“Social Accountability and Community Engagement: CCRC National Benchmarks and Peer Best Practices”

1. “Social Accountability and Community Engagement: CCRC National Benchmarks and Peer Best Practices” Aging Services of California May 4, 2011 Presented By Jocelyn Martin, Holleran Lynette Tidwell, Eskaton

2. Why are we talking about Social Accountability? • Connection to Quality First • Ensuring fulfillment of mission • Heightened tax-exempt scrutiny • PR/marketing efforts are secondary gain

3. Why is Holleran talking about Social Accountability? Hospital and community partnerships Familiarity with community benefit programs and activities Responsibility to bridge gap with expertise in Aging Services

4. Study Rationale • Learning process and tool for educating members and furthering the field • Many do great things for their community, but could improve the “telling of their story” • Survey developed by Holleran, Lyon Software and LeadingAge with peer review from several providers throughout the country • Content largely driven by existing standards as to “what counts” and “what doesn’t count” according to the IRS • Holleran utilized expertise and knowledge, as well as Catholic Health’s Association's “Evaluating Community Benefit Programs, Appendix D” and Quality First components

5. Study Objectives • To gather statistics on how not-for-profit (NFP) continuing care retirement communities (CCRCs) are recording and tracking their social accountability activities. • To provide statistics that will allow providers to benchmark their activities/figures with peers. 3. To demonstrate how NFP CCRCs are serving their communities and use this information in communications with outside organizations (governing bodies and elected officials). 4. Utilize information to set future performance goals.

6. Social Accountability Study • Online survey • Email blasts • LeadingAge this Week and CCRC Listserv • Telephone interviews to supplement • CCRC target • Of the 1,861 CCRCs 82% are NFP (according to “Ziegler National CCRC Listing and Profile”) • Seeing most significant activity and challenges to their tax-exempt status • May expand in the future

7. Interpreting the Results • Results are preliminary (full report to be released soon by Holleran and LeadingAge). • The results simply reflect a sample of 200+ CCRCs and may not be representative of all CCRC organizations. • Results should be used for direction and educational purposes.

8. The Results

9. Percentage of CCRCs with Specific Reference to Social Accountability in… N = 151

10. Mission Statement • Take a hard look at Mission Statement • Not necessarily a requirement by the IRS, but a number of healthcare organizations are explicitly talking about their role in the surrounding community (good steward of the community, etc.).

11. Budget • Increasingly, just counting unreimbursed care is not enough. It certainly isn’t for tax exempt hospitals. • Many, if not all hospitals specifically budget community benefit dollars. • Generally what happens in the hospital world, the senior living world is a few years behind. • If there is a challenge to a CCRCs tax exempt status, being able to point to a line item (s) in the budget for SA efforts, would help a great deal.

12. Strategic Plan • This would probably be the most important in my mind. • If it’s in the strategic plan, that tells me that it has been an intentional discussion within the senior management and the board.

13. Does the organization produce an annual Social Accountability report? N = 146

14. If yes, is report embedded or is it independent? N = 81

15. Social Accountability Report • Section in Annual Report, at a minimum • Giving • Community Support • Social Accountability • Consistent with Quality First principles

16. Social Accountability Report • Not just a list of what you’ve done, tell story with statistics embedded

17. Social Accountability Report • Separate report • Distribute to the community • Post on website • Share with area partners, vendors, elected officials, etc

18. Social Accountability Culture The Board of Trustees discusses the Organization’s Social Accountability Goals N = 139

19. Board of Trustees Discusses… • HUGE • Must have buy-in from the top down • Board education • SA efforts • National trends • Board subcommittee for SA? • Board liaison that owns SA?

20. Social Accountability Culture The organization has at least one clearly designated individual who is directly responsible for Social Accountability performance. N = 139

21. One Designated Individual • Very important • Most hospitals have at minimum, an individual, in charge of this program; many have entire departments. • Need for internal ownership of SA program • Ensure culture of SA • Messaging

22. Social Accountability Culture Residents, Staff and other key stakeholders have been informed of the Social Accountability program. N = 139

23. Residents, Staff Involvement • Menno Haven, a CCRC in Chambersburg, Pennsylvania • Social Accountability part of Culture • Not “us and them”

24. The organization has successful community partnerships in place N = 137

25. Who are considered engaged “community partners”? N = 141

26. Importance of Partnerships • Demonstrates commitment and integration into the community • More than just “networking!” • Integral part of healthcare reform • Knowing what is happening in the community assists with understanding image and strategic opportunities for service delivery • Having solid, positive community partnerships reduces likelihood that the local community will challenge NFP status

27. What tool do you use to collect your social accountability statistics? N = 142

28. Tracking • If you are doing great things and don’t have the ability to quantify SA efforts, does it matter? • Recommendation is to have an established database, tracking mechanism, or software (e.g. CBISA) to collect data on an ongoing basis

29. Activities provided for free in the past year N = 138

30. Activities provided for free in the past year (cont’d) N = 138

31. What can we learn from the tax-exempt hospitals? • Hospitals: “Community Benefit” • IRS requirements for hospitals has increased • Community Benefit Reporting • Schedule H, which requires an explanation and proof of community partnerships • PPACA: All tax-exempt hospitals must conduct a community health needs assessment every three years OR receive a $50K fine

32. Social Accountability

33. Eskaton Services • CCRC • MLRC • Independent/assisted • Care centers (skilled nursing) • HUD communities • Licensed home healthcare • Community services • Telephone reassurance • Information & assistance • Adult day healthcare

34. Definitions • The generous commitment of time, talent and resources to benefit the integral development of the community. • Collective unpaid actions oriented toward social development that leverage talent and human capacity.

35. Measurement Categories • Activities that have a directly measureable financial cost • Community service programs • HUD development costs • Special event sponsorships • Advocacy and investment in community education • White paper • Longevity Rules • National Demonstration Home

36. Community Benefit Activities • Use of facility for outside meetings/support groups • Use of facility/program for research • Use of facility for training, education classes and internships • Facility/program sponsored community education classes

37. Community Benefit Activities (continued) • Staff and residents volunteerism/ fundraising • Staff as representatives in community boards, committees and advocacy groups • Facility/program participation in health fairs and clinics

38. External Volunteers • Boards • Community groups • Individuals

39. Tracking • Quarterly reports by Eskaton residences and programs • Online tutorial • Audited financials • Pictures and stories • Newsletters

40. Lessons Learned/Challenges • Staff understanding of terminology • Not giving ourselves enough credit • Counting things that shouldn’t be counted

41. Successes • Easy to read • PR and fundraising tool • Enhanced awareness of Eskaton staff • Themes

42. Themes • Eskaton Gives Back • At Home in the Community • Better Together • Sharing with Friends

43. Questions & Discussion

44. For more information contact: Jocelyn Martin at jmartin@holleranconsult.com 717-285-2402 Lynette Tidwell at lynette.tidwell@eskaton.org 916-334-0810