Housing Strategies to Improve Employee Recruitment, Retention and Overall Health
Housing Strategies to Improve Employee Recruitment, Retention and Overall Health
As housing costs have continued to skyrocket nationwide, many middle-income hospital and health system team members have found it increasingly difficult to find high-quality and affordable housing options. The lack of available housing has exacerbated the staffing challenges for many hospitals and health systems. This strain has impacted employee recruitment, retention and the overall health and well-being of health care employees.
Hall Render attorney Danielle Bergner discusses various strategies that hospitals and health systems may consider to address housing challenges faced by their team members.
Podcast Participants
Danielle Bergner
Attorney, Hall Render
Moderator: Thanks so much for joining us today. We’ll get started in just about one minute. (silence) Thanks so much for joining us today. We’ll get started in about one minute. All right, well hello and welcome to today’s webinar. Thank you so much for joining us. My name is Julie Senesac and I’m the digital marketing manager here at Hall Render. And I’ll be here in the background answering any questions. Today we’re presenting housing strategies to improve employee recruitment, retention and overall health, presented by Hall Render attorney Danielle Bergner. Just a little housekeeping before we get started. If you have any questions during the presentation, please go ahead and type them into the Q&A box in your Zoom control panel. We will have some time towards the end for questions. Any questions we don’t have time to address today, we’ll make sure to follow up with you via email. Now I’m going to turn things over to our presenter, Danielle Bergner.
Danielle Bergner: Thank you, and thank you everyone for joining today. We have great interest in this topic as I’m gathering from the registrations for the program today, I hope we all find some great information. Let me advance my slide here. First, just a little bit about Hall Render, Hall Render Advisory Services, and myself. I have actually worked in the housing industry for about 17 years now. Most recently here with Hall Render, advising hospitals and health systems nationally on a range of real estate issues, including housing strategies and action plans. Hall Render, and Hall Render Advisory Services, we like to say we focus our services as an extension of your in-house team. We have lawyers and non lawyers who partner to coach and advise our clients through real estate challenges with pragmatic objective and conflict free advice that has earned us the trust of hospital and health system clients nationally.
Danielle Bergner: I’ll start with a brief program overview. We’re really focusing today on housing as it impacts the issue of employee recruitment, retention and overall wellbeing for hospitals and health systems. This is the second in our housing as healthcare series. And we are focusing today specifically on employee housing, because it has become such a critical tipping point issue for so many of our clients around the country. So first we’ll talk a little bit about, what is the problem? Well, how does this dovetail with other staffing challenges that healthcare is facing right now? We’ll talk a little bit about how this is a two-pronged problem, lack of affordable housing versus lack of available housing. Which are two distinct issues that we have to understand at the outset of developing any strategy. And then we’ll finish the program today with a summary of actual strategies that hospitals around the country are using and have been using for quite a period of time now in some cases.
Danielle Bergner: We will focus today on the concept of permanent housing options for employees. I emphasize permanent because there are other temporary housing strategies, some of which I’m sure many of you are familiar with. Things like renting rooms and hotels with surplus capacity, trailer type housing accommodations. Those are topics we will not be covering today. Today’s focus is really on the concept of permanent housing solutions for hospital and healthcare employees. So first, we are, as an industry in a crisis, in a letter written to Congress this month actually, the American Hospital Association states that the workforce challenges facing hospitals are a national emergency that demand immediate attention from all levels of government and workable solutions.
Danielle Bergner: They note that hospitals have seen a decrease of nearly 105,000 employees since February 2020, which has resulted in an increased reliance on contract labor from healthcare travel staffing firms, which of course as many of you know, are charging hospitals exorbitant rates for labor driving up overall expenses at every level. In other words, setting aside housing as a contributing factor, healthcare is in crisis as it pertains to providing adequate levels of critical staffing.
Danielle Bergner: So how does housing contribute to this problem? Here is just a collection of recent headlines. In preparing for this program I searched just the last five months and came up with several dozen headlines specific to the issue of housing contributing to staffing problems for hospital and health systems. Headlines like, housing for hospital workers called a crisis. Florida hospitals say potential staffers cannot find affordable housing. The housing crunch means Montana hospitals cannot find or keep workers. These headlines are just indicative of the geographic range of the problem. This is no longer a market specific issue, this is now a national issue. And increasingly we are seeing hospitals and health systems developing proactive strategies to address the housing shortages in their communities.
