Emeritus Senior Living, the country’s largest assisted living company, has crafted detailed plans to respond to PBS Frontline and ProPublica’s investigation of the company and the assisted living industry.
Saying the report could lead to “the call for more stringent regulation,” the company emailed an eight-page strategy memo to the leaders of the nation’s major assisted living chains, asking them to put up a “united front.” Karen Lucas, the company’s vice president for communications, said Emeritus developed the media strategy in conjunction with trade groups and other assisted living firms.
“Everyone is working together to make sure we’re educating the public,” Lucas said.
Emeritus has also developed a response plan for the employees who run the company’s roughly 500 facilities, telling them to comment on Frontline’s website and Facebook page and on ProPublica’s Facebook page. The company also instructed workers to encourage residents in Emeritus facilities to post positive comments on Yelp, Caring.com, and Google “to offset the potential negative backlash created” by the investigation.
ProPublica and Frontline have obtained the strategy documents, which are posted here:
Email from Granger Cobb,
Re: Frontline Broadcast
See original document >>
Emeritus Strategy Memo: Frontline Industry Response Materials
See original document >>
Emeritus Response Plan
for Employees: Frontline Checklist for Eds
See original document >>
Email from President & CEO Granger Cobb:
Subject: Frontline Broadcast
From: Granger Cobb
Sent: Monday, July 15, 2013 3:35 PM
As many of you are aware, Frontline will be airing a story on the assisted living industry on July 30. The title of the program is “Life and Death in Assisted Living.” As the largest assisted living provider, Emeritus is going to be featured in the story; however, this is an attack on our entire senior living industry. We believe Frontline is using the isolated incidents in this story to promote stricter and more nationalized regulation for the industry and to suggest that for-profit corporations and caring for seniors are somehow incompatible.
In the hopes that we present a united front, I have attached materials that include key industry messages developed with input from experts at ALFA and ASHA as well as our own team. To ensure the public remains confident about residing in or having their loved ones reside in assisted living, it is critical that we present a consistent message.
Please take a moment to read the attached, modify as you see fit, and share with your teams as appropriate. We are trying to balance the need to prepare staff, without drawing more attention to the story than it might otherwise garner on its own. As an industry, we care for one of the most fragile populations in society. We need to get our message across – that assisted living fills a consumer driven niche by creating a place where seniors can retain their independence, dignity, and quality of life, while having access to care and assistance as needed. We know that residents in assisted living communities have a satisfaction rate of greater than 90 percent. This is the message we need to be telling – that, as an industry, we care for more than 1 million seniors, providing them with the resources to lead purposeful, fulfilling lives and that we accomplish this with a very high degree of customer satisfaction.
I have received messages of support from many of you regarding this story, for which I am deeply appreciative. I am convinced that if we stand together, we can successfully counter the picture Frontline is trying to portray of our industry and tell the wonderful stories of compassion and nurturing our residents experience every single day.
If you have any questions or concerns about the Frontline story, I encourage you to contact me. Thanks for your support.
Granger
Granger Cobb– President & CEO
Emeritus Senior Living | 3131 Elliott Avenue, Suite 500 | Seattle, WA 98121
(206) 298-2909 | Fax: (206) 204-1547 | gcobb@emeritus.com | www.emeritus.com
Our Family is Committed to Yours.®
Emeritus Strategy Memo:
Frontline – Assisted Living Response
Materials
What we
know
The Frontline Documentary that will be examining the
assisted living industry will air on Tuesday, July 30 on PBS. In an average
week, more than 4.6 million people watch Frontline. Among the 285 PBS stations airing
FRONTLINE, there are 459 total weekly plays. Programs are often picked up by
NPR and other mass media public radio and TV programs. FRONTLINE's
audience tends to be affluent and well-educated. They are more likely to hold
executive or professional employment positions than the general population.
For the last year, Frontline has been investigating a few
unfortunate and tragic resident incidents that happened several years ago at
four of our Emeritus communities, and by interviewing disgruntled former
employees. They also sat in the courtroom during the trial in California that
resulted in an adverse jury verdict.
