Dear Colleague,I would like to personally welcome you to the kickoff of our most important and probably our most challenging initiative of change to date. Our goal in bringing you together today is simple: Our vision is for Avante to be respected as the best provider of quality care in the industry, supported by a culture dedicated to creating a respectful homelike experience for each of our residents. In order to enrich the Avante resident experience on a day to day and hour to hour basis we will need to place the importance of the resident experience “First”. We will need to constantly innovate on how we can exceed our resident’s expectations by listening to what is important to them and paying attention to details that affect their personal experience. Avante should be more than just a place for our resident’s to live out their remaining years.

Our challenge will to be to get to know each of our residents and family members better. By knowing more about their personal backgrounds and interests we improve our ability to embrace each of them by taking the extra step and improving their personal experience. You will need to ask yourself how you can go beyond your resident’s expectations and enrich their lives.

The workshop has not only been designed to share with you what we have learned by studying how other organizations have improved the customer experience, but more importantly we will be asking you to identify and commit to how you personally can improve the resident and family experience. The key to our success will be for us to all work together by leveraging our valuable experience and knowledge collectively so that we can innovate around the resident/family experience. At the conclusion of this workshop everyone will be required to commit to taking the ideas and concepts learned, back to the work place, and actually start integrating what you have learned into your daily responsibilities.

There are several ways we will be able to measure our progress against this exciting cultural change: • Improved Resident and family satisfaction • Improved Occupancy • Improved employee engagement and retention • Improved referrals by all sources • Improved positive working environment

This is by far the most important change we are attempting to make at Avante and it is obvious this will take every one of us committing to this change. Good luck and let me know how I can personally help you accomplish our Vision.

Dean J. DickmannPresident and CEO

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TEAM MEMBER INTRODUCTIONS • Please give your name, the number of years you have worked in Health Care and how long you have worked for Avante. • State your current position/job. • Answer the question: “Who do you believe is your customer”? • Give an example of either great or poor service you recently experienced.

PROGRAM DELIVERABLES AND OBJECTIVES • Create a caring, respectful, responsive culture focused on enhancing the Avante experience for our residents, family members and associates. To differentiate Avante from our competition by continuing to develop a reputation for quality of care and safety, and by providing a family experience that exceeds our resident’s expectations. • “Operationalize” the Avante Experience by integrating executional excellence into every aspect of our business. • Educate every associate on what we can learn from other organizations known for creating an excellent customer experience. • Identify critical opportunities to exceed your resident and family member expectations of their Avante experience. Discuss every personal opportunity you have to exceed resident and family expectations. Critical opportunities are referred to as “Moments of Truth” and other personal opportunities are referred to as “Touch Points”. • To accomplish these stretch goals we will all need to focus on our resident and family member’s experience; “The right context in the best environment delivered with the right emotion and passion”.

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AGENDA •MODULEONE:FOUNDATIONS A. Introductions B. Deliverables and Objectives C. Agenda D. Avante’s Mission Statement and Values E. The Avante Resident Experience •MODULETWO:THEAVANTEEXPERIENCE A. Why we have decided to focus on the Resident Experience B. How we arrived at this important goal C. What can we learn from other organizations? D. The Avante Resident/Family experience. Our strategy •MODULETHREE: IMPROVINGTHERESIDENT’SEXPERIENCE A. Placing your Residents, Family Members and Associates First B. Greeting and Phrases C. Understanding the “Communications Loop” D. Body Language E. Responsiveness F. Service Recovery G. Delighting the Resident or Family member H. Surprising the Resident I. Story Telling J. The Pride Model •MODULEFOUR: MOMENTSOFTRUTHANDTOUCHPOINTS A. Define and identify Moments of Truth and Touch Points. B. First Impressions C. Greetings D. Call lights E. Entering a Residents room F. Responding to Resident and Family member requests G. Food Service H. Handling complaints I. Identifying your personal Moments of Truth and Touch Points J. Your personal Commitment

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MODULE ONE: FOUNDATIONS

• The Klurman family founded Avante in 1989 after building several Nursing Homes throughout the South East during the 60’s, 70’s and 80’s that were run by third party operators. • Do any of you know why the company was named Avante?

