Top U.S. senior living provider transforms compliance & care procedures in over 325 communities with FORM OpX


For more than 30 years, one of the nation’s leading senior living providers has led innovation and excellence in senior care across the globe. With 330 communities in the United States, Canada, and the United Kingdom, the provider redefines senior living by focusing on the individuality of each resident, hiring values-based teams, and investing in technology that ensures best-in-class care and compliance in every community. As the fifth-largest senior living provider in the U.S., this organization protects and ensures quality of life for each resident. The organization’s Senior Director of Quality sought out a more efficient solution for tracking and improving best-in-class safety and care for every resident.

The Challenge

With 10 years of experience as a former regulator for the state of Pennsylvania spent auditing personal care homes and with experience in recreational therapy, the Senior Director of Quality combines the best of all worlds for the senior living communities: compassion, care, and expertise in tracking regulatory compliance. “While I was working at a hospital, I began to notice areas where I could improve quality of life for patients and efficiency for our teams,” the Director says. “So I decided to become an advocate.” 

As soon as she joined the team as Senior Director of Quality, she immediately saw an opportunity for improving Community Performance Assessments (CPAs), Facilities Standards Reviews (FSR), site visits, and advancing the organization’s auditing system. But with hundreds of communities spread across almost 30 states, the Director of Quality knew she needed a system robust enough to track each state’s regulations while also aligning to the overarching advanced standards above and beyond what states require.

Each community audits regulatory compliance standards for 24 categories, including Care & Services, Fire Safety, Residence Rights, and Infection Control—a category modified during the COVID-19 pandemic to measure compliance with COVID-19 policies—and each community is required to record its assessment results for regional review. The Quality Management team is responsible for ensuring execution and compliance with regulations per state and community, and prior to FORM OpX, each auditor performed in-person visits to an average of 57 different locations per year, resulting in high-travel expenses, lost time spent commuting, and difficulty pinpointing areas of risk quickly and efficiently. After in-person site visits, the Director of Quality and her team identify problem areas and begin improvement planning procedures. Naturally, these layers of audits require great amounts of detailed visibility and context; but the team was struggling to gain real-time visibility into conditions in its use of Word documents to conduct audits, before then progressing to Excel spreadsheets, and found its manual processes simply weren’t cutting it. “The biggest problem with Excel spreadsheets was the time and effort we spent collecting data for our portfolios,” the Director says. “We also couldn’t assign a score to our audits or to our CPAs, which made it difficult for us to truly understand how we were performing across communities in terms of compliance and quality.”

Top Functions at Each Senior Living Community

The Solution

Sunsetting Manual Processes

First, the Director of Quality and her team set out to design an internal system that tracked statewide regulations and procedures for each individual community. “We used this system to map all regulations for assisted living, and then created a code for each one,” she explains. Using this system, the team could easily identify which states required specific regulations, such as 24-hour nursing care, before applying that code to each category and community. From there, the team leveraged FORM OpX to create an auditing, scoring, and performance improvement system to ensure regulatory compliance and location-specific execution of each procedure—and they also layered in scoring for company standards to exceed state regulation baselines to deliver world-class resident experience. Using 24 compliance categories, the Quality Management team created smart mobile forms and checklists—including CPAs—within FORM OpX for community assessors to complete on-site with ease and efficiency on mobile, which dynamically adapted by location requirements—something that wasn’t possible before using FORM OpX.

Once a community form is submitted, the Director of Quality can immediately view individual results or organize them by location portfolio. Results are color-coded for quick and easy trendspotting, which allows her to swiftly take corrective action before residents are affected. “If I spot a pattern in a portfolio, I can click on the form and view individual scores per question,” she says. “The platform lets me drill down into trends across forms and pinpoint which communities are performing well, and which require extra attention.” If a community or a portfolio is underperforming, she works closely with regional teams to kick off a comprehensive Performance Improvement Plan (PIP) within FORM OpX.