Content
predictions
Because of the direction of that research and additional
information we’ve received from the reporters and producer, Emeritus and the
Assisted Living industry as a whole will not be presented in a positive light.
Frontline is likely using these incidents to suggest tougher
and more nationalized regulation for the entire industry. We also believe their story will hit on
these themes:
Ineffective
regulation of Assisted Living at the state level
Inadequate
disclosure / visibility for the public
Putting
profits over people, as evidenced by:
Understaffing and insufficient training
Heavy focus on sales rather than quality
Inadequate investment in care in order to service debt, finance
growth, and satisfy investors
Violating regulations by admitting residents
improperly
Violating regulations by not transferring
residents as required
Industry
impact
We believe Emeritus will be heavily featured in this
documentary; however, this broadcast could contribute to a loss of public confidence
in (and the call for more stringent regulation of) the entire assisted living industry.
Response
preparation
In preparation for any questions or concerns your
communities may receive as a result of the story, the Emeritus Communications
Team has prepared key messages related to these themes for you to customize and
use in any media statements or talking points required for inquiries about the
Frontline program. Our hope is that by communicating similar messages, the
entire industry will put forth a united front by disseminating consistent
information to all our constituents.
In addition, we’ve provided some tips and guidelines on
handling media inquiries or responding to the story via online channels.
If you have
any questions about the Frontline story or the
Emeritus response plan, please don’t hesitate to contact Karen Lucas at 206-204-3038
or MaryBeth Dagg at 206-554-1908.
Handling Media Inquiries About the Broadcast
Please be aware that after this Frontline broadcast, your
company and/or communities may get media inquiries to comment on the story or
any of the issues being brought to light in the broadcast. Make sure staff is prepared to handle
these inquiries.
As experts and leaders in the senior living industry, it
is important that your voice be heard. Please consider responding to any media
requests.
In-Service Community Staff
At the community level, make sure staff, especially
anyone who answers the phone, is in-serviced on your media protocols. Here are some procedural tips for
handling calls that may be useful to them:
1.
If the media calls, indicate that the
Executive Director is with a resident and that they will get back to them
before the reporter’s deadline or as soon as possible.
2.
Obtain the following information while they
have the media on the phone:
Reporter’s name
Affiliation
Phone number and email address
Deadline (very important)
Any questions he/she needs answered
Write down the questions and tell them that the
appropriate person will get back to them before their deadline.
Media Response Do’s and Don’ts
To help you for
a media interview or response, whether it’s on paper, via phone or in front of
a camera, here are some do’s and don’ts to keep in
mind.
Media Response Do’s
Do
prepare and approach your response/interview from the public’s viewpoint.
Do
prepare three to four key talking points and continue to hit those points
throughout your response/interview.
Do
assume every word you say will be quoted.
Do
keep to the facts and keep answers short and to the point.
Do
be confident. You are the expert.
Do
make your delivery conversational. Be comfortable and be yourself!
Do
provide examples, or make
comparisons to make your point, when relevant.
Do
cite sources when necessary.
Do
be honest. If you don’t know an answer say, “I don’t know that
answer. We will get back to you on that.”
Do ask them
questions, for clarity or to confirm they’ve explored all the angles.
Do express concern
to show you care, but don’t be emotional.
Do watch your
local news to see examples of how other companies/people handle media
responses. See what works/what doesn’t.
Media Interview Don’ts (with tips)
Don’t
ever say "no comment." This is your chance to tell your side of
the story. If you haven't had a chance to review the story or issue. Say
"I'd very much like to comment on this as soon as I've seen the
story/gathered more information. You can also ask a reporter if you can
follow up with an answer before a certain day/time. In most cases, there
is always something you can say about an issue, even if it’s just
encouraging the reporter to take a broader look at the topic or see it
from a different angle.
Don’t
conduct an impromptu interview if
a reporter contacts you directly. Before submitting a statement or
participate in an interview, prepare thoroughly with written talking
points and a practice Q&A session with a colleague. Again, set
yourself up with three to four key points you’d like to communicate during
the interview.