The Avante Mission StatementOUR MISSION IS TO IMPROVE THE QUALITYOF LIFE FOR OUR ESTEEMED RESIDENTS,OUR|COLLEAGUES, AND OUR COMMUNITIESBY EXCEEDING EXPECTATIONS ---- ONEINDIVIDUALATATIME

Exercise: 10 Minutes • Review the Avante Mission Statement and write down your thoughts on how this statement can help guide your activities and priorities on a daily basis. How does this statement relate to the resident and family experience?

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AVANTE VALUES

Accountability Taking personal responsibility for

acting with urgency, problem solving, stewardship and integrity

Visibility

Demonstrating your passion for Avante’s vision to be the best provider of resident service and care by acting with sincerity, willingness and knowledge

Achievement Setting stretch goals, driving for results and celebrating our successes

Nurture Fostering a culture of humility, respect, dignity, and compassion

Teamwork

Sustaining high performance teams through a spirit of collaboration and respect for all colleagues

Excellence Striving to exceed our residents and families

expectations by listening and delighting our customers with great service and care

WHY DID WE CREATE A SET OF VALUES? • They support a Desired Culture • They give guidance in the absence of policy • They help us execute our Mission Statement by “Walking our Talk” • They act as another foundation for the Avante Experience • They support the regulatory reality of our industry. For Example: One of our goals is for each resident to achieve his/her highest practical level of quality of life within their physical/psychological limitations. • They help everyone in the organization align around critical behaviors that overtime will be visible to everyone including our residents

Exercise: • Take 10 minutes to review Avante the values and evaluate how well you will “fit” with the Avante of the future. Identify at least one value that you will work to improve and give yourself a specific goal for improvement.

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OUR AVANTE CUSTOMERSWHO? WHY? • Residents It is their Home

• Family Members They often make the decision and are frequent visitors. They care!

• Associates The need to support each others efforts to create a great Resident experience

Question: Who is Corporate’s customer?

“If you are not serving a customer, you had better find some-one to support who is”

RESIDENT QUIZ HANDOUT (Handout # 1)(SHOULD TAKE ABOUT 10 MINUTES TO COMPLETE)

RESIDENT QUIZ RESULTS (Handout # 2)

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HOW CAN THIS TYPE OF DATA HELP US IMPROVE

THE RESIDENT EXPERIENCE? • The more you know about the Resident’s preferences the better chance you have to improve their experience. • Knowing your residents is a “Professional Skill” that you should view as a never finished journey.

HOW COULD AVANTE BENEFIT FROM DEVELOPING “BEST PRACTICES” ON THE RESIDENT EXPERIENCE? • Improved reputation in each of our communities? This should improve associate pride and lead to a reputation as the “Provider of Choice” • Improved census? Strong word of mouth should improve census and profits over time allowing us to reinvest in the company and our associates. • Alignment around a common vision of excellence can contribute to a strong team culture that can be rewarding for both our residents and associates. • Consistently responding to resident concerns and exceeding expectations should lead to a improved 5 Star Rating for Avante. • Less rework, streamlined processes, and less personal stress.

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MODULE TWO: THE RESIDENT EXPERIENCE

MAKING THE BUSINESS CASE: • Companies known for their focus on improving their customer’s experience continuously improve market share and profits. • A one percent increase in Avante census increases revenue by approximately $2,000,000 annually. • It takes 3 to 5 times more effort to replace a customer than retain an existing customer. • Poor service accounts for 20% to 30% of lost customers. • Poor service (Not Product ) is the most common reason businesses lose customers. • Poor service gets more word of mouth than good service. (Remember how most people answered during the introductions)

IN 2008 AVANTE SURVEYED 125 KEYCORPORATE AND OPERATIONS PROFESSIONALSASKINGTHEMTOIDENTIFYTHEMOSTCRITICALCAPABILITIES THAT AVANTE WOULD NEED TOEXCEL AT IF THEY WISHED TO IMPROVE ANDGROW. THE LIST INCLUDED 95 CAPABILITIESIDENTIFIEDINTOPPERFORMINGCOMPANIESONAREGULARBASIS.

