Senior Care Academy
Senior Care Academy is a podcast dedicated to providing valuable information and expert advice on navigating the world of senior care for both senior care providers, and families with aging parents. Hosted by industry professionals, each episode covers a wide range of topics including healthcare options, legal considerations, financial planning, and emotional support for caregivers. If you are a healthcare provider, have aging parents, or are a senior adult, this podcast is for you! Tune in to gain valuable insights and resources to help you make informed decisions and provide the best care for your loved ones.
Senior Care Academy
Leading with Empathy: Kyle Ruth-Islas
Have you ever wondered what it takes to humbly lead a community through the golden years of their lives while juggling the complexities of healthcare management? Kyle Ruth-Islas, the heart behind the operations at the Redwoods Community for seniors, pulls back the curtain on a career that's not just a job, but a calling. From his Canadian beginnings to his transformative roles in sunny California, Kallo's path is a masterclass in empathy, continuous learning, and the art of asking the right questions.
This episode isn't just a look into the life of a senior care COO; it's an exploration of the pivotal role communication and support play in shaping successful teams. Kyle dives into the strategies that foster transparent dialogues and how he navigates the labyrinth of policy creation and financial management—all while ensuring his staff feels heard, valued, and empowered. His insights are a powerful reminder that leadership isn't about having all the answers but about removing the obstacles in your team's path.
Beyond the boardroom, Kyle shares his personal growth through Certified Dementia Practitioner training, shedding light on the profound impact it has on both caregivers and those they care for. Balancing this heavy responsibility with the joys and challenges of family life, he invites us to see the person behind the profession—complete with a passion for the Man of Steel. So, buckle up as we journey through the lessons of leadership, the intricacies of skilled nursing, and the delightfully human side of our dedicated guest.
Everybody. Welcome to the Senior Care Academy podcast, a podcast focused on the aging space focused on seniors. Today, we're excited to introduce is our guest, Kallo Ruth Eastlafs. He is the chief operating officer and administrator at the Redwoods. Community for seniors. Kyle, thanks so much for joining us today. We're excited to have you.
Speaker 2:Thank you for having me. Excited to be here.
Speaker 1:Tell us a little bit about yourself where you're from. How long you've been in senior space for.
Speaker 2:Going back all the way to the beginning, I was born in Toronto, Canada and lived there for the first few years of my life. My family then moved over to Winnipeg, Manitoba where we lived for a few more years. And then we eventually made our way down to Kansas here in the United States, so that was the first place that I lived here in the US. And we were there for a good amount of time, maybe about five years or so, and then we came out to California, which is where I've spent most of my life I've been here ever since, mostly in Northern California with a few little trips down to Southern California every now and again. Eventually, I would go to a Sonoma State University. I got my undergraduate degree in psychology. And then when I graduated, I started in the senior living industry as called an administrator training intern. Essentially, that's a structured internship program through the California Department of Public Health the goal is to sort of learn basics, the nuts and bolts of what it takes to be a nursing home administrator, specifically in the state of California, because there are some state specific regulations that are quite extensive. And it's what allowed me to become eligible after I completed the internship to sit for the licensing exams as get that credential. Shortly after I completed that internship, I got my first job that what's now referred to as a life plan community up in Davis, California as their health services manager. He's there for a little while. And then I made my way back to where I actually did my AIT administrator and training internship at the Jewish home of San Francisco as it was known then. It's currently the San Francisco campus for Jewish Living. I was there for a number of years, just shy of maybe about six or seven, somewhere in there. Had a number of different roles there, but that was my first position as a licensed nursing home administrator and was there during the beginning of the pandemic. And then a little after that, I was the executive director at a retirement community that offered independent living, assisted living, as well as memory care. Was there for a little while, and then I became the program administrator at a nursing home that was specifically geared towards serving older adults that were struggling with various psychiatric conditions, whether it be schizophrenia, major depressive disorder, things of that nature. And then after that, I found myself in my current position. Is Chief Operating Officer of The Redwoods, a community of seniors here in Mill Valley, California. On the personal side, somewhere in there, I went back to school at University of San Francisco and got a master's degree in nonprofit administration. But more importantly, I'm a proud husband and father to my wife Chloe and my daughter, Eva.
