CALA News & Views | Issue 52 | Workforce

work force

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CALA Board of Directors

OFFICERS Board Chair David Eskenazy, CEO, Cogir Management USA, Inc. Vice Chair Danielle Morgan, CEO, Clearwater Living

Treasurer Laura Fischer, Chief Operating Officer, Integral Senior Living Secretary Courtney Siegel, President & CEO, Oakmont Management Group

DIRECTORS

Michel Augsburger, Chairman & CEO, Chancellor Health Care, Inc Mark Cimino , CEO & Co-Owner, CiminoCare Dave Coluzzi, President & CEO, Carlton Senior Living Tara Cope, Chief Legal and Administrative Officer, Vi Senior Living Denise Falco , Senior Vice President of North American Field Operations, Sunrise Senior Living Paula Hertel, Founder, Senior Living Consult Rick Jensen, President & CEO, Northstar Senior Living Darolyn Jorgensen-Kares, Chief Operating Officer, Continuing Life, LLC Michelle Kelly , Senior Vice President, Investments for National Health Investors, Inc Rodger Lederer, Senior Vice President, Marsh Senior Care Practice Ray Leisure, Division Vice President, West Division, Brookdale Senior Living Douglas Lessard, COO & Executive Vice President, Belmont Village Senior Living Tana McMillon , Regional Vice President of Operations, Silverado Memory Care Nancy Schier Anzelmo, Principal, Alzheimer’s Care Associates Todd Shetter, Chief Operating Officer, ActivCare Living Jay Thomas , Assistant General Counsel, Operations, Atria Senior Living

EX-OFFICIO DIRECTORS Josh Allen, Principal, Allen Flores Consulting Group Joel Goldman, Partner, Hanson Bridgett

IN

THIS ISSUE

I am excited to be writing the opening message for the workforce issue of the CALA News & Views . This edition takes readers through a range of topics relating to growing and strengthening the senior living workforce. At the same time the CALA team has been hard at work putting this issue together, CALA itself has been focused on its own workforce transitions. I am honored to be CALA’s new president and CEO and am privileged to be working closely with Sally Michael as she approaches retirement later this June. Sally has led CALA so exceptionally well for the past 25 years and I look forward to building on the success she has brought to this organization. This isn’t the only workforce change at CALA. We recently welcomed Cindi Alvidrez, membership manager; Danielle Parsons, vice president of government affairs; and Pam Amundsen, director of meetings and events , who takes on that position as Nancy Ball retires after 18 years with CALA. As CALA builds out its own workforce, what isn’t changing is our commitment to supporting members in their efforts to serve their residents. Selena Coppi Hornback, senior director of public policy , continues to bring members tremendous value as we work to impact regulatory and policy changes and shape the development of and participation in the CalAIM program, to name a few. You’ll once again see the evidence of the efforts of Jan Trifiro, vice president of professional development , as you experience the stellar education programming at our spring and fall conferences. And at those conferences (and every day at CALA), the work of Katherine McLoskey, director of operations , and Brandi Pittman, administrative assistant , ensure members enjoy a smooth and welcoming process, in addition to keeping our office operations running smoothly. This very News & Views highlights the positive creative contributions of our workforce team Denise Brandt, director of workforce development and Agnes de la Vega, senior workforce development specialist . Each and every CALA News & Views showcases the talent of Haty Pietrasz, director of creative design , who is responsible for the impactful covers and eye-catching layout, as well as our website and digital design, and Kevin Swartzendruber, director of marketing and communications , who writes many of the articles and oversees CALA’s marketing and communications initiatives, including the impressive launch of CALA’s new brand. Throughout it all, CALA remains a remarkable organization with members united in a shared commitment to senior living, residents and their families, and to each other. The CALA team is proud to be working with each and every member and looks forward to continued growth together. MESSAGE from the President & CEO

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Building Better Teams: Insights from Two Senior Living Leaders

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Cultivating Tomorrow’s Senior Living Leaders

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3 Ways to Become a More Influential Leader

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Updated Dementia Rules Focus on Person Centered Care

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Advancing Careers in Senior Living

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USC Internships Empower Students to Serve Older Adults

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Elevate Your Skills in Senior Living

CALA News & Views – Submission Policy At this time, CALA does not accept unsolicited articles or queries. Many of the articles we publish are written by our regular contributing writers. We appreciate the time and energy people put into making suggestions for our current and future issues. Our organization’s policy, however, prevents us from accepting for review any unsolicited submissions.