HEREARETHETOP3IDENTIFIED. • Understand our residents and their needs. • Be the customer service leader in our markets. • Deliver value to our customers (Residents and family members ).

ADDITIONAL REASONS FOR FOCUSING ON THE RESIDENT EXPERIENCE: • Do you believe our competition is focused on improving the resident and family member experience? • Compliments our focus on quality of care. • “Improving product is limited ----- Improving the customer experience is limitless” - Dr. Michelli

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WHAT WILL IT TAKE TO MAKE THISCULTURAL CHANGE: • Exhibiting a “How Can I Assist You” attitude in every interpersonal encounter with the resident or family member. The point is that it starts with the right attitude. We must check to make sure we are always on the resident/family members agenda “First”. • Treating our residents with respect and dignity. We must also treat each other this way. Why is this important? • Selecting colleagues who enjoy the challenge of exceeding our resident expectations should help to align Avante teams around a shared vision.

WHAT WILL IT TAKE...WEMUSTTAKETHETIMETOCAREFULLYSELECTTEAMMEMBERSWHOARENOTONLYQUALIFIEDTECHNICALLY,BUTSHAREOURPASSIONFORTHEAVANTEEXPERIENCE!A profile for our individual contributors at our centers must be agreed on that looks something like this: • Compassionate • Approachable • Action Oriented i.e., Self starter • Humility to balance strong drive • Caring • Accountability/follow through • Passion for the elderly

WHAT WILL IT TAKE...It will take leaders who demonstrate the following skills and behaviors: • Empower their direct reports and avoid over managing • Demonstrate a passion for improving the resident experience • Balance a strong drive for results with humility & compassion • Demonstrate personal accountability by “Walking the Talk” and holding others accountable

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WHAT ELSE WILL IT TAKE... • Maximize every opportunity to exceed resident expectations by identifying both “Moments of Truth” and “Touch Points” • Honest, quick “Service Recovery” when occasional mistakes are made. • A new language that focuses on emotional tone, greetings, problem solving and answering the telephone • Innovative products and services that enrich the resident experience • A new approach to marketing and sales that focuses on building relationships in each community • Aligning processes, structure, and rewards with our service focus • A responsive team culture • A willingness to empower those closest to the resident

BEFOREMOVINGTOTHENEXTMODULEPLEASECONSIDER THE FOLLOWING ANALYSIS OF WHYWENEEDTOFOCUSONTHERESIDENTFIRST: • Because the resident has a need; we have a job • Because the resident has a choice; we need to be their first choice • Because the resident needs our assistance; we must be on their agenda - - not our own • Because the resident’s needs can be urgent; we must be quick and responsive • Because each resident is unique; we must be flexible • Because the resident and their family have high expectations; we must work hard to exceed their expectations. • Because the resident is satisfied; we expect more • Because we have resident’s; we have a future

“THE PURPOSE OF A BUSINESS IS TO CREATE - - - A CUSTOMER”

- Peter Drucker

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MODULE THREE: EXCEEDING RESIDENT EXPECTATIONS

We will cover the following keys to accomplishing this goal:

• GREETINGS • FRIENDLY PHRASES • USING THE “ COMMUNICATIONS LOOP” • BODY LANGUAGE • PERSONAL ACCOUNTABILITY • RECOGNIZING OPPORTUNITIES • SERVICE RECOVERY

GREETINGS AND PHRASES • Set the tone for each resident interaction. Remember that you never have a second chance to make a good first impression. • Always identify who you are and ask how you can assist. For Example: Hello, you look like you may need some help? I am Betty and I am a Certified Nursing Assistant. How can I assist you? • Demonstrate a personal interest by asking sincere questions, listening and using good body language • Demonstrate a sense of urgency is assisting others. What may not seem important to you may be uniquely important to the resident or family member. You might even want to acknowledge that this is obviously very important. • Use calming language in dealing with complaints that require quick service recovery.

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HOW DOES THE RIGHT GREETING AND USE OF PHRASES SET THE TONE FOR THE REST OF THE RESIDENT INTERACTION? • A good greeting helps create a tone that you care and that the resident is special • Your enthusiasm is contagious • Always using your first name to introduce yourself personalizes the greeting • Offering assistance lets the resident or family member you are anxious to serve them in any way you can • A since of urgency can is conveyed by your quick and responsive action and follow up

TIP: Use greetings and phrases that are natural to you, but make it clear to the other person that you are on their agenda - - - Not your own!

