Nearly a decade in the past, Well being Dimensions Group started pivoting from a deal with expert nursing to private-pay senior dwelling. That transfer paid off as the corporate surpassed the 50-community mark earlier this yr.
The corporate has lately expanded relationships with actual property funding trusts (REITs) together with Ventas (NYSE: VTR) and Sabra Well being Care REIT (NASDAQ: SBRA). Now, after an 11-property development spurt in Could, HDG is taking a well-deserved breather – not less than till early 2026, in response to CEO Erin Shvetzoff Hennessey.
“We have to get our methods, know-how and reporting in place the HDG approach, however it additionally takes time to construct belief and relationships with the on-site groups. If you happen to deliver on too many communities too rapidly, they lose the eye they want,” she mentioned throughout a latest look on the Senior Housing Information podcast, Remodel.
The Minnetonka, Minnesota-based senior dwelling supplier helps its development utilizing three operations teams that act as integration groups to deliver newly onboarded properties in control on gross sales, basic operations and care coordination.
“After we get a brand new alternative that comes throughout our desk, whether or not that’s an acquisition or administration alternative, we like to have a look at the market, and thru our consulting follow, have entry to simply wonderful market intelligence and to grasp the demographics of that space,” Shvetzoff Hennessey mentioned.
Bettering staffing dynamics at native communities is a key element of getting new websites built-in into the HDG fold, as company workplace help can assist in recruitment of aggressive positions like licensed care employees.
“It’s given our groups the chance to deal with onboarding in a relationship pushed approach,” Shvetzoff Hennessey mentioned. “It’s not transactional, not onto the following factor, we’re simply actually teaching and mentoring and supporting these groups.”
This comes as HDG is “rethinking the way in which that we ship care” as rising acuity adjustments dynamics of senior dwelling operations. Expertise integration has additionally been crucial for HDG throughout its latest development spurt, Shvetzoff Hennessey mentioned.
Additionally In 2025, HDG, which manages 50 senior dwelling communities throughout 9 states, is celebrating its twenty fifth anniversary.
Editor’s word: The next podcast transcript has been edited for size and readability
Hearken to the total episode right here.
On HDG’s pivot from expert nursing to senior dwelling:
We made a acutely aware determination to maneuver extra into senior dwelling. That shift was very intentional. These of us who got here up in expert nursing are nice at operating lean companies, caring for high-acuity sufferers, and navigating heavy regulation, which applies throughout senior care. However we additionally knew we wanted extra in areas like hospitality, culinary packages, operations, and life enrichment. We expanded into reminiscence care and made certain we had the appropriate crew, with numerous hiring and coaching, to ship excellence in senior dwelling.
About 9 years in the past, we started regularly shifting our portfolio from being predominantly expert nursing to a broader combine throughout the continuum of care. We nonetheless have ten expert nursing communities, and they’ll at all times be a part of our portfolio, however we’ve considerably expanded into senior housing.
We’ve been very deliberate in how we’ve grown, specializing in regional presence so our groups could be within the communities, know the employees, and know the residents. In our occupation, absence doesn’t make the guts develop fonder; we wish to be there, hands-on.
We additionally make sure that our objectives align with our possession companions by understanding their long-term plans, funding methods, and dedication. We use a transparent set of standards when evaluating new communities so we will proceed rising, however not too quick. We’ve all seen what occurs when organizations develop too rapidly.
We’re persevering with to develop, however in markets the place we all know we will excel, with groups that ship nice care to residents and robust help for our employees. It takes self-discipline, as a result of new alternatives come up on a regular basis and also you wish to say sure to all the things. However we’ve realized to remain selective and considerate in how we develop, and that self-discipline is what helped us cross the 50-community mark this spring.
On evaluating new communities to handle:
I really like taking over new communities and serving to our shoppers. Your first intuition is at all times to say sure, we’d like to, however then it’s a must to take a step again and ask, ‘Ought to we? How are we going to do that? What’s the appropriate path for that neighborhood and for our group?’
We even have a documented course of that we observe, and we’re fairly open about it. When a brand new alternative comes throughout our desk, whether or not it’s an acquisition or a administration alternative, we begin by wanting on the market. Via our consulting follow, now we have entry to unbelievable market intelligence. We examine the demographics of the world, the demand for the product, and what value level is sensible. Our consulting crew can go on-site, secret store the market and actually assess the long-term power of that space for the precise product sort we’re contemplating.
