Transcript Generated by AI 00:00 Hey, Mark Parkinson back with Park Place and 00:02 really excited today because we're recording our Let's Talk segment for the 00:07 month. 00:07 And I'm doing it with two of my favorite people in the world, 00:11 Owen Hammond and Steve LaForte, who have built what is a really exciting 00:16 company in Cascadia. 00:18 And we're here today to try to figure out how Cascadia has done it and what's 00:22 what's next for Cascadia. 00:24 And I'm really looking forward to the conversation. 00:26 I, at the outset, want to thanks First Quality for 00:29 sponsoring the Let's Talk segment. 00:31 Sima and her entire team have done so much for the sector and so much for the 00:36 folks that they work with and couldn't thank First Quality enough for making all 00:41 of this possible. 00:43 Cascadia, if you haven't heard of it, you need to know about it and it 00:46 certainly anybody on the West Coast and certainly in the Northwest knows about 00:49 Cascadia, but I think pretty soon everybody across 00:52 the country is going to know about this company. 00:54 It started modestly 11 years ago with one building. 00:58 It has methodically grown into a powerhouse now with 71 skilled nursing 01:03 facilities, 14 assisted living facilities, principally in the Northwest. 01:08 But again, I think you're going to see this company 01:10 expanding. 01:11 Some people have asked me if Cascadia is the next Ensign and PACS, 01:15 and I think it might be. 01:16 We'll, we'll have a conversation about that 01:18 today. 01:19 But it's certainly impressive what they've been able to accomplish in 11 01:23 years. 01:24 They haven't just gotten large. 01:25 They've also done some great things on the clinical and the quality side. 01:29 The best evidence of that being that they are absolutely crushing it with the AHCA 01:33 Quality Awards. 01:34 Those of you that are involved in the AHCA Quality Award program know that it's 01:38 basically impossible to receive a gold award. 01:41 In the entire history of the program, there have only been like 50 buildings 01:45 that have received that award. 01:47 Usually, it's either one or two a year. 01:50 Remarkably, in the last five years, Cascadia has received 5 gold awards. 01:55 There have been some years where the only gold awards have been to Cascadia 01:59 buildings, which is a remarkable accomplishment. 02:02 Owen and Steve, welcome to Park Place. 02:05 Thank you. 02:06 Thank you for thanks, Mark. 02:07 Great to be here. 02:08 You guys here really, really fun. 02:10 Owen, it's tough to add buildings now. 02:15 You know, I talk to people all the time. 02:17 They're saying how can we grow our our footprint? 02:21 And it's a really tough time right now because the sector's doing well and it's 02:25 hard to get buildings in this environment. 02:27 How have you gone from 1 to 71 SNFs in in, in this 11 year time period? 02:34 Yeah, you know, I actually get that a lot. 02:36 I always get the question of how do you guys, 02:39 how did you guys get so much so quickly? 02:40 And you know, it is interesting to me. 02:46 I did transitions, I did turnarounds my whole career. 02:49 And it was funny that right about the time you turned it around, 02:53 you'd have this big pop and people would say, what was the magic? 02:57 What was the lever you pulled? 02:58 It was just like one thing. 02:59 And you're like, well, this is something we've been building on 03:02 and I and, and then now it's coming to fruition. 03:05 And I think relationships are like that. 03:07 It's, it's how you operated and how you carried 03:09 yourself when you were running buildings, how you treated your staff. 03:13 How did you treat people on your companies? 03:16 And I think as that kind of progresses over years, 03:18 I think people want really great people to stay in this industry. 03:22 And, and those people seem to find each other 03:25 in the industry. 03:26 And when they're thinking about divesting, they're going to find somebody that's 03:31 going to the best they can carry on the legacy. 03:34 And you know that they've that they've contributed for the last, you know, 03:38 15-20 years and they want to hand it over to somebody that they, 03:41 they feel is going to do that justice. 03:44 And so that's a big thing. 03:46 Relationships have been a big key. 03:48 The other thing is taking troubled buildings is hard to do. 03:53 And it's, it's not one of those things where you're 03:56 like, OK, we'll take this troubled one and then you 03:58 give us a good one. 03:59 It's not how transitions work and, and, and acquisitions. 04:03 And so we at the very beginning took on some pretty tough buildings. 04:08 One said, quite honestly, I look back and I'm like, 04:10 that was kind of reckless because they were pretty difficult. 04:14 And if they would have went the other way, it would have been tough for us. 04:16 But we were committed to to making a difference in those buildings and we did. 04:20 And I think that goes a long ways too. 04:22 We weren't just looking for something that was just a win for us. 04:25 We wanted to go prove ourselves from the beginning and luckily we had some great 04:29 people come with us and, and we've been able to do that. 04:33 And I think that perpetuated. 04:34 So that was a big thing. 