Cindi Alvidrez, Membership Manager cindi@CAassistedliving.org

Pam Amundsen, Director of Meetings & Events pam@CAassistedliving.org Denise Brandt, Director of Workforce Development denise@CAassistedliving.org Selena Coppi Hornback, Senior Director of Public Policy selena@CAassistedliving.org Agnes de la Vega, Senior Workforce Development Specialist agnes@CAassistedliving.org Heather Harrison, President & CEO heather@CAassistedliving.org Katherine McLoskey, Director of Operations Danielle Parsons, Vice President of Government Affairs danielle@CAassistedliving.org Haty Pietrasz, Director of Creative Design haty@CAassistedliving.org Brandi Pittman, Administrative Assistant brandi@CAassistedliving.org Kevin Swartzendruber, Director of Marketing & Communications kevin@CAassistedliving.org Jan Trifiro, Vice President of Professional Development jan@CAassistedliving.org katherine@CAassistedliving.org Sally Michael, Executive Advisor sally@CAassistedliving.org

CALA STAFF

Heather Harrison, President & CEO

455 Capitol Mall, Suite 222 Sacramento, CA 95814 Phone: (916) 448-1900 www.CAassistedliving.org

Copyright © 2025 California Assisted Living Association. All rights reserved. No part of this publication may be reproduced or transmitted in any form - print, electronic or otherwise - without written permission from CALA.

m Better Building teams q INSIGHTS FROM TWO SENIOR LIVING LEADERS

By Kevin Swartzendruber, CALA Director of Marketing and Communications

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In a rapidly evolving landscape, successful senior living communities rely on more than just a strong mission – they require the right people to bring that mission to life. In this special Q&A, two CALA members – Tara Arancibia, vice president of recruitment at Belmont Village Senior Living , and Shadi Rafat, senior director of talent acquisition at Silverado – discuss the core qualities they prioritize when hiring, the new recruitment practices they’ve introduced to stay competitive and the retention tools that keep their teams strong. From tapping into unconventional talent pools to leveraging technology and community partnerships, their firsthand experiences offer valuable guidance for anyone seeking to build and maintain top-tier senior living teams.

focusing on skills-based hiring, where we prioritize a candidate’s potential and transferable skills over their direct experience for specific roles. We also leverage our networks by engaging with schools, associations and organizations to elevate Silverado’s brand awareness. Additionally, we stay up to date on pay rate trends and conduct comprehensive salary analyses, enabling us to provide leadership with insights that lead to competitive market adjustments, ultimately helping us attract and retain top talent. Have you actively recruited professionals from other industries? If so, which backgrounds have transitioned well into senior living, and what lessons have you learned? Tara Arancibia: We find many transferable skills in hospitality professionals and educators - particularly those who have worked with special needs populations. Shadi Rafat: We recruit from senior living, skilled nursing, hospitals, care homes, home health and hospice settings, as these professionals have hands-on experience with our population. We also find that hospitality professionals transition seamlessly into caregiving roles. Q Attracting Talent from Outside Senior Living Could you share any new or creative tactics you’re using – such as technology tools or community partnerships – to attract qualified candidates? Tara Arancibia: Belmont Village owns and operates communities in various cities across eight different states. Each city has unique opportunities for community partnerships with schools and social service programs focused on offering job placement services to underemployed members of the community. We prioritize strengthening these partnerships to identify qualified candidates. In addition, we find having flexible interview times and hosting in-person hiring events to be beneficial as well. Q Innovative Recruitment Approaches

Skills and Competencies

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Which specific competencies and personal qualities do you find most critical when hiring for senior living roles, and why? Tara Arancibia: The competencies will vary by position but in general, we find the most successful candidates prefer engaging roles, have a passion for helping older adults thrive as they age, and demonstrate patience and empathy towards others. We value candidates who have a proven work history that demonstrates dependability and loyalty. Shadi Rafat: Some of the most important traits we seek at Silverado include empathy, professionalism, self-awareness, adaptability and a positive attitude. Many families and residents we serve are navigating memory impairment or hospice for the first time, making it essential for our associates to demonstrate these qualities while providing support. How have your recruitment strategies evolved in response to today’s changing workforce and market demands, and what adjustments have proven most successful? Tara Arancibia: We often find our most successful hires are direct referrals or internal promotions. We’ve found success through our employee referral program, our internal career training programs and through community referral partners. While we continue to use digital postings for active external job seekers, we also enjoy investing in our existing employees and maximizing the external referral partnerships for candidates. Shadi Rafat: Our team focuses on a proactive approach to hiring by building robust candidate pipelines for all positions nationwide. This approach has significantly reduced agency costs, overtime and time-to-fill while also boosting associate morale. This strategy includes Adapting Recruiting Practices

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and our in-house Leadership Development courses. Our employee engagement platforms drive performance, recognize accomplishments, and help create a supportive environment where team members feel appreciated and empowered. Shadi Rafat: At Silverado, we ensure fair compensation through regular market-based pay adjustments and enhance employee engagement with referral bonuses, tuition assistance and professional development opportunities. To support work-life balance, we offer flexible scheduling and continuously refine our strategies through ongoing associate feedback. We also celebrate achievements with large-scale recognition initiatives, including awards and Employee of the Month honors. Many of our leaders have risen through the ranks, reflecting our commitment to internal mobility, and we support this growth with structured onboarding and training programs. g