Speaker 1:That might have been one of the best introductions I think I've ever heard. That's awesome. I'm excited to dive in with you today. You mentioned one thing that kinda caught my attention about your career and beginning of your career was your role as a IT. Can you talk a little bit about your role now and how your role as an AIT skills you learn there translates to what you do now.
Speaker 2:Sure. By far, the most complex, the most regulated care setting type, if you will, that I've worked within is a skilled nursing facility. That AIT internship was specifically geared towards learning the day to day operations and regulatory requirements of a skilled nursing facility. I've kind of playfully referred to it as training with weights. Everything else is you know, not to put it lightly or make light of the challenges that come along and working in different levels of care, but Having expertise and experience in skilled nursing makes a lot of other things seem less overwhelming, at least that's been my experience. I certainly understand that others may feel differently about that because there are unique challenges in working in different types and levels of care with different client populations, if you will. Some of the specifics that I have found have been very helpful no matter where I've worked, could be summed up in attention to detail. There's quite a bit of auditing and checking in on various things as part of the day to day operations to make sure that things are running properly and in accordance with whatever applicable regulations there are. That was one of the biggest things that I did to support the organization as an AIT was participate in their quality assurance program by completing routine audits in various subjects, whether it be going down to a kitchen and do an audit to make sure that we're using, say, food handling practices or going through clinical charts to make sure that any as needed medications were either being used or discontinued, so as to avoid any unnecessary medication used. I think I'd also say that my experience as an intern was also very helpful because it gave me a lot of foundational skills to build relationships with a diverse group of people and help sort of teach me how to go to people with the mindset of how can I help, how can I support versus coming in with, say, my own agenda, my my own goals or what have you? Because in the various positions that I've held, one of the things that I have found has really helped me build positive relationships is that I always come to the table when I'm meeting somebody new asking questions as opposed to making assumptions.
Speaker 1:Wow. That's pretty powerful. Not very many people can say that about themselves that they have that skill or they can recognize that ability. We had a senior leader on the podcast a month or two ago. His name was John Warner, and he talked about listening skills. Very, very insightful things about listening. I love that. You included that. What are you've noticed change about yourself? The more you ask question, what about that kind of helps you be different, be better?
Speaker 2:I would say that I find myself repeatedly and consistently humbled when I actually take the time to ask the questions. And candidly, there's pretty good amount of times where I'm thinking to myself, oh, good. I'm glad I didn't jump to a solution and I asked the question because I would have been very long. And I think it just deepens the skills that one has around building empathy with other people because you're taking the time to really try to put yourself in their shoes. What are the challenges that this person is up against how can you as maybe their coworker, their peer, or their supervisor perhaps? How can you help versus making things more difficult, if you will? I think it's Yeah. Common knowledge or at least I would hope it's common knowledge that one of the most prominent reasons why somebody may choose to leave an organization is because they're dissatisfied with their supervised and at least my anecdotal experience personally and talking with folks that I've worked with personal contacts as well. Not only does that ring true, but, you know, a lot of times, the reason why a person is dissatisfied with their supervisor is usually at least one or a combination of factors, which is I don't feel like my supervisor recognizes me. And that's a tricky subject because recognition is to a certain extent subjective. What I feel is positive recognition might not necessarily be meaningful for another person. And that kind of segues into the next challenge, which is a lot of supervisors, they do choose to go in with a certain agenda for whatever reason. I'm certainly not trying to be judgmental about it. But by doing that, I think one of the byproducts of it is a lot of folks don't feel heard, and then that's when they'll say, I don't feel like my opinion matters. I don't feel like I'm listened to. I don't feel like I'm seen as an expert saying on all of these domains of evaluation that you'll see on an employee satisfaction survey. And managers are a key heart of that. If you actually take the time to try to ask these questions, understand what's going on, give the person the benefit of the doubt, that they're a hardworking, capable, professional, and perhaps there are just barriers that maybe they can't quite figure out how to overcome or maybe they or they're not empowered to overcome them. But they don't have the resources to overcome them. And that's where you as the supervisor have an important responsibility to sort of clear the deck and help people and support people in doing their best work.
