Executive Insights: Aging Care 2023

Executive Insights: Aging Care 2023

Source: Louisville Business First
By Lisa Benson

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Louisville often calls itself the home of the aging care and aging innovation industry. We gathered three top professionals in the field to talk about the state of business and how they are navigating through major challenges in workforce, funding and attitudes toward senior populations. Joining this sponsored content conversation were Mary Lynn Spalding, president and CEO of Christian Care Communities; Mary Haynes, president and CEO of Nazareth Home; and Dr. Arif Nazir, chief medical officer for BrightSpring Health Services. This discussion took place in March of 2023.

MODERATORWe’ve heard a lot in recent years about the impact of the aging Baby Boomer population and concerns over the strains it will place on our health care system as they begin to need more aging care services. How are your organizations dealing with increasing demands of the senior population and how is that impacting your services?

SPALDING: Well, it is a challenge because, quite frankly, there’s more people to take care of than there are people to take care of them, and that’s the basic fundamental of supply and demand. The reality is that our workforce is changing, and obviously, the impact of COVID caused further changes in that workforce. But as far as Christian Care Communities, what we have done specifically is to focus on workforce. We have divided our human resources department.Our vice president of operations is exclusively responsible to work with individuals and make their jobs easier, her main focus is on recruitment and retention. We still have a very robust human resources department that looks at more tactical things like benefits and compensation.. But what we have been able to find is that through the pandemic, we lost a lot of people, as did many organizations. What we’re wanting to make sure is that those people that have remained in the health care industry feel good about what they’re doing. We have had to use agency staffing, which is a challenge for many organizations. I’m proud to say today that we have significantly reduced, if not eliminated, agency staffing in over 90 percent of our campuses. And we’ve done that on the ones. We’ve done that by listening to our employees, by reacting to what their needs are to try to develop programs and services that will wrap around those needs to make sure that they continue to enjoy this industry.

NAZIR: Everybody’s just trying to figure out who are the people who are going to provide the care. We just have significant resignations, and you hear concepts like “quiet quitting” and all those issues just are real for us in day-to-day life. I think we all have to think outside the box. BrightSpring has many services lines, from pharmacy to hospice to home health care, but I’m going to focus more on the primary care side because that’s where I’m more engaged. I think the answer is experimentation. As a primary care leader, what I’m busy in, with the help of other leaders at BrightSpring, is how can we create more efficiency and more fun for front line teams. I think that is where we need to be redesigning our health care systems. I see that a lot of us kind of just sit and wait for policymakers to bring more dollars or to make some policy change before we can think differently, but at BrightSpring, we are challenging ourselves. How can we, in the current environment, think more innovatively in how teams can get better help. And one example I’ll give you is we are looking at how frontline practitioners and consultant pharmacists can work together so that they can make their lives easier and more fun and meaningful. There are many interesting experiments that we are leading at this point to create more value, extract more value out of the same environment we have. We are also trying to be very innovative in how we engage our frontline staff, listen to them more, as Mary said, and pay attention to what their needs are. And finally the role of tech and data – we are trying to explore that. I will talk a whole lot more about it later, and I’m sure in this conversation. Tech and data is on everything. Actually, tech and data that’s not paid attention to can actually create more burden for the frontline. We need to be very cautious in how we use it. think we need to do a whole lot of work in regard to experimentation around the well-being of the frontline team first. And once we have figured that out, then we can think about more tech and innovation and so forth. I’m very excited that we are using this tough time to redesign how care is being delivered, and we are seeing a lot of successes.

HAYNES: Looking at the growth in the marketplace, we’re looking at our services to be more designed to what people are wanting. A short stay is what people want because they want to be at home. We’re looking at how to diversify what we do to serve that short-stay person. For us, the recovery-to-home program has always been very robust. We are great at that. U.S. News and World Report listed us this past year in the top 10 percent of skilled nursing facilities in the country. That’s something we’re good at, and we want to stay in that because we believe that even as home becomes the hub of health care, there will still be needs for skilled nursing. We’re streamlining those programs and looking at shorter length of stay. We’re here in Louisville, so we’re always looking at what do we do well up against what other people are doing well and making decisions about where is the best place for us, knowing that most authorities say that one out of four people are going to intersect with a long-term care, subacute provider at some point. So, there’s definitely a place for all of us in the market.