Shadi Rafat: We are leveraging AI to streamline and enhance our recruitment process, from assisting with email campaigns and job ads to rewriting job descriptions for greater impact. At the same time, we partner with schools and host virtual hiring events to engage with potential candidates, while actively sourcing through social media and seeking referrals from every contact. Furthermore, we recently invested in a new Applicant Tracking System (ATS) and Customer Relationship Management (CRM) system to enhance the candidate experience, build robust pipelines, automate outreach and closely track recruitment trends. What specific retention strategies or employee engagement programs have you implemented to reduce turnover and nurture a supportive, long-term team? Tara Arancibia: At Belmont Village, we foster long-term retention by valuing employee voices, providing internal career growth opportunities and offering ongoing learning through platforms like Franklin Covey, Relias Retention Strategies and Tools

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INTRODUCING “ Ada ,” CALA’s AI Mascot! We’re excited to introduce you to Ada, our new AI resource designed on the WiseOx software platform to assist with questions about RCFE statute and regulations. This valuable service is a benefit of your CALA membership, so we encourage you to sign in and start exploring Ada’s capabilities today. Ask Ada

Cultivating Tomorrow’s Senior Living leaders Shaping the Future Through Innovative Internships and Programs

Senior living communities rely on compassionate care,

innovative thinking and building a robust pipeline of new talent is essential to ensuring those values thrive in the years ahead. Two organizations – Carlton Senior Living and Continuing Life LLC – are pioneering internship and early-career programs that attract, nurture and retain young professionals in the field. Here’s how they do it, and why their approach is making a difference.

By Kevin Swartzendruber, CALA Director of Marketing and Communications

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CARLTON SENIOR LIVING: A Multi-Faceted Approach

For Carlton Senior Living , recruiting young professionals begins with intentional outreach. President and CEO Dave Coluzzi notes that his organization participates in CALA meet and-greet events where members have the opportunity to sponsor students’ conference attendance and engage with them directly. “Attracting young professionals and students to senior living requires a proactive and engaging approach,” Coluzzi said. “One of the most effective strategies we’ve utilized is participating in CALA’s student meet-and-greet events, which I have personally been involved in for several years.” He explained that many of the students Carlton meets have backgrounds in healthcare, hospitality or business but are unsure about their precise career direction. “By exposing them to the rewarding and multifaceted nature of senior living, we help them see how their skills and interests align with the profession,” he

honing their analytical, leadership and public speaking skills.

“Our internship and student programs are designed to be both structured and adaptable, allowing participants to gain a well-rounded experience based on their background, interests and career goals,” Coluzzi said. “For individuals with prior experience or strong potential in a specific area, we take a more customized approach.” This flexibility helps students gain confidence in day-to-day responsibilities while also exploring the bigger picture of how a senior living community operates. Measuring Impact Through Growth and Retention Carlton assesses its internship initiatives through several lenses: conversion of interns into permanent roles, departmental placement, feedback from participants and performance indicators such as leadership potential. Coluzzi said interns over the last few years have each found a unique niche – ranging from sales to nursing – while some rose to departmental leadership positions. “Over the past few years, we’ve welcomed seven students into our program, and each has found success in a unique way,” he said. “Several former interns started in care roles and have since grown into leadership positions within their respective departments.” One intern moved into a sales director role, while another discovered a passion for activities programming. Others pivoted to clinical paths, including one who now manages a skilled nursing facility. Coluzzi emphasized that this diversity of outcomes speaks to the range of opportunities within senior living, whether students remain with Carlton or move on to other organizations.

said, noting that the company also leverages social media, career fairs and partnerships with educational institutions. Hands-On Experiences and Tailored Learning Once students sign on, Carlton emphasizes real-world exposure. Interns have the opportunity to rotate through various departments or focus on a specific area of interest. If they choose to rotate through departments – culinary, care, administration, sales and activities – participants present their insights to a committee,

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SUCCESS STORIES from Carlton Senior Living

KATHERYN LEJANO Graduating from UC Davis in 2016,

Katheryn discovered Assisted Living by chance when she received a scholarship email inviting her to the CALA conference. There, she connected with Carlton Senior Living and soon became the company’s very first intern. Although she had initially considered nursing, Katheryn’s internship opened her eyes to the broader possibilities of senior care and leadership. Following her internship, Katheryn accepted a few different roles on Carlton’s HR team, ultimately joining “Carlton University,” which helps train and develop staff company-wide. She said each opportunity deepened her commitment to improving resident care. Inspired by the hands-on experience, Katheryn is now pursuing a bachelor’s degree in nursing while continuing her work at Carlton. “Starting a career at Carlton so young, with a group of individuals invested in my success, gave me so much purpose, drive and motivation to keep growing as an individual, both personally and professionally,” Lejano said.

