Seniors Housing

& Care Journal

Paper of Merit

Employee Total Motivation (ToMo): A

Key Performance Indicator of Customer
Satisfaction
Kristen V. Paris, PhD; Richard M. Howell; Edie R. Smith

ABSTRACT

Problem: This article highlights the importance of measuring and tracking employee workplace
motivation, its relationship with both employee and resident satisfaction, and its role in creating a
high-performing culture in seniors housing communities.

The Resolution: The results of this study suggest a positive correlation between employee
motivation, employee satisfaction, and resident satisfaction. Employees with the highest
motivation are more likely to recommend their community and are more likely to be satisfied
with both their working conditions and their job overall. Communities with the most motivated
employees also have the most satisfied residents.

Tips for Success: These results point to the need for owners and operators of seniors housing
communities to put measures into place to increase and/or maintain employee motivation.

Keywords: Motivation, customer satisfaction, employee motivation, employee satisfaction

16 2018 Volume 26 Number 1

INTRODUCTION community executives need to be focused on their
employees’ total motivation—that is, why employees do
The success of a seniors housing community is rooted their work (Doshi & McGregor, 2015). Total Motivation,
in a wide variety of elements—from the location of the or ToMo, is the simple theory that why people work
community to the people who fill its rooms and the determines how well they work. Rooted in the framework
employees who provide its services. Each attribute of a of Deci and Ryan’s (1985) self-determination theory,
community affects the satisfaction of its customers and ToMo postulates that there are six reasons or factors why
employees and, more importantly, their willingness to people work. Three factors are considered to be intrinsic
recommend the community to family and friends. or direct motives and lead to higher performance, while
three other factors, the extrinsic or indirect motives, lead
More than a half century ago, Leibenstein (1966, p. to lower performance (Doshi & McGregor, 2015).
413) argued that “for a variety of reasons people and
organizations normally work neither as hard nor as The three factors that increase motivation are play,
effectively as they could,” and he regarded motivation to purpose, and potential. The first factor, play, occurs
be a major determinant of efficiency. Since Leibenstein’s when a person engages in an activity simply because he
work, the discussion about what motivates real people or she enjoys doing it. The work itself is considered to
in real organizations has centered around a variety of be rewarding. Play is the strongest of the direct motives.
theories, including the idea that managers should focus The second direct motive, purpose, occurs when a
on commitment rather than control (Walton, 1985), and person engages in an activity, not necessarily because
that new, innovative work systems and management he or she enjoys doing so, but because he or she values
practices should enhance that commitment through the outcome or the impact of engaging in that activity.
involvement and empowerment of employees (Freeman This direct motive falls between the strongest, play, and
& Kleiner, 2000; Mohr & Zoghi, 2008; Osterman, 1994; the weakest, potential. The third contributing factor to
Osterman, 2000). motivation, potential, refers to finding value in a second
order, or an indirect, outcome of engaging in an activity.
The most contemporary theories of workplace motivation, In other words, a person might engage in an activity that
however, assume that employees will initiate and persist he or she may not derive much enjoyment from because
in various jobs to the extent that they believe their the activity will eventually lead to something better or
persistence will lead to desired outcomes or goals (Ryan move the person closer to his or her personal goals.
& Deci, 2000). Employees are often motivated by external
factors such as bonuses, promotions, job evaluations, or The other three reasons why people work detract from
the opinions they fear others might have of them. Yet, their overall motivation. These factors include emotional
just as frequently, they are motivated from within, by their pressure, economic pressure, and inertia. Emotional
own interests, sheer curiosity, morals, or abiding values. pressure, when fear of experiencing emotions such as
These intrinsic motivations are not necessarily externally disappointment, guilt, or shame compels a person to
rewarded or supported, but nonetheless they can sustain engage in an activity, is the weakest of the three indirect
passions, creativity, and continued efforts. The interplay motives. The effects of economic pressure, the second
between the extrinsic forces acting on individuals and the indirect motive, can be much more severe and, thus,
intrinsic motives and needs inherent in human nature have a greater impact on motivation. Economic pressure
is the basis of what researchers Edward L. Deci and refers to engaging in an activity solely to gain a reward
Richard M. Ryan (1985) have described as their Self- or to avoid punishment. Someone is said to have high
Determination Theory. economic pressure when he or she works at a particular
job simply to collect a paycheck or avoid getting fired.
Total Motivation Finally, and most important, inertia, the strongest of the
indirect motives, is the idea that a person continues to
To build a high-performing culture in a seniors housing engage in an activity simply because he or she did it
community, or in any organization for that matter, yesterday. In other words, there is no good reason why he