MODERATOR: How has your work-force changed since the pandemic and what strategies are you using specifically to address workforce challenges?

NAZIR: Just referring more towards our frontline primary care team and the staff we work with in the nursing home and other settings, their needs and demands are changing, as they should. Particularly since the pandemic, everybody’s demanding more flexibility. I think how we are responding to that is trying to think about the vision statement or the mission statement of the work we do for our company. It must include staff well-being as the key thing. I think it even has a place before we say anything about the patient care. To me, a good, meaningful vision statement must be that we believe in the best possible world for our frontline staff so that they can provide the best possible care. I think everybody needs to sincerely believe in that. And then you need to have a very clear strategy, and for me, that strategy is purpose. Most of the people who want to work in the front line do it because of a purpose and a mission. I think with all the regulatory structures and all the other burdens we put on people, that purpose apparently gets lost somewhere. I go to a nursing home and I see my nurses and my nurse practitioners work, and so many times, they’re just being a servant to a regulatory checklist. That is not why they became a provider or a physician or a nurse. They wanted to have an impact. What we are trying to look at and trying to do some good inquiry from our frontline is: What does purpose mean to them? How can we make them believe there’s a purpose? And one thing we have figured out is that they need to be better team members, they need to know that the nurse practitioner that is coming in is their colleague, their team member, and they work together. And then they need to know their outcomes. They need to have data right at their fingertips to know what kind of impact they’ve had, how many hospitalizations they have prevented, how many dollars they have saved the health care system because that is as important also. We are looking at many ways of creating more teamwork, more meaningful dashboards that are not 30, 60, 90 days old but as old as yesterday, so they can take action, learn from those things, and provide better care the very next day. We’re doing some interesting experiments that are working well in that regard.

HAYNES: Redesign, I think, is where we all are in both our existing programs and the way we relate to the community and certainly the role of the team members. During COVID, a lot of people enjoyed being at home. In the direct care world that we’re in and the service world, we don’t have a lot of jobs that folks can do remotely, yet at the same time, we’re called to try to make our positions afford people more time off. We’ve looked hard at redesigning and listening to the people – what works for you? We’ve shortened some shifts to four hours; we’ve lengthened some shifts to 12 and 16. It’s listening and trying to find the best way for them to contribute. And as Dr. Nazir said and Mary Lynn would echo, in the mission-driven world, we have such meaningful work, and we have an opportunity to listen and redesign that work. We also have enacted our Nazareth Homes Foundation to fund employee scholarships. We’re looking at ways to help people stay at work and upskilling is, of course, a new buzzword. Looking at the people who have made a commitment to be present and to be here and to give – how can we expand their giving; how can we create a better life for them at work and also build the organization? We’ve developed apprentice programs that we are participating in through a grant with the Department of Labor with strategies and steps on how to build skills, increase competency in the workplace, and also provide some wraparound services. You know, for us, we’re a workforce of women, and these women are very burdened. They’re raising their family, maybe another, and many of them are working other places, too. To try to help them only work at one place is something that we’ve been very devoted to. How can we improve their work life? We’re all in it together. Listening to people that make that commitment to our ministry and mission and the people we serve, that’s who we want to be in business with. What helps people helps business, and that is something we are leaning into.