Scoring System

  • GREEN: 90% – above
    • Action plan: High-fives
  • YELLOW: 80% – 90%
    • Action plan: Regional Escalation & Improvement Planning
  • RED: 80% – below
    • Action plan: Regional Escalation & Improvement Planning

Implementing Performance Improvement Plans (PIP)

The company’s culture of care begins with dedicated and engaged teams, and the Director of Quality ensures each community’s team has the tools it needs to provide the best care possible. “The system is only as good as the people who are using it and the information we’re getting from it,” she says. She reinforces the organization’s core values—passion, joy in service, stewardship, respect, and trust—by developing ongoing learning opportunities and improvement plans for each community team when necessary.

Our teams rely on this system to help them gain insight into what they don’t know— and then drive positive impact with that knowledge.

Senior Director of Quality, Top Senior Living Provider

After careful review and identification of negative trends, the Director of Quality and her team trigger PIPs within FORM OpX to community assessors. “It’s up to us to identify the issue and re-train our team members with a timeline for continuous improvement, which is typically six months,” she says. “Then community teams will redo the CPA or a specific form to make sure each standard is met and processes are fully-understood and executed.” Regional teams also perform site visits to confirm execution, which are built within FORM OpX, and the team can track monitoring of all regional team members from start to finish. The Director can also visually overlay pre-PIP and post-PIP scores to analyze whether a problem has truly been resolved, and take action if not. “Our teams rely on this system to help them understand what they don’t know,”  she says. “I want everyone on my team to feel empowered in knowing what each regulation means to their jobs and to their responsibilities.”

The Results

Increased Visibility & Communication

Empowerment is a key result the employees experienced after implementing FORM OpX. The Director of Quality and her teams now have an intuitive tool to understand compliance and performance across every community—all with the touch of a button. “Within FORM OpX, we can see all community scores and results in total,” she says. “All we have to do is login and view results for a specific portfolio or an individual location. We never had that insight before with our paper tools.”

All we have to do is log in and view results for a specific portfolio or an individual location. We never had that insight before with our paper tools.

Senior Director of Quality, Top Senior Living Provider

Additionally, each team at a regional and corporate level can access the dashboard with results tailored to their roles, creating a detailed network of transparency, collaboration, and motivation to improve. “Each community can see their results instantly, identify the trend themselves, and share those results with their team members,” says the Director of Quality. “Regional members can see their portfolios and view scores for others, so if they see the east region performing better than the west, they think: How can I motivate my teams to do better?” 

And when it comes time to improve, the Director of Quality has exactly what she needs to communicate with teams across functions. “If I spot a negative trend in Dining, I can export a report and share it with the vice president of that function,” she says. “Together, we can see each specific area that needs work and take corrective action almost immediately, and our partners can use that information to train their teams.” All teams are required to share results with the corporate team on a quarterly basis, making the easy reporting and exporting features within FORM OpX a game-changer for all teams. “This platform is the main source of data our regional VPs use to report to leadership,” she says. “They use it to answer key questions such as: ‘Are we stable?’ ‘Are we performing well—and if we’re not, what is our action plan and how are we deploying it to our teams?’” When the teams feel informed, engaged, and empowered to do their best work, each community resident reaps the benefits.

Improved Regulation Tracking & Compliance

While the senior living provider isn’t the first to digitally measure compliance, its method of constantly adapting to state and organizational regulations sets it apart from competing communities. “We go above and beyond; our goal is to exceed state standards to deliver the ultimate resident experience in quality and safety,” the Director of Quality says. Her team not only tracks compliance against state regulations and corporate standards, but they also use FORM OpX to automatically adjust each form to meet new requirements throughout the year. She explains:

“We’ve implemented a change management program that adds another layer of regulation into the platform. Many companies create an auditing tool and use that same tool over the course of 10 years. Often, you’ll start seeing discrepancies in what the tool is finding and what the state is finding, because it’s an outdated system. We use FORM OpX to keep up with the times: Depending on what’s happening in our environment, in the state, or in a specific community, those regulatory-based questions change, so we’re always up-to-date on what’s needed to comply.”