Speaker 1:I'm thinking now about the times like I feel heard, are the times where you mentioned, where you understand both sides of the conversation, where you really don't make assumptions. As an administrator, a chief operating officer, you hold a a high position of leadership. Are there times where you need to feel heard by your employees or those who work with you? And and what do you do to make sure that you communicate effectively?
Speaker 2:Oh, certainly. Yeah. We're we're all human beings, and we all have that innate need to feel heard and to feel like we're not alone, so to speak, and that we're in it together. There have definitely been a number of times where I've been working with my team, and this is not necessarily exclusive to the Redwoods. But where I feel like my team needs hear where I'm coming from because I don't want them to misunderstand my intent. I don't want them to misunderstand why I'm doing, what I'm doing, what I'm trying to accomplish. For better, for worse, I always try to be as transparent as I possibly can be with my team so that I'm not misunderstood. Nobody feels that they're being treated unfairly or that decisions are being made recklessly or thoughtlessly. Some of the things that I try to do to accomplish that I always joke around with my team that I preface everything I'm going to say with a ten minute explanation of what I'm not trying to say, what I'm not trying to accomplish. Just to try to help folks understand where I'm coming from a bit better. I try to use my words very carefully. I try to phrase things in a way that doesn't come across as absolute. So for example, there are a number of times where I'll use expressions like it seems to me or I've observed This is my understanding because I'm trying to communicate to folks. I have not closed the door on this. I truly do want to hear what the feedback is, what's really happening? Are there things maybe that I don't know, that I should know? And you need to back that up, not just in your words, but, of course, in your and when folks tell you the truth, it's very important that you react in a way that doesn't discourage them from sharing the truth the next time.
Speaker 1:Maybe go through your day to day, what that's like in your current role now and you have a personal experience that you'd like to share about. Things that you do where communication is required, whether it's with a resident or an employee. Mhmm. What does that look like?
Speaker 2:I think I'd refer to it as a sort of a running joke or cheesy or cliche statement is that no one day is like another day in senior living. I think a lot of folks could say that about their industry, but it certainly rings true for this one. But generally speaking, a lot of my day is sort of a desk work where I could be doing a number of things, whether it be creating or revising a policy and procedure that might be reviewed by a surveyor and may be reviewing different contracts for vendors or other types of services that we need to further supplement our operations. I do try to get up out of my chair and go to certain check-in meetings so that I can keep my ear to the ground on what's happening in the community. And, of course, seeing where I can be supportive or removed barriers. Kind of on that subject, there are quite a few meetings that you do have to attend, whether it be a quality assurance committee meeting, a daily stand up meeting, sort of a routine management check-in meeting, or one on ones with direct reports. Things of that nature. I was kinda joke that sometimes if you're not careful in watching your calendar closely, you can fill your day essentially with meetings. And then when are you gonna have time, sort of sit down and and actually do the work that you say you're gonna do in all of those meetings. So you do have to be very diligent with your time management in a lot of different positions in the industry because the calendar can fill up very quickly. There's an element of financial management, whether it be looking at staffing reports to make sure that we're hitting any required staffing ratios that we have and making sure that we're keeping the organization on budget and that we're staffing at a level that is sufficient to meet the current needs of our residents and the different levels of care that we offer. Of course, there's the occasional board meeting that I don't prepare for and then participate in things of that nature. So a lot of walking around, a lot of talking with people, and a lot of looking at the computer and trying to, you know, work on various pieces of documentation that we'll need for some reason.