Seniors Housing & Care Journal 17

or she continues to engage in the activity. Table 1. 2017 Watermark Resident Surveys Received, by
Level of Care
High-performing cultures maximize the motivations that
lead to higher performance and minimize those that lower Level of Care Number Percentage
performance. This is known as creating ToMo. According
Independent living 2,530 70%
to Doshi and McGregor (2015), many companies in
the United States have fairly low ToMo. A common Assisted living 915 25%
misconception that often fuels these low scores is the Skilled nursing 159 5%
idea that leaders have to be authoritarian to attain high
performance. However, Doshi and McGregor found quite Total 3,604 100%
the opposite; happy employees and high-performing
organizations are not mutually exclusive. Investing in one The IL survey instrument queried residents on various
leads to the other. Organizations that create a balance services provided by the community (e.g., housekeeping,
of play, purpose, and potential are able to combat low maintenance, dining, care), their overall satisfaction with
performance and increase their bottom line. their community, and their demographics (e.g., age,
sex). The survey provided space for residents to record
In this article, we highlight the importance of employee comments and suggestions for each service area and for
ToMo on both employee job satisfaction and overall the community overall.
customer satisfaction among Watermark communities.
We also discuss the variables that contribute to and Residents answered the questions relating to the service
detract from ToMo. Results are discussed in terms of their areas using a 4-point improvement scale: “needs
implications for developing a high-performing culture in no improvement,” “needs minimal improvement,”
the seniors housing industry. “needs some improvement,” and “needs considerable
improvement” (Table 2). The questions addressing
METHOD overall quality were answered on a 5-point agreement
scale (“strongly agree,” “agree,” “neutral,” “disagree,” or
Overview of the Survey “strongly disagree”).

For the past 4 years, Watermark Retirement Communities The employee survey consisted of a series of questions
has engaged ProMatura Group to conduct, analyze, and related to the overall delivery of services at Watermark
report the findings from satisfaction surveys conducted communities; evaluation of the employee’s job,
across its continually growing portfolio. The survey is coworkers, work environment, and available resources;
conducted annually, on paper or online, with residents opinions about the employee benefit package; opinions
of the independent living (IL) residences, residents of the Watermark community in general; satisfaction
and families of the assisted living and long-term care with the Watermark community; and the six-item ToMo
residences, families of the memory care residents, and questionnaire (Table 3). With the exception of the ToMo
among all Watermark employees. For the purposes of questionnaire, employees answered all survey items using
this article, we focus only on the IL residents because a 5-point agreement scale (“strongly agree,” “agree,”
they represent the largest level of care among Watermark “neutral,” “disagree,” or “strongly disagree”).
communities, and, as a result, make up the largest
proportion (70%) of residents who completed a survey
(Table 1). Likewise, we only included employees from
those communities that offer IL services.

18 2018 Volume 26 Number 1

Table 2. Service Areas and Overall Satisfaction Questions in Table 3. Overall Satisfaction and Total Motivation (ToMo)
IL Survey Questions in Employee Survey

Service Areas Addressed Scale Used Overall Satisfaction Areas Addressed Scale Used

Reception Improvement Scale Watermark appears to run smoothly. Agreement Scale

Housekeeping Needs no improvement I am willing to recommend employment Strongly agree

