Windsor Healthcare has managed the impossible… and here is how they do it.

By Steve Moran

This is one of the toughest articles I have ever tried to write.  

I spent a week in New York and that included most of a day at Windsor Healthcare, a New Jersey-based, family run skilled nursing company that has the best employee turnover rates I have ever seen. In most buildings most years they have a sub 10% turnover rate.   For example, one inner city building that has more than 100 care staff (CNAs & licensed nurses) had zero turnover for all of 2014 and 2015 was almost as good.

Here is the problem. I asked them to describe how they manage to accomplish this and it is more like magic than some secret sauce management formula. It was not because they were unwilling to share, because they answered every question I asked. They showed me data and talked about processes and I honestly am still not sure I can describe how they pull this off.

Don’t think theirs are some high-end boutique skilled nursing homes. They have typical resident mixes of Medicaid, Medicare, private and managed care payor residents. The home I visited was nice, but not some spectacular hospitality-style nursing home. It was just amazingly comfortable.

It Is All About People

Their bottom line is that everything they do is about the people they serve as owners and managers. Every residents’ needs, desires and wants are paramount in the day-to-day life of their homes. The underlying thinking looks something like this:

  • Every single resident is someone’s grandparent and deserves grandparent-style care.

  • Carepartners (frontline staff) are as important as every other team member and, as important as residents, is providing exceptional care.

Nuts and Bolts

  • I started by asking about their hiring process and got kind of a funny look. They use no systems at all. They bring in candidates, talk to them about their philosophy of caring for elders. They invite other team members and residents to be a part of the hiring process. If there is not consensus, the person does not get hired. They hire almost exclusively for attitude.

  • The goal is to make this a family-like environment where family members have different roles but equal value.

  • They want people to grow and succeed. They run AIT programs in all of their homes.  

  • They practice what they preach. This means you can talk to people about how things are, how things can be better.   

  • CNAs are part of meetings and play a meaningful role in the process.

  • They trust all carepartners to do the right thing, which translates into the best thing for the residents.

  • They are flexible. This is all about people, which means that systems have to serve the end goal and that they are not the end goal. Stuff happens and flexibility is key to the best interests of everyone.  

  • They don’t have anyone working with them that has a mean spirit.

  • While not quite calling it that, they are big on cross-training. The big idea is that people are delighted to do what needs to be done. They look for ways to help each other out.

  • Communication is a huge value. They understand that people do better when they know what is going on. Good news/bad news, it is important that everyone is on the same page.

  • They are actively engaged in doing some really big life enrichment activities. These activities become focal points for residents and team members. This has a huge impact . . . more than even they know I expect.

Dining with a Twist

They made a conscious decision never to use trays for residents in their dining rooms. Food is brought up in bulk, and plated and served in each dining room. This gives residents the opportunity to make choices at the time they are served and to appreciate the aromas of the food. In the particular community I visited they serve a large population of Korean elders. As you can see in the photo, I had to sample the food. I sat with an elderly couple who spoke almost no English, but we had a great conversation with the help of a translator and the woman kept pushing me to eat her pears and milk.

And . . . they are currently looking for an administrator who would like to work in this environment.