INNES MCFARLANE Driven by her longstanding interest in serving older adults, Innes pursued a gerontology degree at Sacramento State University. Upon learning about a CALA conference meet-and-greet, she seized the opportunity and connected with Carlton Senior Living. Soon after, Innes began working as a care partner at the Sacramento community while still in college. Recognizing her dedication and desire to learn every aspect of Assisted Living, Carlton offered her a place in its internship program, where she spent about a month in each department – from dining services and housekeeping to shadowing managers. This immersive experience gave Innes invaluable insight into how each role contributes to the overall success of a senior living community. She is currently sales director at Carlton Senior Living in Davis. “Carlton has been nothing but good to me,” she said. “I think the amount of growth that I have had since I’ve only been with the company for five years makes me want to come to work every day and be my best because they absolutely give that back to me tenfold.”

GIANNI AMARI After discovering his passion for senior living through childhood visits to his father’s RCFE communities, Gianni decided to attend a CALA conference meet and-greet in search of new opportunities. That decision led him to connect with Carlton Senior Living, where he was soon hired as sales director. Through hard work and a commitment to providing excellent care, he has now achieved his longtime goal of becoming an executive director – a realization of the future he first envisioned while still in college. He will be transitioning to executive director at Carlton Senior Living Fremont in April. “Carlton has such a focus on the staff — all the employees, frontline staff, the managers,” Gianni said. “Everyone preaches the idea that if you have capable people in place to do their job, and you make sure they’re happy, they can do their best work possible.” Gianni’s success story highlights the impact of a supportive environment and shows how one conference connection can transform a dream into reality.

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CONTINUING LIFE LLC: Building Pathways in Clinical Care

our screening over time,” Jorgensen-Kares said. “We stay very close to participants and have learned that there is lower success with high school seniors who immediately enroll prior to becoming familiar with our community and working in a professional environment.” Continuing Life also brings high school students – particularly those enrolled in health science pathways – on bus tours of its Continuing Care Retirement Communities. This hands-on exposure helps younger students see what day-to-day life and work in senior living are really like, Jorgensen-Kares said, noting that even a brief visit can spark interest in caregiving or administration. SUCCESS from Continuing Life LLC

Meanwhile, Continuing Life has pursued a slightly different strategy to attract students into senior living. Darolyn Jorgensen-Kares , the organization’s chief operating officer , points to outreach at local high schools as a major success driver. A pilot Certified Nursing Assistant (CNA) scholarship program, along with partnerships with vocational or nurse training schools, also creates direct pipelines of motivated individuals. “We have some very successful outreach programs at different high schools, a CNA pilot scholarship program that has been a great source of marketing, and we have experienced moderate success and partnerships with vocational training/nurse training programs,” Jorgensen Kares said. CNA Scholarship Model One of Continuing Life’s most innovative approaches involves prepaying tuition for CNA candidates and paying them minimum wage during their training period, as long as they work part-time in the community. Students sign an agreement to stay for at least 18 months once certified, although Jorgensen-Kares acknowledged this commitment can be difficult to enforce. “The pilot program does come with some risk including prepaid tuition for CNA training, minimum wage to be paid to the individual for a maximum of 160 hours and, while in school, the individual must work in some capacity at the community,” she said. “Overall, we believe the benefits outweigh the risk.” By working at the community in positions such as caregiver, server or activities assistant, prospective CNAs gain a realistic picture of the environment and expectations before they move into full-time clinical roles. Refining for Better Outcomes After learning from past participants, Continuing Life adapted its approach to improve retention. Instead of sponsoring CNA training right away, the organization now prefers that high school graduates or new hires work on-site for around nine months before receiving the scholarship. This ensures they have time to adjust, develop a professional mindset and confirm that senior living is a good fit.

ANA THOMASSEN After successfully completing Continuing Life’s scholarship program, Ana found herself drawn to resident care in ways she had not expected.

The program taught her practical skills and bolstered her appreciation for serving older adults, giving her a solid foundation to build upon. Eager to broaden her impact, she transitioned into social services, where she discovered a deep fulfillment in supporting residents and families through various challenges. She has been given the opportunity to support residents and families in various capacities, deepening her understanding of their unique needs solidifying her commitment to advocating for others and striving for improved services. “This experience has had a profound impact on both my career trajectory and personal growth,” Ana said. “It has equipped me with essential skills in resident care while significantly enhancing my appreciation for the profession.”

