Like the great TV detective Columbo, Long-Term Living columnist Gary Tetz (Funny You Should Ask) always has one more question. In this bimonthly feature, he talks with long-term care leaders about anything that pops into his mind. He’s as surprised as you are that they’ll speak to him, and apologizes in advance for whatever inanity he might blurt out in the pressure of the moment.

Ian Cordes, aka “Mr. Florida Long-Term Care,” is a consultant specializing in healthcare communications. More importantly, he was born in Canada, which instantly created a bond of transcending brotherhood between us.

Besides running his own marketing company, he’s executive director of the Florida Medical Directors Association, and the business manager for the Florida Association Directors of Nursing Administration/LTC and the Florida Health Care Social Workers Association.

Our conversation started poorly, with a malfunctioning tape recorder and an embarrased promise to call him back. Like any good Canadian would have done, he did his best to set me at ease with a story when I came crawling back an hour later.

Hello again, Ian. I think everything’s working now.

I once interviewed someone in state government related to long-term care, only to realize later that instead of flipping over the tape, I had used the same side twice. So I lost half the interview.

I know the feeling. So you got through another election?

We sure did.

No hanging chads?

No. We came out of this one unscathed.

My editor refers to you as “Mr. Florida Long-Term Care.” I’m wondering what your duties are, and if you have to wear a sash.

(Laugh) Every time I hear that I cringe.

You’ve also been called a nice guy with a sense of humor.

(Nervous laughter) Hmmmmm.

You literally grew up in long-term care. Tell me about that.

I did. Back in the 1960s and 70s my dad ran a number of nursing homes in Montreal, Canada.

Montreal. Really? I’m Canadian also, but haven’t seen that part of the country. I never made it past Moose Jaw.

(Laugh) We were all originally from Quebec. I literally voted ‘no’ to separation from Canada in May of 1980, and then later that week got into my car and drove straight to Florida. And I’ve never looked back.

So you’re not a member of the FLQ? (A violent Marxist revolutionary group called the Front de libération du Québec that precipitated a national crisis in 1970.)

No, I don’t think so. But I remember the soldiers on the streets in Montreal.

So you got started in a family business?

Basically, my dad’s buildings were mansions with 10 or 12 bedrooms that had been turned into nursing homes. They were really gorgeous—three and four story, right downtown, with a home atmosphere. They even had dumbwaiters that sent the food up and down. On weekends when he was called in for emergencies, I would accompany him.

By the summer I turned 15, he had also started a 12-story assisted living apartment complex that was really quite unique and far ahead of the field back then. A dishwasher was going on vacation and he had no one to replace him, so I worked for two weeks straight washing dishes. That was my first job in long-term care.

Followed by many others, I take it.

I started off working in the maintenance department of a nursing home here in West Palm Beach. I’ve worked in housekeeping, I’ve been a bookkeeper, an assistant administrator, an administrator, and a regional marketing coordinator. I spent 10 years in operations doing just about everything you can do other than nursing, and I grew to really appreciate and have great admiration for the people who work in this industry.

Let’s say I’m an assisted living operator on the brink of financial ruin—I realize that’s hard to imagine. But assuming I’m doing everything right with the care and operation, what expert marketing advice could you give that might help turn things around?

There are some external factors that you simply cannot change. The current state of our economy is certainly a glaring example. There are people now in assisted living whose portfolios are in the tank, and that limits their ability to continue paying the fees they could afford when the market was better. So that’s affecting everybody.

In dealing with that as an operator, one of the things you need to do is step back for a moment and look honestly at everything you’re doing. You might even consider hiring somebody with an outside point of view, so that when you start looking at making proposals and changing programs, you don’t have that infighting and predisposed bias to resist change.

You should start by reevaluating the marketplace, and finding out where your particular facility fits. You could do a standard SWOT analysis [strengths, weaknesses, opportunities, threats], and if necessary, reposition your facility based on the outcome of that. Come up with some different programs to attract new residents and, hopefully, keep the ones you have. But unfortunately, you’re still going to be dealing with folks who may still not be able to afford your services and have to leave no matter what.

What are some of the most effective marketing techniques you’ve seen used for assisted living?

It’s really all of the above. Also, if you’re an administrator or a director of nursing, you need to be out in the community promoting your facility and just be visible. You’ve got to bring people in for events and introduce your facility to the community at large. Get press releases out there to your peers and local media for special events you’re involved in or are supporting. And make sure people always know what your mission is.

