Corrections or additions?

This article by Kathleen McGinn Spring was prepared for the July

4, 2001 edition of U.S. 1 Newspaper. All rights reserved.

In Assisted Living, Empathy Counts

Take notice. There is a 56-hour course that leads to

top jobs in a rapidly expanding industry where the base qualification

is a high school diploma. Perfect for empathetic peacemakers with

a background in health or social services, and an aptitude for finance

too, the job is Certified Assisted Living Administrator.

Jennifer Courlas, co-owner of Lakewood-based Professional


Living Services, teaches the course along with her business partner,

Mary Ann Barbato, starting on Monday, July 9, at 6 p.m. at


County Community College. Cost: $1,700, not including a $500 testing

fee required by the state. Call 609-586-4800, ext. 3281.

Courlas and Barbato were in on the ground floor of assisted living,

which is a way of caring for elderly individuals whose needs range

from a little help with household chores to round-the-clock care.

In contrast to nursing homes, assisted living facilities generally

provide small apartments rather than dorm-like rooms, and put less

emphasis on nursing and more on individualized care. Courlas says

assisted living was born in the mid-1990s amid complaints against

the state’s existing care system.

"The senior population in New Jersey was not happy with the


says Courlas. Lynn Fishman, then Commissioner of Health, sent five

people, including Barbato, on a fact-finding trip to Oregon, a state

that has pioneering assisted care programs. The group observed the

Oregon system for two weeks, and then gathered information from other

states. As a result of this research, the state’s Department of Health

and Senior Services in 1996 drafted a regulation (Number 8:36) that

Courlas says is a blueprint for the broadest system of assisted living

in the country.

Prior to the adoption of this regulation, increasingly frail seniors

would move along a continuum of care. An elderly person might move

to a residential health care facility when he needed help with meal

preparation, be transferred to an assisted living home when he was

no longer able to take his medication without supervision, and end

up at a nursing home should he need round-the-clock medical care.

Now, in most cases, an elderly person in relatively good health can

set up housekeeping in an assisted living facility, and stay there

even if his health deteriorates.

At the time assisted living was being launched in New Jersey, Courlas

and Barbato, who helped write the regulation, were working at


Homes & Services, the Roszel Road-based elder care corporation.


then human resources director, started an assisted living unit for

Presbyterian, but she and her friend decided that the new type of

senior care was taking off so fast that it would be a good idea to

launch an entrepreneurial enterprise to move nimbly into the space.

The two became Certified Assisted Living Administrators through a

course offered by Excellence in Caring, a Cape May-based business.

They then came up with their own curriculum, got it approved by the

state, and started teaching their own courses, which they hold about

once a month. The classes, made up almost entirely of career changers,

who, Courlas says, "don’t want their bosses to know what they’re

doing," are held at night and on Saturdays, freeing the pair for

consulting work during the day.

There are now 150 assisted care facilities in the state. Approximately

six of them have been closed to admissions for failing to abide by

all the regulations that govern them. "For the first few years,

the state was lenient," says Courlas. "Now, six years later,

they’re closing facilities down." When a closing occurs Courlas

and Barbato are often called in to figure out what went wrong, and

to fix it. The process can take a year or more. "Nine times out

of ten," she says, "it’s the policy. That’s where all the

glitches come."

For example, she says, the facilities are to sit down all new


and teach them the values that, by state regulation, govern care.

These include choice, dignity, privacy, independence, and


Each employee is to understand how these abstractions translate into

care of their charges. They learn, for instance, that a patient who

needs help with bathing is to be asked what kind of assistance he

would like rather than being undressed and summarily whisked off to

a shower. This instruction is to be given once a year to all


but, Courlas says, it is not uncommon for harried administrators to

skip past it in their eagerness to get hands out on the floor.

After finding the problem that got the facility in trouble, often

as the result of a call from a concerned family member to state


Courlas and Barbato show facility administrators how to fix it —

and how to avoid such lapses in the future.

Other consulting work comes from preparing new facilities to open

by helping them comply with regulations and get the permits and


they need to operate, and from marketing facilities that are under


Courlas says the greatest satisfaction in her work comes from sitting

with a patient who is facing death serenely in a facility that has

become a home. Working in assisted living facilities is never easy,

and rarely is a 40-hour-a-week job, she says, offering this


to those who might want to take up the challenge:

Who signs up? Courlas recalls the stock broker, a refugee

from Wall Street, who took her course and made an excellent assisted

living administrator, and the card store owner, who found the


difficult, but is hanging in there. She gets a lot of nurse’s aides.

"They’ve been doing it for 15 years," she says. "They

realize they know how to do it. They’ve watched administrators screw


What are the key skills? "You don’t need a health

care background," says Courlas, "but it helps if you bring

with you some experience." What you do need, she says, is a good

head for finance. At the larger facilities, there may be a Marriott

at the helm, but even there, the administrator is responsible for

day-to-day budgeting. Along with an accounting aptitude, candidates

"have to be able to listen." A lot. Responsible for residents

and staff, and having frequent dealings with residents’ often anxious,

and sometimes guilty, families, administrators need to "listen

with two ears."

Superb people skills are essential. Administrators will be in charge

of workers who are not paid terribly well and who are doing an


difficult job. Skill as a negotiator is essential.

How about the salary? At a small, private facility, an

administrator can expect a starting salary of $55,000 to $65,000.

At a large facility, that figure goes up to about $85,000. If the

facility is fully-staffed by competent people — a situation that

is not all that common — an administrator might work just 45 hours

a week or so. Add staff vacancies or difficulties of any sort, and

the hours can soar. And don’t expect week-ends off, Courlas says.

"Families often visit on Saturdays and Sundays," she says.

Administrators often content themselves with taking a Wednesday off.

While this is not a soft job, it might be just the thing for an


nurturer who is not afraid to take on bookkeeping chores, and wants

a job where he can make a difference every single day.

To find out more about assisted living services at home from a sponsor of this page, please visit

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