“We have learned from the candidates and also improved

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OSCAR HERRERA Oscar’s journey began in a high school classroom, where a chance encounter with a flyer announcing Continuing Life’s

scholarship program changed the trajectory of his life. He seized the opportunity to go through the program while he was employed. This unique arrangement allowed him to learn the ins and outs of resident care, develop communication skills and master time management – all essential skills that would serve him well in a fast-paced environment. Upon completion of the program, Oscar transferred to the skilled nursing facility where he honed his clinical expertise and learned the true value of teamwork and compassion. He was also encouraged by mentors and the supportive environment to pursue higher education, which he said wouldn’t have happened without such valuable experience he received in the program.

A Shared Vision for Future Leaders

Taken together, Carlton Senior Living and Continuing Life exemplify how senior living communities can develop early-career professionals through structured yet flexible programs. By combining immersive, rotational internships with strategic educational partnerships, these organizations create pathways for students – many of whom may not have previously considered a senior living career – to experience the rewards and possibilities in the field. Carlton’s approach shows how exposure to multiple facets of operations can lay the groundwork for future leadership. Meanwhile, Continuing Life’s emphasis on clinical pathways addresses a critical staffing need and offers students a tangible way to break into healthcare or senior care. Both organizations, however, share the conviction that early career programs must be robust yet adaptable, reflecting the diverse career aspirations of the next generation. “By creating opportunities for students to explore, grow and thrive in senior living, we are not only filling immediate staffing needs but also investing in the future of the profession,” Coluzzi said. Jorgensen-Kares echoed that sentiment, adding that early exposure to senior living – whether through tours, part time work or scholarship programs – can ignite a long-term passion for serving older adults. “These students are pre disposed and hungry to learn,” she said. As senior living continues to evolve and the demand for senior care expands, programs like these will remain essential. They build a pipeline of skilled professionals who understand the nuances of resident care, cultivate a sense of community and bring fresh ideas to longstanding challenges. By placing a premium on mentorship, hands-on learning and personalized growth, Carlton Senior Living and Continuing Life LLC are helping to shape the next generation of leaders –individuals who can carry forward the values of care, innovation and compassion. g

STORIES

ARIANNA MUNOZ For Arianna, the OakView Health Center scholarship program was more than just financial assistance – it was the key that unlocked her dream of attending nursing school. By covering her tuition, the scholarship lifted a weight off her shoulders allowing her to concentrate fully on her studies. In addition to monetary support, she received mentorship from seasoned professionals who nurtured her skills and inspired her to embrace the values of empathy, resilience and continuous learning. This enriched educational experience became the foundation upon which she built her career, culminating in her current role as a charge nurse in the skilled nursing facility. The support she received “not only made my nursing education possible but also inspired me to pursue a career dedicated to providing compassionate care to others,” she said.

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Become Ways 3 TO A More Influential Leader

By Jen Shirkani

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LEVERAGE EMOTIONAL INTELLIGENCE TO INSPIRE TEAMS AND DRIVE RESULTS

1 Tell stories rich with emotion. Brain research provides an interesting look at the way people connect on a neuro level. When two people are communicating using stories that are rich in emotional context, their brains “couple” and both experience a rush in neurochemicals. By being comfortable using emotional expression, you will increase your ability to hook people to your message and enroll them in your ideas. 2 Adapting to their communication style. By using the EQ skill of empathy, you can observe and identify the preferred communication style of others. Some are formal and reserved and want meetings that are scheduled, organized and come with a pre-shared agenda. Others are spontaneous and casual and respond best to unplanned brainstorming or problem solving. Knowing your own preferred style first is important because it is likely the way you approach others without realizing it. Try taking the opposite approach that may not come naturally and see the difference it makes. 3 Being present. It is very easy to be distracted by the number of tasks, interruptions and technology tools that steal our attention. Clearing your mind before interacting with others allows you to focus on the person in front of you. Using self-awareness to recognize your emotional state helps you to better connect your mood to your behaviors, and alert you if those behaviors are having a negative impact on someone else. Also, if people know you will be fully present with them, they will be more likely to feel meetings with you are productive. Paying attention also helps you better read others and understand what they care the most about. If you want to reach a mutually beneficial outcome, knowing this helps you be a better negotiator. This executive director used storytelling as a powerful way to teach and coach her associates. She focused on the communication techniques that her direct reports responded to best. And instead of being impulsive, she used self-management skills to think before rushing to action. You can focus on the three Rs of EQ: Recognizing , Reading and Responding and use these techniques to help yourself build more accountability and influence. g Jen Shirkani is a nationally recognized speaker and author on the topic of emotional intelligence, she has worked with senior living providers nationwide since 2001 and has been a featured speaker at CALA since 2004. She is the author of Ego vs EQ and Choose Resilience , guides for leveraging the power of emotional intelligence.