Don’t
ever trust that anything you say
or write to a reporter is “off the record.” Everything you communicate to
a reporter can be quoted, even if they assure you they won’t use it.
Don’t
ever argue with a reporter. The
media is looking for relevant sources and compelling interviews to add
value to their stories. Building positive relationships during a difficult
interview may make them consider coming back for a more positive story.
Don’t
talk too much and go off on
tangents. Try speaking in soundbites and, when
appropriate, make comments that are two to three sentences long.
Don’t
answer mechanically. Be loose and
conversational.
Don’t
speculate or exaggerate. Stick to
the facts, or you might have to back up your statements at a later
date. Be comfortable saying, “I don’t know,” or “I can’t speculate
on that.”
Don’t disparage
your competition. This will say more about your own ethics and practices
than it will about the other company. If a question comes up about your
competition, let a reporter know you can’t speak for other businesses,
then transition back to your message.
Don’t feel
like you have to answer every question. With practice, skilled
interviewees can respond to a question by bridging the answer back to one
of their three key points they’ve identified earlier. If nothing
else, it’s fine to say, “I’d be happy to answer that after all the facts
are in/after our day in court/after we receive a judgment on that/once
we’ve had a chance to review all the research/once we complete our
internal investigation, etc.
Don’t
miss the loaded question. Skilled reporters have a knack for delivering
leading and loaded questions. Keep an ear out for questions that
include incorrect assumptions about the topic or your business.
Also, beware the reporter who slips in a hard ball after delivering
several easy pitches. Keep aware, don’t be caught off guard, and ask
them to rephrase the question for clarity, if needed. Correct them
if they make incorrect allegations as part of their question.
Set the Story Straight
on Social Media Posts
We want to encourage Industry leadership to post a
comment if you feel like you can add value or clarification to the story. We’ve
included posting guidelines below if you would like to express your opinions on
the coverage.
The
story will be posted on the Frontline website at www.frontline.org. Additionally, on the Frontline Facebook
page, they will post a “So, what did you
think?” question for people to comment about the story: http://www.facebook.com/frontline?fref=ts.
The story link will also be on the ProPublica Facebook page at http://www.facebook.com/propublica?fref=ts.
Posting Guidelines
In posting, it is
appropriate to state what company you work for in what capacity, although it is
not necessary to give your name.
Be extremely
professional, courteous and articulate.
The best response is not
defensiveness, but by explaining a specific personal story the benefits of
assisted living to seniors and families. Expressing disappointment in the
coverage is acceptable.
Demonstrate that you
have intensive experience working with this very fragile population, and
explain some of the challenges if you feel appropriate to what you wish to say.
Other posters’ comments
may be hostile and accusatory, but please do not respond with anger or insults.
Keep it professional.
Only post once. If your
comment is disputed or criticized, just let it go.
Thank you to all of
you who are willing to share your knowledge with the public through these
venues on such an important issue.
KEY INDUSTRY MESSAGES
Who Benefits from Assisted Living (AL)
Seniors
During much of the 20th century, seniors who
were no longer able to live independently could arrange for care to be
delivered in their home or they could be admitted into a nursing home. The
first choice could be expensive (or a burden on family member caregivers) and
fraught with the risks associated with a lack of training and oversight. The second choice generally resulted in
a loss of independence, dignity, privacy, and a diminished quality of life. In
institutional settings like the traditional nursing home, the senior’s life was
subordinated to the rules and schedule of the institution. The assisted living movement changed that.
Assisted Living meets the needs of
seniors who:
Are unable to, or choose not to, live at home, yet do not need 24/7
skilled nursing care.
Live alone without adequate assistance available to them to eat healthfully,
manage medications, perform their activities of daily living, manage
safety issues, or stay socially active.
Want to live independently in their own apartment while having the
peace of mind of knowing care is available should the need arise.