Speaker 1:Very task oriented. Would you say, like, detail oriented or kinda managing the macros of your community. You mentioned overviewing staffing reports I know that in the senior care space caregiver burnouts big, physician burnouts big. And those are big issues, but are also smaller issues, you know, like difficulty dealing with clients or difficulty with payments. What would you say the Redwoods does to stand out in terms of retention of their employees and care for them?
Speaker 2:There are a few things I could say about that. And I think first and foremost, we truly do try to maintain a culture where everybody is respected, everybody has a valid opinion to share, whether it be a staff member, a resident or their family member when they share feedback with us about things that perhaps are not working as well as we'd like, that's taken very seriously. There's a thoughtful effort to look into that and to see how we could possibly do things differently or better. So having and maintaining and finding ways over time to enhance that culture of respect culture of collaboration, I think, is very important. Of course, we wanna make sure that on the staff side of things, that we're providing a total compensation package that is truly competitive and needs to the extent that we can, the needs of the individual, whether it be, truly a competitive wage. One of the things that the Redwoods does that I personally have not experienced before is there's no out of pocket expense for healthcare, for our staff. So essentially through a combination of the health insurance that we do offer and the supplemental benefit, our staff members essentially have no out of pocket cost or health care costs, which is a wonderful thing because, of course, health care can be quite expensive. It can really add up even with insurance. Sort of going back to the culture of mutual respect. We try to find different ways where we're going to the employees to get their feedback directly so that we're being proactive as opposed to reactive. Of course, it kinda going back to what I was sharing before, doing our utmost as a management senior leadership to make sure that our staff are supported in doing their best work, whether it's making sure that the equipment we're asking them to use is in safe working addition that we've given proper training on safe operation of the equipment or carrying out other aspects of their essential functions. Without the staff, we can't care for the residents, so we need to make sure that we're treating them very well. And it's also very important because I find that every now and again, it's sort of a misstep finding different ways for us to inject a fun and happiness into the workplace. Our HR department does a wonderful job of finding seemingly every possible opportunity to do some kind of staff celebration events where we're having fun, we're sharing food and drinks, giving away prizes, playing games with one another, and just building that sense of camaraderie. You know, ultimately, we wanna make sure that we're fostering a strong connection between the staff and the organization because the more we do that, the more that we can help our staff members feel very proud to work here the more that we can help them build connections with the people that they're working with and really love what they're doing here. That's just gonna help the staff retention. Exponentially. And I like to think that we do a good job of walking the talk in all of those areas here at the Redwoods. I'm definitely a sort of ongoing growth process will never be done, let's say, perfecting our
Speaker 1:Yeah.
Speaker 2:Employee engagement programs. But I like to think that we put an honest effort forward and do job.
Speaker 1:That's pretty amazing. I love that because it just goes to show what open dialogue clear communication can do to help retain employees. I spoke to a CEO of a company a few weeks ago, and she said that there isn't necessarily a shortage on people willing to work. There's just a shortage on dialogue. There's a shortage on communication. There's a shortage on care. That's pretty awesome that you guys focus on that. Do you guys at the Redwoods, like, integrate technology into what you do at all? And has that made an impact on you? What ways do you do that?
Speaker 2:Yeah. There's a certain amount of use of technology here at the Redwoods that that we do. And in other places where I've worked, it's been due to the pace at which technology changes, I would say that there's probably a lot of really great products that are out there that we're not currently using. For example, we just went through a significant transition with our electronic medical record so that we're able to use a product that allows us to have an enhanced level of sharing information electronically so that we can improve continuity of care between the various providers that we work with. It gives us access to some enhanced mobile technology for point of care or charting. That application is one of the core pieces of technology that we use or that any your living community that uses an electronic medical record we use. It's important to have a robust comprehensive tool for the staff to use because unfortunately due to all of those regulations I was alluding to earlier, good, bad, or indifferent, there's a heck of a lot of clinical documentation that the staff are possible for doing to make sure that we're doing everything that we need to do on the day to day. And so the more that we can increase efficiency and in increase the ease of use, if you will, with these different types of applications, the better. And one of the other things like others that we've also used for folks that have some cognitive impairment are these robotic pets like cats and dogs? It may sound perhaps a little silly. For somebody that has moderate to advanced dementia, and I've personally seen this. They form pretty deep attachments to these robotic pets and it will express care, you know, whether it be petting or taking care of them. You know, maybe on the lower tech side of the spectrum, but definitely a powerful example. And we use other pieces of technology, whether it be for musical engagement or other forms of activity engagement.