04:36 And then, you know, being true to that consistently, 04:39 once you start getting some accolades, like you mentioned the, the, 04:43 the gold awards, understanding that that is a lot of work 04:47 and that that it's never a great place in this industry to become complacent. 04:52 I think then you have to change your mindset into we better stay up and live 04:57 to that potential that we continue to have right now and exemplify it in the 05:01 future. 05:01 And I think that drive for us has also given a lot of people comfort when 05:06 they're looking to divest acquisitions. 05:08 Plus we try to just keep it pretty common. 05:11 You know, we're not, we're not throwing the lawyers in there, 05:13 no offense, Steve, but we're not throwing lawyers in there 05:15 to try to mucky up the transition. 05:17 So we try to be really flexible on closing. 05:20 We try to make sure that it's, you know, the feeling and surety of close is 05:23 there. 05:23 And so I, I think that's, that's kind of how we've done it. 05:27 And honestly, it's just been in a pretty organic way. 05:30 When I started, I honestly didn't, didn't know where we'd end up. 05:34 We said W West of the Mississippi. 05:36 Our first one was a relationship with the Fogs. 05:39 They were gracious enough they were looking to divest one of their buildings 05:42 that happened to be in Boise. 05:43 And because of our relationship with them, Greg Stapley and I, 05:48 we were able to get that first building and, and really from there platformed out. 05:53 Yeah, I mean, it's, it's really a great story that, you know, 05:57 treating people well and considerably, you know, 06:00 in in a considerate manner isn't just the right thing to do, 06:04 it's also good business. 06:05 And, and, and, and when I look at you on, I think we, we have, 06:08 I have a there's a leadership book that I love called Leadership and self Deception. 06:11 And I suspect you've read it and know about it. 06:14 And I just feel like you sort of embody the values of treating people like people. 06:18 And it's it's great to see that that's paid off. 06:21 Steve, you're you, you're one of the most interesting people. 06:24 I know you, you really are. 06:27 And you just, you got such a multi faceted background 06:30 with your, your, your, your legal expertise, your, 06:33 your government affairs expertise, your deep commitment to SNFs and all of 06:37 that. 06:38 But on top of that, you also are really heavily into creating 06:41 relationships. 06:42 Talk, talk about the, the importance that you've seen with 06:44 these relationships that you've created. 06:46 I think, well, thank you. 06:50 I, I, I appreciate all of that. 06:53 I, you know, I think that this is an interesting 06:57 sector and many moons ago when I entered it, I, 07:01 I think one of the things that impressed me and also sort of left me wide eyed a 07:07 little bit was how collegial the sector is and how close people are and how 07:14 supportive people are. 07:16 And that has really stayed with me over the course of a couple of decades where 07:22 the relationships I create come back around and I'm always very cognizant that 07:28 somebody that you're dealing with today might be somebody you're not dealing with 07:35 for a while. 07:36 And the 10 years they're going to come around and they're going to be a key 07:39 relationship person. 07:40 So when I when I first joined up with Owen 11 years ago, 07:45 we were nine months out from getting that first building, he noted. 07:52 One of the things that I think Owen brought an amazing vision and an amazing 07:58 operating capacity and expertise. 08:01 I think a thing that I brought was relationships. 08:06 I've been around the block a couple of times. 08:08 I'd worked for big operators. 08:10 I'd built a company, I had done a lot of finance work, 08:14 you know, to allow a company to grow and get a 08:18 platform and I kept all those relationships really tight and really 08:23 active. 08:24 And so you know, I was able able to utilize that to sort 08:27 of springboard into the growth that Owen talked about where is we went along the 08:32 reach that we were dealing with, the lenders that we were dealing with, 08:37 some of the operators that we were dealing with, 08:40 Owen had great operating contacts. 08:42 But then some of the other we we took buildings from Kindred, 08:45 we took buildings from Orianna. 08:48 In the midst of that, I had relationships with certain of the 08:51 people. 08:51 I had relationships with the lawyers back from my legal days. 08:55 And all of it makes things work a lot easier. 08:59 It makes the trains run on time. 09:01 You know people's rhythms, you know their hotspots and you know how 09:06 to, you know, push certain buttons where you're all, 09:11 you're all on the same page. 09:13 And it becomes more of a win win than it already is. 09:17 And we've sort of taken that approach and it was one of the things from a cultural 09:21 standpoint, from an ethical standpoint, we're not a transactional company. 09:26 We're a relationship driven company. 09:29 And it's not about the last nickel, it's about maintaining those 09:34 relationships. 09:35 It's about creating win wins and it's about working together. 09:40 And you know, so as we move forward, that has really worked and it works all 09:44 the way down from top to bottom. 