We additionally look intently on the native workforce. There are markets with nice demand for senior housing or expert care, but when the workforce can’t help it, that’s a significant problem. These two issues, market power and workforce, are what we take a look at first to ensure we could be profitable.
From there, we dive into monetary efficiency, each present and projected. We’re fairly conservative in that evaluation. We take a look at the size of the operation, the sources we have already got in that geography, and what we would wish so as to add. We assessment the way it matches inside our present areas and study each element intently.
We have now a development management crew that evaluates every alternative after which presents it to our government crew for a call. I feel many corporations strategy this in related methods, however one factor that makes us somewhat completely different is that we do reference checks on our administration shoppers. These checks deal with values, as a result of we really worth our partnerships. Managing a neighborhood for somebody is such a detailed relationship, and for those who’re not aligned on values and priorities for residents and employees, it may be troublesome.
That’s why we’ve truly mentioned no to some partnerships once we knew the match wasn’t proper. It’s so vital for us to guard our tradition, our values, and the way in which our crew works and needs to be handled. So in our closing section of due diligence, we embody a reference verify on our shoppers — and that’s one thing we’re pleased with.
On HDG’s development pause
We’re sort of in a pause proper now. We’re rolling into October and we took on our final group of 11 properties in Could. We have been very planful about that, understanding we’d have a number of months the place we wouldn’t tackle something new. We’d like to ensure our methods, tradition and operations are absolutely built-in into these new communities.
When individuals come to HDG – and these explicit communities have been rebranded as Dimensions Dwelling – it takes time. I at all times say it’s a must to win their minds and their hearts. We have to get our methods, know-how and reporting in place the HDG approach, however it additionally takes time to construct belief and relationships with the on-site groups. If you happen to deliver on too many communities too rapidly, they lose the eye they want.
So we’re nonetheless in that pause. I feel we’ll deliver on some new properties in late fall or early within the new yr. These previous few months have been actually pleasing. It’s been enjoyable attending to know the brand new communities, their leaders and residents, and it’s given our groups time to deal with onboarding in a very relationship-driven approach. It’s not transactional or rushed. We’re teaching, mentoring and supporting these groups.
The final 15 communities we introduced on have been dealt with by our new transition crew. We even have three operations groups at HDG. The transition crew focuses on new communities becoming a member of the administration portfolio. We developed it a few yr in the past as a result of bringing on new communities could be very completely different from working present ones.
When this crew is available in, they roll out new manufacturers and methods, host meet and greets, go to all three shifts and maintain welcome ceremonies. There’s swag, balloons—it’s a celebration. It’s very completely different from our consulting operations crew which handles turnarounds and receiverships. In these instances, we’re centered on protecting the license, the lights on and the residents secure.
Then now we have our stabilized property operations crew which manages communities which are already performing nicely. They deal with ongoing high quality enchancment—getting from 90% to 95% occupancy or from four-star to five-star high quality. It’s about fine-tuning, which could be very completely different from onboarding or turnaround work.
All three groups use the identical methods and processes however have completely different leaders and portfolio sizes. This final group of 15 was managed by the onboarding crew which is interdisciplinary—operations, scientific, monetary, culinary and human sources, everybody working collectively to onboard these new communities. It’s been nice to observe that crew in motion, and as soon as they end this section, they’ll be prepared for our subsequent group of property earlier than handing them off to our everlasting operations crew the place they formally grow to be a part of the HDG household.
On sustaining REIT relationships:
Not a secret in any respect, it’s actually about having the appropriate companions. Somebody requested me a few months in the past how I sleep at evening working with REITs, and I mentioned, I sleep simply tremendous. You simply must work with the appropriate companions. They’re nice. We don’t have any issues.
We have now about 16 possession teams, and two of them are REITs, Sabra and Ventas. They’re nice relationships, and every of us brings one thing distinctive to the desk to make it work. We began our relationship with Sabra a few years in the past by means of a triple internet lease at a neighborhood in Texas. We now have one other lease with them in Wisconsin, and we additionally handle 5 communities for them in an RIDEA construction, which isn’t a triple internet lease however a third-party administration settlement.
It’s been an superior relationship. Sabra brings know-how and pilot packages to us, like their latest one with robotic vacuums. They vet and spend money on our communities and assist implement these packages. They carry actual property, capital and know-how, and we deliver our working mannequin and model. We’re higher collectively, and it’s a real partnership.