Speaker 1:That's pretty expensive use of tech. You're a certified dementia practitioner. Right?
Speaker 2:Yeah. Through the National Council of Certified Dementia Practitioners years ago, I took their Alzheimer's disease and dementia care seminar, and I was able to get that credential.
Speaker 1:Can you talk a little bit about what motivated you to do that? And then talk a little bit about your experiences? I've never heard of becoming a certified dementia practitioner. I don't know what it entails, what it looked like for you at the beginning. That's pretty cool.
Speaker 2:I would say that, you know, throughout my career, again, I've been very humbled with the seemingly endless number of things that I just don't know about. And as I was taking on different job opportunities, I was realizing that because I didn't know about these things with any degree of detail that I couldn't be as effective as I otherwise could be in my role. And by virtue of that, I couldn't be an effective partner to the staff that I was either supervising or working with. To the extent that I can, I've tried to sort of take it upon myself sometimes with my employer. So important sometimes without to try to improve my knowledge in various areas that I felt were needed for my role. And dementia care, of course, was a very prominent subject and I over the years have gone to different types of dementia care training seminars to try to get the latest and greatest information and see how I incorporate best practices into the work that I was doing and with the team that I was working with. So years ago, when I realized that I needed to know more about dementia care and was trying to look into perhaps a more rigorous course to try to get more in-depth knowledge base. I came across this organization, the National Council of Certified Dementia Practitioners. I saw that they had can't remember the exact number of hours, but it was more than one day. Wanna say it was, like, twelve to sixteen hours or something like that, where I would sit through their seminar and at the end, if I met all of the criteria, that I would be able to earn this credential. And so I was interested. I applied to sit in on their course. They let me in. Thank goodness. And, Satya, the course, I thought it was very comprehensive deep dive into the nuts and bolts of a dementia care from various different perspectives, whether it be providing care for activities of daily living, whether it be activities, end of life considerations, they really kind of covered the a to z, and I'm a pretty high degree of detail. When I was just reviewing the curriculum, I was inspired to actually attend their trainer seminar so that I could use their curriculum and bring it back to the facilities where I was working, and I did do that for a period of time.
Speaker 1:Wow. What type of impact did you see it as a result of that?