SPALDING: To sum it up in one word, it’s intentionality. What I mean by that is that splitting the two departments created the opportunity for intentionality. When we focus on retention, we’ve done something called an EAR meeting – and EAR stands for “employee at risk” – because each one of our employees has a different story, and the reality is that they may have a different need. To Mary’s point, some people may want to advance their career, others are just getting by. We need to be sensitive as an organization to make sure that we understand that, and we react to that appropriately. These EAR meetings happen with regular frequency and look at each individual. We’ve mirrored it on the clinical side. We had something that we would have clinically at-risk. That was an individual that was older that was at risk for falls or something like that. This is the same type of thing, using that same principle for our team members. What we have seen is that our biggest risk area is in the first 90 days of employment. We have launched a huge CNA initiative training program, and we offer that across the state. For a lot of those individuals, this is their first entry into health care. And with the populations that we serve, at times … create very difficult work. For those with no past health care experience challenging situations can be frightening. We focus on that first 90 days of employment to get people onboarded, to have them have a sense of community and a sense of team through these employee-at-risk surveys. Back to the use of technology, we want data real-time. We want it fast; we want to be able to use it. We push surveys out to all our staff, and they can respond. And they’re going to get less than a 24-hour response to whatever their issue is. If there weren’t enough medical supplies in the medical supply closet last night, their leader is going to know, and they’re going to replenish it when they come back to work the next night.It all flows through intentionality. The second thing I would say is caring and compassion. If we want care and compassion from our staff for our elders, which is what many, many elders do want, we’ve got to be caring and compassionate to them. We have something called the Heart to Heart Fund through which an individual can submit a specific acute need, and we can fund that up to $1,000 for that individual almost instantaneously. Sometimes people live beyond their means, and if they need a car repair, they can get some sort of response quickly. It does go through a committee, we do have a process for it, but it lets them know we care about them. The other neat thing about that is that our employees contribute to that fund. So that means that they care about their team members. They may not need those funds at a particular point in time, but one of their team members might.

MODERATOR: How are you strategizing around engagement and keeping your employees engaged in their work?

NAZIR: We lead almost 100 nurse practitioners in very tough environments such as nursing homes, ALF, and senior living. The day-to-day burden can lead to a lot of monotony and tiredness and questioning, “why am I doing this?” We have to keep them engaged, and the most important thing is that we, as leaders have to be more engaged with them in the front line. That is something which we always believed, but I think since the pandemic, that just has become a big focus for me personally. For example, I’ve opened a day in my work where I spend it in the field now. I spend a few hours with a nurse practitioner one day, with another nurse practitioner another day, and through them, I also spend the day with the nursing home team. This morning, I was with a nursing home team, and we did a lot of learning and education together as a grand round, where we reviewed patients together. That has given me my purpose back, to be more engaged with the front line team. We try to keep the grand rounds fun ¬– people are laughing, there’s jokes around, and that is the best way to learn and educate.Those are some of the strategies that I’m engaging in personally because now I’m finding some hidden value, which I just couldn’t see as clearly as before. Again, this experimentation will lead whole change in different models. If Arif Nazir and Julie can have so much fun in the front line rounding together, why can’t Dr. Smith and the other team members have that? I think there’s so much more that we are not getting value from. It’s day-to-day teamwork. We need to redesign how people engage. Another thing that my executive team is doing now is that every quarter we are setting up Zoom meetings with a group of practitioners who are in the same geography, so they feel like they’re a team. We get on the Zoom or a Teams meeting with them and try to understand what their challenges are, a little bit about their family life, and we share our family life stories with them to create that engagement and intimacy, and that has been received so well. And I believe that I know a whole lot more about my team members that I didn’t know before.

HAYNES: We’re in the relationship business, so we’ve always been in close relationship with our staff. COVID challenged that and caused us to look at tech differently and look at software platforms, and we embrace those. They’ve been tremendous. Just as Mary Lynn was mentioning about the push notifications, we have a software platform called ENGAGE that does that push-out randomly multiple times a day, just checking in on people – How are you feeling? You get that quick response, and it allows us to take the temperature of what’s going on under the roofs and be able to address that much quicker. We’ve probably done a better job of listening to the people we serve, getting their feedback, and getting the provider in that conversation. So while we’ve always known that our relationships are our secret sauce, I think right now we are living into that and lifting up those on the team. We have a little measuring stick right now about our environment of care, and it’s about how easy or hard is it for anybody under any of our roofs to get a cup of coffee. It may sound funny, but everybody can relate to it because it tells a story. It tells who’s important to you, how easy is the system to use. Is it personal? Who has power? Where is the level playing field? So, to Mary Lynn’s word, “intentionality,” and to Dr. Nazir’s word, “well-being,” I think COVID has caused us to prioritize some of the things that we thought we were good at. We had a great foundation, but now we’re living into that, and it’s making a real difference.