We additionally began working with Ventas somewhat over a yr in the past, and that’s been one other nice relationship. These are all third-party administration preparations throughout 15 communities in Wisconsin. Ventas is a superb group to work with, and so they deliver unbelievable sources. They share business insights, information and instruments that assist us function extra successfully. They carry broad information, and we deliver market-specific expertise, so it’s a powerful steadiness.
These relationships are actually vital to us, and I see them increasing over the following few years. We’ve been so lucky to have such all kinds of possession teams. My enterprise accomplice Amber and I are house owners of some property ourselves, and we additionally work with cities, counties, the VA, personal fairness teams, not-for-profits, spiritual organizations and hospitals. So many alternative companions belief us to run their senior care organizations.
Wanting again over 25 years, these partnerships have been actually particular, each with our administration and consulting shoppers. Certainly one of our administration agreements is 25 years outdated. We’ve identified these individuals a very long time, and it’s been lots of enjoyable.
On classes from development:
That basically got here from expertise. Bringing a brand new neighborhood into HDG isn’t the identical. They’re all completely different. Some will probably be with us long-term and simply want a reputation change, some come on briefly throughout a receivership, and others are in between. We realized we will’t deal with all of them the identical. We would have liked completely different groups with completely different ability units, and that was an enormous studying—understanding that operations aren’t simply operations. It’s extra nuanced. These devoted groups got here immediately from that realization.
One other huge studying was how crucial the on-site groups are to a profitable transition. A transition includes know-how, methods and information, however on the finish of the day, it’s about ensuring on-site groups have what they should do an important job. Have they got the appropriate staffing, advertising help and care sources? Specializing in these management groups has been a significant precedence.
Over time, we’ve additionally realized the significance of streamlining operations and methods. You possibly can’t change all the things to the HDG all of sudden, it’s too overwhelming. However utilizing constant know-how companions and KPIs helps roll issues up in a extra streamlined approach.
And at last, retention is big. We have now over 90% retention throughout transitions, which we monitor intently. When groups flip over an excessive amount of, you lose progress. We’re very intentional about ensuring these groups really feel related to us and the group, and that these relationships are constructed straight away.
On how staffing has advanced in senior dwelling:
I feel whereas most of our communities are doing rather well with staffing, there are nonetheless some areas the place it’s actually troublesome. It’s not nice in all places. We have now markets which have bounced again and are doing fantastic however others are nonetheless struggling, particularly rural areas the place there merely aren’t sufficient individuals. Even for those who recruit and retain everybody, the workforce simply isn’t there.
I used to be an ED in a really rural neighborhood in Iowa a few years in the past, and about eight or 9 years in the past we began centralizing recruiting. That was an enormous change for us. We introduced our recruiting crew into our Minneapolis central workplace the place they deal with postings, recruiting, scheduling interviews and screening candidates. It’s all performed by the HDG crew. That enables the on-site groups to deal with what actually issues, assembly candidates, making closing choices and onboarding new hires.
We all know how difficult hiring could be. You may need ten individuals apply and 5 interviews the place two present up and one stays. We would like the on-site groups centered on that one who stays. The opposite 9 we deal with centrally by protecting them in our community, doing background checks and managing the setup course of. Centralizing recruiting has been a recreation changer as a result of it will get the very best candidates rapidly to our communities so the groups can deal with hiring and retaining nice employees.
What I need our on-site groups centered on are the issues we will’t do for them on the company workplace. We see ourselves as a help middle for our communities. The on-site groups ought to be centered on having sufficient employees to look after residents, sustaining occupancy and offering high quality care. Every little thing else we will centralize, together with insurance coverage, advantages, billing, recruiting, income cycle and even social media.
Now all our communities should do is snap a photograph of an exercise or occasion and ship it to our social media crew. We deal with the captions, releases and posting. We would like them to deal with being current and having fun with these moments whereas we care for the remaining.
That strategy has been an enormous assist in retaining employees. By eradicating administrative duties from the communities we let individuals do what they got here to do, care for individuals. We deal with the admin.