Danielle Bergner: So what do we have here? Well, I call it a perfect housing storm with two prongs, lack of available housing and lack of affordable housing. On the available side, the reality is available housing inventory has decreased nationally in most markets. In some cases we’re seeing peak inventory at less than 40% of what it was two years ago. In other words, demand for housing is far outpacing supply. This has been going on for a number of years and what we’re seeing now is the result of underbuilding for the better part of the last decade. The second prong of the perfect housing storm is lack of affordable housing. Housing is considered affordable if it costs less than 30% of a household’s income. So you can see how with constrained supply, escalating material costs, a prolonged period of low mortgage rates, record inflation and other pandemic fueled factors such as remote work and the increase of second homes have created a perfect storm for the current housing market. So we have constrained supply, we have demand that cannot be met, and we have costs that have been increasing dramatically in recent years.
Danielle Bergner: Here I say hospitals are innovating because the problem is unfortunately only getting worse. The graph here is showing the relationship of median home price to household income over the last 20 years. And what you can see here is median home price is far outpacing the increase or I should say, lack of increase in real median household income nationally. And as you can see from the chart, the divide is only growing wider, which means housing is getting less and less affordable for the average American.
Danielle Bergner: I inserted kind of a colorful quote here by Shawn Tester the CEO of Northeastern Vermont Regional Hospital. He says, on the topic specifically of providing housing for hospital employees, he says, “When you’re haying and the baler breaks and there’s a thunderstorm coming, you got to figure out how to fix the baler and get the hay up in the barn.” In other words, when he was asked, why is Northeastern Vermont Regional Hospital getting into the housing business? His response basically is, because we have to. We don’t have a choice anymore. We are unable to recruit and retain employees in our market if we don’t do this.
Danielle Bergner: So transitioning from kind of a general overview of what the problem is, which I know many of you are familiar with. I want to really dig in now and talk specifically about different strategies that hospitals and health systems are using around the country. As an over view, we’ll touch here on the concept of direct benefit programs, a master lease housing model, housing acquisition and development, community land trust partnerships, public housing authority partnerships, and regional housing initiatives. This is by no means an exhaustive list of how hospitals and health systems can or are engaging in solving housing issues in their communities. But I do think it’s representative of a range of strategies that hospitals and health systems may want to consider at the outset of thinking about how they may want come at housing. I do note here, there is no one size fit all approach. A successful housing strategy often involves layering a number of different approaches depending on what the issues are.
Danielle Bergner: So first let’s talk a little bit about direct benefit programs. Employer assisted housing programs have been around for a long time. They have been used in the healthcare and non-healthcare contexts for many years. Basically assistance in an employer housing program can be provided in a number of ways, typically through financial assistance, sometimes in the formal of a down payment grant or a loan and rental subsidies. Sometimes those are forgivable loans, sometimes they’re not. It does require internally at the hospital level, the development of formal policies that address eligibility, repayment and forgiveness terms. And education and credit counseling are also typical components of a direct benefit program focused on housing assistance. One example that I saw recently was in South Carolina where the Beaufort Memorial hospital is offering a $10,000 home buyer assistance program for its employees. Another interesting example that I want to point out, which is not financial assistance per se, but I thought it was a creative tool.
Danielle Bergner: St. Luke’s Health System in Boise recently launched an online portal right on their website that connects hospital employees with area landlords and invites landlords to connect their available units with hospital employees. So it’s a way for the hospital to connect its employees with housing, to connect landlords with hospital employees without necessarily offering a direct financial benefit. Although I do note St. Luke’s also has financial investment in housing strategies as well. And then just a footnote on this concept of direct benefit programs, I think it’s, one of the trends that we are seeing nationally is healthcare clients looking more globally at their suite of employee benefits to include not just housing support but non housing support work. Things like childcare, tuition assistance, mental health programs. So maybe sometimes if a hospital or a healthcare system is thinking about housing, I would also encourage them to think about these other potential options for benefit programs that would enhance the overall wellbeing of employees.
