By David Hahklotubbe, gerontologist

Huzzah!  You must not be suffering from information overload.  That’s great.  Make sure you pay close attention to this edition which is chocked full of the dark side of the reputation management of the long-term care industry, from a seasoned insider.

Ok, now that we have covered some of the fundamentals of what the community offers, how they manage their team and a bit of philosophical approach, let’s dig deeper into reputation.

Ideally, you would be making your choice based on word of mouth feedback that you’d receive from a direct consumer, but unfortunately, this is not the most common method.  While I’m not personally a huge fan nor believer in “feedback” websites like YELP!, (who by the way deliberately named their company after a term that means “a faint cry for help”), these sounding board-style sites do have some merit.  And, while many of the rants and pot-shots you’ll come across are authored by disgruntled former employees or direct competitors, it’s wise to look at two key indicators:  1.  Volume of complaints vs. Compliments and 2. Central Themes of the complaints.  To spell it out… As a consumer, I would be looking at the frequency of the complaints to suggest that there are some lingering unresolved issues.

Let’s assume for a moment that the complaints are driven by disgruntled employees posing as consumers.  Well, doesn’t that speak to the fact that their leadership may be questionable?  And perhaps we shouldn’t assume, giving the benefit of the doubt that YELP and other sites are operating as they should, if the consumers ARE the author, these are red flags that you should keep in mind before you walk through the doors.  I will give you an example – I am copying and pasting a legitimate post I read just today which could easily be assumed to have come from a disgruntled former employee who was recently let go.  I assure you, since I know the consumer as a family member of a resident at this community, that this is legitimate.  For obvious reasons, I will keep the business and author anonymous;  “I’m updating my review and lowering my rating. Just when it seems like they have great staff in place, I mean really great staff, they quit. Including the exercise teacher, the best driver ever, the assisted living director, the dining director…to name a few! They need to VALUE their staff above all other amenities. I don’t care about the fountains and all the upholstery and pillows, please hold on to your good staff.”

What immediate red flags would come to mind after reading this?  Poor management, lack of adequate and quality staffing, zero personnel appreciation, low wages, compromise of integrity or maybe job ambiguity coupled with poor training?  Sure, that would be a good assumption.  And, in this case, very accurate, as I am very familiar with this company.

So, as if the water wasn’t murky enough in a field that is complex to navigate… enter the “dark side”.  Long-term care is a lucrative industry.  It has attracted a large cross-section of players and investors, many who just look to the bottom line, which makes it very competitive.  With lots of money at stake, it is critical that, regardless of the quality of the product/service, they live and die by “census” (the amount of elders in occupancy).  Any threat to “census” is a threat to the bottom line and therefore a threat to people’s jobs.  The threat of revenue loss or loss of job influences people’s decisions and puts ethics squarely in jeopardy.

As you would imagine, negative reviews are a black eye to anyone’s business.  So, what does one do when they get a negative review?  There’s only a few things you can do.  Ideally, you’d take that feedback, look at the complaint and objectively look at if there is any merit to it and remedy the issue.  Sadly, many don’t.  Another tactic would be to offset the negative review with a few positive ones to drown it out.  But how do you do that ethically?  You don’t.  And this is where things go off the rails.

What I am about to share with you is 100% true.  I have worked for more than one company (briefly) who have employed these following tactics….  1.  Incentivizing positive reviews with contests.  How does this work?  They send out a notice to residents and family members that if you post a positive review, your name will be entered into a raffle to win a month of free rent.  This is mind-blowing how unethical this is yet high-profile.  There is no shame.  2.  Requiring staff to post a positive comment with penalty in the balance.  While some of the consequences were understood and not spelled out, it was clear that if you didn’t participate in boosting the overall rating of the community, you were not a “team player”.  In essence, you were coerced to compromise your integrity to keep your job.  In other words, the positive reviews were not sincere and motivated by personal gain rather than truth – aka conflict of interest.  But, as many have defended, this is war and this is the only way to fight back.  I’ll let you, the reader, decide if this is a “best practice”.

But wait, just when you thought it was bad, it gets worse.  The big marketing machine behind many of these communities, after either not enough participation or in an effort to bury their bad ratings, go several steps more.  1.  It is not uncommon for the marketing folks to employ professional review companies who use fake user accounts to script glowing reviews in exchange for money.  How this is legal is beyond me, but it’s an actual “industry” fueled by fraud.  2.  The company themselves will open multiple fake user accounts and continually write positive reviews for each of their communities.  The savvy consumer can catch this in action as one profile may claim that their loved one lives in multiple locations across a large company’s portfolio.  Fact check me, it’s enlightening and entertaining.  But, lastly, number 3.  Number 3. Is the most despicable of all.  The logic behind number 3 is; the field of long-term care is highly competitive, if we are coming in at a 3.5 star rating and our neighboring communities are coming in at between 4 & 5 stars, and we’ve done all we can to boost our stars, it’s time to start lowering theirs.  That’s right, you heard me, number 3 is the meeting I’ve been in behind closed doors that instructs us to create fake accounts with the explicit intention of going to our competitors YELP!, social media and other vetting sites, to bomb them with horrible reviews that are complete fabrication.  Sick sick sick stuff.  I have the pleasure of having spared my conscience and never stooped to that level of unethical behavior, but I know way too many people that felt the pressure of losing their jobs and actually pressed send.  Very sad.

So, why am I sharing all this?  It’s time that the curtain is pulled back and everyone see how these machines are running under the hood.  It may come as no surprise to you, or it could be shocking, but either way – everyone should know this.  And, the next time you attempt to use public rating apps to guide your decision-making, keep all this in mind – that perhaps it’s not the most reliable source.  In the next BLOG, I will share some of the more reliable sources and rate them from 1-5.  If I were to rate YELP and it’s similar cohorts, I’d put it as a solid 1, as unreliable.  Happy Hunting!

Love David