O ne day, an executive director was told by a member of the dining services team that there was a 3-year old in the kitchen office, that she was the daughter of the executive chef and the child had been coming to work with him all week. They reported that she had been well behaved and hadn’t caused any problems. Nonetheless, it was against the organization’s policy, so the executive director knew she had to address it. Her first reaction was shock that someone would think that was appropriate to do and her instinct was to prepare a disciplinary action to bring with her to meet with the chef. But she stopped and reflected for a moment and decided first to gather some information before jumping to action. When asked what was going on, the chef acknowledged his error in bringing his daughter to work, but the reason was because he had lost childcare for the week and his wife was out of town caring for a dying parent. He explained that the kitchen was already short-staffed, and they had several extra events and tours on the schedule for the week, so he didn’t want to call out and leave the team even more under-resourced. It was a situation with less-than-ideal options and the executive director could tell the chef’s intentions were in the right place. Instead of moving straight to discipline or criticizing him, she instead listened with empathy. She was reminded of a similar dilemma she faced as a young leader many years earlier and shared that with him. Together they discussed other ways to problem solve in tough situations. She did end up documenting his infraction, but he understood why and felt better equipped for future situations. Leaders who demonstrate emotional intelligence Recognize their strengths and weaknesses and they are in touch with their own moods and how they are affected by them. They also Read others. They maintain social awareness to learn what someone needs and plug into them to gain understanding. They also Respond appropriately, customizing their responses to the person or situation they are in using interpersonal adaptability. The good news about emotional intelligence (EQ) is it is a set of skills that can be measured and learned. It has a higher impact on workplace success than intelligence (IQ), personality or even technical skills. By focusing on this critical skill set, leaders can increase their influence with employees, residents and family members. By using a few self-aware behaviors, you can use emotional intelligence to increase your influence by following three simple tips:

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UPDATED Dementia

Rules Focus on Care PERSON-CENTERED

SHIFTING FOCUS TO BEHAVIOR-BASED SUPPORT , ELEVATING STAFF TRAINING AND ENGAGEMENT

The new dementia care and related regulations, which went into effect on Jan. 1, 2025, bring the most significant regulatory changes to Residential Care Facilities for the Elderly in many years. This article addresses some of the most impactful changes as providers familiarize themselves with the new regulations. While the new regulatory package in large part addresses residents with dementia or Major Neurocognitive Development (major NCD), the changes go beyond dementia care to impact all Assisted Living providers.

By Selena Coppi Hornback, CALA Senior Director of Public Policy

T he focus for resident safety and making environmental changes to help minimize risk are no longer based on a diagnosis of dementia but are required when a resident displays behavioral expressions. Behavioral expression encompasses behaviors displayed by a resident that could result in harm to themselves or others. Some of the expressions listed in 87101(b)(3) include unsafe wandering, elopement, expressions of frustration and lacking hazard awareness or impulse control. The definition provides that there can be many causes that lead to these behaviors including, major NCD, fatigue, illness, overstimulation or medical interactions, among others. Ongoing appraisals and reappraisals are required to help identify changes that require additional interventions. In addition to the changes made based on behavioral expressions, significant changes have also been made regarding resident medical assessments. The intent is that resident need initiate action, rather than a diagnosis or lack of diagnosis. CALA is working to ensure that, while the focus of these regulations is to enhance the experience for residents with dementia, they don’t end up creating unnecessarily restrictive environments for residents without dementia. The Department of Social Services (DSS) has confirmed to CALA that the intent of the regulations and implementation is to be resident-centered and focused on ensuring the resident is not a danger to themselves or others due to behavioral expressions or access to toxic substances, medications, sharp objects, etc., not restricting other residents. Questions about implementation and additional guidance will likely be needed, and DSS is regularly asking CALA and other stakeholders for feedback to ensure clarity and consistency in the field. Please let us know about your experience with inspections and other areas where you have questions about the new regulations. Behavioral Expressions DSS added a new definition for behavioral expression to help guide Assisted Living providers and medical

care practitioners in making determinations regarding situations and items which may pose a risk of harm to residents if allowed unsupervised or direct access. Staff that interact with residents should be trained to identify these expressions in addition to caregivers who are required to receive initial and ongoing dementia care training. Everyone involved in the resident’s care and wellbeing are included in these discussions and the resulting care plans. Appraisals and Reappraisals Identifying whether a prospective resident or other residents would be at risk if the prospective resident is allowed access to specified items is the most significant change to the 87457 Pre-Admission Appraisal. DSS has clarified their intent is not that if one resident in 100 would be unsafe around scissors that no one in the building can possess scissors. The safety risk is meant to be person-centered and specific to the resident who, because of a behavioral expression, may not be allowed unsupervised or direct access to scissors. The RCFE will be responsible for identifying those safety risks during the pre-admission appraisal and through ongoing interaction and reappraisals to document these behaviors or risks, describe the behavioral expression, identify events occurring just prior to the behavioral expression, if known, and identify the interventions that will be implemented to minimize the health and safety of the resident and others using the least restrictive intervention. When behavioral expressions are identified, the RCFE must bring them to the attention of the resident’s medical professional and any specialized care providers, which must be documented, for their recommendations and document any resulting changes in care. Medical Assessments DSS has removed the requirement that a physician conduct the medical assessment and has recognized that other health care professionals, including Nurse Practitioners and Physician Assistants, can conduct medical assessments under the scope of their practice. DSS also struck references to LIC 602 in the regulations,