Danielle Bergner: So transitioning now from the direct benefit model, I want to talk a little bit about the master lease model. The basic mechanics of a master lease housing model are this, the hospital master leases homes and apartments, and then subleases them to hospital employees. Often with the assistance of a contracted residential property manager to ensure that all of the various residential regulations are being complied with and so forth. And also because, one of the things we’re keenly aware of is housing is not healthcare’s core business. And so the more that hospitals and health systems can get themselves out of the day to day of leasing and managing residential real estate the better, because it is very difficult to build an internal competency specific to residential rental practices. So here the hospital master leases homes and apartments, subleases them to hospital employees. And then the benefits of this type of model, master leasing housing allows a hospital to better control the inventory that’s available in the market over time.
Danielle Bergner: It ensures to the greatest extent they can that units are available for hospital employees when needed. A master leasing strategy can also be a fast way for hospitals to secure housing inventory. And that is assuming housing inventory is available, which in many markets today that is one of the challenges. I also note on the benefits side that a master lease model can also be very appealing to landlords because it offers a reliable revenue stream. And so what you have here basically is the hospital or the health system serving as a guarantor of sorts to a residential landlord. That is obviously a very valuable benefit to landlords as opposed to underwriting each individual residential lease based on the credit of an individual tenant. The challenges with a master lease model, and I say challenges, but I would say it’s probably better characterized as realities.
Danielle Bergner: The master lease rents can be higher than what hospitals can recoup through subleases, which does require financial subsidy when that’s the case. This is typically the case in very high rent markets. So I note an example down at the bottom, the Vail Health organization has actually master leased many units for the better part of two decades now. And they just recently renewed their master lease at that development and they’re actually expanding their master lease program. And if you think about it, that makes sense.
Danielle Bergner: Vail is a high rent district. It has been for a very long time. And so here, what you have is Vail Health basically subsidizing the rent through this master lease program where they master lease at the market rent, but then ultimately when needed they sublease at more affordable rents to keep the rents affordable for the people that live there. It is in a way, if you think of about it this way, it’s kind of a rent control program that’s achieved through a master lease model. The challenge of course is that in some markets and today, unfortunately, many markets there may be no inventory available to master lease.
Danielle Bergner: The next strategy I want to talk about is what I’ll just call generally housing acquisition and development. This is, I would say a more permanent solution in the sense that the focus of a program like this is really to create more high quality affordable housing units that will be available potentially to hospital and healthcare employees, but also potentially to the wider community depending on the program’s goals and objectives. So increasingly hospitals and health systems are purchasing land for future development for residential purposes. They’re purchasing existing housing units, rehabbing them and helping to finance the construction of new affordable housing units as a strategy to create and support again, permanent housing options. I cite a couple of examples here. One being Atrium Health in the Charlotte area of North Carolina. Atrium has been very active in recent years with a robust DNI and community investment strategy with a heavy focus on housing.
Danielle Bergner: This one example I point out is a partnership that Atrium did with a local nonprofit organization and a developer, which called for the creation of 341 affordable apartments with 20% of the units, quote unquote, set aside for hospital employees. What that means is Atrium basically made a financial contribution to this project and in exchange 20% of these 341 units will have a rental preference attached to them for hospital and health system employees. Another example I notice here is the Martha’s Vineyard Hospital, which recently purchased 26 acres of raw land for future housing development. I pulled this one out as an example because Martha’s Vineyard Hospital is a critical access hospital. Again, in a high rent district, and recently devoted, I think $3 million of their budget specifically to housing issues.
Danielle Bergner: And a lot of the hospital and health system leaders say, “Would we like to ideally put that $3 million to other uses? Yes. But if we don’t put the money to this use, we’re going to increasingly have difficulty recruiting and retaining staff, which means we will not be able to meet our core business objective.” And so I don’t want to say it’s reluctant. I think a lot of organizations are embracing it, but it is a little bit of a curve in terms of healthcare stepping into the housing space and recognizing that, the fact is the market and government have not kept up, they’re not keeping up and they’re probably not going to keep up going forward.