SPALDING: I think that reengagement starts with trust. When Christian Care had its first case of COVID, quite frankly, Mary Haynes was one of the first people that I called to say, “How are you dealing with that?” I trusted that Mary would provide solid information. When you’re looking to reengage people and to have them stay with your organization, they first have to trust. They have to trust their team. They have to trust their organization. Then I think the second piece of it is they need to be proud of who they’re working with and working for. For Christian Care, we have two campuses, specifically, that are in the Louisville area. One, we truly take care of individuals who are very challenged. Our downtown campus, we have a lot of folks in independent living that prior to moving into independent living had been homeless. And as many people know, there’s a huge homeless problem and challenge in the city of Louisville. I think a lot of people look at people that are homeless as individuals who are younger, but it happens to seniors as well. If you can imagine the burnout rate for our staff in trying to meet those needs, very large needs, is huge. Then we have another campus in Middletown where we have a lot of folks there who have dementia, which again, is another challenging population. When you look at how do we engage and reengage, I think it’s employee appreciation. I think it’s trust. I think it’s listening. And as Dr. Nazir said, it’s just finding the fun. Some days, it’s harder to find that fun, but we challenge all our leaders that are out there to take a minute to step back and to do that. And then last but probably most importantly for Christian Care, our foundation is spiritual care. We have full-time chaplains, and many times, they pick up on issues that individuals are having, and they’re able to lean in in a different way. Those individuals can engage with people and help to reduce and prevent that burnout.

MODERATOR: The issue that is often top of mind among providers of aging support and care is payment for services. What’s the outlook for balancing that increased need for services and the financials?

HAYNES: It is on all our minds. We were hopeful that COVID would shine the spotlight on us for the value of what we bring to our community. That spotlight was pretty bright, and it had a variety of impacts. One is, I’m not certain that it made folks want to be under the roof of a facility. It made them want to be home where they had more control. And of course, that’s always been the trend here in the U.S.: care at home. Often, we’re in a competitive situation for that dollar, whether that federal or state dollar goes to home or goes to brick and mortar, and the trend is to home and not to those of us that provide congregate living and very safe settings that keep people whole where there is well-being and a sense of security. It is a competitive situation for the federal and state dollar. Here in Kentucky, many long-term care centers are very dependent upon Medicaid. We’ve not had a real increase in daily Medicaid payments in about 10 years. So right now, we’re very much in an advocacy position with our elected and with CHFS. Every one of us on this call this morning have been advocating with our elected officials for the last six months to try and rebase Medicaid in Kentucky, to make that rate more comparable to the increase in wage. Wages have increased 30 percent. I think most of us would say food has increased about 14 percent. And of course, our care of the people on the team, as we’ve talked about here today, being the No. 1 reason that we will sustain as an organization, is that we can build a team and afford them a quality of life in the marketplace. To keep up with that, we’re at a very painful intersect with income and expense. We’re grateful for the chance to talk about it because it is a community problem. It’s not a provider problem. These are decisions that communities have to make about what sort of care and provision and environments that will be existing in the community as we see the aging group grow. The World Health Organization says that ageism is a real threat to the health of every community, and that one out of two people in America right now have ageist attitudes. We are a workplace of females; we are a workplace of folks who don’t have many advantages, and I’m always ready to stand in the public square and advocate for the people who work with folks who are aging in our country and also those who are aged. I think it’s important to use every platform we can to raise that issue up at least for discernment, if not solution.