09:47 It's our employees, it's our our employees within their 09:51 milieu, it's within the organization, it's our facilities and our services 09:57 center in our communities. 10:00 And then it's our bigger relationships in the wider world. 10:03 It's our key vendor relationships, it's our government affairs association 10:08 relationships and it's our financing relationships. 10:12 And all of those become integral to developing a network and developing a 10:17 healthy infrastructure for us to continue to do what we do. 10:21 And and you know, one of the nice things is it's great our 10:25 people are very receptive and they've all adopted this relationship driven culture. 10:31 And you know, just working in that type of environment 10:35 out of day-to-day basis is incredibly gratifying. 10:38 Well, it certainly helps explain how you've 10:40 been able to grow at a time where many companies have not been able to do that. 10:45 Now, Owen, one of the things that I love about 10:47 Cascadia is that you guys have, I call it the West Coast offense. 10:52 I think you call it the field driven model. 10:54 It's this model where you really empower the local, 10:58 the folks that are in the buildings to make most of the key decisions. 11:02 Your your administrators, you call them CE OS, your Dons, 11:06 you call them Co OS. 11:08 And it's more than just a title. 11:10 They really get to make decisions, which I think is a it's a very different 11:15 kind of structure than a normal top down structure that we see sort of east of the 11:20 Mississippi, West of the Mississippi. 11:22 This is really gaining a lot of of other people doing this as well. 11:26 So just tell us how this works, why it works and, and, 11:30 and why you've come around to this this approach. 11:34 Yeah. 11:34 I mean, I, I think part of it, you know, I cut my teeth with enzymes so they're 11:39 field driven as well. 11:41 And so that was already kind of ingrained and that's what actually attracted me to 11:46 a company like Enzyme was there was this, there was this willingness to give more 11:50 control to the people that are actually making the decisions in the field. 11:54 And, and over the years, I've kind of narrowed it down to, 11:57 to our industry. 11:58 And this is maybe not fair, but we're really into two, two divides. 12:02 There's the ones that are top down. 12:03 They, they mitigate risk, which is what this is all about. 12:06 You mitigate risks by having layers of protections all the way down in the field. 12:13 And then they find people that can execute those decisions and those game 12:17 plans at the facility and then they layer it with all these protective resources 12:22 and other things to make sure that their, their investment is protected and, 12:27 and that works. 12:28 There are people and there are companies that that works really well with. 12:31 And then there's the other side that, that feels like the biggest risk is to 12:35 not give the control to the people on the, on the front lines really. 12:39 And we, we believe in kind of the other aspect of 12:42 it is and, and, and that is if we hire really exceptional 12:45 people and that's why we call them CE OS and CN OS because we're not looking for 12:50 an administrator. 12:51 We're not looking at somebody just takes what we want to do and just administer it. 12:55 We want somebody to come in that's creative, that's driven, 12:58 that can manage multiple things is multifaceted. 13:01 And the, the problem with our industry is we 13:03 haven't really attacked and went out and found these people because there's some 13:07 barrier, barriers of entry. 13:09 And so people will leave a very corporate job to come to something like what we 13:16 provide at Cascadia if they know that it really is true. 13:22 When we say it's field driven, you can make decisions. 13:25 And so that this, this field driven model, let's go with the the West Coast offense, 13:29 right? 13:30 So the how this would work is you want the quarterback at the line of scrimmage 13:35 to be able to look out, see what the defenses lined up as, 13:39 call an audible, you know, do whatever we need to do to because we 13:43 see something out there that's on the field that your level in the field. 13:48 You can see it directly. 13:49 You can see, you know, the offensive line cheating over to try 13:52 to do a blitz, right? 13:52 So you can move some, you know, you're running back over to block that. 13:58 And then you make that audible. 13:59 You you go and then you hope that that play is going to give you a better result. 14:03 The other way of looking at it is if it's not that, 14:06 then you're looking at the person making the calls up in the press box that's 14:10 looking from afar and not really getting that ground level. 14:13 The grass, the smell, the looks, the sounds, everything. 14:16 They're not, they're not looking at that. 14:18 They're just looking at from this far, far viewpoint. 14:20 And that's fine. 14:21 That can be helpful. 14:23 But we believe that if we have really talented people that have those skill 14:27 sets to evaluate and look and make the right decisions at the local level, 14:31 it actually mitigates our risk even better. 