Danielle Bergner: And so I think healthcare is recognizing this is a problem that healthcare has to address for healthcare and we probably can’t lose much time doing it in most markets. I also want to note with housing acquisition and development that what you often have here is a development partner that really does all of the, most of the heavy lifting in terms of the financing and development of the project, the ownership and management. The hospital’s role tends to be more passive, typically financial support, possibly a land donation. And then also the employees set aside component, which is usually what I see hospitals and health systems getting in an arrangement like this.
Danielle Bergner: Another concept to touch on here is, and it’s kind of an outgrowth, I would say, of the acquisition and development model, is models that involve the use of what’s called a community land trust. A community land trust is a legal mechanism, often a nonprofit that ensures the long term affordability of housing. They do this through the recording of deed restrictions, which restrict the long term conveyance and pricing of the property, or in some cases, the community land trust actually retains ownership of the underlying land to accomplish it. The end purpose is the same, which is that the land that the house is on is basically permanently rent restricted or purchase price restricted, creating a long term, again, more permanent solution to an affordable housing problem in a community. I note here a couple of examples. On one end of the spectrum is the Maggie Walker Community Land Trust, which was funded in part by Bon Secours Mercy Health.
Danielle Bergner: This organization is very active. They buy, rehab and sell homes at a reduced price subject to permanent restrictions on resale value. I would characterize this as a community investment strategy. The Maggie Walker Community Land Trust organization is not focused specifically on hospital or healthcare employees, but the work that they do certainly benefits the employees of the health system working in the area. Another example, which is on a much smaller scale would be a hospital partnering with a community land trust on a smaller project, perhaps involving the donation of hospital owned land to the community land trust for development, subject to long term affordability restrictions and potentially a right of first opportunity for hospital employees. Which means that the hospital employees would have a first opportunity to buy those homes at the reduced purchase price before they could go to the open market for sale. This is a more hospital centered strategy, not as much of a, quote unquote, community investment strategy. But again, accomplishing the same thing, which is creating long term permanent affordable housing for hospital and healthcare employees.
Danielle Bergner: The next model I’d like to talk about is the public housing authority partnership model. I use this model because I like to remind people that public housing authorities are really powerful entities. They are governmental entities, often mission aligned with hospitals when it comes to advancing the affordable housing needs of a community. Public housing authorities also possess unique financial resources and often an abundance of knowledge that can be helpful in advancing in affordable housing development. One example I cite here is a recent project in Denver with Denver Health. Here, Denver Health partnered with the Denver Housing Authority to repurpose a surplus hospital administrative building for 110 units of housing. Financial sources for the project included the low income housing tax credit, which was facilitated largely through the public housing authority and a ground lease financing which was provided by the hospital system.
Danielle Bergner: I like this example because it layers a number of different strategies and achieves a number of different objectives. Denver Health here had a surplus building like many hospital systems do around the country. And fortunately this one was well suited to a residential conversion and instead of selling or donating the land outright, here Denver Health structured their land contribution as a ground lease financing. And so ultimately Denver Health will retain the land in perpetuity, but will essentially subject it to a long term ground lease to facilitate the development of these affordable housing units. I thought this was a really creative, a really thoughtful example of some of things that hospitals and health systems are doing around the country. And also a good example of how to leverage the tools that a public housing authority can bring to the table.
Danielle Bergner: And here my last strategy slide is focused on regional housing initiatives. One of the dynamics that we’ve become very in tune with around the country is there’s a very big difference between housing initiatives in urban areas and housing initiatives in rural areas, and rural meaning much less populated areas. And how you approach your housing strategy really depends on whether you are urban or rural. In less populated areas what we see is a successful strategy will often require a regional approach or even a statewide approach, depending on how rural the entire state is to incentivize development of new housing units. Here the challenges are a little different. In an urban area there’s no shortage of buildings. There’s no shortage of developers. There’s no shortage of capital. All of the parties who want to be involved in a housing development project are in place.