Speaker 2:Well, it's difficult to say because a lot of it is sort of qualitative. I can tell you that at least in the sessions that I held with a lot of the frontline staff, that we're providing the care to our residents that have dementia. It was really great to see amongst the staff that we're participating there was a lot of great opportunity for building connections with one another and sharing as practices because what I've experienced to be somewhat commonplace And it tends to come out when you're doing a training in dementia care because one of the most, at least in my opinion, effective exercises that you can do in a dementia care training because every person with dementia is a unique person. You can have sort of broad brush strategies, but you have to sort of be a detective and really get to know somebody to figure out what specific strategies are going to work for this person based on where they're at in the disease process of dementia. And by virtue of that, what I've come across many times and I'm sure other providers have as well is that you'll have One or a couple of staff members that are really excellent at working with a resident that has dementia because they've learned something, they've learned some kind of strategy that allows the care process to flow that much more smoothly. But they maybe don't share that information because they don't think that it might be helpful for others And when you do these trainings and you start opening up the discussion to say, has anybody encountered a resident with dementia that exhibited this behavioral expression? Have you ever encountered a scenario where a resident was perhaps trying to wander away from a safe care setting? And unfailingly, everybody's encountered that many times, and so we start digging into that. And we we ask, oh, would you mind sharing a story? Please don't name names, or we don't need to get that specific, but give us a sense of what happened. What did you do? What worked? What didn't work? And so you get a lot of unplanned learning that comes out in these seminars. And then when you're doing it with staff, you end up getting a greater sense of camaraderie because you're helping your coworkers, you're sharing best practices that might actually make their job a lot easier, which might end up translating into a better more effective care for the resident themselves. So that was sort of one thing. And, of course, there were a few that decided to go out and pursue the certified dementia practitioner credential themselves after they took up the class. And so it was great to see somebody advance their professional skills based off of something that was made available through the organization. That was a great experience. And there were certain examples where when I would go up to the neighborhoods or nursing units where residents with dementia were living, you get those in the hallway pass through buys where someone will say, oh, so this just happened and I used this that I heard in this class and it worked. And you get those little victories along the way. So I like to think there was a positive impact from offering that training in different ways and in a lot of ways a positive impact that I didn't expect.
Speaker 1:Yeah. I think it would be kinda difficult to have quantitative measurement of what impact training other people would be like. I know for me personally my grandma had suffered from dementia a little bit and kinda learned a new aspect about their personality. Everything is laid out in a sense where what you see is what you get. And it could be difficult some days to track their train of thought or track what they're feeling. And I remember feeling especially close to my grandmother before she passed just learning a certain grunts or certain movements or certain looks, meant certain things, and I think my strategy, you can validate it, was just understanding their schedule, understanding their routine, what made them come go on that kind of matching that. That's definitely what I learned was the best.
Speaker 2:I would agree with that if I could briefly interject their I think what you're touching on is what I would refer to as healthy, child, lunges that we as community the provider face when we're trying to provide person centric care to people that have the diagnosis of dementia. Because of course, we're an organization. We have certain systems that we have to follow their regulations. We have to follow. And so there's a tension between trying to do things on the resident's schedule as you were saying and doing things in a manner that allows us to continue to effectively and consistently run the operation. So it's something that's a constant subjective conversation of how can we make this more person centered well at same time being able to do this, not just use these same general strategies, not just for this person, but how can we apply it broadly to all of our other residents that have dementia? Because we wanna be fair and consistent.
Speaker 1:What would you say to the person who maybe is a caregiver listening to the podcast? Someone who may be struggling with a diff co patient, whether it would it be dementia or whether it be some other medical condition. What would you say to that person in terms of advice?
Speaker 2:Well, first of all, I would have to say thank you for doing what you do. It's not easy. And I know a lot of times you can feel alone in being the caregiver to somebody that has this diagnosis, but know that you're not alone. There are many people that are in your shoes that I'm sure would welcome some sort of mutual connection to share different experiences and perhaps find mutual strategies that would benefit both. So I think I'd probably have to start there And as part of that, I would also say there are a number of resources that are available that you may not be aware of for caregivers as So for example, if it was a caregiver that was working for our organization, like many others, we have an employee assistance program. One of the services that's offered at no cost is counseling services. And a lot of folks may not necessarily be aware of that, but that can be a very helpful thing to do to try to bend some of that pent up emotion in a safe space. And following that, I think I'd wanna also offer a word of encouragement by saying that there are probably a lot of times where you feel like you're failing and not doing a good job, but trust me, you're doing better than you think. Just the mere fact that you're showing up and trying to do your best speech volumes. And I think I would also wanna say that when possible, when practicable, the more that you can further your own knowledge of how to effectively provide care and service to somebody that has this diagnosis, it can make things perhaps a little bit easier or more straightforward. I always use the expression, put more tools in the tool belt because if one thing's not working, it helps to have a plan b, a plan c, and so on and so forth, so that you can keep trying different things and adjust your approach. One of the things that's very difficult to talk about with caregivers because we certainly don't want to come across as offensive or dismissive of what they're going through. But there are scenarios where sometimes we as the caregivers, the staff, if you will, where we're creating the problem. And by virtue of that, we're causing residents to have negative behavioral expressions, whether it be calling out or striking out, and you have to sort of see it from their going back to what you were saying about doing things on their schedule. From our perspective, we might be going to a resident to say it's time for breakfast to need to help you get to the dining room so that you can have your meal because we're asking them to do things on our schedule. And perhaps that person doesn't want to eat breakfast at that time. From their perspective, there's this person in my apartment. They're bugging me. They're trying to get me to go somewhere. I don't wanna go. And they won't leave me alone. So there are sometimes where a resident may get aggressive or just upset, angry, when we're trying to get them to do things that they don't want to do. And so it's very helpful in those scenarios as a caregiver to polately exit from that situation, make sure the resident, of course, is safe, and then perhaps go back and try it again later and see if you get a different response. Or sometimes there might be a staff member that has a special connection with that particular resident who could help. Again, going back to the team approach, nobody's alone, sometimes we have to approach it in that respect.