Caregivers/Spouses/Adult
Children
There are 20
million working, unpaid caregivers in the U.S. Forty percent of family caregivers have
symptoms of depression according to an Assessment of Family Caregiver
report. Assisted living meets the
needs of caregivers who:
Need peace of mind that their loved one’s safety, health
and emotional needs are being met while they work or attend to their own
children.
Are seeking more quality time with their loved one rather
than only spending time providing the daily tasks of caring for their loved one.
Staffing and Training
Assisted living communities have staff available 24/7 to
provide assistance, care, activities and social engagement for residents.
Assisted living
communities are staffed based on the level of care and service needed by the
residents.
Residents are evaluated upon move-in to determine the
amount and type of personal care they need as well as how they typically enjoy
spending their day.
The caregiver-to-resident ratio
can vary by community, by resident acuity and/or by state regulations. Each
community plans their staffing according to state regulations and the specific
needs of their residents to ensure that the need of each resident is met. For example, if a
40-apartment AL community serves a very independent group of seniors, there
would be fewer caregivers than a community with 40 residents in need of greater
assistance.
When planning appropriate
staffing, the number of staff on each shift is one consideration; but it is
just as important to have staff with the right skills, training and experience.
Our
staffing levels are in compliance with state regulations and in some cases
exceed those regulations depending on the level of care required by residents
at each individual community.
Our community
leadership has the authority to increase staffing levels at any time to meet
the needs of residents.
Turnover varies across assisted living. Communities pay
competitive wages, seek people who want to work with seniors, and offer
substantial training; however, caring for seniors is difficult work.
Business & Investments
Assisted Living is a consumer-driven resource available
to seniors and their families. It is a highly competitive industry with a
variety of options available; therefore, senior living communities have every
motivation to provide residents with quality care, services and experiences in
order to retain them as customers.
Residents sign a residency agreement prior to moving in
to a senior living community. This agreement is similar to an apartment rental
agreement and generally renews annually.
Residents and family members who are not completely
satisfied can choose to move to another community – usually with only 30
days’ notice.
Assisted living operators understand that the
key to financial success lies in delivering a very positive customer
experience. If a community does a
good job of providing care and service with a high degree of customer
satisfaction, they will enjoy high occupancy and be able to charge a fair rate.
The financial investors and lenders believe the senior living sector will
continue to grow in order to meet increasing demand as the senior demographic
expands and the consumer becomes better educated as to senior living options.
Safety Issues
Assisted Living providers care
for one of the most fragile populations in society – and it is a
profession fraught with numerous daily risks.Professionally managed AL
providers understand and manage those
risks 24/7.
Professionally
managed AL communities work to maximize safety and minimize the chance of human
error.
Yet, even
when every reasonable precaution has been employed and policies and safety codes
have been strictly followed, accidents
will sometimes occur.
AL communities have systems in place to help reduce the
chance of falls and injury that may result due to falls. And, if a fall does occur, staff is
available 24/7 who can respond to assist the resident.
Accidents and misconduct issues in AL communities are
reported by staff to supervisors, who then notify the proper authorities. There
are multiple ways to report issues both to company authorities and to state and
federal authorities.
Following an accident, there is an internal
investigation, the incident is reported to the state, and steps are taken to
minimize the possibility of a similar occurrence.
Balancing a resident’s safety with their right to independence
and choice can be challenging. Assisted living communities offer a higher level
of support and safety, while preserving the quality of life that comes from a
residential environment with private apartments.
Like all Assisted Living communities, we have a zero
tolerance policy on abuse. Neglect and abuse is not tolerated in any of its forms
– physical, emotional or financial – and is dealt with swiftly and
aggressively.
Complaints are taken seriously by Assisted Living
communities. Every provider has a complaint resolution process. In addition to the providers, each state
has a complaint system in place.
Additionally, most states require assisted living communities to make
their state inspection reports available to consumers for review.
Family Education Re: Safety
Issues
Family education
and awareness as to what is provided in an AL environment as well as the
limitations of an AL environment is essential. The AL environment cannot eliminate
risks; however, it seeks to minimize risks, while maximizing quality of
life. This balance should be made
clear to residents and families prior to move-in.