NAZIR: Mary has just put me in that kind of mood. It’s about how sad it is that we have such ageist attitudes, unfortunately, in our communities, and the poor funding just a product of that. When you have nursing home closures and AL closures at a bigger risk than other institutions like casinos and restaurants, then you have a problem in your society. You know what you value more in your society. There should never be a situation where a nursing home or AL should be at risk of closure because they are doing the noble work of taking care of the most deserving people. To me, it’s heartbreaking as a physician when I see, no matter what company we work with at BrightSpring, our operational leaders are working, I would say 60, 80, 100 hours a week just to make this business be viable. That is just hard for me to see. The commitment I have as a physician leader at BrightSpring Primary Care CMO is that we will do anything to be respectful of that. One example is that I truly believe that medical directors should be paid for the value they bring and not flat fees. . We as physician leaders have to assure that anytime we engage, it is clear what value we are adding. As physicians, we need to see how we are partnering with these very, very constrained, resource-strapped institutions and be a partner in that. At BrightSpring, we are coming up with new models where physicians, practitioners are not just a vendor who just go in the building to make visits and pick up ethical revenue, but how can we be a better partner to make the life of our frontline teams easier so that we can extract more value together from a system. Things that a nurse practitioner or a physician can do, they should be doing that. They should be entering those orders; they should be writing those notes in the electronic record, preventing any time wasted on the staff to scan and copy etc. Why should a nurse who is so busy doing so many other things be depended upon for those tasks when they don’t even get paid for those things. I always tell my frontline team, nurse practitioners and physicians, medical directors, any single time we are compensated, we should think about, “What was the value I gave back to the patient and the team.” We just need to do this math in our mind and be very ethical on every single dollar that we get paid for, any service we provide. I’m very, very much focused on that. At BrightSpring Primary Care, we are creating new teamwork processes to bring more value. We are redesigning the role of the medical director. It shouldn’t be just at a stated dollar amount every month. It should be dependent upon value. I’m hopeful that with the value-based transition that we are going into, hopefully that will help us design new ways of looking at things so that we can at least use the same dollars in a better way. I think nursing homes and assisted living finally getting some control over these dollars through the value-based systems like the I-SNP and the E-SNP programs, the ACO models, give me hope because finally, we can have some more control on how we want to redesign some of these models of care.

SPALDING: I’m going to say we’re in crisis. I think until our society recognizes that we’re in crisis and accepts that word, we will not get the speed and the call to action that we need. The reality is that there’s a lot of closures of skilled facilities, of personal care homes, happening across the Commonwealth. Don’t forget where I started. We’ve got more people to take care of than we have people to take care of them. So where are those people going to go as these closures continue, as these changes continue, and who’s going to take care of them? That’s our reality. So with that said, I think everyone has good intention. Maybe one of the things about doing this for a long time, and I’ve been doing this for over 25 years, the reality is that I’ve seen health care change. I saw when there weas a time in health care that there were dollars to do innovative things, and they were available, and the care was enhanced, and people were happy. Then I’ve seen these times, which are the scarcity. I think our challenge is that when COVID hit, not only health care workers but firefighters and police officers and all of these frontline individuals were viewed as heroes, but unfortunately, we’re not putting the dollars back to those heroes. Until we realize that we’re in crisis, we’re not going to get the call to action that needs to happen quickly enough to bring the subsidies to where they need to be to avert this crisis.

MODERATOR: And on top of that financial crisis, we also have a scarcity in geriatricians. So let’s talk a little bit about that and how that’s impacting our region’s ability to care for this aging population.

