Senior Living Operations Management Guide [+checklists]

Senior Living
Published on:
March 25, 2024
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There are around 6.5 million people living in the U.S. that are in need of regular assistance during their day-to-day activities. Many amongst these numbers turn to assisted living facilities to address these support needs. In 2004, states reported that there were 36,451 licensed facilities operating with a massive 937,601 living quarters, units, or bedrooms. 

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Industries around senior support, communal care, and assisted living aren’t going away any time soon—a fact many organizations have tried to capitalize on. Some have found success and benefited occupants with consistent, reliable care and smooth operations. But some have found, through trial and error primarily, that running an assisted living facility isn’t as easy as it seems on the outside. 

So many things have to happen behind the scenes to make an assisted living facility not only successful, but consistently functional. And when the health, safety, and overall quality of life of occupants is at stake, it’s important to get it right. That’s why we’ve put together this guide for senior living operations management: so that you have the tools you need to consider all the details and improve, streamline, or start your assisted living operations the right way. 

What is Operations Management for Senior Living Facilities?

Operations management for senior living facilities include everything from facility maintenance and upkeep to team oversight and resident care. Anything that needs to be taken care of at the facility or for overall resident satisfaction falls under operations management. It’s anything that maintains overall operations for the organization—that’s why it’s so critical to have a plan in place for these operations. 

Things that fall under operations management for senior living facilities might include: 

  • Ensuring appropriate staff levels
  • Overseeing employee responsibilities and activities
  • Keeping main spaces and resident rooms clean and operational 
  • Maintaining equipment, public amenities, and resident quarters
  • Quality and safety assurance across the property/properties
  • Streamlining food and beverage services for occupants
  • Ensuring that all laundry is washed, sorted, and returned 
  • Organizing events and activities for occupants 

And this just scratches the surface of all of the activities, promotions, tasks, and initiatives that fall under operations management in a senior living facility. Every facility has slightly different operational needs—different facilities provide different levels of care, have varying levels of occupancy, and include independent amenities or offerings. Regardless of what’s included, the key to success lies in examining your operations management strategy, hiring the right people and minimizing churn, defining clear organizational goals, and identifying definitive needs for the facility, occupants, and staff. 

Goals of Senior Living Operations Management

First and foremost, the goal of senior living operations management is resident comfort and happiness. Assisted living facilities exist to help and house occupants who require additional care, can no longer safely live on their own, or who need the connection and community a senior living group provides. This is the fastest goal to identify and communicate when it comes to hiring, facility maintenance, housekeeping work, and more. 

The next general goal most facilities identify is around reputation management—to draw in more residents, establish your position in the industry, and maintain and improve facility quality over time, you’ll need to manage your operation’s reputation. A facility’s reputation is mostly made up of general word of mouth (how people talk about your operation and its offerings), online reviews and discussions, and advertising initiatives. 

By ensuring your guests are happy, you’re already helping to manage your reputation by encouraging positive discussion around operations. But incentivizing residents and resident families to submit reviews about your facility can help to further boost your reputation and often even lends to marketing and advertising goals. Advertising and marketing looks different for every facility and goes beyond reputation with the added goal of resident retention, lead identification, financial goals, and more. However, prioritizing reputation management as part of your advertising and marketing initiatives can be a great jumping off point for establishing further marketing and advertising goals. 

Finally, another top goal of senior living operations management: ensuring safety and security across your facility. Prioritizing the safety and security of your facility isn’t just important for operations; it’s critical for risk prevention at a senior living property. Depending on the level of care of the occupants at your facility, you’ll have to ensure no one is able to accidentally harm themselves while on the property. You’ll also need to verify the security of your facilities, putting systems in place to track who is allowed on the property and when, how you report suspicious activity, and more. 

Additionally, it’s important to think through security and safety processes like clearly marking when floors are wet from cleanings or protocols around how things are managed if there’s a viral outbreak amongst residents. Take the time to work with your security and risk prevention teams to plan for potential problems so you’ll be prepared to respond when and if a security or safety threat emerges.

Structure and Challenges for Senior Living Operations Teams

Running a senior living facility can be an incredibly rewarding endeavor—but it comes with a multitude of challenges. First, it’s an industry with fairly high churn when it comes to both personnel and residents. According to the Bureau of Labor Statistics the industry experiences an employee churn rate of 50%, a percentage that seems to be continually rising and shifting. The median average turnover rate for residents isn’t far off at around 47%, with an average length of stay being around 22 - 29 months. 

Reducing churn by working to hire the right people for your operations is of chief importance—but so is preparing staff for the inevitability of high occupancy turnover, especially in a post-COVID world. Many seniors within assisted living facilities live with chronic illness, memory or cognitive behavioral issues, disability, and other health concerns. 

