Tertianum is Switzerland’s leading provider of assisted-living services. It is a private company providing residential and care services to older clients at locations throughout Switzerland. The company is noted for its broad and flexible range of modular offerings.
Integrated value generation
As Switzerland’s leading provider of assisted-living services and accommodation, Tertianum contributes significantly to enhancing the quality of life of people in the third phase of their lives. The Group operates in 76 locations, offering 3 000 care beds and some 1 800 apartments. The key priority for all Tertianum residences is to ensure the satisfaction and well-being of their guests.
Because its guests have a variety of requirements, Tertianum offers a range of individual, modular solutions. The spectrum ranges from providing living accommodation with the highest possible degree of autonomy, to high-quality catering, to comprehensive health services. All offerings allow a combination of accommodation and care, with each guest free to determine how much support he or she requires.
Municipalities not wishing to maintain their own care homes can enter into specific service agreements with Tertianum. The company will then establish a cooperation agreement with a real estate investor and the municipality, under which the municipality avoids having to invest in real estate or cover any operating deficits which may arise.
Successful collaboration with the Group
Through Tertianum, Swiss Prime Site is pursuing a uniform growth strategy. The know-how which this Group company has accumulated over the years covers every aspect of the assisted-living sector. This expertise helps the Group to grow its share of this market.
Tertianum operates a total of 76 assisted-living centres, of which 20 are owned by Swiss Prime Site Immobilien. These properties, which are sited in a wide range of locations, have excellent value-retention characteristics, partly thanks to their secure, long-term leases and partly thanks to the care with which Tertianum operates them. Tertianum provides Swiss Prime Site Immobilien with access to investment properties. Wincasa also benefits, since it is mandated with administering them on behalf of Swiss Prime Site Immobilien.
Business opportunities and business risks
Organisations providing services to older people, some of whom require care, are subject to regulation. Compliance with this regulation involves considerable administrative effort, since regulatory requirements are generally becoming more restrictive and each canton has its own specific rules on subsidising assisted-living places. Economy drives by some cantons are also exerting upward pressure on costs. To counteract these trends, the substantial range of services provided has to be matched by streamlined administrative processes.
In meeting the cantons’ requirements, Tertianum can draw on a wealth of internal knowledge. By using standardised processes, the company can open new care centres efficiently, while simultaneously continuing to develop the core services it delivers.
By providing a range of accommodation and care services to some 4 200 clients, Tertianum achieved operating income of CHF 449 million in 2017. The high occupancy rates its centres enjoy is testimony both to the company’s strong working relationships with doctors and hospitals and to the reputation its care services have earned. In 2017, the company’s growth strategy enabled it to build or acquire a number of new facilities, adding a further 230 beds and 109 residential apartments to its overall capacity.
Tertianum’s 4 303 staff enjoy a high level of job security. The company offers a range of training courses, some of which are organised in collaboration with teaching institutions, to ensure that its employees receive ongoing vocational training. Tertianum’s motivated, well-trained staff make a significant contribution to its successful business performance (for more details, see the «Attractive working environment» section on pages 69 ff.).
Individually tailored services complemented by active dialogue
In addition to its guests and their friends and relations, Tertianum’s stakeholders include doctors and medical practices, hospitals, health insurers, suppliers, local authorities, elected politicians and the local populations in the locations in which it operates. To maintain its dialogue with these various groups and to promote a sense of community, Tertianum regularly hosts public information meetings, panel discussions and cultural events. Every year, each Tertianum centre organises some four such initiatives.
Tertianum needs to configure its offering to meet the changing needs and expectations of its guests. To ensure that the services it provides to its target clientele properly reflect current local requirements, the company regularly conducts market analyses and surveys. It also holds an annual strategy meeting.
Every three years, Tertianum carries out a survey to gauge the satisfaction of its guests, suppliers and employees. The insights thus gained assist the company in its ongong efforts to develop and optimise its operations.
One preferrred partner for assisted-living services, one uniform brand
Tertianum’s objective is to maintain its position as Switzerland’s leading provider of assisted-living services. In 2017, the company systematically strengthened its ties to local municipalities with a view to facilitating the establishment of public private partnerships. These initiatives resulted in one new partnership in Richterswil, further development of the Salmenpark accommodation and care centre and the creation of the new Park Ramendingen facility in Gommiswald.