14:33 They can go and address an issue with a, a, 14:36 a resident's family immediately instead of saying, no, I can't, 14:40 I can't deal with that. 14:41 You got to run it up to corporate. 14:42 That's not helpful, That's not useful. 14:45 And why that really makes a difference is your staff want you to be able to make 14:50 decisions and help them that you want them to be empowered on the local field. 14:54 And never this idea that, sorry, corporate, corporate won't let us do that. 14:58 That never is good and it's never said. 15:01 And so that 80% of the decisions we try to make the field capable and able to 15:06 make those decisions. 15:07 20% ish, No, we're not going to have, you know, 15:10 5 different EMRs and we're not going to have a bunch of payroll systems. 15:14 So, but as much as humanly possible with the 15:17 right talent, we want the field to be making those 15:21 decisions. 15:21 And, and we think it's done really well. 15:23 And I think a lot of people, we're attracting a certain type of people 15:27 that other industries don't get because they're coming with those skill sets and 15:32 then we're teaching in the industry and then they're doing really well. 15:36 Yeah, So Steve, how, how hard is it to give up control? 15:40 And I, I mean, I, I know your, your background is, 15:42 is as a lawyer in litigation and you're thinking about all the things that can 15:46 happen in buildings that you wish, you know, 15:48 you could tell people not to do or to do. 15:50 How, how hard is it to actually give up 15:51 control? 15:52 And how do you do that? 15:54 It's really, it's really hard. 15:57 I, I think it's interesting. 15:59 I mean, I think it's an interesting. 16:01 I, I, I personally have had an interesting 16:04 evolution because I, I started out in this sector and I was a 16:08 lawyer and you know, they're start and stop. 16:11 Lawyers like to be in control. 16:14 They like to be top down. 16:16 They like to be risk management. 16:19 And and I worked for two of the bigger is outside counsel, 16:23 2 of the bigger companies in the sector, Sun Healthcare on the skilled side, 16:29 Emeritus Assisted Living on the AL side, large public companies that were top down. 16:37 It's successful, but you know, a completely different model. 16:41 So that was really where my context came from. 16:44 I built a company with a couple partners. 16:47 They were top down, we were top down. 16:50 So it was really where I came to Cascadia as I think thankfully, 16:55 I started at the beginning of our evolution. 16:59 So I got, you know, I in Owen and I, I just, you know, 17:03 had a very fluid dialogue. 17:06 And so I'm like, OK, I get this. 17:08 I'm not sure how it works in practice. 17:10 But let me say, I think one of the nice things about it, 17:14 about the learning experience though, has been our people are great and we are 17:20 a team and we are collegial and it's real. 17:23 It's not, it's not words on paper, it's not mantras. 17:27 It is we are a cohesive group and we work together really well. 17:32 And one of the things that I found is there's a way. 17:35 If you think something is a way they should go, you, 17:39 you collaborate with the person and you don't dictate, but you say, OK, 17:44 I hear where you want to go and I want to get you there. 17:49 What if we shift this a little bit? 17:51 What if you shift that a little bit? 17:53 And I think you get to the right results in a collaborative way. 17:57 And there are times when I've had people say, no, 18:00 I want to do it this way regardless. 18:02 And hey, at the end of the day, as long as it's legal, 18:06 regulatorily compliant, I want to make it happen for the people. 18:10 And I think that becomes part of it too. 18:12 Working with great people, working with great a great field. 18:15 You want them to have what you want. 18:18 I think the, the key thing for me and I and I've 18:22 alluded to it is people. 18:25 And one of the things that I really learned about the model and you know, 18:30 my collaboration with Owen is hire great people and let them do what they do. 18:37 And one of the fun things about Cascadia was always before I became Owen's partner 18:43 in the variety of roles I had, whether it was chief legal officer, 18:48 government affairs director, I've had I've had the most titles, 18:53 I think in Cascadia. 18:56 And I'm not sure if that's good or bad. 18:58 But in all of my roles in that place, I always had autonomy to do what I needed 19:06 to do to advance our initiatives. 19:10 And that taught me internally, this is how you do it with the people, 19:15 let them make the decisions they're on the field and respect that and be a 19:20 culture of yes. 19:21 So, but it took me some time, I will admit. 19:24 And I stubbed my toe a couple times. 19:26 Yeah. 19:27 So, Owen, I love your mission statement to be a 19:29 force of good. 19:31 You have 5 values. 19:32 But we, we don't, we can't cover each of them. 19:35 But ownership jumps out at me. 19:37 So. 19:38 So how, how do you make ownership real? 19:40 How do you give ownership? 19:41 And what is the impact? 19:43 Yeah, you know, to me, that's one of the the more grounding, 19:48 really important. 19:51 It's a philosophy that that really connects people with the vision. 