFi in the far hallways,” she said.

Merrill Gardens also researched hotel groups, and contacted some operators, for best practices on operating multiple brands, and discovered that elements such as accounting and management could be done at a centralized location. This is something that the company is already set up to accomplish.

“Some of the big [hotel] chains were the ones who told us that the same operations person will oversee multiple chains within that organization. I thought, we’re already kind of doing that now,” Gall said.

Recommitment to diversity

Merrill Gardens is taking steps to improve diversity among its executive ranks, in the wake of Black Lives Matter protests across the nation. In one community, the staffing ratios across departments is nearly evenly split between white people and people of color.

The leadership ranks, however, were the exception.

“We had 10 people in leadership and there was no one of color. And that was a punch in the gut to see it,” Gall said.

She formed a diversity team of trusted advisors that will help identify areas for improvement in the operator’s efforts moving forward. She also strengthened her determination to be a advocate for diversity, drawing from her own experiences in the industry while being cognizant of her own blind spots.

Gall recounted being at an industry meeting three years ago with a Black nurse. When she noted all the white males at the conference and how women have to work harder in the industry to succeed, the nurse told her, “You should try to be a black woman.”

It was a reality check for Gall.

“It hit me really hard that day to go, ‘Wow, I was a little bit ignorant to that fact.’ Since that day, I’ve sort of taken it to heart,” she said.

Gall believes that Merrill Gardens’ leadership can identify and nurture people of color for executive career paths, and the early discussions and recommendations from the diversity team will lay the foundation.

“We can be the ones who take them under our wing and say, ‘This is a great industry for you, and we’re going to help you get to where you want to go,” she said. “We already have a good mentoring program. I want it to be a little more specific to what we’re looking for.”

Lessons from Chinese Covid-19 response

Gall cited Merrill Gardens’ experience in China with informing its quick response to the pandemic in the United States. The company is one of a handful of U.S.-based operators with communities in China, which has an older adult population that is expected to grow to 300 million by 2033.

When the virus forced Chinese authorities to shut down the country, they literally meant it.

“That meant our employees couldn’t leave the building; they had to be in the communities,” she said.

The main benefit to this approach was that, if a community was free of Covid-19 at the time of shutdown, it would stay that way until the building was deemed safe to reopen.

While Merrill Gardens could not completely shut down its communities in the States, the Chinese response was on the company’s mind when Vice President of Operations Kyle Reiter called a meeting on February 29, reminding executives that Merrill Gardens had a community in Kirkland, Washington located ten minutes away from the Life Care Centers nursing home that was the epicenter of the first notable Covid-19 outbreak in the U.S.

“If nothing else, it was just knowing how serious this was. This was not something we were going to mess around with,” Gall said, of the perspective that Merrill Gardens had early in the pandemic.

More than four months into the pandemic, Merrill Gardens is still dealing with positive cases, but those have shifted from residents to employees. This has not surprised Gall; as the country reopens, it is hard to track staff movements outside a facility’s walls. To mitigate this, the provider continues to educate employees and their families on the importance of wearing masks and practicing social distancing.

The silver lining in the rise of employees testing positive for the virus is that the majority of cases are asymptomatic, and employees are following quarantine guidelines established by the Centers for Disease Control and Prevention (CDC) until they are cleared to return to work. Most notably, staff infections are not cascading into serious resident outbreaks.

“I feel optimistic that our protocols are working, because I’m not seeing an employee test positive that’s translating into positive residents,” she said.

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