From a business point of view, the decision to apply uniform Tertianum branding to its entire range of assisted-living offerings is highly significant, since it enables the company to raise its profile and strengthen its market. Tertianum also streamlined its legal-entity structure, thus enhancing its administrative efficiency.
By availing itself more systematically of the opportunities offered by digitalisation, Tertianum was able to make significant progress towards a standardised process environment in 2017. Preparations were made for the staged introduction of an enterprise-resource-planning (ERP) system, which will enable the company to control and monitor its administrative processes electronically. Tertianum also purchased the careCoach system in 2017. In future, this will enable the company to manage all its data-processing applications electronically. This will make the planning and documentation processes for all care and support services entirely electronic. Tertianum also formulated a clearly defined strategy for its ambient assisted-living offering. The plan here is to test new technologies which will help older people to continue living in their own homes for longer. Possible concepts include using intelligent sensors to dectect and report falls, monitor lavatory use or record food consumption.
Compliance and social commitment
Individualised services and regulatory requirements
In providing services to its guests, some of whom have specific care needs, Tertianum is assuming a substantial responsibility. For that reason, the services, risks and risk-mitigation measures involved all need to be precisely defined. These aspects are covered in binding agreements concluded between Tertianum and its guests. In recent years, demand for individually configured services has increased. Tertianum has responded to this by developing a modular catalogue of services from which it can tailor individualised service offerings. The company regularly evaluates, adapts and expands its service catalogue.
Organisations providing services and care to older people must hold a number of specific licences and meet a wide range of regulatory requirements. The principal statutory framework here is enshrined in adult-protection law. This legislation determines who represents the interests of an adult in the event of his or her mental capacity becoming impaired and what medical procedures can be carried out. The way in which food and medicines are described and defined is also subject to specific legislation. Besides requiring disclosure of the origin of these products and the substances they contain, these laws also lay down safe procedures for storing and disposing of them. The relevant authorities verify compliance with these various requirements on a regular basis.
Protecting personal privacy is the key priority
The protection Tertianum affords its guests not only covers their health but also includes a duty to exercise great care in protecting their specifically defined fundamental rights, which are protected by Switzerland’s constitution. Service providers such as Tertianum have a special duty of care, particularly towards people who are old, frail or in need of assistance, since they are often less able to ensure that their rights are respected. Personal privacy-protection regulations not only specify how confidential medical information is handled by third parties, they also require assisted-living residences and care homes to ensure that the privacy of their guests is respected. Tertianum has defined a set of internal principles governing the handling of confidential data which also encompass information relating to employees and business partners. When they sign their employment contracts with Tertianum, all staff also commit to a duty of care with regard to personal privacy. In addition, the company holds training courses on this topic in order to reinforce awareness of the issues involved among its staff.
Tertianum manages sensitive data in a password-protected system. Data protection is integral to the company’s quality-management procedures. It also forms part of the ISO and sanaCERT certification processes it undergoes and the audits carried out by its regulators. Furthermore, mechanisms are in place for both guests and employees to lodge complaints should they come across any infringements of data-security regulations. Employees can make anonymous calls to the integrity line. Guests can address their complaints to the care and support management team, the management of the centre in which they live, company management and, ultimately, to the cantonal ombudsman or the national data-protection intervention unit.
Social commitment and utility to society
Tertianum takes care to ensure that affordable solutions can be offered to people of limited means. The 76 centres it operates form part of the local and regional healthcare infrastructure. Experience has shown that Tertianum provides high-quality services at lower costs than its peers. This enables the company to generate genuine economic added value for the municipalities in which it operates. Furthermore, since the company is a private service provider and does not receive any deficit guarantees from the local communities it serves, this eases the burden on the public purse further. An additional benefit to society is that by living in accommodation which also offers ancillary services, older people are able to live in homes of their own, thus postponing their potential future admission to costly care institutions.