19:55 So you we were talking about be a force for good. 19:58 I think when people are actually connected to it, 20:01 where that when that result happens that they feel a part of that. 20:05 And so for us, anything we can do to allow them to feel 20:08 truly like a partner, like an owner, and that they make those decisions as if 20:13 it was their own money, if it was their own family members, 20:16 if it was, if it was their son that was working for 20:19 him or whatever, they want to have the ownership in those 20:23 decisions. 20:23 And part of that is you have to give up some things. 20:27 And that is control. 20:28 And, you know, we talked about being innovative in 20:31 different ways of management and different ways of running companies. 20:35 I think that people talk a lot about that, but they never give the space to do it. 20:39 And I think that's a scary thing for a lot of people. 20:41 For us in that collaborative nature, I think great debate equals great 20:46 decisions. 20:47 And so you will have a better conversation when people feel like owners 20:51 in that conversation because they feel like they've got skin in the game and to 20:55 help them get skin in the game. 20:58 With my prior owners, what we did is we did some profits, 21:01 profits, interest and we, we had given out, 21:04 I think it was 11 buildings that we had owned. 21:07 We had given out a percentage of, of that building's upside. 21:12 And I think we had 130, 140. 21:15 Steve, you could correct me, people, all walks of life, not, not, 21:19 we're not talking C-Suite here. 21:20 We're talking everybody had a piece of that. 21:23 And when we had this event a year ago where I bought my partner's out, 21:27 they all got a check for any of the upside that they received in those 21:30 buildings. 21:31 And so it was something real. 21:33 And just to give you one more aspect of that, 21:35 both Tim and Steve have always exemplified that, 21:38 that that is something that they've always lived. 21:41 They've everything they've done, they have done it with this idea that it 21:46 is theirs. 21:47 And, and so when I had this opportunity to do 21:50 Cascadia, revisit this new Cascadia idea onward, 21:54 the two people I of course wanted to bring on were Steve and Tim. 22:00 And so from from people that worked in our company to now owners in our company, 22:04 I can't think of two better people. 22:06 And that is a true example of that ownership. 22:09 If you act like it, you do it, then we're going to do everything we can 22:12 to make sure that you become an owner. 22:14 In this case, I'm lucky because I have Steve and Tim as 22:17 the ultimate partners. 22:19 And just so that the viewers understand, we're not just talking about ownership in 22:23 a on a theoretical basis. 22:24 You, Owen, have actually given up some ownership to 22:27 your two new partners and the and you guys intend to give up actual ownership 22:32 to folks in the buildings. 22:34 And I mean, I think that that's something people that 22:36 need to understand when they look at the success of it. 22:39 And then in, in this last year, just this last year, 22:42 we have actually given up 15%. 22:43 I know it's, it's privately held. 22:45 So I mean, it's, it's not like it's open market where the 22:47 value is like astronomical. 22:49 But as we grow and as we make decisions, these 15% of the company's already given 22:55 out to people in, in one year. 22:57 And our intent when we we decided we're all going to go on this journey past that 23:01 that had been a year ago was we want to give a good chunk of this company out so 23:06 that as we become more successful that this affects the lives of hundreds of 23:10 people and not one or two people. 23:12 Yeah, awesome. 23:13 Steve, as a result of that, and that's also a result of the field 23:18 driven model, your CEOs make a lot more money than a 23:22 typical administrator across the country. 23:26 What what do you see is the impact of that? 23:29 I assume you've been able to get a different type of, of leader. 23:33 I exactly. 23:35 I, I think the impact of that becomes 23:37 circular. 23:38 We attract entrepreneurial people, we attract committed people, 23:43 we attract people with an ownership ethic. 23:47 They want to be part of this, not because not because it's a number on 23:52 a piece of paper that might be higher or could be higher than what somebody else's 23:57 number is, but because they're going to commit to it. 24:00 They're going to dive in and they have ownership. 24:03 And it's not, you know, it's a number that's based on performance 24:07 and they know that they have to hit that performance. 24:11 And it really is. 24:13 It becomes circular within the organization. 24:16 It becomes circular within the teams because we're field driven and each 24:20 facility operates as a zone, but then they have cohorts and then they 24:24 have regions and that's to collaborate with each other and that's to support 24:29 each other is sister facilities. 24:31 But the leaders also drive each other and they drive each other in best practices 24:37 and they drive each other in performance. 24:40 And it becomes, you know, again to be repetitive, 24:44 but it becomes circular and it grows on itself and keeps going round. 24:51 And I really think it does it, it, it distinguishes us in the marketplace 24:57 from other operators and it allows us to share the bottom line again in a 25:03 different way than than the ownership, ownership equity ownership, 25:09 but in a way where people are accountable and people on a daily basis live that 25:16 ownership ethic. 