The level of care from one facility to the next will depend on the type of facility and the kinds of residence you service, but regardless, your staff will likely be challenged to assist with various long-term health conditions that affect your seniors’ daily lives. Some types of senior living facilities with various degrees of assistance include: independent living facilities, assisted living facilities, and memory care.

Independent living facilities

Independent living facilities offer the least care assistance. These are typically complexes made up of multiple townhomes, condominiums, or single-family homes with a selection of amenities and limited services available on the property. Generally groundskeeping and building maintenance are covered by the operations management in charge of these communities. There are fewer staffing needs with an operation like this, and it typically operates with less oversight than its more assisted counterparts. 

Assisted living facilities

Assisted living facilities cover a wide range of senior living facilities—this type of facility combines shelter with various personal-care amenities such as food services, laundry, and property maintenance, among other things. These are facilities in which residents do not require regular nursing care, but may need assistance with daily activities like bathing, dressing, and preparing or eating meals.

Memory care

Facilities that provide memory care assist with residents that have developed memory impairments such as Alzheimer’s or dementia. When you’re working with occupants with memory impairment, it’s even more critical to have educated, caring staff to assist them. Dementia can exist without Alzheimer’s, while Alzheimer’s is the most common cause of dementia. Dementia affects a person’s ability to remember, reason, think, and even move. Alzheimer’s is a debilitating and ultimately fatal illness that affects nerve cells in the brain that are responsible for memory and other mental functions. 

Because brain function is heavily impacted with these conditions, occupants dealing with memory impairment can be exposed to additional safety risks in your facility. This is why it’s critical to employ the right team for the job, maybe even including medically trained staff members or nurses on site. 

Hiring Senior Living Facility Personnel 

One of the most important aspects of operations management when it comes to senior living facilities is hiring the right personnel. Because senior living operations are very people-centric, every employee, from leadership staff members to housekeeping personnel are essential to operational success and resident happiness

Since it takes so many people to adequately operate and maintain assisted living facilities, the day-to-day from department to department can get segmented and, in some cases, political. In many cases, employees begin to vie for control or established hierarchy—and this is often one of the key catalysts for the industry’s high churn rate. 

The senior living industry is also one of such high growth that there are a lot of problems with understaffing. There are more senior living facilities now than ever, and many of them don’t have the personnel they need to be operating at the level their management team would like to see.

And because the industry is understaffed, there are lots of jobs available, meaning that staff members don’t feel particularly pressured to stay in one place if they’re not getting what they want out of their current position, leading again to that ever-growing industry churn rate. 

Additionally, some employees don’t actually know what they’re getting into when it comes to working at a senior living facility, particularly in facilities where residents have higher support needs or require memory care. If you don’t set clear expectations while hiring or if you hire someone without the necessary education, training, or experience, you could end up rapidly losing your new hire simply because they got in over their heads. 

To help mitigate this issue, it’s important to hire with longevity in mind: 

  • Seek out people with similar work experience and/or transferable education.
  • Find potential personnel who have an understanding of senior support concerns. 
  • Clearly describe the day-to-day expectations of working as part of your operation. 
  • Look for employees who are warm, caring, and comfortable working with occupants. 
  • Identify candidates that are confident and enthusiastic about the work they’ll be doing. 
  • Keep an eye out for interviewees that are creative and flexible problem solvers. 
  • Prioritize candidates with great interpersonal and communication skills. 

Individuals who demonstrate enthusiasm, warmth, and interpersonal skills will often create more connections with staff and occupants that build community and help reduce churn. Fostering relationships not only between staff members and departments but between personnel and occupants also helps to improve and maintain high morale across your facility. 

Other operational challenges 

The potential of dealing with significant health concerns coupled with the advanced age of many occupants means that a certain number of residents pass away from complications or simply old age during their stay, and you and your team have to be prepared for handling that. This reality also comes with an elevated need for risk assessment and prevention to avoid liability issues as well as to prevent complications in resident care. 

You have to ensure that occupants dealing with memory issues are provided a safe environment for their physical level of ability—meaning accessible transport is available, such as elevators, wheel chairs, walking equipment, etc. You also have to plan for the possibility of residents wandering and getting lost in your facility. All of these things can pose operational challenges. 

To top it off, many senior living facilities are operating all of their management processes utilizing pen and paper methods and radio communications. In practice, this has historically worked fine, but with modern technological advancements on the rise in hospitality and assisted living markets, pen and paper puts your operations management behind by decades. Not only is it easy to misplace paperwork, but handwriting can be misconstrued, and it can make logging and documenting processes more challenging and cumbersome than they need to be. 