Exercise:Pair up and take the next 15 minutes to agree on the best greeting for each of the following scenarios. Also be prepared to give an example of a inappropriate greeting for each scenario. • Answering the telephone • Greeting someone who approaches the reception desk • Dining Room greetings • Handling problems or complaints • Offers to provide assistance to family members

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UNDERSTANDING THE COMMUNICATIONS LOOP AND INCORPORATING IT INTO YOUR PERSONAL TOOL SET WILL HELP YOU EXCEED RESIDENT AND FAMILY EXPECTATIONS

THE4STEPSARE; • LISTEN • CONFIRM • RESPOND • FEEDBACK

STEP ONE: LISTENING. Good listening requires: • Active Listening • Demonstrating your patience by not interrupting or finishing other’s sentences • Staying focused and avoiding distractions • Avoiding Selective ListeningSTEP TWO: CONFIRMING your understanding requires: • Accurate retention of what you heard • Repeat back what you think you heard for clarity • Listening for the root issue • Avoiding jumping to conclusions • Probing for claritySTEP THREE: RESPONDING to what you have heard requires: • Suggesting a solution or action that preferably exceeds expectations • Taking personal ownership of a solution • Demonstrating a strong since of urgency • Confirming what the resident/family member can expect in terms of the actions and time frame STEP FOUR: FEEDBACK requires: • Closing the communications loop by understanding the level of satisfaction • Asking if there is anything else the individual needs assistance with • If the response involved a handoff to a colleague checking to see if the response worked • Reflecting on what you learned from the feedback and what you would do differently next time“We will need to become a learning organization”

LISTEN

CONFIRM

RESPOND

FEEDBACK

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THE IMPORTANCE OF USING GOOD BODY LANGUAGE AS YOU USE THE “COMMUNICATIONS LOOP”Create a personal checklist for your body language that includes avoiding the following tendencies: • Frowning rather than smiling • Habits that give away your lack of patience • Failure to maintain eye contact • Appearing disinterested or distractedRESPONSIVENESS IN DEALING WITH RESIDENT AND FAMILY MEMBER NEEDS REQUIRES: • Personal Accountability • Authority to Act • Deciding when and how to evolve others • Quick Service Recovery to overcome occasional service breakdownsDEMONSTRATING PERSONAL ACCOUNTABILITY REQUIRES: • Personally owning the issue and the solution • Insuring a positive outcome even if the request is passed onto another colleague • Using the Feedback Step in the Communications Loop if the issue has been elevated • Taking the “Extra Step”AUTHORITY TO ACT MEANS: • Avante is empowering every colleague to take actions the exceed residents, family members and other guests expectations. The means you can use your own judgment to temporarily discontinue your current activity or find a team member that can. • Using this authority not only requires judgment, but will require you to prioritize and respond to multiple activities with a since of ownership and urgencyKNOWING WHEN AND HOW TO INVOLVE OTHERS REQUIRES: • Great teamwork, which is a common characteristic of great service organizations • Identify the type of interventions and issues that arise that require team members to count on each other

Exercise: 10 MinutesDISCUSS OPPORTUNITIES TO IMPROVE THE RESIDENT EXPERIENCE AND LEVEL OF SERVICE THROUGH IMPROVED TEAMWORK.

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SERVICE RECOVERY: A key to resident and family satisfaction • Even the best occasionally experience service breakdowns • A “Recovery Friendly” system makes it easy for customers to report problems and for employees to respond quickly and efficiently • Great Service Recovery requires a “No Blame” culture. The focus needs to be on quick recovery first and then feedback to discuss what we can learn to help avoid similar occurrences in the future • One method of avoiding some of the service breakdowns that occur in organizations is for everyone in Avante to be alert to spotting “Service Contradictions”