Thanks to FORM OpX and the dedication of the Quality Management team, the organization stays on the cutting edge of innovation and at the forefront of regulations and standards in every state. This ability to intelligently and quickly adapt to shifting regulations became its greatest strength when COVID-19 barreled its way toward vulnerable communities in 2020. As teams grappled with the lack of a national response, the senior living provider had to address COVID-19 protocol on a state-by-state level, often in the face of regulations that were changing weekly.

Increased Safety & Reduced Risk

In 2020, COVID-19 threw every business a curveball—but for senior living communities, the risk was even higher and the regulations were more demanding than ever. The teams at this particular set of communities immediately jumped into action and adapted their existing FORM OpX infection control forms to meet rapidly-changing COVID-19 requirements and to keep residents safe—and experienced unexpected efficiencies as a result. “FORM OpX is incredibly adaptable,” says the Senior Director of Quality. “As soon as new regulations began to come out, we implemented them into our forms and deployed them to our communities.” She also asked her community teams to perform self-assessments while she attended remotely via Zoom or FaceTime calls. “We adapted our assessment forms, we built an entire process around remote CPAs, and we began training our teams on how to perform an audit remotely.” After seeing success from a remote auditing process supplemented by FORM OpX, the Quality Management team decided to keep working remotely in the long-term—performing regulatory audits with community teams via mobile, and visiting communities to assess high-risk areas when necessary. Ultimately, COVID-19 helped the Director of Quality create an auditing process that eliminated the need for frequent on-site visits and the inefficiencies her whole team felt. “FORM OpX highlights what’s most important and what’s most relevant to us,” she says. “We’ve experienced full ROI from FORM OpX in travel expenses alone.”

The senior living provider also created a COVID-19 Committee to keep detailed records of executive orders to accelerate orders of PPE or to improve safety on-site as soon as new information was released. As COVID-19 variants began emerging and new protocols were reinstated, the Director of Quality could easily unhide regulatory form questions that had been hidden after regulations were reversed, ultimately saving her teams time and busywork re-adding form criteria. “We could easily re-implement standards that were previously waived,” she says. The team escalated the infection control subcategory to its own category for regulatory compliance procedures, and regularly tracks performance to ensure residents and team members are protected from the virus. Within each form, teams can reference the COVID-19 Response Plan to fully understand processes as they complete tasks, and the Quality Management team can track form completion and measure infection control scores in real-time.

Greater Peace of Mind for Residents

At the heart of the company’s technology strategy is the comfort and improved quality of life it provides for community residents. Team members, including the Director of Quality herself, regularly sit down with residents and use FORM OpX to record their overall satisfaction with the community—in addition to answering curious questions on how the solution works. “It’s just like any other mobile app: You open it on your phone and answer a series of questions on how we’re doing,” she demonstrates one of her conversations with a resident. “The answers go directly to the people who need to know, and they’ll see if we’re doing well, or they’ll work to fix what we need to improve.” Sometimes the fix is as simple as restocking a resident-favorite brand of coffee—but most times, it’s carrying out a task that preserves the sense of safety, independence, and trust each resident places in the hands of a team member. “Our job is to be of service to each and every resident in our communities,” the Director of Quality says. “FORM OpX helps us have a positive impact on our communities, and that’s what matters most to all of us.”

About FORM OpX

FORM OpX empowers teams to improve operational compliance by digitizing audits and inspections to reduce risk and improve safety and quality from the frontline. FORM OpX mobile workflows make it easy to capture the right data, at the right place, at the right time – every time. Teams stay connected with instant frontline communications on mobile, and real-time insights allow leaders to spot and fix issues quickly and measure trends over time so teams can take action on the opportunities that move the business forward. Learn more about the power of FORM OpX here.

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