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clarifying that the LIC 602A is a courtesy form and that any form that contains all regulatorily required information is acceptable. DSS is working to update their LIC 602A to incorporate the changes made through this regulatory package and CALA will share that with members once it becomes available. CALA has also updated our medical assessment form to include the new requirements, and it can be accessed from our Dementia Care Resources webpage. Assisted Living providers that use the current LIC 602A will need to provide an addendum to the medical professional to capture the additional information until DSS updates the form, and CALA has created an addendum form that can be used for this purpose. Another change with the medical assessment is that residents with a diagnosis of dementia are no longer required to have a new medical assessment every year. All prospective residents must have a medical assessment within the last year prior to moving in and an updated medical assessment is only needed when required by DSS.

DSS has created a new requirement that all residents be encouraged to have an annual visit with their medical professional and include documentation of the visit in the resident’s record as proof of the visit or document the resident’s refusal. This change is meant to help encourage all residents to take advantage of the Medicare annual wellness visit, which should include screening for cognitive impairment. Dementia Care Resources CALA has created several resources to help members with the new regulatory requirements and also includes tools from other dementia care experts. Visit CALA’s Dementia Care Resources webpage for tools to help identify and understand the new regulatory requirements, a new medical assessment tool for prospective residents, a behavioral expression appraisal and plan, and much more. And also visit the DSS Dementia Care Information and Resources web hub for additional tools and information. g

A STEP-BY-STEP GUIDE for tracking and reducing use ANTIPSYCHOTICS:

CALA recently updated our Toolkit for Reducing Antipsychotic Use, which helps track the number of residents living with dementia that have orders for antipsychotic medications and ways to promote non-pharmacological interventions.

Download Now

CALA NEWS & VIEWS I ISSUE 52 | MARCH 2025 16

It’s our business to know your business. Let our senior housing attorneys help you navigate the challenging business and regulatory issues that arise in today’s complex and competitive market.

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Diane Marie O'Malley DOMalley@hansonbridgett.com

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Advancing Senior CALA’S

WORKFORCE INITIATIVE EXPANDS CAREER PATHS AND PROFESSIONAL GROWTH

By Denise Brandt, MS, CALA Director of Workforce Development

PARTNERSHIPS WITH ARGENTUM

Over the past year, CALA has made significant strides in workforce and professional development, forging new partnerships, and expanding opportunities for individuals seeking careers in senior living. From engaging with national symposiums to strengthening college outreach and launching innovative collaborations , CALA remains dedicated to helping our members build a skilled and passionate workforce. With a focus on connecting students, job seekers and senior living professionals, these initiatives continue to shape the future, ensuring a strong talent pipeline for years to come.

CALA is partnering with Argentum to leverage the national resources available to our members here in California. Through this collaboration, CALA members gain access to a wealth of workforce development tools, training programs and relevant research designed to address the growing demand for talented professionals in senior living. Additionally, initiatives such as the

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Careers in Living

National Workforce Symposium CALA’s President and CEO along with the Director of Workforce Development attended the inaugural two-day event in Arlington, VA in early August 2024. Alongside other state partners, HR and workforce delegates, CALA representatives heard about Argentum’s plans to support workforce growth and initiatives across the country.

Regional Workforce Symposium CALA is collaborating with Argentum to plan a regional workforce symposium. This event will take place on a community college campus in San Diego. The symposium will focus on promoting career opportunities in senior living and fostering discussions on curriculum development to support students interested in this field. Stay tuned for updated event information very soon.

Direct Workforce Services (DWS) CALA continues to collaborate with Argentum to share opportunities through DWS and American Job Centers. We hosted webinars for Human Resources member representatives in the Sacramento and Los Angeles regions, providing insights into DWS services and the On-the-Job Training Cost Recovery programs available through government initiatives. CALA looks to eventually expand into the San Francisco and San Diego regions.

Quarterly Best Practices Meeting The CALA workforce team is meeting quarterly with Argentum representatives around best practice ideas. This initiative brings together workforce representatives from state associations, including Texas Assisted Living Association and Wisconsin Assisted Living Association, to share insights and foster collaboration.

Direct Workforce Services (DWS) program and workforce symposiums provide our senior living communities with valuable insights, networking opportunities and resources tailored to their unique regional needs. By tapping into Argentum’s expertise and nationwide network, CALA ensures that its members in California stay ahead in recruiting, educating and retaining a high-quality workforce.