Speaker 1:The way you're answering these questions makes me almost gonna work come work for you. You guys create such a wonderful environment, and you'd make a great boss. I'm sure your practices in the workforce also translate to your home life. Can you talk a little bit about the impact that your family has had on your work, and then what it's been like to be married, to be a father, and how that's impact to July?
Speaker 2:Oh, sure. Well, whether it's my position or if it's a nurse on the floor, a CNA of it, there's a potential for this to be a very demanding job, both from a time perspective and an emotional perspective. Just the nature of what we're doing here, And so one of the things that I've had to really work on and focus on and I'm very grateful that my wife has been a true partner to me and has engaged in conversation with me about what was working well, maybe what was not working well. And from her perspective, I really had to try to work card to find that balance of fulfilling my responsibilities at the community in such a way that I can feel comfortable that I've done a good enough job, so to speak. While at the same time having that balance at home where I can be a present husband and a present father up to my child. So I think that's helped me sort of reframe priorities. And at the end of the day, when I I maybe have twenty unanswered emails or what have you rather than trying to scramble through and answer all of them. I might look at them and say, okay. I'm gonna answer these five because those are somewhat time sensitive or urgent. And these other ones, they'll be just fine. If I wait until tomorrow morning, it's more important that I at home now and spend a little bit of time with my wife and daughter before it's been time so to speak. You know, I think also it's and I mean this in the best possible way that being married and being a father has certainly, at least in my opinion, enhanced my capacity for patience because when you're having to make a life with somebody else, you know, that is not an exact clone of you. Inevitably, you're going to come across differences and, you know, whatever they be. There has to be a healthy give and take and you wanna make sure that you're meeting your partner where you're at and finding ways to conduct yourself in a manner that's positive and always being open to their experience, their thoughts and feelings and making some adjustments when you need to and when it's appropriate. And certainly being a dad, I have to say that, you know, I'm not very I'm not very eloquent in talking about this just yet, but it's a really wonderful thing to become apparent because your whole view of the world sort of changes in terms of what you think is important and not important. And what I was talking about before of having that work life balance, so to speak, to make sure that you're there and you're present. So you just took on a whole new level of importance and significance. I've learned new ways to feel and experience happiness when I see my daughter learn something new for the first time or even when she does something as simple as laugh. It's like an instant mood elevator. Those are some of the ways that those things have affected people so far.
Speaker 1:I think you speak pretty eloquently about that. I really appreciate that answer. Think about my dad. I know that family can either be a hot point or a cold point in the senior care space. You know, some families are really engaged, involved, and some families just aren't. What strategies have you seen work? Or what do you implement to engage the family and sharing for the person who's at your home or just in general?