NAZIR: I would add to that it’s not just the geriatrician crisis. We have a gerontology crisis. You talked about CNAs who are experts in taking care of the older. We talked about the nurses. I’ve been talking about psychiatrists, talking about social workers, anybody in the field of gerontology, we are just absolutely lacking. Being a geriatrician myself, I know we are almost 30,000 geriatricians short of where we need to be, and there is just no hope looking at the current pipeline. I absolutely believe that policymakers have their work cut out for them to incentivize people to take on these very tough professions. Why do we have incentives to be a cardiologist or somebody who does interventions? Nothing wrong with those professions. We need those, too. But I think it’s just because those are highly paying and highly recognized specialties. I think geriatrics, gerontology, geriatricians, all of those should be incentivized because it is a very, very hard job to provide high- quality geriatric care in any setting. I think we have our work cut out for us. Louisville is no different than the country. We absolutely are struggling. I can count on my one hand how many geriatrician colleagues we have. And they’re stellar geriatricians, and we are honored to have them, but we need more. Unfortunately, we just lack incentives to make young physicians make those decisions to spend their life in geriatrics. Media has a role to play, which has to be positive. I published a story through one of the peer review journals three years ago that 80 percent of the news that comes out from the media about care in nursing homes is about disasters and negativity. Why do we have to focus on that when millions of things happen every day in our nursing homes and assisted livings and geriatric centers are absolutely noble? Like, all the respect for residents, the hugs and the kisses and the above and beyond help, which is not part of the job description of CNAs, happen every single day. I see that happen. No surveyor ever makes a note of that on their sheet. The only thing they make a note of is what, out of those 1,000 handwashes they had to do, they forgot one, and that becomes the source of problem for everything and then that gets in the news. What kind of approach are we taking towards publicizing geriatrics? It’s just beyond me at this point. So, I appreciate this panel because I think this absolutely is needed. We need to talk about the beauty and the benefits and the attraction of this field.

SPALDING: I think continuing to have those success stories always helps, and I think that attracts more folks into the field. But I think that the other piece of it is just recognizing that we respect the aging population. We talked earlier about ageism. Many cultures are very respectful of the aging population. Quite frankly, the older that I get, the more that I recognize that I want to be respected, as do we all. The reality is that that we have to continue to push because that needs to be a revered and honored position, not “Oh, gosh, I’m a CNA,” a certified nursing assistant. It should be “Oh my goodness, you got your certified nursing assistant license, that’s an amazing job!” We just have to have that paradigm shift occur in our in our society.

HAYNES: It is a balance of compassion and competence, and I think our field often is represented as not requiring as much competence as it truly does. There is an expertise that makes a difference. In an aging community here in Louisville, if we’re going to say we’re the center of aging and wellness, then what is the science, what’s the foundation that makes that a real statement? It’ll be a real statement when there is a wealth of professionals who are convicted and committed in this science of aging wellness. Part of that ageism is nobody wants to be old. Everybody wants to be healthy. So, if that’s what the culture is asking for, then let’s do better at lifting up professionals who have made it their life commitment to know the science and the expertise of aging well. Let’s put a dollar on that.

MODERATOR: What do you all see as the next big shift that’s coming in aging health care?

NAZIR: All of us, as executive leaders, have seen just seen a barrage of innovators coming into the industry. Every week, I have emails from innovators reaching out because they have found the big solution to fix health care. Many of them, unfortunately, come from a place where they have not been in the setting; they have not engaged much with older people. They’re just coming from a tech point of view. I think there’s going to be a whole lot of noise that we will have to deal with. I think that the balance is 95 percent is noise, and 5 percent is where we’ll have true solutions. All of us health leaders have our job cut out for us to find a way to help those 5 percent meaningful solutions come to the front. Now, those 5 percent solutions that are going to be meaningful are going to be related to artificial intelligence, helping decisions to be made better at the bedside, robotics to help our staff, which we don’t have, to do the hard, heavy-lifting jobs, for example, creating flexibility in schedules, remote patient monitoring, which is meaningful, not just noise. Right now, we’re dealing with so much noise around the remote patient monitoring. Everybody has a remote patient monitor. Unfortunately, all those things at this point are clunky. The wi-fi and the cellular technologies don’t work consistently. There’s too much data that is hard to make sense out of. It is making the frontline teams frustrated because they have to deal with all this data. They’re worried about lawsuits now because they didn’t address something abnormal. To me, all these tech solutions right now are kind of Band-Aids. We need to figure out the science of geriatrics and teamwork. How does a doctor interact ad partner with a CNA that it is uplifting for the spirit of the whole team? How does a consultant pharmacist bring value to a director of nursing and a physician as a team member rather than pleading for them to make a change after something has happened and nobody is paying attention to their recommendations? We have so many opportunities in very basic day-to-day teamwork and interaction and engagement with each other. I think that is where the innovation needs to happen – how we act to be a better team; how we teach and train and add value; to each other, how we have more fun together. And once we figure that out as better team members, then absolutely, we need to figure out the AI, the robotics, and the remote patient monitoring. We just have to be very cautious and make sure that in our effort to install technology, we do not burden the frontline any more. I just want to make sure we are very careful with that.