Tertianum is convinced that it is primarily by assuming responsibility as a service provider and focusing on its clients’ needs, rather than by adhering to regulations, that it is able to deliver quality care. That is why it supports senesuisse, the Swiss association of economically independent residential and care homes for older people. This association represents the interests and concerns of long-term care providers and is committed to counteracting excessive regulation of the healthcare sector.
In 2017, Tertianum once again supported the St. Gallen dementia conference, which focuses on the provision of person-centred care to people with dementia. In 2012, based on its many years of experience in the assisted-living sector, Tertianum established the Viventis Foundation, to which it contributes CHF 50 000 each year. The foundation’s objective is to improve the quality of Assisted Living. Viventis provides financial support to older people living in residential and care homes to help improve the quality of their lives.
Dialogue fosters identification with local communities
As a private provider of healthcare services, it is essential for Tertianum to be positively perceived by the local communities it serves in order to ensure high occupancy rates for the residential and care accommodation it offers. For that reason, the company maintains a regular dialogue with local councillors, local authorities and local communities. The size of each Tertianum centre also affects the range of services it offers. Its offering in each location is determined in accordance with such factors as specific cantonal approaches to care provision, local purchasing power, the rental income required by landlords and the availability of staff in the region concerned. The size of each centre also affects the range of services it offers. In 2017, Tertianum opened three new centres – Park Ramendingen in Gommiswald, Al Vigneto in Tenero and Etzelgut in Zurich Wollishofen. In Wattwil, the newly constructed Krone centre replaced the previous Kronenwiese facility. The existing La Gottaz residence in Morges and the Parco Maraini residence in Lugano were also incorporated into the Tertianum Group.
Sustainable products and services
Guest protection is a team effort
The health and safety of its guests is Tertianum’s number-one priority. Robust security procedures and continuous monitoring of guests’ health are important duties for the company’s staff. Employees attend regular training courses to learn the skills they need to avoid individual mistakes and to correct them should they occur. Every Tertianum centre also has its own security manager, who works with staff to ensure that hygiene and security directives are observed.
In order to raise the quality of its services further, Tertianum will establish company-wide quality-management proecedures in accordance with the revised ISO 9001 standards formulated in 2015. In 2017, the company’s centres in German-speaking Switzerland successfully passed their sanaCERT recertification tests. All processes are regularly evaluated in the course of internal audits and external examinations carried out by regulators and insurers. All interventions relating to health and safety are monitored in accordance with Critical Incident Reporting System (CIRS) criteria and other established protection protocols.
Maintaining sustainable purchasing standards
In 2017, Tertianum’s expenditure on goods and services amounted to some CHF 58 million. The key items purchased were healthcare consumables, food, beverages, maintenance services, water and energy. During 2017, the company was able to reduce its costs significantly by harmonising its supplier portfolio and streamlining the range of goods and services it buys. Supply contracts are awarded on the basis of regular reviews, the next being scheduled for 2018.
For Tertianum to ensure that its purchasing activities remain sustainable, it is essential that its suppliers also adhere to appropriate social and ecological standards. Accordingly, when the company buys a given type of product for the first time, it prioritises those which meet specific ethical and ecological standards and can be delivered and disposed of with minimal environmental impact. In 2017, Tertianum was able to renew two major contracts with Swiss suppliers operating certified, sustainable value chains.
The company’s food-purchasing policies give preference to local and seasonal products, because they are more sustainable from an ecological and social point of view. In choosing its suppliers, Tertianum opts for local companies and organisations where possible.
Protecting the environment
Steady progress towards environmental sustainability
To the extent its status as a tenant permits, Tertianum implements measures to reduce its energy consumption and its emissions of harmful substances. Examples of such initiatives include recycling the heat generated by air-conditioning and ventilation systems, installing LED lighting and optimising the operating schedules of its technical infrastructure. The energy and emissions savings resulting from these policies cannot yet be quantified, however, since the first environmental data recordings were made in 2017 (see table). Tertianum also strives to reduce the quantity of water consumed by its laundries and by its guests for their personal use. The use of water-saving shower heads helps to achieve this latter objective, as do aerators and flow-limiting devices on taps. Tertianum can, however, only reduce its water consumption to the extent consistent with maintaining the high standards of hygiene it practises. Wherever possible, waste products are recycled, with household rubbish, glass, paper, tins, electrical products, green compost, catering biomass, special waste products and medical-supply waste all being collected separately. Tertianum handles all medical-supply waste in accordance with current regulations.