25:17 And I think it's important to our success. 25:19 Yeah, I, I think it's interesting. 25:21 My guess would be there's probably maybe 1500 to 2000 buildings now across the 25:27 country, mainly on the West Coast that have some 25:31 sort of version of this model as it, as the, 25:34 as you all and these other companies expand to the East Coast. 25:39 It's going to be very interesting to see what happens because it's such a 25:44 different model and it's such a different compensation structure. 25:47 I I, I'm, I'm really dying to see what sure, 25:50 but it makes complete sense to me what you're doing. 25:54 Both of you are also known for a particular sort of expertise, 25:57 and I want to focus on that as we come to the end. 26:00 Owen, I know that you have a real commitment to 26:03 technology and the utilization of technology in skilled nursing facilities. 26:08 What are your thoughts on that and what are your general thoughts on AI? 26:12 Yeah, I, I am definitely a closet. 26:16 I think actually Tim and Steve kind of found out something that they never knew 26:20 about me. 26:21 And that's kind of my closet nerd. 26:23 When I, I was a kid back in 386 when the old 26:26 modem was out and I was on quick basic making a little programs and stuff like 26:30 that. 26:30 I, I realized I couldn't be a programmer 26:32 though, because it required math and I wasn't 26:35 great at that. 26:35 And so that kind of ended my career as a programmer. 26:37 Plus, I don't think I could be sitting all day 26:40 long, but but what what is interesting about it 26:43 is I go back to this idea of innovation. 26:45 Our industry is lagging behind in my opinion on innovation and technologies 26:49 and things that are out there. 26:50 And that's been traditionally in the past thwarted a little bit because regulators 26:56 don't really want to change what's what's already in whatever is happening right 27:01 now. 27:01 And so when you try to evolve and you try to change, 27:04 they'll kind of slap your finger or they'll come and say you can't do that. 27:07 No, that's not going to work. 27:08 And they'll give you tags or whatever else. 27:10 So it creates this idea that we're just going to do what they tell us to do and 27:15 we're not going to mess with it. 27:17 Well, it's interesting as, as this AI has started to develop itself. 27:23 When the Seahawks were in the Super Bowl, I actually built my first agent took me 5 27:28 1/2 hours, had no idea what I was doing. 27:30 My son kept asking, Hey, what are you doing? 27:31 I'm like, oh, no, I'm watching the game. 27:33 But I was building an agent. 27:34 And for those of you don't know what that is, it's, you know, in the AI world, it's, 27:38 it's basically an artificial intelligence. 27:40 And I, I started thinking about this in more of 27:44 a practical way on our industry. 27:46 And what we need in this industry is this big leap forward. 27:51 We have technology, we have ways of being predictive, 27:56 ways of being preventive on our clinical side. 28:00 And So what we've done is we actually started a company called Jockey Box. 28:03 And for those of you don't know what Jockey Box means, 28:05 I grew up on a potato farm and that's your glove compartment. 28:08 And in that glove compartment, you throw all your important things and 28:11 you lock it up and nobody steals it. 28:14 And so we've got a lot of industry knowledge. 28:17 We're subject matter experts in a lot of things. 28:19 And when you combine it with AI and you can kind of merge those two, 28:24 what we've created is actually a more of an AI partner. 28:28 Just like we have team partners out in the field, 28:32 we have this AI partner who can immediately pull information from our 28:36 last 10 years of actual performance and can look at that and look at trends. 28:42 It can also look and immediately find places that you can create efficiencies. 28:48 And it can also have a dialogue, which sounds weird, 28:50 but it can also have a dialogue with you on what does that mean? 28:54 How can we interpret this? 28:55 What else are we missing on this? 28:56 How can we look at our Medicaid rates and then and improve those? 29:00 Build me a policy on this and that and it can be done in seconds. 29:04 And why we feel like this is the, the future for us is, well, 29:08 it will be the future because we're committed for this one and sole purpose. 29:14 We want to take menial tasks and things that our nurses and CNA's are doing and 29:20 make them done and with AI so that they can get back to the bedside and take care 29:25 of the people that they got into the industry for. 29:29 I don't know why the regulatory regulations have got so onerous that it 29:35 pulls these amazing people away from our, our, you know, our residents, but it, 29:40 it is the way it is. 29:42 And so we're going to, we're going to combat that and we're 29:45 going to take every opportunity to use AI to not only strategize, 29:48 but to take these menial tasks away from these great people and let them go do 29:52 what they do great. 29:53 And that's take care of our residents. 