at Watermark to a friend.
Maintenance Needs minimal improvement
I am willing to recommend Agree
Executive director Needs some improvement Watermark to a prospective resident.
Neutral
Dining Needs considerable I am satisfied with my working
improvement conditions at Watermark. Disagree
Fitness I am satisfied with my job at Watermark.
Strongly disagree
Spiritual
Social ToMo Questionnaire
Education I continue to work at my current job
because the work itself is fun to do.
Wellness services (play)
Overall Satisfaction Areas Addressed I continue to work at my current
job because I believe this work has an 1 Strongly disagree
I have made friends here. Agreement Scale
important purpose. (purpose)
The staff is friendly. 2
Strongly agree I continue to work at my current job
I feel safe and secure here. because this type of work will help me 3
Agree to reach my personal goals. (potential)
I feel “at home”.
I continue to work at my current job 4
Neutral
This community appears because if I didn’t, I would disappoint
to run smoothly. myself or people I care about. 5
Disagree (emotional pressure)
I am willing to recommend 6
this community. Strongly disagree I continue to work at my current job
because without this job, I would be
This community offers me 7 Strongly agree
worried I couldn’t meet my financial
good value. objectives. (economic pressure)
The staff is competent to There is no good reason why I continue
do their job. to work at my current job. (inertia)
I am satisfied with the
quality of services here.

I am satisfied with my.

quality of life

Seniors Housing & Care Journal 19

Survey Participation Employee Demographics

In an effort to ensure both the validity and reliability of Among the 669 employees included in this study,
the survey results, we included only communities with the largest proportion (37%) worked in food service;
a minimum of 20 IL residents and 20 employees who 26% worked in security, maintenance, housekeeping,
completed a survey. A total of 1,959 IL residents and 669 or laundry; and 22% worked in administration and
employees representing 29 communities were included community life. The remaining 15% of employees worked
in the analyses presented in this article. The margin of in nursing, sales and marketing, or transportation services
error is ± 1.4% for IL resident responses and ± 2.4% for (Table 5). The demographic characteristics of employees
employee responses (Table 4). are listed in Table 6.

Table 4. Quality Improvement Surveys Distributed and Table 5. Distribution of Employees by Department
Returned, and Response Rate Among Participating Indepen-
dent Living (IL) Watermark Retirement Communities Department Number Percentage

Administration and community life 146 22%

Variable 2017 Survey Food service 245 37%
(N = 29) Nursing 29 4%
IL resident surveys distributed 2,787 Sales and marketing 44 7%
IL resident surveys completed 1,959 Security, maintenance,
housekeeping, and laundry 177 26%
IL resident response rate 70.3%
Transportation services 28 4%
IL resident margin of error ± 1.4%
Total 669 100%
Watermark employee surveys distributed 1,093

Watermark employee surveys completed 669

Watermark employee response rate 61.2%

Watermark employee margin of error ± 2.4%

20 2018 Volume 26 Number 1

Table 6. Distribution of Employees by Age, Sex, Highest Level of Education, Employment Status,
Job Tenure, and Department

Attribute Department Total

Administration Food Nursing Sales and Security, Transportation
and Service Marketing Maintenance,
Community Housekeeping
LIfe and Laundry
Mean ToMo Score 53.8 20.9 40.0 57.8 27.5 33.1 33.6
Age, years*
< 25 10% 46% 10% 0% 5% 0% 21%
25 to 34 16% 17% 24% 17% 16% 10% 17%
35 to 44 10% 12% 35% 13% 18% 21% 17%
45 to 54 22% 13% 14% 23% 24% 28% 19%
55 to 64 21% 10% 14% 35% 29% 34% 20%
≥ 65 22% 3% 3% 12% 8% 8% 7%
Sex*
Female 88% 60% 93% 89% 59% 29% 68%
Male 12% 40% 7% 11% 41% 71% 32%
Highest Level of Educational Attainment*
Grade school 0% 2% 0% 0% 5% 4% 2%
or less
Some high 1% 23% 3% 0% 11% 0% 12%
school
High school 19% 42% 35% 17% 52% 43% 38%
graduate or
G.E.D.
Some college/ 45% 26% 41% 33% 25% 36% 31%
associates
degree
College 27% 7% 17% 43% 5% 7% 14%
graduate
Graduate or 9% 0% 3% 7% 2% 11% 4%
professional
degree
Employment Status*
Full time 71% 59% 52% 98% 88% 79% 72%
Part time 27% 41% 45% 2% 11% 18% 27%
Temporary 1% 0% 0% 0% 0% 0% 0%
Per diem 1% 1% 3% 0% 1% 4% 1%
Job Tenure*
< 2 years 42% 50% 48% 46% 34% 36% 43%
2 to 5 years 27% 30% 37% 16% 25% 32% 28%
6 to 10 years 18% 10% 15% 14% 19% 21% 15%
> 10 years 13% 10% 0% 25% 22% 11% 14%
*p < .001.