Many operations have taken their processes to a digital space, utilizing operations management applications to digitize and automate certain procedures and streamline how they run their facilities. This eliminates the need for radios and clipboards by providing staff with all the tools they need to complete their jobs on the go and communicate with their team straight from their individual smartphone or provided mobile device.

Departments and Areas of Senior Living Operations Management

Much like at a hotel or extended-stay rental, operations at a senior living facilities are broken down into several areas or departments of focus: Concierge and Reception Operations, Resident Relations and Health Operations, Maintenance and Facility Improvements Operations, Activities Operations, Food and Beverage Operations, Housekeeping Operations, Laundry Operations, and Transportation Operations. 

Example of Senior Living Organizational Chart

🩺 Resident Relations and Health Operations

A vastly important segment of senior living operations management lies in resident relations and health services. Residents of a senior living community come to such facilities in a variety of ways: some choose to be there, some are moved there for health and safety concerns, some are transferred after the passing of a loved one or caretaker, amongst other reasons. Regardless, many residents and potential residents have reservations or even anger about the idea of losing their independence. 

There’s often an adjustment period that takes place when a new resident moves in, and sometimes they adjust quickly while other times they’re much slower to warm up to the idea. Some residents even remain resistant to being in a senior living facility the entire time they reside there. These differences in feelings and experiences can become a source of anxiety for managers and residential staff. That’s why it’s not only critical to have great personnel, but equally important to have procedures in place around resident relations and health operations. 

Some things managers can do to help foster ideal resident relations include: 

  • Providing new residents with a welcome letter that includes information such as important telephone numbers, resident services, policies and procedures, and emergency and safety details. 
  • Create and regularly distribute resident opinion surveys to gain occupant feedback on the quality of the facility and staff. 
  • Immediately address and respond to resident complaints to quickly find an appropriate solution and maintain resident satisfaction. 
  • Elect no fewer than 6 residents to a resident council to meet regularly and become representatives of the community, encouraging continued resident involvement in improving living conditions and communicating grievances early. 
  • Prioritize health initiatives around immunization, regular physical exams, urinalysis, cardiovascular exams, and more to support ongoing resident health. 
  • Consult with residents about emergency plans and advance directives to ensure they are informed and have help with planning for their family’s future. 
  • Oversee wellness programs that foster healthy habits for seniors in the community.

🔨 Maintenance and Facility Improvements Operations

Regular facility maintenance is crucial in keeping senior living residents happy and comfortable. Having a maintenance schedule keeps the physical aspects and assets of your facility safe and functional for residents and staff. 

Regular maintenance to amenities and resident room assets is usually the first maintenance need that comes to mind, because it’s immediately resident-facing. But it’s equally important for equipment used and operated by staff to be adequately maintained for functionality. If a washing machine breaks down, for example, you could have residents waiting exorbitant amounts of time for fresh bed sheets and towels, and ultimately this could lead to reputational harm and negative reviews from residents or their families. 

For maintenance involving resident-facing services and assets, you’ll need to have a system in place for receiving and completing guest requested work orders. Many facilities utilize digital maintenance tracking systems such as Xenia to submit work orders directly to the maintenance team’s mobile devices—from there, teams are able to complete the work on the go from their mobile device and the work order details are logged for historical reference and asset tracking. 

Your maintenance team should also plan for procedures around regular preventative maintenance to protect both residential assets and staff equipment. Residential assets include things like boilers, HVAC systems, in-room safety equipment, chillers, amenities such as a pool or gym, and more. Staff equipment might include things such as laundry machines and equipment used for food and beverage storage and preparation. 

To plan for regular preventative maintenance at your senior living facility: 

  1. Identify assets and equipment that needs to be regularly serviced.
  2. Determine a schedule for preventative maintenance: daily, weekly, monthly, quarterly, annually, etc. 
  3. Create checklists or detailed process steps for how to complete preventative maintenance around the identified areas and asset types.  
  4. Distribute your maintenance checklist to the maintenance team and ensure they have a way of logging these maintenance tasks so that you can keep tabs on asset health. 

🎨 Activities Operations

Over the course of living in an assisted living facility, many residents can find themselves apathetic to repetitive and mundane day-to-days if there aren’t stimulating activities or enrichment opportunities to look forward to. Part of providing the best quality of life for your seniors is ensuring that they have ample opportunity to socialize, express themselves, get creative, experience a change of pace, and more. Having an Assisted Living Activity Calendar is crucial to managing this endeavor.