Danielle Bergner: In a rural area you don’t have those pieces necessarily in place. There may be no developers willing to come into the area because it’s not worth their time. There may be no contractors willing to mobilize a team to build anything in a rural area because it’s not to scale to make it profitable for them. And so in these types of circumstances, it’s a unique planning exercise because you often need to bring the resources and you often have to get the project to scale to get the right people interested in doing the project. So one really creative example that I’ve come across in recent months is with the Southeastern Colorado housing initiative. This initiative was led by a number of nonprofit economic development agencies in collaboration with the state and with some federal funding, some ARPA funds. And basically in this model, the regional agencies essentially led the RFQ process.
Danielle Bergner: They led the contracting process. They identified a developer. They identified communities, counties, local governments that were willing to participate. Here there was one hospital district participating where they donated land essentially to the economic development agency. The economic development agency contracts with the developer for the construction of the house. And then when the house is done, the hospital district purchases it back from the developer for an agreed upon market price. And so it isn’t the simplest structure, but I will say it was awfully creative. And it really impressed me in terms of how it brought all of these parties together to tackle a housing issue that for many, frankly for decades had kind of plagued the region and they didn’t know what to do. And now they have 63 houses going up over the next six months. And so the good work is getting done. It’s not always easy to do, but there are models out the there that can help hospitals do it.
Danielle Bergner: And then I’ll wrap up here to talk a little bit about how hospitals and health systems may want to approach a housing strategy. At the outset let me say, it can be overwhelming because it’s not part of a hospital’s core business. You’re working with parties and concepts, and ideas that are maybe not particularly familiar to those inside of your organizations. And so, one of the things I recommend when we start working with a hospital on a housing strategy, is I say, “Okay, don’t bite off too much at the outset. Let’s just take this in pieces.” And what we talk about is a phased approach to a housing strategy. Phase one being the establishment of a clear vision, goals and identifying assets for the endeavor. So we start by talking about, well, what are the hospital’s primary goals?
Danielle Bergner: What is the vision for this project? How are we going to make those things measurable? The next part of this phase one process is identifying land, building and financial resources that the hospital can bring to the table. Sometimes this is surplus land. Sometimes this is the acquisition of dilapidated homes around the hospital. Sometimes this is just straight financial assistance. Sometimes the hospital says, we don’t want to donate land. We don’t have land to donate. We don’t really want to rehab houses. What we’d like to do is write a check and we’d like someone else to do these things. And we can work with hospital systems to help them develop those strategies as well. And then the other really important part of the phase one work is identifying stakeholders and partner resources.
Danielle Bergner: It’s very difficult in housing to have a big impact if you are not bringing multiple stakeholders and partners to the table. The other concept I really spend a lot of time thinking about when I look at these projects for our clients is the concept of leverage. I would like our hospital client dollars to be leveraged on a housing project to the greatest extent possible so that the value of that hospital investment is multiplied because we have other stakeholders at the table. Other stakeholders might be governmental agencies, they might be housing agencies, they might be the philanthropic organizations. They might be developers who are bringing a private investment to the table.
Danielle Bergner: And so the goal when I look at these projects is not always, how is the hospital going to solve this problem? What I look at is, how is the hospital’s investment going to leverage the greatest possible impact by bringing other people and other dollars to the table? Phase two then looks like, what I call organizing the team and developing the plan. Engaging those stakeholders, getting their buy-in, and then developing the plan and the program, whether it’s a direct benefits plan and coordinating that with legal or an HR. Or it is a wide scale housing development project and it’s coordinating the development and financial partners. It’s really heavy on organizing the parties to make this happen. And then phase three is implementation. It’s the contracting, it’s the land acquisition, it’s the program implementation. And so I kind of take a little time to go through these phases with clients, because sometimes what I find is people get a little overwhelmed at the magnitude of taking on a housing project. And the reality is you can, reduce it to more bite size pieces if you’re thoughtful about it.