Seniors Housing & Care Journal 21

Table 7. Formula for Calculating Employee Total Motivation (ToMo)

Motive Statement Response × Weight = Total

Play I continue to work at my current job because the work itself 1-7 × 10 =
is fun to do.

Purpose I continue to work at my current job because I believe this work 1-7 × 5 = Direct
has an important purpose. Motives
Potential I continue to work at my current job because this type of work
will help me to reach my personal goals. 1-7 × 1.6 = –
Emotional I continue to work at my current job because if I didn’t, I would 1-7 × 1.6 =
pressure disappoint myself or people I care about.

Economic I continue to work at my current job because without this job, I 1-7 ×5= Indirect
pressure would be worried I couldn’t meet my financial objectives. Motives
=
Inertia There is no good reason why I continue to work at my current job. 1-7 × 10 =
ToMo

RESULTS Figure 1. Mean Employee ToMo Scores by Department

Calculating ToMo 57.8

53.8
ToMo Score (Mean)

40.0
Employee ToMo was calculated from the results of six 33.1 33.6
27.5
questions, each with anchors of 1 “Strongly Disagree” and 20.9

7 “Strongly Agree” (Table 7). Each question is weighted

according to how closely related it is to the work itself. The
Administra@on Food Service Nursing Sales & Security, Transporta@on TOTAL
more the question relates directly to the work itself, the & Community
Life
Marke@ng Maintenance,
Housekeeping
stronger the weight. The direct motives of play, purpose, & Laundry
Department
and potential are totaled and the sum of the indirect
motives of emotional pressure, economic pressure, and
inertia are subtracted. ToMo scores can range from -100 more educated than employees in other departments.
to 100. Employees in food service, who had the lowest ToMo
We should note that employees in administration and community life, as well as those in sales
scores, were the youngest and, consequently, had the
and marketing, who had the highest ToMo scores, were older and more educated than employees
Employee ToMo Scores shortest job tenures. Food service employees, along with
individuals
in in Employees
other departments. security, maintenance,
in food service, who had thehousekeeping, andthe
lowest ToMo scores, were

Employee ToMo scores ranged from -99.6 to 100, with laundry,

youngest and, were the least
consequently, educated.
had the shortest job tenures. Food service employees, along with

a mean score of 33.6. Employees who indicated they individuals in security, maintenance, housekeeping, and laundry, were the least educated.

worked in administration and community life (mean ToMo Relationship Between Employee
= 53.8), as well as those in sales and marketing (mean Satisfaction and ToMo
Relationship Between Employee Satisfaction and ToMo
ToMo = 57.8) had significantly higher ToMo scores than
employees in any other department (Figure 1). Employees Employees indicated their agreement with four statements
Employees indicated their agreement with four statements regarding their overall satisfaction
in food service had the lowest ToMo scores (mean ToMo regarding their overall satisfaction with their Watermark
= 20.9), followed by those in security, maintenance, community:
with willingness
their Watermark community: to torecommend
willingness recommend employment employment
at Watermark to a

housekeeping, and laundry (mean ToMo = 27.5). at Watermark

friend, to a Watermark
willingness to recommend friend, towillingness tosatisfaction
a potential resident, recommend with their
Watermark to a potential resident, satisfaction with their
working conditions, and overall satisfaction with their job at Watermark (Table 8). More than
We should note that employees in administration and working conditions, and overall satisfaction with their
one-third of all employees strongly agreed with each of the statements.
community life, as well as those in sales and marketing, job at Watermark (Table 8). More than one-third of all
who had the highest ToMo scores, were older and employees strongly agreed with 14 each of the statements.

22 2018 Volume 26 Number 1

Table 8. Employee Agreement With Overall Satisfaction Measures

Statement Agreement, % of Employees

Strongly Disagree Disagree Neutral Agree Strongly Agree

I am willing to recommend 3% 4% 13% 43% 36%

employment at Watermark to
a friend.

I am willing to recommend 3% 3% 9% 42% 43%

Watermark to a prospective
resident.