Xenia Assisted Living Activities Calendar

Facility operations around activity planning and enrichment ensure that your occupants won’t fall prey to boredom or ennui and help maintain their overall satisfaction and well-being. You can provide residents with a leisure and interest survey upon arrival to get ideas of additional activities to include and to provide specific residents with activities matched to their personal interest. Depending on the type of community, some activities that are often included within or as part of senior living facilities are: 

  • Group fitness
  • Yoga classes
  • Art lessons 
  • Craft sessions 
  • Golf outings
  • Tennis lessons
  • Aquatic fitness classes
  • Swimming lessons 
  • Travel groups 
  • Volunteer opportunities 
  • Dance classes 
  • Meditation groups 
  • Film or book clubs 
  • Band practices 
  • Music lessons 
  • Shopping trips 
  • Cooking classes 

🍽 Food and Beverage Operations

Choosing a menu and service style is often the first step in planning out food and beverage operations at your facility. It’s important to carefully consider these decisions too, as it’s costly to change later and any later changes generally result in pushback from residents who have grown accustomed to a certain way of doing things.

Xenia Assisted Living Weekly Dietary Menu Builder

Deciding on a menu typically comes first and you’ll need to pay special attention to ensuring your meal plans are nutritionally sound. Once you’ve established the food you’ll be providing your residents, you’ll have to decide how to serve it. There are three main service types for food and beverage operations in the assisted living industry: buffet or tray-line service, á la cart or restaurant style, and seated table service. 

Buffet Service

Tray-line service or buffet service allows for residents to move through a line of food options and select which elements they’d like to include in their meal. Facilities that provide buffet service must meet all local guidelines around health and safety for mass, self-service dining. Food should also be organized in the line to encourage appropriate serving sizes to reduce costs and avoid waste. Although buffet services can provide savings on labor cost, it can pose challenges for older residents who may find it difficult to hold their own trays or dish out their own food. 

Restaurant Style Service

Restaurant style dining services are typically the most expensive type of food and beverage service a senior living facility can provide its residents. This service style mimics the service of an actual restaurant: guests place their order from a provided menu and must be ready to wait for their food to be prepared at the time the order was placed. This luxury food and beverage option is designed to feel sophisticated and typically requires more experienced and skilled cooks and a more built out kitchen staff to properly distribute the work. 

Seated Table Service 

Seated table service is not unlike the dining on many cruise ships: with this food and beverage service type, residents are directed to the dining area at certain times of day and upon arrival they’re provided with a ready-made meal from your facility’s menu. This is an affordable way to provide seated dining for a large number of residents with considerably less overhead than restaurant style dining. Kitchens planned for this style of service need large preparation and storage areas for handling mass quantities of food.

🧹 Housekeeping Operations

When planning housekeeping operations management for a senior living facility, you’ll need to consider the frequency of resident room visits, what’s cleaned during each visit, when deep cleanings take place, the cleaning of common areas, and more. It’s also important to understand that for some residents, the regular housekeeping visit may be one of the few visitors they receive, so your housekeeping staff should be trained on how to interact with residents and how to represent your facility in the most positive way. 

Housekeeping will take care of things like vacuuming resident quarters, wiping and sanitizing surfaces, and cleaning bathroom fixtures and surfaces, among other things. The housekeeping department can also be critical in notifying the resident relations staff on any changes to an occupants health or wellbeing that they notice while being present for cleanings. You can create a checklist for different cleaning areas and cleaning types to ensure your housekeeping team follows brand and quality standards across your facility. 

🧼 Laundry Operations

How you conduct laundry operations at your senior living facility will depend somewhat on local water and sewage constraints, facility size, and mechanical barriers. These factors will likely be the deciding influence between whether or not you conduct laundry services in-house or you outsource these operations. With in-house operations, laundry transportation is completed more quickly, since it’s already on site. It also ensures that linens and other articles are readily available in case of emergencies. Additionally, with laundry conducted in-house there’s a reduced likelihood of residents’ items being lost or stolen. 

There are some cons to running laundry in-house though. The cost of operating and maintaining laundry equipment can be quite high. Your facility also needs adequate space for large washing and drying machines, and you’ll need to hire technically qualified staff to man this equipment. 

Laundry Preventive Maintenance Checklists

Assisted living facilities can save money on equipment and staffing by outsourcing to a commercial laundry service that charges by the pound and picks up and delivers laundry on a regular basis, but this often requires additional inventory tracking. It can also mean your operation has to compromise on the quality of cleanliness of items and linens and the likelihood of lost or stolen articles goes up.

🚕 Transportation Operations

Your senior living facility’s transportation services allow residents access to grocery shopping, independent errands, doctor visits, religious services, and more outside of the facility. Many residents in senior living facilities no longer have access to a car, and some no longer even hold active driver’s licenses, so it’s crucial for your team to have plans in place to provide regular transportation services. 


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