Families need to
understand that AL communities don’t provide one-on-one
care and are not a
full-security lock-down environment.
Families should understand how a community employs fall management systems and take
recommendations for ambulation assistance equipment seriously. They should also
know that even with comprehensive fall management systems in place, 100% fall prevention
is extremely difficult to achieve in any environment.
Alternative Care Options
Before the assisted living sector existed, the only
option seniors had were boarding homes with limited or no supportive services
or nursing homes at twice the cost of assisted living and with a much more
institutional environment.
For millions of Americans, nursing homes are still the
only option due to rules in many instances requiring seniors to go to nursing
homes if they are receiving Medicaid.
For others, nursing homes are often the only place seniors can go for
short-term rehabilitation due to Medicare reimbursement requirements.
Professionally managed AL communities are not in
competition with these other options, but we are a newer and growing
alternative for those seniors who cannot or do not wish to live alone any
longer.
Regulatory Issues
Assisted Living communities are licensed and regulated in
each of the 50 states.
We think state regulations are important; for
example, we welcome state inspections to give us a report card on how we are
doing. It’s important for us to get
this feedback from a third party so we can continue to improve and address any
problems that arise.
State
regulatory agencies have been evolving to keep up with the increasing
popularity of assisted living as a preferred choice for senior living, and the
economic realities of these options.
Unless state regulation determines otherwise, residents
of assisted living communities can generally stay if the resident, the
resident’s family, the resident’s physician, and the community all agree
assisted living is the best option for the senior.
Regular unannounced inspections are performed by state
regulators to ensure communities are in compliance with state requirements and
standards.
Professionally managed AL communities regularly perform
internal inspections and not only meet, but most often exceed, the standards
set by the state.
Policymakers are working to improve regulations from
state to state. When one state
improves or changes regulations, other states learn from these experiences and
make improvements in their own states.
Each state has a resident bill of rights that is enforced
and AL communities must preserve these rights while providing daily care and
service for the resident.
Proposed Federal
Regulation
From time to time, federal regulation of AL communities
is proposed as a way to fix the problems of the industry. Federal regulation,
if imposed, would increase costs for consumers without increasing quality of
care.
We believe the states are in a better
position to determine what their respective citizens want and to be responsive
to that. The Federal government would have to take a one-size-fits-all approach
that would limit choice and increase costs to the consumer. We do see the
federal government playing a role in promoting and celebrating the fact there
are market-based options for seniors and their families to turn to offering
quality care and advancing quality of life.
Federal regulation of assisted living would stifle
innovation and would not allow for the flexibility assisted living communities
require to continually adapt to consumer preferences.
Emeritus Response Plan for Employees:
Frontline Checklist for EDs
(All Emeritus Communities)
Managing this type of media exposure requires your full attention and commitment to all the action items below. Whether your community was mentioned in the story or not, your community can be impacted.
IMMEDIATELY AND ONGOING
Solicit positive comments and reviews from your residents and families and have
them post on Caring.com, Yelp, Google and other review sites to offset the
potential negative backlash created by the Frontline story. Look for this button
on E & Me for Online Review tools.
If you have something positive going on in your community – a resident's 100th birthday, an
Alzheimer's Association fundraiser, a community outreach program, or a free seminar for the public – send a press release to the local media using the release templates on E & Me. If you don't have something going on, plan something!
Launch staff appreciation initiatives and recognize employees for their good work. Post
compliments in public places or the staff break room.
Anticipate extra attention and scrutiny from regulators and make every effort to ensure your communities are in full compliance.
Be positive and keep your staff focused the great job they do every day.