I am satisfied with my working 3% 4% 14% 45% 35%

conditions at Watermark.

Overall, I am satisfied with my 2% 4% 14% 41% 38%

job at Watermark.

When we took a closer look at the proportions of employees Figure 3. Percentage of Employees Who Strongly Agree
whowestrongly
When agreed
took a closer look at thewith each
proportions statement,
of employees we found
who strongly agreed with each They Are Satisfied With Watermark Communities, by
that
those with thethathighest Department
statement, we found those with ToMo
the highest(i.e.,
ToMo those
(i.e., thoseinin administration
administration and
and community life, and particularly those in sales and
community life and particularly those in sales and marketing) were the most likely to recommend
marketing) were the most likely to recommend Watermark Sa@sfied with Working Condi@ons Sa@sfied with Job Overall
Watermark as both a place to work and a place to live (Figure 2).
as both a place to work and a place to live (Figure 2). 64%
Percent of Respondents

59%
who Strongly Agree

48% 47%
38% 41%
Figure 2. Percentage of Employees Who Strongly Agree
Figure 2. Percentage of Employees Who Strongly Agree They Would Recommend
36% 36% 38%
35%
26% 28% 28% 28%
They Would Recommend Watermark Communities, by
Watermark
Department Communities, by Department

Administra@on Food Service Nursing Sales & Security, Transporta@on TOTAL

Recommend Employment Recommend as a Place to Live & Community Marke@ng Maintenance,
Life Housekeeping
71% & Laundry
Percent of Respondents

Department
61%
who Strongly Agree

46% 47% 45% 43%

41% 38% 39%
35% 36%
31% 31% 32%
All four measures of overall satisfaction were significantly
correlated with employees’ ToMo scores (Table 9). As an
All four measures of overall satisfaction were significantly correlated with employees’ ToMo
employee’s ToMo score increased, he or she was also
Administra@on Food Service Nursing Sales & Security, Transporta@on Total
& Community
Life
Marke@ng Maintenance,
Housekeeping
more(Table
scores satisfied
9). As anwith working
employee’s at Watermark,
ToMo score aswas
increased, he or she wellalsoas more
more satisfied

Department
& Laundry willing
with toatrecommend
working Watermark, as wellthe community
as more both the
willing to recommend ascommunity
a placebothforas a
employment and as a place
place for employment and as a place to live. to live.
Likewise, employees in administration and community
life, asemployees
Likewise, well asin administration
those in sales and marketing,
and community were
life, as well as those most
in sales and

satisfiedwerewith
marketing, the working
most satisfied conditions
with the working conditions atat Watermark
Watermark and Table 9. Pearson’s Product Moment Correlations Between Employee Total Motivation
and most satisfied
most satisfied overall with their jobs (Figure 3).
overall with their jobs (Figure 3). (ToMo) and Measures of Overall Satisfaction

Satisfaction Measure r Value

Figure 3. Percentage of Employees Who Strongly Agree They Are Satisfied With
I am willing to recommend employment at Watermark to a friend. .39*
Watermark Communities, by Department
I am willing to recommend Watermark to a prospective resident. .43*

I am satisfied with my working conditions at Watermark. .45*

16

Seniors Housing
17 & Care Journal 23

Table 9. Pearson’s Product Moment Correlations Between overall satisfaction composite score (sum) was calculated
Employee Total Motivation (ToMo) and Measures of for each resident, which could range from a low of 3 (a
Overall Satisfaction rating of “1” on each of the three questions) to a high of
Satisfaction Measure r Value 15 (a rating of “5” on each question). Higher numbers
indicate greater satisfaction with the community. The
I am willing to recommend employment at
mean overall resident satisfaction score determined the
Watermark to a friend. .39*
community’s resident satisfaction group.
I am willing to recommend Watermark to a
prospective resident. .43* Five of the 29 participating IL communities (17%) were
I am satisfied with my working conditions at placed in the strongest group, meaning they had the
Watermark. .45* highest mean resident satisfaction scores. Resident
Overall, I am satisfied with my job at satisfaction scores in the top group ranged from 13.81 to
Watermark. .48* 13.32 (Table 10). Eight communities were in the weakest
group, with a range of scores that were not significantly
*Note. Correlation is significant at the .01 level (2-tailed). different from each other (10.42 to 9.17). The remaining
16 communities were in the strong and weak groups.