29:55 Wow, OK, so I, I second Steve, you are a nerd. 29:59 You just demonstrated that it's an impressive and you're an impressive nerd. 30:03 The fact that you can create this stuff. 30:05 That's, that's, that's incredible. 30:07 I want that you've been able to do that, Steve, your, 30:09 your expertise in government relations, even when you guys were a very small 30:13 company, you were back in DC helping the American 30:16 Health Care Association out with all of its lobbying stuff. 30:19 What why is, why is GR important? 30:24 GR is integral to our sustainability and our success to me because this is a 30:31 public private partnership and there are parts of it we like and there are parts 30:38 of it we don't like, but it is what it is. 30:41 And we are partnered with the government. 30:44 And I think, you know, the government doesn't always want to 30:48 acknowledge that it's actually a partnership, but but it is. 30:52 And these are citizens who need care. 30:57 They need care whether it's under the Medicare program or the Medicaid program 31:02 and with the Medicaid program even more important, 31:05 long term care and the governments not providing it and the government doesn't 31:10 have the capacity to provide it. 31:12 So there partnering with us, they're contracting with us, they're, 31:18 you know, regulatorily enabling us is a private 31:22 actor to provide that care. 31:25 And so with that is our reality with the reality that you know, whether it's, 31:31 you know, MA or you know, manage private it, 31:34 it's all it's still all flows from the government, the reimbursement. 31:40 So 98, 99% of our reimbursement comes from government resources and everything is 31:48 regulated kablooey all over the place, crazy regulations. 31:55 And so the only way you truly create long term sustainability to me is having your 32:03 voice in the mix. 32:04 And really early on at Cascadia, you know, one of the things that we discussed there 32:10 was, you know, only a half a dozen of us at that time. 32:13 We had a couple of buildings and, but we realized this, 32:18 this paradigm that we existed in that the government was our partner. 32:23 How do we get our voice in the mix? 32:25 How do we ensure that what we're doing now is not what we're doing 10 years from 32:32 now, That we evolve and we create 32:34 sustainability. 32:36 And I think we, when I talk to operators and, you know, I, 32:39 you've heard me say this, I think the biggest thing is get your 32:42 voice in the mix. 32:43 Get your voice out there. 32:44 Talk to your representatives, talk to Washington, 32:48 talk to your state legislators, talk to health and welfare, you know, 32:52 in your state or Department of Health, whatever it's called, 32:56 talk to your governor, work those relationships. 32:59 And one of the things I knew from, you know, when I was young, 33:05 I was in DC and I was on the Hill was you can't just walk into a congressman, 33:12 the senator, state legislator, governor's office and say day one, hey, 33:18 I want this. 33:19 I don't know you. 33:19 I've never met you. 33:20 I haven't developed a relationship. 33:22 And right, we're going back here to something we 33:24 talked about earlier, which is relationships. 33:27 You have to develop those relationships and you have to go visit those people. 33:31 You have to talk and tell them what you're doing. 33:33 How can I help you? 33:34 How can I help you ensure that the residents of your district district have 33:39 good healthcare, have access to healthcare, have quality. 33:44 And so you develop those relationships, relationships over time. 33:48 And then when the time comes that you need something, you're not a stranger. 33:53 Hey, you know, we've worked together now. 33:56 You know, we have an issue in the state. 33:58 Can you help us with this? 34:00 And, but and you, you know, sometimes you get part of what you want. 34:06 Sometimes you don't get what you want. 34:08 But, you know, it's a fluid process, but you've got to be in it. 34:12 You've got to have your voice in the mix. 34:14 And it's something that's been important to us. 34:16 And it's worked. 34:18 Yeah. 34:18 Hopeful. 34:18 Hopefully you're successful. 34:20 Inspire others to be as involved in government relations as you all have been. 34:26 When? 34:26 Congratulations, man. 34:27 I mean, you, you, you had a big impact before Cascadia, 34:31 but obviously the last 11 1/2 years you've had an incredible impact. 34:35 Your generosity, you're creating, you know, 34:38 new equity partners do all the stuff you're doing in buildings is incredible. 34:42 Where, where do you see the future? 34:45 Both, both are either of Cascadia or of the 34:48 sector. 34:49 Where are are you? 34:50 I, I think about how you might, you know, conquer the US I look in the, 34:53 it's your map, your background there. 34:55 Maybe are you looking to conquer the world with your I see here the whole map. 34:59 Where, where do you see everything going? 35:02 Well, we're working on this side. 35:04 And then we'll, you know, it's interesting, you know, 35:07 I actually think we're at a, a wonderful time in our industry. 35:11 I think off the heels of COVID, things became so difficult and so tough 35:16 that really the only committed people stuck around. 35:20 It's kind of like the wheat and the chaff. 