Attractive working environment
Open communication and good health-management practices ensure continuity
Working in the assisted-living sector is a challenging task for Tertianum’s employees. They need to be highly qualified in their specific disciplines. They also need to display great empathy in interacting with others. The recruitment and retention of appropriately qualified staff is thus an important task for those managing the company’s residential care centres. The Group has developed a uniform process and a range of specific measures to help them in this task. In 2017, the Tertianum Group added a Head of Care Services to its executive-management team, an initiative which emphasises the importance Tertianum attaches to its activities in this area. The company also eliminated one level from its organisational hierarchy in order to bring its Group executive management closer to the management teams at individual centres.
The long working and attendance hours, the physical effort required by daily care activities and the emotional stress resulting from client deaths typically result in high absentee and fluctuation rates. That is why it is indispensable for the company to observe good standards of health management in its operations. Tertianum strives to achieve the best possible levels of health protection for its staff by monitoring their working and attendance hours, ensuring they themselves have appropriate care-management support and arranging for them to have regular health checks and vaccinations.
For employees and managers alike, Tertianum’s HR business partners are their primary source of advice and support. Should any employee have a grievance, he or she can turn to appropriate internal units, report the matter to an independent ombudsman service or contact the integrity line. Tertianum staff can also avail themselves of the services of AXA Care Management.
A fair, flexible and modern employer
Tertianum sets store by treating its employees with respect and supporting them in the performance of their duties. Accordingly, its staff policies are based on the principles of open communication, mutual appreciation, fairness, equality of treatment and equality of opportunity. Tertianum regards its multicultural staff as a source of enrichment. While the company has a policy of equal pay for equal work, it does not have a policy of specifically furthering opportunities for women, because they are already well represented in its various professional disciplines and in its management hierarchy.
The recruitment of new staff, adherence to the terms of collective employment contracts, monitoring pay parity and offering flexible working-time arrangements to its staff are important elements in the company’s efforts to ensure that its employees are treated fairly and equally. Responsibility for adherence to these principles rests with the Tertianum Group’s executive-management team and its human resources department. Should an instance of discrimination arise, Tertianum employees can lodge a complaint with the integrity line. No cases of discrimination were reported in 2017.
As a forward-looking, attractive employer, Tertianum demonstrates its considerate attitude towards the individual circumstances of its staff through initiatives such as modified working hours for employees with children. Most Tertianum centres have established individual employment contracts which are recognised as equivalent to the relevant collective employment contracts applied throughout Switzerland. Tertianum’s staff benefits are available to both full-time and part-time employees and the pensions payable under the company pension scheme are only partially reduced to reflect state pension benefits.
For the last five years, the Tertianum staff association has represented the interests of employees vis-à-vis management, thus ensuring that the company’s staff have their say in the various aspects of Tertianum’s operations. In 2017, the staff association was reorganised to reflect Tertianum’s current regional structure and mix of national languages. Twelve individual constituencies now elect one staff-association representative each.
The staff association’s mission is to ensure that working conditions, the working environment and the range of benefits offered are attractive for employees. It is currently working on harmonising pay levels within a new salary system which Tertianum plans to introduce in stages from 2018.
Maintaining competitiveness through continuing staff development
In order to meet its growing need for qualified staff, Tertianum pursues an employee-retention strategy based on continuing education and training. Currently, the company trains 330 apprentices in the fields of care, catering, facility management and administration. It also offers a wide range of internal and external training courses and specialisation programmes in areas such as dementia and gerontopsychiatry. In additoin, Tertianum runs a continuing-education centre which provides the statutory training that staff working in a number of disciplines are required to attend. In order to ensure that they have the technical, management and personal skills they need, all staff in all functions and at all levels formally review their personal development and the continuing education and training opportunities available to them as part of their annual appraisal process.