SERVICE RECOVERY: Processes Required • A process for accurately identifying resident/family issues • Empowered, trained staff that can respond and resolve issues quickly • A culture that acknowledges we can do better by quickly apologizing for service breakdowns and inconveniences • A culture in which leadership constantly reminds every one that being alert for service breakdowns and service contradictions is everyone’s responsibility • A process for feedback that creates a learning organization, and eliminates a majority of future errors

“Eighty percent of customer’s problems are caused by bad processes, not bad people”. - John Goodman

SERVICE RECOVERY: Personal Tips • Listen and let the resident or family member vent their issue • Ask the resident or family member how you can make up for the service breakdown • Focus on expediting a timely recovery solution • Follow up to insure execution and obtain feedback

SERVICE RECOVERY: Operational Tips.Develop facility processes and protocols for: • Call bell response • Lost clothing • Food Service issues • Resident and family member complaints • Answering the telephone • First impressions • Shift handoffs and communications

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COMMENT: Protocols and processes encourage service consistency and excellence in delivery and will support our “Journey” to “WOW SERVICE”

Exercise: 10 Minutes • Identify a service breakdown you have witnessed with either an internal or external customer. Then record what you believe the ideal recovery process and protocols should look like. Share your process/protocol solution

DELIGHTING AND SURPRISING OUR RESIDENTS AND FAMILY MEMBERS BYEXCEEDING THEIR EXPECTATIONS TAKES: • Identifying and recognizing every “Touch Point” or important opportunity to exceed expectations; “Moments of Truth” • Focusing on the resident/family member’s priorities - - - not your own • Reminding yourself to stay on their agenda - - - not your own • Taking the extra step to surprise your resident/family member with a solution or extraordinary service that exceeds their expectations

Exercise: 10 Minutes • Reflect on an example of someone exceeding your expectations. Give a specific example of how you could take an “Extra Step” in your current role. Please write it down and pass it in.

STORYTELLING’S ROLE IN IMPROVING THE RESIDENT EXPERIENCE • Helps to reinforce a great service culture by acknowledging colleagues who have taken the “Extra Step” • Leverages the natural communication channel (grapevine) in the organization and keeps great service top of mind • Reinforces a model for risk taking, empowerment and action

Exercise: 10 Minutes (Handout # 3) • Read the stories we are handing out and be prepared to share a story that you observed or comment on one that you think is most impressive. Record your thoughts about how we can share these wonderful examples of great caring service?

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Use the Avante “pride model” as a reminder of how to exceed resident and family member expectations. Pride helps build loyalty.

P Personal Accountability R Responsiveness and Recovery I Interest in Residents and Family members D Delight our Residents and Family members E Exceed Expectations

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MODULE FOUR: Discovering Your Personal Moments of Truth and Touch Points

DEFINITION: Every contact point or opportunity you have to meet or exceed our Residents and Family member’s expectations to create a positive impression of Avante

IMPORTANCEOFIDENTIFYINGMOMENTSOFTRUTHANDTOUCHPOINTS • To anticipate needs and requests • Develop Avante best practices • Opportunity to provide additional training and re-design of processes • Practice good responses and service recovery • Identify additional opportunities to “Delight” our residents • Provide a platform for what our organization and culture should celebrate

FIRST IMPRESSIONSExercise: 10 Minutes • Discuss what influences your first impressions when you enter a hotel or full service restaurant • What are the implications for Avante?

AVANTE FIRST IMPRESSIONS: EXAMPLES • Buildings: Clean, neat, odors, attention to detail • Receptionist: Friendly, smile, warm helpful greeting • Telephone: Personalize your greeting (Put a smile in your voice) • Employees: Neat, clean, uniforms, etc. • Teamwork: Avoid “Not my job”

AVANTE FIRST IMPRESSIONS: POOR FIRST IMPRESSIONS • Failure to acknowledge a family member’s presence (Too Busy) • Eating at the Reception Desk • Being placed on indefinite “Hold” when calling the Center • Messy work areas

Exercise: 15 Minutes • Handout # 4 (First Impressions Scenario). Participants should take 5 minutes to read the scenario and then identify the opportunity(s) to improve the first impression