HAYNES: Technology is definitely an advantage, and it is an explosion right now. Most of us have some affiliation here in Louisville with the Thrive Center. I’ve been on the board of the Thrive Center since we began. Our goal there is to find the right intersects that represent the consumer, the provider, and the entrepreneur and to bring that conversation closer, so the tech that is available is what I call a workforce spare. I want tech to save time, not make more time and intensity. Home is going to be the hub of life and aging and wellness, and we’ve got to find ways to intersect around that.

SPALDING: I very much agree with what they’re saying. I think that the only thing that I could possibly add to their remarks is the notion of blending our historical knowledge with looking at the future. I totally agree with Dr. Nazir. There’s a lot of noise there right now, which tends to overcomplicate things. From our vantage point, at least for Christian Care, we’re getting back to basics. We’re focusing on that interdisciplinary team and then using the innovation that comes through technology, the choices that people want to make, whether they want to be in an institutional setting or whether they want to be in the home, and having that interdisciplinary team come at these issues from all different angles to come away with something that’s going to be useful to that elder. That’s been our big focus. In the past,we would call it “strategic planning.” I think we’re at the juncture right now that we’re unfortunately faced with sustainability planning and coupling that with some of the strategic work that we’re doing. I describe it to people as like driving with one foot on the accelerator and the other foot on the brake, and we’re doing a little bit of that right now, too. 

MODERATOR: Is there anything that we didn’t talk about today that you think is important for Business First’s audience to understand?

NAZIR: I’m going to promote the power of reflection, which means that we all need to look at ourselves, at how can we bring more value. Before we complain, and we should, because there’s a big issue, we just need to look at our own conduct and see what else can I personally do to improve the care of the people whom I’m responsible for. Am I being a good team player? Am I being a role model? Am I creating learning opportunities for the others? Am I being respectful? Am I being patient? Am I listening to my patients, or am I just cutting them off in 10 seconds like most people do? I think there’s so much we all can do with our personal conduct to be on our best behaviors because we are privileged to be in this position, be frontline, be an executive team member. It’s such an honor to be in the place we are, to provide the care to our older and most deserving people. Let’s just look at our own conduct and see if we can be the best version of our own selves.

HAYNES: Thinking about the environment of care ¬– that’s something that I’ve been encouraging in every group I’ve been in. Systems theory is something that I live in, and so I think the only way we are going to find solutions is to look at what’s dragging us down. Whether it’s individually, as Dr. Nazir is saying, or what in the system is making it not succeed? I think the impression of aging and the impression of the individuals who are involved in that expertise deserves lifting up. I wouldn’t have done my job here today if I hadn’t talked about our environments, and that is that they are great to live in, they’re great to work in, they’re great to play in. We represent our community. If we all think that Louisville is a center of aging and wellness, then we’re all a part of that. How can we work collectively, collaboratively, how can we share to make that better for every person who’s in that niche because that niche represents who we are. And I think it’s a great one. I think aging and wellness services here in Louisville are great, and we all share in that. It’s something to sustain. So how can we grow it, how can we lift it, how can we make it better?

SPALDING: My professional career’s been spent in the city of Louisville. Although I’ve traveled to different states, I always come back home. And what home means to me is that in Louisville, as a community, we care for one another. We have that history. . I always call it a big small town because we’re very inviting. But I think that the thing we underestimate is that we have a lot of very, very bright minds in senior living, in senior care, in innovation. We need to continue to leverage that because that gives me faith and hope in the future, and I think all of us should take heart.. We do a lot of collaboration. We care for one another, and I think that not only the folks that are on this panel, but a lot of others in the community are very, very strong in this area. I think in that regard, we’re very blessed, and we have a bright future.

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