Danielle Bergner: And just a few practical takeaways before we open it up for questions. First, always understand the problem in your market. Just because affordability is a problem in the other county it doesn’t mean that’s the problem in your market. You have to understand, is our problem that we don’t have the inventory? Is our problem that it’s not affordable? Or is it a combination of both? And then recognizing that there is no one size fit all solution, multiple approaches are often needed for a successful overall strategy. And then third, consider a phased approach to make strategy development and program implementation more manageable for your teams. I invite everybody on the program today to stay connected with Hall Render healthcare real estate insights. We publish a podcast. We have a weekly real estate briefing that you can subscribe to and we often publish articles and blogs. In this slide are links to the various resources, which you will receive after the program today. And with that, I’d like to hand it off to Julie.
Moderator: Thanks Danielle. Did we want to take some time to go through any of the questions?
Danielle Bergner: Sure.
Moderator: Okay. We’ve got one here. Are the costs of subsidizing housing costs allowed to be included on cost reports for critical access hospitals?
Danielle Bergner: That’s a great question. The answer is sometimes. That is actually a question we explore with our clients in typically that phase two analysis, where we really start digging into program planning and implementation and how we might be able to structure it to achieve the best possible tax related outcomes. So that’s a great question and the short answer is yes, sometimes.
Moderator: Great. Here’s one asking about experience with tax-exempt bonding finance model, when funding housing projects. Any pros and cons you could share about this model?
Danielle Bergner: Yes, no, that’s also a good question. We do have quite a bit of experience working with tax-exempt bond financing for housing, although that’s typically facilitated through a private sector developer not by a hospital. Not that it can’t be, but again, it really goes to the question of whether the hospital wants to be on the front line of developing, owning, operating the property, or does the hospital prefer to be more in the financing seat by donating land, donating money, donating resources. Pros and cons just generally with tax-exempt bond financing for housing, one you have to have scale. So tax-exempt bond financing is not feasible if you’re building 12 units. Tax-exempt bond financing is feasible if you’re building 200 units. And so bond financing, tax credit financing, these more sophisticated finance vehicles for housing really require projects to be to scale.
Moderator: Great. We’ve got one here. A question about the Atrium example. How does the hospital determine who gets housing? How do you decide who gets the subsidized home? What’s the criteria?
Danielle Bergner: Right. That’s a great question. So here in the Atrium model, which is very similar to a lot of models around the country, Atrium is not in an active role as it pertains to the evaluation of potential tenants. So Atrium basically has a program to refer their employees to these housing opportunities. But once they’ve been referred, the evaluation of that tenant is done by the property management firm that’s overseeing the management of that property. And that’s done to ensure that all of the, for example, fair housing laws and other regulatory requirements applicable to a project are being satisfied. The hospital itself in this case is not doing that itself. They’ve essentially … They refer their employees to the property management firm, the property management firm evaluates those tenants the way they would any other tenant. And then if they qualify, they get the unit and if they don’t, then they may not, even if they are an employee.
Moderator: Great.
Danielle Bergner: That’s a good question.
Moderator: Yeah. As a follow-up to that, someone asked, how do you begin to measure the success of something like this? Is it against like a traveler agency costs?
Danielle Bergner: Yeah. So that’s a really great question. It’s one that gets asked all the time. So in all honesty, I think it’s very difficult to measure it in hard dollars. How do you measure the cost of not attracting and retaining employees? How do you measure the cost of losing employees because they don’t have a place to live? These are hard of things to do. I will say though that one metric could be, with permanent housing that you don’t need as many travelers. So is that a metric that a hospital may want to track if it goes into a housing strategy? Yes.
Danielle Bergner: Are there studies that have been done, longitudinal studies that have been on the financial benefits of housing programs for hospitals? Not really. There’s a really good study that was published a number of years ago in partnership with Bon Secours Mercy actually, where they studied and developed a formula essentially for measuring what they coined the social return on investment, which measures not just financial, but the broader social impact of these programs for hospitals. And that is, I will say a theme that I hear frequently with hospitals that are doing this, that they view it not just as a tomorrow bottom line type of issue, they view it as a larger community investment issue.
Moderator: Great. We’ve got one here. Can you speak to the income tax implications for individual employees who receive hospital subsidized housing?