On recruitment altering with resident acuity:
I at all times say, ‘We work in expert care. You possibly can’t scare us.’ We’re used to excessive acuity, decrease margins and a extremely regulated setting. We nonetheless have 10 expert communities in our portfolio. Some are campuses and a few are standalone, however if you stroll by means of our senior dwelling communities, there are additionally lots of high-acuity residents, and that’s the way it ought to be. We would like individuals to decide on a care setting they love and be capable of keep there by means of the top of life. That ought to at all times be the aim.
There’ll at all times be a necessity for expert care and a spot for individuals who want that stage of help. However as individuals reside longer and have extra advanced well being wants, now we have to ask what we will do in our settings to assist them keep and obtain nice care. That comes right down to nursing. We’d like nurses who’re well-trained and well-supported. For a lot of nurses, that problem is thrilling as a result of they get to construct robust relationships whereas additionally dealing with increased acuity care.
For us, it’s about recruiting nice nurses and giving them the instruments and coaching they want. The scarcity of caregivers and nurses is regarding for everybody. I felt such reduction when LPNs have been included within the staffing mandate discussions, as a result of they’re really the spine of nursing in expert care and senior dwelling. They do unbelievable work, and leaving them out of these calculations was an enormous oversight.
As we take a look at LPNs, RNs and nursing assistants, we’re excited about continue to grow their expertise. Possibly nursing assistants grow to be remedy aides. We have to proceed educating caregivers to do the work solely people can do, whereas letting know-how, AI or automation deal with what could be performed elsewhere.
It’s about rethinking how we ship care and ensuring our most dear work occurs on the entrance line. We have to make the roles of those that bathe, feed and look after residents simpler by giving them the appropriate coaching and instruments. Something we will centralize, automate or outsource helps. We’re already utilizing robotic vacuums for corridors and eating rooms so our groups can deal with resident areas and public areas.
For nurses, know-how like audio documentation may give them extra time with residents and extra time for assessments. It’s by no means going to be all or nothing, however now we have to suppose creatively about handle increased acuity effectively. Do now we have sufficient individuals? Do now we have the appropriate know-how? As a result of wanting forward, there are going to be lots of people to look after.
On know-how integration to help operations and development:
I feel it’s an enormous piece, however I additionally suppose we’re at all times persevering with on that journey. We’re working with our AI Activity Drive to grasp how we will use new know-how and robotics. Certainly one of our greatest initiatives proper now’s round information integration. As each operator is aware of, there’s a lot information coming at us from each system—monetary methods, EMRs, EHRs—it might really feel overwhelming.
We’re centered on pulling that information collectively and making it simpler to make choices. We’re engaged on a big ERP undertaking to streamline information and enhance scientific dashboards. The aim is to make info simpler to entry for frontline groups and cut back the quantity of reporting that on-site groups must ship to the company workplace. Something we will pull routinely helps us make sooner choices and provides our groups extra time to deal with residents.
Expertise has been an enormous a part of what we’re doing, and I feel over the following few years it will likely be an excellent larger alternative for HDG. There’s one thing new and thrilling on daily basis, which could be overwhelming, however our focus is on good analysis, considerate coaching and utilizing information in a significant approach
On future outlook and the corporate’s subsequent 25 years:
I really feel just like the final 25 years have passed by within the blink of an eye fixed, however issues have modified a lot. After I take into consideration the following 25, I think about extra development and unprecedented demand. We’re going to have lots of people to look after, and it will likely be our accountability to do an important job offering high-quality, lower-cost care. Every little thing we do has to help a sustainable well being care system.
For HDG, I see continued development and a constant deal with high quality. We’ll hold increasing our consulting companies and rising our communities. In consulting, we’ve already served round 1,300 organizations, and there will probably be extra of that. I count on new service strains, extra know-how and extra work in house and community-based care.
What I don’t wish to change are our values. We’ve stayed true to our 5 core values for 25 years, and I don’t see that ever altering. I don’t need our tradition to alter, and we are going to by no means transfer exterior of senior care. That’s the place our ardour is, and as we develop, our focus will at all times be on seniors.
It’s thrilling to consider the longer term. Many people have been collectively for 15, 20 and even 25 years. It’ll be enjoyable to look again on what we’ve achieved and ahead to what’s forward. I hope the following 25 years deliver extra of the identical—development, new crew members, nice care and a continued dedication to our mission.
That is an unbelievable time to be in senior care. We’re entering into this demographic second with a beautiful firm and an important crew, and we’re able to take full benefit of it.
