Written by Chris Nichols, Client Solutions Manager at endevis Recruiting | Retention and member of the LHC Marketing and Communications Cohort
On April 17th, Lucinda “Cindy” Baier, President, CEO and Director of Nashville’s 6th largest publicly traded company Brookdale Senior Living, joined Leadership Health Care for an Executive Briefing. Before becoming CEO of the largest owner and operator of senior living communities in the U.S. in February 2018, Baier had worked as the CFO at Brookdale since December 2015. The discussion, moderated by Jessica Wells, AVP for Education & Research at HCA, would range from Baier’s career journey to the future of post-acute care
On her career ascent:
Baier grew up on a farm in Central Illinois and began her career as an accountant after attending Illinois State University. Her belief in accounting is that it is the “language of business”; that without the understanding of how a business makes money, one cannot help an organization begin to grow. Learning this lesson has allowed Cindy to work in a variety of industries such as manufacturing, retail, professional services, defense contracting and, ultimately, healthcare.
On Brookdale’s business model:
With about 900 communities and 75,000+ employees, Baier explains the essence of Brookdale’s business model as, “We take care of people… you wouldn’t be in healthcare if you didn’t want to take care of people.”
Brookdale has the broadest continuum of care of anyone in the industry: home health, skilled nursing, independent living, assisted living, & memory care.
Brookdale is an organization built on mergers and acquisitions. Before the organization could flourish, there were cash flow issues that had to be addressed due to underwater leases. The senior living business currently has more supply than demand and developers have built without regard to market conditions but Baier says that oversupply is just a matter of timing. Brookdale is focused on communities where there is an opportunity to win vs. places where Brookdale was better off to write a check, terminate the lease and grow the business by providing more services in the area.
On Disruptors in healthcare:
Baier noted that we are at a time where movement is occurring from a structure built on paying for a service to one that is built on outcomes. The economics around our business have changed and will continue to change.
Medicare Advantage allows non-traditional services to be covered such as non-skilled labor to assist in the home and transportation to and from appointments. Many residents say that want to age-in-place at home, but when they move into a Brookdale community we often hear they wish they had moved in sooner due to the increased socialization of the communities, among other advantages.
Baier excitedly stated, “Because we are the largest and have the most experience, we have best-in-class data. One of the things we have been able to do is take data from the entire time we have been in operation and we have seen that falls is one of the biggest issues. We have looked at different things that we can do around falls management to ensure fewer hospital visits and improve quality of life and outcomes for our residents.” Additionally, Baier says “All of our communities’ employees have been trained to see potential changes in behavior of residents to reduce the possibilities of hospitalizations and other outcomes that are not in the best interest of the patient.”
On Current Initiatives & Strategies:
Baier is most passionate about the initiatives that align with Brookdale’s people management. There is a strong focus on enhancing the team’s experience and looking at opportunities to provide a hand up to someone who may be on, for example, the dietary team and give them the opportunity to grow within the organization.
Brookdale is also focusing on the home-grown nature of healthcare and focusing on building the local presence while using economies of scale to increase purchasing power on things that aren’t hyper-local. However, things just as simple as tailoring menus to match the culture of the market in which the community is located have been increasingly positive for our residents.
Advice on growing your career:
Build a network of experienced professionals and take the hardest job you can do. You don’t have to know 100% of the job but find people who can help you solve the issue. Additionally, there is no substitute for hard work. First-in, last-out allows you to take on additional responsibilities. Finally, be helpful. Believe that if you help people, you will benefit from that.
On what the Nashville Health Care community could do better:
Baier says, “We are in a time of massive change in the health care industry and we need to forecast the future better to understand what challenges we need to solve.” Baier wants to work with hospitals and acute care systems to ensure both aspects of the continuum can benefit.
Brookdale’s Board Structure & its Diversity:
Before Baier joined the, there were seven men and one woman. Today, the board is evenly split male/female and has diversity in the form of one African-American woman. She says 80% of healthcare decisions are made by females so having a more well-rounded board allows Brookdale to bring new ideas to the forefront that might have otherwise been lost.
On REIT ownership structure & its challenges:
Brookdale has paid hundreds of millions of dollars to exit leases. They were very popular a decade ago or more, but as soon as these agreements were signed they created a misalignment of interests. REITs would get a fixed payment and the operator would get all the economics of that. It is a great model when the market is strong, but due to changes in the economic system it became very painful to the operator. You are seeing a move to more of a sharing of the economics vs. the previous format of fixed rent.
Overall, Baier brought an insightful perspective to the often-overlooked senior population and the future of care provided to those mainly 65+. The changing economic structure within the business is seemingly at the forefront of Brookdale’s most pressing challenges and the retention and growth of the team is a primary focus for Baier and her team.