IL Communities Grouped by Residents’ Relationship Between Resident Satisfaction

Mean Overall Satisfaction Score and Employee ToMo
We used data from the surveys completed by IL residents After we separated the 29 communities into resident
to calculate an overall resident satisfaction score for satisfaction groups, we analyzed the data to determine
each community. Each of the 29 communities included if there was a relationship between the mean resident
in these analyses was placed into one of four resident satisfaction score of a community and the community’s
satisfaction groups: the strongest group had the highest employee ToMo score. When we included all employee
overall satisfaction mean, while the weakest group had departments, there was no difference in the mean ToMo
the lowest overall satisfaction mean. scores by resident satisfaction groups. Once we isolated
the employees in administration and community life and
We determined a community’s resident satisfaction group sales and marketing, and compared ToMo scores across
on the basis of the community’s average of the sum of resident satisfaction groups of communities, we found
three 5-point Likert scale satisfaction questions: (1) I am that the communities in the strongest resident satisfaction
willing to recommend this community to a family member group had the highest mean ToMo score. Likewise, as
or friend, (2) this community runs smoothly, and (3) I am resident satisfaction declined, so did the mean employee
satisfied with the quality of services at this community. An ToMo score (Figure 4).

Table 10. Mean Resident Satisfaction Composite Scores in Resident Satisfaction Groups

Resident Highest Lowest Number of Number of Percentage

Satisfaction Score Score Properties Independent of
Group Living Properties
Residents
Strongest 13.81 13.32 5 345 17%
Strong 13.28 12.06 9 391 31%
Weak 11.90 10.42 7 705 24%
Weakest 10.42 9.17 8 388 28%

24 2018 Volume 26 Number 1

the communities in the strongest resident satisfaction group had the highest mean ToMo score.

Likewise, as resident satisfaction declined, so did the mean employee ToMo score (Figure 4).

Figure 4. Mean Administration, Community Life, Sales and While much work remains, the results of this study show
Figure 4. Mean Administration, Community Life, Sales and Marketing Employee ToMo
Marketing Employee ToMo Scores by the Community’s that among Watermark communities, employees in
Resident
Scores by the Satisfaction Group
Community’s Resident Satisfaction Group
administration and community life had the highest ToMo
scores, while food service employees and employees
63.6
58.8 in security, maintenance, housekeeping, and laundry
50.4 had the lowest scores. We noted that employees in
ToMo Score (Mean)

46.7

administration and community life, as well as those in

sales and marketing, who had the highest ToMo scores,
were older and more educated than employees in other
departments. Employees in food service, who had the
Strongest Strong Weak Weakest
lowest ToMo scores, were the youngest and, consequently,
Resident Sa=sfac=on Group had the shortest job tenures. The results emphasize the
importance of including questions that address workplace
DISCUSSION
DISCUSSION
motivation among employees, putting procedures in place
to increase that motivation, and tracking any changes in
To our knowledge, this article is the first of its kind to scores from year to year.
To our knowledge, this article is the first of its kind to highlight the role of employee motivation
highlight the role of employee motivation (ToMo) on
both employee
(ToMo) on both employee and resident
and resident satisfactionsatisfaction in industry.
in the seniors housing the seniors
We have We also pointed out that the departments whose ToMo
housing
highlighted theindustry. We have
importance of measuring highlighted
and understanding motivate employees scores correlated most strongly with higher resident
thethatimportance
the factors