35:22 You know, you're, you're trying to separate the true seeds 35:25 and the ones that are just there and kind of posing, if you will. 35:28 But what that is kind of done is kind of cleared out a little bit of this 35:32 hesitancy or people that are trying to just make money or whatever it is and 35:36 they're not truly committed to what we're trying to do. 35:39 And that's allowed us to have this pure kind of sense of commitment to this 35:44 industry. 35:45 And I think that as a baseline is going to, is going to, 35:47 is going to pay off in spades for us in the future. 35:51 And I, I think that that foundation of that is 35:53 going to be able to allow other parts of the, the company or the country. 35:57 You had mentioned West Coast offense, the East Coast has an amazing, I, 36:01 I don't know how they run 600 bed buildings. 36:03 You know, there's so many things that we can learn 36:05 from them as well. 36:07 But what I'm noticing is there is an outreach that hasn't been there before 36:10 where we're trying to actually, if you will, 36:12 cross pollinate what we're all learning to try to make this better for all of us. 36:17 And so I actually think that the future is very bright for us. 36:20 I know that the supply is contracting. 36:21 I know we've had like 700 plus buildings, you know, 36:25 go go away in the last just the last six years. 36:28 That's a problem. 36:29 There is not enough nursing homes, there's not enough staff to take care of 36:34 the people that are coming on. 36:35 And I'm not going to not going to go down the silver tsunami because we've talked 36:38 about that for a long time. 36:39 But I do believe that are are the great thing about living in the time we are now 36:45 is medications and different services are allowing people to live longer and 36:50 healthier longer. 36:51 The problem though is when the body becomes frail and it is at that point 36:55 where it needs it, it usually happens and they are so frail 36:59 that you need a higher level of service. 37:02 And at some point it will inundate the hospitals and inundate the the skilled 37:07 nursing. 37:07 And then in, in a lot of ways, I think these CON states need to get 37:12 ahead of this and either allow some more creative ways to come in and add 37:17 buildings. 37:18 And I think HUD and other places need to find some some financing options for us 37:21 to start building some of these buildings because they are going to be needed. 37:25 Home health Hospice is not designed to take care of these high acuity patients 37:29 in the manner that a skilled nursing would. 37:31 So I think the future is very bright. 37:33 I think we've got the best leadership out there ready to take this on. 37:38 I see other organizations similar to ours and ones that are completely opposite of 37:42 ours doing some pretty amazing things. 37:44 And one thing I will commend Steve with he from the very beginning is he had this 37:49 outreach on a national level and we felt like we were a national company literally 37:54 with like 2 buildings. 37:55 You know, we felt we felt that immediately and 37:58 partly is because of his the days when he played political and tried to become the 38:02 president running for Ronald Reagan and other people. 38:05 But I think it's great. 38:07 I also think with this technology, not only are we going to be able to say 38:11 we have great quality, we're going to have a better way to prove 38:14 it and show it. 38:15 We're going to have a better way to actually protect it. 38:18 When you think about AI, and I know I'm going to not trying to 38:22 nerd this out again, but when you can look at the, the, 38:26 the metrics for somebody in the clinical care and you can, 38:29 you can preemptively know somebody that's not eating, 38:32 not having this much water intake on this medication that they're going to be a 38:37 high priority for, you know, wound intervention. 38:41 We can get in there and, and figure that out right away and 38:44 prevent a, a very bad situation for any of our 38:47 residents. 38:47 And that's just a very small piece of it. 38:50 So I think quality is going to win this out. 38:52 And I think over the next years, we are going to have some of the most 38:57 extreme examples of how quality is going to advance. 39:00 And I think we're going to see even better outcomes across the board because 39:04 we're ready, we're primed, everybody wants this. 39:07 Now. 39:07 We have some tools that we never had before that are going to be relatively 39:10 inexpensive and we're going to be able to inject those into any buildings that are 39:14 out there on A and again, a very cost effective way. 39:17 And I think it's going to raise the bar quite a bit. 39:19 Great. 39:19 Well, thanks so much to both of you. 39:21 It's an inspiring story, what you've done. 39:23 And I know that this is just the beginning for Cascadia, for both of you, 39:27 for Jim, for the whole team that you got there. 39:30 Very, very exciting. 39:31 And we really appreciate you telling the story here on Park Place. 39:36 I want to thank again, First Quality for their continued 39:39 sponsorship of the Let's Talk segments, which allows us to do this and not charge 39:43 for it. 39:43 We greatly appreciate that and everybody at First Quality and thanks all of you 39:47 for watching and for your continued support of Park Place.