Danielle Bergner: Yes. That’s a great question. So the short answer is when anyone who receives housing for less than market value is receiving that it’s possible they will have a tax implication. The caveat being, if this is structured as an affordable housing development where the rents are subsidized in a way and the residents are restricted to certain income levels, it’s possible that that income would not have to be recognized. But that is something that has to be thought through as part of the program analysis.
Moderator: Great. That also kind of links to someone who asked, how does this work if the employee quits?
Danielle Bergner: So that goes back to, for example, the direct … So let’s talk about a couple different things there. The direct benefit program, let’s say there was a loan made for somebody to buy a house and that employee quits. That goes back to that issue of having to have programs and policies developed around, when is a loan forgivable? When does it have to be repaid? The short answer is hospitals can set those programs up any way they want to so long as they’re being administered fairly. And so the answer is, it depends on how a benefit program is set up for that. In the context of something like a person renting an apartment who got the apartment on a preferential basis because of their status as an employee, that would be more difficult. So would you be able to evict somebody who’s no longer an employee? I would say that’s very difficult in the rental concept. I think that that issue probably comes more into play when loans have been made by the hospital to the employee to subsidize housing needs.
Moderator: Great. One here. I would love to hear if you have any examples specifically or recommendations for small rural critical access hospitals, in addition to the Martha’s Vineyard examples, specifically those with limited financial resources for their housing work.
Danielle Bergner: Yeah. That’s a good question. So one I mentioned in the program is the Kiowa County Hospital District in Southeastern Colorado. This is a very small hospital, very limited financial resources. They had one piece of land that they could donate for this project, which ultimately made it go. It did involve an investment on their part, it’s not free. But there’s a good example of a very small critical access hospital that without this duplex being built they literally have nowhere for recruits to live.
Moderator: Yeah. Someone asked, how do employees feel about working and living together?
Danielle Bergner: Yeah. So there are things that have worked and things that have not worked in that respect. I think one of the issues that has to be thought through specific to this question is, what does this place feel like when it’s built? So does it feel like employees are living in a dorm? Because that’s a good example of where employees may not like the arrangement, it may not be successful. Or does it truly feel like they’re living independently in a nice apartment building where they are truly living separately? So there are, I would say there’s case studies of things that have worked, things that have not worked. And generally what has not worked are designs that look and feel more like a dorm type of setting as opposed to market rate apartments.
Moderator: That makes sense. We’ve got a few more here. I’ll just go through a couple more and if anyone wants to submit any questions in the Q&A panel, we’ll make sure to get back to you via email after the webinar. So we asked, how are healthcare organizations balancing the housing needs of their employees with those of their patients in terms of their investment of time and resources?
Danielle Bergner: Yeah. So this is why it’s challenging because housing is not healthcare’s core business and there is a balance, and some organizations are large enough that they can absorb a lot of housing capacity in their internal staffs, others are not. And that’s where I will say, that’s a role that we’ve been playing increasingly with some of our clients where we’re kind of filling that gap for them because the core business is healthcare and that is never going to change. Regardless, there is a certain level of staffing support that has to be committed to any housing endeavor. You can’t avoid that. But I do think that selecting and working with the right partners is what makes all the difference.
Moderator: Yeah. Last question here, before we wrap up. We’re wondering if you can touch on eligibility and selection criteria considerations for hospital employees offering housing subsidies, childcare, transportation assistance.
Danielle Bergner: So the answer to that question is, it’s all over the board. It really depends on what the hospital wants to accomplish with it. It depends on what the specific challenges of their employees are. We do have internally some examples of what clients are doing, but it really is, it would be hard for me to summarize one particular set of eligibility selection criteria because they really are all over the board. I will say one common thread tends to be need based. And so there has to be some component to the selection eligibility process that evaluates bonafide need.
Moderator: Great. Well, thank you so much Danielle. This has been really great. And thank you all for joining us today. Just so you know, we will be sending out an email with a link to a recording of today’s presentation, as well as a link to download the slides. If you’re interested in learning any more about any of the topics we’ve discussed today, feel free to reach out directly to Danielle, her email and phone number is on the screen. Or you can always find more information on our website hallrender.com. Thank you as always for joining us and we hope you have a great day.
Danielle Bergner: Thank you.