WEEK OF MONDAY, JULY 22
Hold an all-staff meeting to discuss broadcast and its impact- distribute the following:
FAQs for families and residents
In-service staff on media protocols
Review FACT SHEET Crisis Communication and the Media
Hold management staff meeting to discuss and distribute the following:
Media statement
Tips to respond online
WEDNESDAY, JULY 31
Respond to resident/families inquiries using FAQ document
Respond to story online at:
Frontline's website www.frontline.org
Frontline's Facebook page http://www.facebook.com/frontline?fref=ts
ProPublica Facebok page http://www.facebook.com/propublica?fref=ts
Emeritus Facebook page(only if someone posts a negative comment) http://www.facebook.com/pages/Emeritus-Senior-Living/82009373317?hc_location=stream
Online review sites where story is mentioned
Launch professional referral outreach efforts, targeting top 20 referrals:
Start the conversation with:
"There was a story about Emeritus on Frontline last night/week and I wanted a chance to talk with you about it." Then, use your FAQ to guide the conversation.
Use the same FAQ provided for families and residents.
Bring them a meaningful leave-behind that is personalized for your unique community - i.e., something made by the residents or the chef's special snack/dessert.
Share specific success stories of the residents they have referred
Frontline
Q & A for Emeritus Communities
July 31, 2013
I heard Emeritus was part of a big media expose on the assisted living industry. What happened?
Yes, Emeritus was featured on a recent Frontline program on the assisted living industry.
It included accounts of some isolated and unfortunate incidents that occurred at other Emeritus communities many years ago.
They were the rare exception to our company's outstanding record of serving hundreds of thousands of seniors over the last two decades.
We were very disappointed by the broadcast, which did nothing to represent the dedication and commitment of Emeritus caregivers.
Can you tell me the details of these incidents?
The story featured two tragic accidents that happened 4-5 years ago, and two families
who were dissatisfied with the care we provided.
I am not familiar with the details and so can't tell you any more than that.
What has the company done to fix the problems?
Emeritus works hard to ensure that there are safeguards, systems, and policies and
procedures in place to prevent these types of incidents.
From time to time, a breakdown in these systems has resulted in an accident or care that
doesn't live up to our high standard.
Our communities work tirelessly to prevent foreseeable risks at our communities. When
we fall short, we hold ourselves accountable and we fix the problems.
Despite the picture Frontline has tried to portray, Emeritus continues to stand firmly
behind, and believe strongly in, its employees and the quality of care they provide.
Emeritus has to pay millions in damages as a result of the California trial. Does this mean resident rates are going to go up?
Absolutely not. Resident rates will not be tied to the damages.
How can I be confident something like this won't happen to my loved one?
I hope you have seen how passionately we feel about providing outstanding care to your
loved one and that you can tell that our residents are like family to us.
We have extremely strict policies that are designed to ensure quality care, prevent risks
and minimize error as much as possible.
We also have very robust customer service systems in place to ensure that the residents'
and families' needs are being met.
Every year, we receive thousands of letters, e-mails and comments that credit us with
improving and transforming lives for both our residents and their families.
In addition to our annual inspection surveys, these letters are just one of the many
testaments to our commitrnent to quality care and safety.
Please know that the staff and leadership at this community are always available to you if
you need to discuss any concerns or issues about the community or the staff.
ALL OTHER COMMUNITIES' MEDIA STATEMENT
Contact: ED Name
Community phone #
MEDIA STATEMENT
Statement for the Media by (ED name, ED title, Community name)
We have seen the recent Frontline program on the assisted living industry which included
accounts of some isolated and unfortunate incidents that occurred at other Emeritus communities
a few years ago. They were the rare exception to our company's outstanding record of serving
more than a half million seniors over nearly two decades.
Despite the picture Frontline has tried to portray, Emeritus communities work tirelessly to
provide the highest level of care to all residents. We also work hard to prevent foreseeable risks at our communities. When we fall short, we hold ourselves accountable and we fix the problems.
Emeritus Senior Living receives literally thousands of letters and emails each year from residents and families commending the care they receive at our communities. In addition to our annual inspection surveys, these letters are just one of the many testaments to our commitment to quality care and safety. Emeritus continues to stand firmly behind, and believe strongly in, our 30,000 employees and the quality of care they provide to our residents at our more than 480 communities in 45 states.