of measuring
to do their and of understanding
jobs, and the influence thewithfactors
motivation on their satisfaction that
and willingness to
satisfaction are those that have significant connections
motivate employees to do their jobs, and the influence and responsibilities pertaining to the company’s
recommend the company. Numerous studies across a wide range of industries have demonstrated
of motivation on their satisfaction with and willingness mission and vision. Among Watermark communities,
that a strong relationship exists between employee motivation, employee satisfaction, and
to recommend the company. Numerous studies across the administrative department (primarily the Executive
acustomer
widesatisfaction
range(Gilbert have demonstrated that a Director) is responsible for leading the community based
& Veloutsou, 2006; Harter, Schmidt & Hayes, 2002; Yang &
of industries
strong relationship exists between 20
employee motivation, on its own as well as the company’s mission and vision.
employee
satisfaction, and customer satisfaction (Gilbert The sales team is responsible for articulating the mission
& Veloutsou, 2006; Harter, Schmidt & Hayes, 2002; and vision to prospective residents. The community life
Yang & Peterson, 2004). In fact, Chen (2011) described team then creates programs that bring the vision into
employees as internal customers whose satisfaction reality. Watermark communities has long observed that
contributes to the overall customer’s satisfaction and communities with these key departments highly aligned
organizational performance. Our study extends these to their mission and vision perform better on a variety
findings to the seniors housing industry and highlights of key indicators, including resident satisfaction and
the need to explore the relationship between employee occupancy rates. Our research appears to confirm these
motivation, satisfaction (both employee and resident), and observations, as a strong connection to a vision would
performance outcomes specific to rates and occupancies. drive positive ratings on direct motivators. Operators will
certainly want to note the importance of having highly
Not only is it important to have satisfied residents who motivated associates in these key departments.
are willing to recommend the community, but having
employees who are motivated, satisfied, and willing to Limitations and Future Research
recommend the community increases word-of-mouth
marketing tremendously and, thus, potentially increases Although surveys were offered to all residents and
sales. According to Nielsen (2012), 92% of consumers employees of Watermark communities, their decisions
believe recommendations from friends and family over regarding whether or not to complete the survey were
all forms of advertising. Having very satisfied employees not necessarily random. Once a survey response rate
and current customers nearly doubles the word-of- falls below 70%, nonresponse bias may begin to affect
mouth reach and potentially increases market share and the results. The lower the response rate, the greater the
profitability in a highly competitive environment. potential for nonresponse bias (Mazor, Clauser, Field,

Seniors Housing & Care Journal 25

Yood, & Gurwitz, 2002). Because of this inherent bias, These findings point to the need for owners and operators
the group of people who choose to answer a survey may of seniors housing communities who want to cultivate
not necessarily represent the customer or employee a high-performing culture to determine the factors
population as a whole. Residents and employees who that motivate staff to perform at the highest level, and
actually turn in a completed survey are more motivated to put measures in place to increase and/or maintain
to take the time to answer the questions than are employee motivation. Based on the results presented in
nonresponders; therefore, this group potentially contains this article, increasing employee motivation should lead
a higher proportion of people who have had very good or, to an improvement in overall customer satisfaction, a
more often, very bad experiences. Changes in response willingness of customers to recommend their community,
rates will have significant effects on the survey results. and, therefore, potentially more sales.
Typically, lower response rates will produce more negative
results, even if there is no actual change in the satisfaction © 2018 National Investment Center for Seniors Housing
level of the population (Rindfuss, Choe, Tsuya, Bumpass, & Care (NIC)
& Tamaki, 2015). Future research on this topic should
attempt to increase the proportions of both residents and AUTHORS
employees who complete a survey, with a goal of having a
100% response rate. Kristen V. Paris, PhD
Vice President of Market Research
Investigating the reasons for lower motivation among ProMatura Group, LLC
employees in food service, housekeeping, maintenance, 19 County Road 168
and security is another topic for future research. Oxford, MS 38655
Determining strategies to increase motivation in these [email protected]
departments, which are key infrastructure departments
that can affect quality of life and safety for residents daily, Richard M. Howell
should be of utmost importance. Multilevel modeling Managing Director of Operations
should be used to help determine if factors beyond Watermark Retirement Communities
younger age and shorter tenures are contributing to 2020 W. Rudasill Road
the lower motivation in these departments. Likewise, it Tucson, AZ 85704
will be useful to determine if older age, longer tenures, [email protected]
and greater educational attainment are contributing to
higher motivation among employees in administration, Edie R. Smith
community life, and marketing and sales departments. Executive Vice President and Director of Research
ProMatura Group, LLC
CONCLUSIONS 19 CR 168
Oxford, MS 38655
Our analyses of the satisfaction survey data of both [email protected]
employees and IL residents of Watermark communities
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Seniors Housing & Care Journal 27

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