What are the most frequent marketing mistakes you see?

Consistency of message is really important. Facilities often stray from that to the point where, over time, there’s so much divergence in the message and image that it becomes confusing. People don’t know what your facility is, or what your specialty may be.

What if I own a skilled nursing facility? How do you help me effectively market a product nobody wants to buy, or even to think about?

I think you’re right, it’s difficult, as I was personally reminded, literally, 10 days ago. My dad recently had open heart surgery and I was with my mother and sister looking for a nursing home for him. The two of them really fell in love with a facility that was brand new. It looked good, it smelled good, it was bright and shiny. Later, we walked into another facility that was 30 years old. It was clean, it didn’t smell, the residents were happy and smiling. I went to Nursing Home Compare [at https://www.medicare.gov] and pointed out to them that the older facility had half as many citations as the newer one. But it really didn’t matter. No matter what I said, they liked the shiny new toy.

And most nursing homes in this country are decidedly not shiny and new.

Yes, that’s something that’s very difficult to get away from.

So what’s the answer? Glossier brochures?

Again, it goes back to looking at your existing marketing program, where you fit in the marketplace and what your competition is. If there’s a new nursing home in the neighborhood, you may have to pump up your marketing budget a bit, and make some changes inside your facility as well. It doesn’t mean you have to spend a lot of money, but even some tweaking of the first impression might help.

Having a solid reputation in the community for providing quality care can be a great advantage over the competition. Promoting a positive image through public and media relations programs can go a long way toward building your facility’s reputation and brand.

What about attack ads? They seem to work well in elections.

Interesting point. But I don’t think so.

I could use grainy and sinister-looking black and white images of that new building from unflattering angles, and feature out-of-context quotes from its administrator.

And then you all get together for the monthly association meetings? It would be open warfare.

There should be plenty of unemployed political campaign staff available now who could help me pull something like that together.

Yes, I imagine so.

You’ve been doing this awhile. Do any marketing campaigns stand out as examples of the best you’ve seen?

It really comes down to the best facilities with the best staff with the best ideas doing the best work, not only with their own residents, but within their communities—hosting events, inviting the public in. Those that do that are the ones that tend to shine. Even if their surveys aren’t always the best in the county, they still earn a long-term reputation for excellence.

And if my survey results are particularly bad, isn’t that when I need to hire a marketing professional such as yourself to create such a flurry of exciting messages and colorful materials that nobody will notice the citations?

Well, you’ve got to do something, starting with cleaning up your act. Then to get past all the criticism and finger-pointing that comes out of those surveys, a concentrated public relations program at that point would definitely help.

But Ian, I’m hiring you so I don’t have to clean up my act. Can’t I solve everything with marketing?

(Laugh) Yeah, right.

Getting back to TV commercials, could long-term care benefit from a talking gecko?

(Laugh) Maybe a talking dolphin here in Florida.

What impact do you expect the Obama presidency to have on long-term care? Will he bring real systemic change, or more of the same?

I think the talk of hope for change is significant, but I’m not sure it applies much to long-term care. The bad economy heightens the need for the federal and state governments to slash and burn as much as they can, and they’re looking for big ticket items to cut. In Florida, and I’m sure all over the country, that’s Medicaid. These are going to be very difficult times for providers, and ultimately for the patients they serve.

Well, you’re a voice of doom.

Then show me some good news.

Sorry, I don’t have any. But doesn’t most real change start locally anyway? Maybe giving up on the politicians is a necessary first step.

Right. It does start locally, and we’ve been looking at culture change in Florida for many, many years. Providers are rethinking how they do things, and we all understand that we’re in this industry for one common purpose, to serve our seniors in the best manner we can.

You’re an award-winning communicator. How could this interview have gone better?

You could have flown me somewhere. Like Seattle. I love Seattle.

No interviewing tips? No faux pas that I committed?

Not yet, but keep trying.

Any final thoughts?

One last thing. I’ve been involved in long-term care for going on 28 years. As my career has progressed from working in the facility dish room to supporting the leaders in long-term care, it’s been a great honor to serve the industry, the residents, and the professionals.

And as the budgets for marketing consultants dry up, you may have the opportunity to go back and wash dishes again.

I may have to.

Gary Tetz

Gary Tetz is multimedia consultant at Consonus Healthcare Services. He was a columnist for I Advance Senior Care / Long-Term Living from 2005-2012.