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GREETINGS: BEST PRACTICES • When greeting residents, family members and guests provide your first name and your title so that people know who they are talking to • Always ask; How you can assist them? • Clarify (If necessary) and restate the person’s issue or request • Remember to smile, be friendly and enthusiastic. “Smiling is contagious” • When answering the telephone start with; “Hello thank you for calling; (followed by the name of the Avante center the caller has reached). Then follow by indicating who they have reached (First Name) and question how you can assist them • Thank them for calling before you hang up or transfer the call

CALL LIGHTS: ONE OF THE STRONGEST INDICATORS THE ORGANIZATION IS FOCUSED ON THE RESIDENT! • While CNA’s have the primary responsibility, who should be prepared to back them up? • Should we set a minimum response time objective? Jot down Yes or No and the standard you would set if it were your responsibility • Besides slow response time, what other service breakdowns could occur? 1. What about turning off the light without rendering the service. “I will be back as soon as possible” 2. Can you think of other potential examples of breakdowns?

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ENTERING A RESIDENT’S ROOM: REMEMBER RESPECT AND DIGNITY ARE ESSENTIAL - - - THIS IS THEIR HOME • Knock before entering • Request permission to enter • Announce yourself ( Name ) • Address the resident as Mr. or Mrs. or Miss • Remember to use your friendly greeting skills

TIP:Ask residents how they would like to be addressed. If the insist on first name only, let them know you appreciate the relationship

• When leaving a residents room always ask the resident; “Is there anything else I can assist you with”?

NOTE:Even though asking is there is anything else seems likeextra work now, research shows it actually saves work in the long run.

RESPONDING TO REQUESTS: Opportunities • Offer to escort the resident or family member rather than just giving them directions • Remember there are no “Dumb Questions”, such as; What time are you serving lunch? • Remember your personal accountability and follow-up to insure satisfaction • Take the initiative to stop family members and guests, who appear to have a question • Confirm your understanding of the request or probe for clarification if necessary • Offer a solution as well as your assistance

Exercise: 10 Minutes (Handout # 7)FOOD SERVICE OPPORTUNITIES:Exercise: 10 Minutes • Reflect on what disappoints you at a full service restaurant?

HOWMANYOFTHEFOLLOWINGSERVICEBREAK-DOWNSDIDYOUIDENTIFY? • Wait time • Menu Options • Friendly server • Food temperature • Food presentation • Condiments • Special Requests recorded incorrectly • Beverage selections (Water offered?)

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Exercise: 10 Minutes (Handout # 8)

RESPONDING TO COMPLAINTS: Our goal is to eliminate complaints through better anticipation, constant review and feedback. This requires: • The right attitude • Good listening skill • The ability to probe for understanding • Calming Skills • Personal accountability and follow-up

BEHAVIORS THAT REFLECTTHE “RIGHT ATTITUDE” • Sincere caring • Respectful • Focused listening • Empathy

GOOD LISTENING REQUIRES: • Patience • Personal interest • Focus • Avoiding interruptions • Listening for understanding

PROBING REQUIRES: • Clarification • Questioning • Searching for “Root Cause” • Asking what it will take to correct the situation

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CALMING SKILL/BEHAVIORS INCLUDE: • The ability to sincerely apologize (This does not mean you have to admit a mistake was made, but that you are not happy if the customer is not satisfied) • Confirming that good service is important to Avante and most important to you personally • The use of Calming phrases such as: 1. Thank you for bringing this to my attention 2. Thank you for your patience while a figure out how we can assist you 3. What can we do to make this “right” for you

Exercise: 10 Minutes (Handout # 9)

PERSONAL ACCOUNTABILITY REQUIRES: • That you own the solution • A timely response • Either resolving the issue personally or insuring that someone else will • Checking for final satisfaction

We have covered several important“Moments of Truth” that we know fromexperience and research to be important to our “Journey” ---- Now it is your turn!

Exercise: 20 Minutes • Given your current role and responsibilities at Avante, identify additional Moments of Truth and Touch Points for your personal customers. Select at least 3 additional opportunities that you can begin to address as early as tomorrow to improve the Avante Experience for others. Write down what you are willing to commit to and hand them in when you are done. We will make copies and get them back to you please indicate your name, location and title on your list of commitments.

Thank you for your participation and future commitment.

We would like to invite the senior leaders present to join us up front to answer any questions