Act as though your customer is right: the hospitality and retail industries have lessons for long-term care providers.

A truly unique field, long-term care may be seen as a blend of the healthcare and the hospitality industries. Because of this, many factors steer the LTC industry away from exhibiting some of the more visible characteristics of any conventional customer service model. We have all heard the well-known axiom "The customer is always right." However, this adage takes on added significance when considering long-term care.

Long-term care is firmly built around its occupancy levels that, in turn, drive its profitability, dictate its staffing levels, and ensure its continued existence. Long-term care also focuses on the quality of the resident's stay. To this extent, long-term care resembles the hospitality industry: Both fields accommodate varying levels of necessities (meals, shelter, laundry, etc.) and comforts (television, activities, and recreation). However, the difference lies in how these services are provided.

The hospitality industry prides itself on being a "home away from home" for its visitors. Conversely, the LTC environment is a permanent home for many of its customers. Although long-term care has grown to include short-term stays for skilled and rehabilitative services, in most cases extended care remains the industry's main focus. The very use of the term long-term care, in fact, reflects this focus.

LTC providers must respond to the environment in which they operate and develop strategies and modalities to interact with the customer in this setting. In particular, the advent of the more informed and interested LTC customer makes this response critical, and the following scenarios are merely examples of the types of positive responses needed to build reputation and ensure the survival and competitiveness of this dual-natured field.

Behind Customer Satisfaction

The axiom "the customer is always right" still holds true. In the book, Eat Mor Chikin: Inspire More People, S. Truett Cathy, founder of the Chick-fil-A fast-food restaurant chain, says, "Even when they are wrong, they are right." This is less a statement of fact than a mental tool that can be used to orient our thoughts, actions, deeds, and responses to focus on assisting the customers and improving their experience. Thus, whether our customers are in fact right or wrong, reasonable or unreasonable, we can do a lot to ease many of their fears. In many cases, an angry family member may only need an outlet to vent or relieve frustration.

Let us consider a few scenarios.

Scenario One

The problem. Mrs. Rogers is an 85-year-old female SNF resident with cancer, type II diabetes, and recently diagnosed Alzheimer's-related dementia. She had lived at home with her daughter for the past two years before it became impossible to care for her there. After one week in the facility, Mrs. Rogers' daughter complains to the CNA attending to her mother that Mrs. Rogers had a wet diaper at 11 a.m. when she went home to wash her mom's laundry. Now she has returned to the facility two hours later and found that her mother still has on the same wet diaper. Mrs. Rogers' daughter is irate. Actually, the CNA changed Mrs. Rogers 20 minutes ago, but apparently Mrs. Rogers had urinated again.

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Proper customer service response. The CNA listens to the daughter and allows her to vent her anger and frustrations. She apologizes to Mrs. Rogers' daughter and, while changing her mother's diaper, explains that Mrs. Rogers had been changed but apparently she had urinated again since then. The CNA also suggests that the daughter speak with the nurse because Mrs. Rogers has urinated more than usual in the last day or so.

Although Mrs. Rogers' daughter has calmed down a bit, she is still quite upset. She approaches the nurse with her complaint. The nurse reviews Mrs. Rogers' chart and apologizes to the daughter but explains that her mother's doctor had recently prescribed a diuretic. She clarifies what the diuretic is for and what its effects are.

The daughter apologizes to the CNA and the nurse and thanks them for their assistance. Later that day she writes a glowing testimonial to the facility administrator about both employees.

Remember that saying, "The customer is always right"? In this case she was wrong, but excellent customer service intervention by two good employees politely and tactfully handling the matter diffused a potentially explosive situation. Mrs. Rogers' daughter was justified in her concerns, although the actual details of the incident were not what she perceived. Like so many in her situation, she was also experiencing feelings of guilt, apprehension, and regret about placing her mom in a nursing home. Less tactful handling of this situation could well have caused the daughter to file a complaint with a state agency or LTC ombudsman or, equally important, she might have told a friend or family member about "the poor service her mother receives at that nursing home," thus creating a bad reputation for the facility.

Scenario Two

The problem. Mr. Jeremy just signed his 70-year-old father into the facility. His father was recently diagnosed with dysphagia and has a diet order for pureed meals. Mr. Jeremy comes to every meal to feed his father. He believes that his father can eat soft, whole foods without having them pureed. "I demand that you give us a regular plate right now. My father has his rights just like all the other residents in here," he says.

Proper customer service response. "I'm sorry, Mr. Jeremy, I can see how this can you upset you. My meal ticket says pureed, but if you give me one second I can get the dietary manager for you, and I'm sure she can assist. Sorry again for the inconvenience."

This is another good example of how we can do our best to extinguish potentially volatile situations. If an employee cannot answer a resident's or family member's question, he or she should simply refer that person to the department or individual who can. Housekeeping, laundry, and all other ancillary staff should be trained to practice the same excellence in service, as seen in scenario three.

Scenario Three

Mrs. Johnson asks the activities director, "Kathy, will Medicare pay for Mom's dentures?"

The activities director replies, "I'm sorry, Mrs. Johnson, I actually don't know how Medicare works, but I am sure that Susan, our business office manager, can help you. Her office is straight down this hall, the first door on the left. You know what? I'm heading back that way now. I'll show you where it is."

Conclusion

The customer service responses required in such scenarios exemplify the following guidelines: Provide service with a smile to residents, family members, guests, and visitors alike; make positive eye contact; greet them pleasantly; and ask if you can be of any assistance.

Our environment may be peculiar, but we can never forget that we, too, are in a customer-oriented business. When we shop at retail stores, we expect a high-quality product and service, as do the many types of LTC customers described above. WalMart and Sears offer a different product than we do, but the quality of service expected should be no different. Our "product" is the quality of care we deliver, and our "service" is the friendly and helpful way in which we give it.

Deke Cateau, NHA, is Administrator of College Park Health Care Center, a skilled nursing facility in Fulton County, Georgia. For more information, call [phone]. To send your comments to the author and editors, e-mail [e-mail]. To order reprints in quantities of 100 or more, call [phone].