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COLLEGE OUTREACH

CALA’s commitment to fostering the next generation of senior living professionals continues to grow through dynamic college outreach initiatives. By engaging with students, faculty and career development programs across California, CALA is creating pathways for students to explore rewarding careers in senior living. From scholarship opportunities and classroom presentations to strategic partnerships and career fairs, these efforts ensure that students from a variety of academic backgrounds have the resources and guidance to pursue meaningful roles in senior living.

Fall Elevate Conference Scholarships The 2024 Fall Elevate Conference marked a milestone with a record number of scholarship recipients. We awarded scholarships to 30 students and welcomed two additional attendees at the student rate. Students represented 10 schools across the state, including 15 students from the University of Southern California.

Inland Empire/Desert Regional Consortium (IEDRC) The workforce team participates in regular meetings with the IEDRC, a collective of workforce education and training providers led by the community colleges in Riverside and San Bernardino counties. These providers have direct access to students and can provide senior living awareness and career pathway opportunities for them.

Hospitality Management Project The workforce team is connecting career pathway opportunities for students by collaborating with Cosumnes River College (CRC) on a hospitality management project for the Spring 2025 semester. The initiative includes three key components: ● a career exploration video featuring career pathway stories from three CALA member chefs, ● a field trip for CRC culinary students to a local member community, and ● a chef presentation in CRC’s state-of-the-art kitchen. CRC, part of the Los Rios Community College District, recently completed a multi-million-dollar project to upgrade its culinary facilities. CALA will also participate in a celebration ceremony scheduled for late 2025. A thorough assessment will be completed at the end of the 2025 spring semester to decide what changes need to be made to the program to enable replication with other hospitality and culinary programs throughout the state.

Engaging College Partners As part of CALA’s strategic plan, the workforce team shared a 2024 fall newsletter with our college network. The newsletter highlighted the scholarship program, expressed gratitude for their support, and included photos, conference feedback, workforce data and a reminder about the expert members available to share career insights in senior living. The current college partner list includes over 1,000 school contacts throughout California and is updated bi-annually. The team has dedicated time this year to increasing contacts in the areas of psychology, sociology and social work. The list traditionally has included nursing, healthcare, hospitality management, culinary arts, gerontology and business administration departments, as well as veteran and career center departments. After an additional newsletter was shared specifically with social science professors focusing on the benefits of a psychology degree in senior living, a psychology club from a school in Northern California reached out with a request for a speaker. A CALA member presented to the group in March 2025.

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By expanding its college outreach initiatives, CALA remains focused on building lasting connections between students and senior living career opportunities. Through continued collaboration with colleges, experienced professionals and workforce development programs, CALA is helping to shape a skilled and passionate workforce prepared to meet the growing needs of the senior living sector. By offering education, hands-on experiences and career insights, these efforts will continue to inspire and support the future leaders of tomorrow. As CALA looks ahead, our commitment to workforce development remains stronger than ever. Through continued collaboration with professional partners, colleges and workforce organizations, we are creating meaningful pathways into senior living careers. By expanding outreach, enhancing professional development opportunities and fostering new connections, CALA is helping to shape the next generation of senior living professionals. We look forward to building on this momentum and exploring new ways to support and strengthen our member’s workforce in the years to come. g

Handshake Handshake career fair opportunities help members across the state to connect closely with thousands of students at colleges and universities throughout California. CALA’s workforce team has a project planned for 2025 to upload available positions from members across the state and match them with schools who participate in Handshake in California.

Webinars and classroom presentations highlighting career exploration with the following schools: ● National Assisted Living Week was celebrated with presentations at College of the Desert: CALA members presented to the hospitality management and nursing programs to discuss their personal journey into senior living. Members promoted the student scholarship opportunities for the Fall conference in Palm Springs. This resulted in five students receiving scholarships from College of the Desert. ● Anthony Vo, executive chef at Sonrisa Senior Living, and recent Hell’s Kitchen participant, presented to culinary programs across California. During the online seminar, Anthony shared his lifelong career journey and what he loves about working in senior living. ● In March, CALA recognized “Careers in Aging Month” with a member presenting to the De Anza College Psychology Club. Our member shared the wide range of roles available to psychology students in the world of senior living and how a psychology degree can prepare you for the opportunities. The Elevate Conference Scholarship was promoted prior to the member visit and shared during the club presentation.

l Gain direct access to talented individuals from numerous college programs l Increase your company’s visibility l Support the development of future leaders Contribute to the STUDENT SCHOLARSHIP FUND!

Instagram Social Media Campaign By connecting directly with college clubs and organizations, CALA’s Instagram social media campaign was developed to focused on key career paths for students. The Instagram posts kicked off in March to celebrate “Careers in Aging” month and highlighted a different area of career opportunity each month. Students were directed to CALA’s homepage, as well as the Career Center, and encouraged to upload a resume at no cost.

EMAIL DENISE@CAASSISTEDLIVING.ORG FOR MORE INFO

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