Speaker 2:Well, I've always tried to practice the starting point of family members. They're part of our team. Their partners in providing care and service to our residents. I mean, ultimately, they know the residents much better than we do. They've grown up with them and enjoyed a different kind of relationship than we have. They have so many valuable insights to share with us. And if I can put it somewhat bluntly, it's a wasted opportunity to not engage in conversations with the family member to get a better sense of who the resident is as a person, what are their likes, their dislikes, simple things, like, what's their attitude towards pain? Are they somebody that's perhaps is not comfortable tolerating any level of pain? Or are they from a culture where perhaps it's frowned upon to talk about pain or discomfort and so they bottle it up and keep it to themselves. Those are all very helpful things for us to know as we're trying to provide nursing center care And it's also important because we, as the providers, have to recognize that this is a highly emotional and difficult experience, unusually anyway, not just for the residents, because when they're moving into a community, like the ones where I've worked immediately Yeah. If it's in skilled nursing or perhaps assisted living, they're sort of a recognition that I'm getting older. I can't do as many things as I used to for myself in the way that I used to do them. And that in and of itself is emotional and can cause grief depending on the person. But there's also an emotional side for the family member as well. They're having to contend with the fact that their mother, their father or sister, brother, whoever is getting a bit older and can't do things the way that they used to do them. And for adult children, and even for the parent, they're trying to navigate a challenging and changing a dynamic where perhaps the adult child is now having to make decisions on behalf of their parents. Whereas, you know, of course, up until that point, so the roles were reversed, if you will. There's a lot more to that, but it's all just to say that it's not uncommon for us to encounter situations where there's quite a bit of emotion, whether it be grief or sadness, anxiety, especially because the average person does not necessarily know the intricacies and the nuances of what it's like to be in a skilled nursing facility or assisted living facility or community until they're actually in one. And as I just said, it's an emotional time and it's usually not a great time to learn something that's complex and difficult when you're already stressed out, so to speak. So It's incumbent upon us as the providers to also be educators. As part of our partnership with the resident and the family, again, not just come in with our agenda, but to present in a clear and concise way. Here's what the situation is. Here's what the options are. Here's what we think you ought to consider as you're waiting the different options and trying to approach it as a true partnership when it's appropriate and when we have partners to engage with. And there are sometimes, and you sort of alluded to this earlier, where there isn't necessarily a family member that's involved in the situation for one reason or another. And in those cases, we still try to involve family members when and where we can because we don't want anybody to feel sort of cut out of the process, if you will. But there are other ways that we also try to approach those situations when the resident may be on their own. For example, in my past, we've unfortunately had to contact public guardian to get a conservator for a resident who was no longer able to make their own decisions because there was no next of kin for this individual. But those are the general ways that we try to approach family members, which is to treat them as part of the team. Try to affirm that they have a lot of valuable insights to offer. We're here to serve them just like we're here to serve the residents, and we're trying to make things less stressful as opposed to making them more stressful, and we try to be educators.
Speaker 1:Now, that's wonderful. I learned so much from these conversations. I learn a lot about how interacting with individuals on a one on one basis is super important, and I learn about how important it is to listen to it and to be empathetic. And things that you talked about earlier in terms of understanding both sides of the conversation, understanding other people, I really love what your insight is. Would you say your background what is it that kind of helps you build with your knowledge now? Is it studies, your school? Has it been your experience? What contributes the most to what you know? Sure.
Speaker 2:I have to give some credit to my wife and my mother and my father and my sisters because from the personal perspective, there have been a lot of learning opportunities over the course of my life so far where they've helped me really see the value in listening twice as much as I speak my father will say, I can't credit him with inventing this phrase, but he's the one that told it to me that we were given two years in one mouth for a reason. Is meant to listen twice as more than we speak. From the personal side, it's just been part of my upbringing and it's been my experience and personal relationship, my marriage. And from the professional side, the undergraduate degree that I got from Sonoma State was in psychology. It's always been a subject that I've just been fascinated by. I love learning about it. I certainly got some very helpful insights from that experience. There were some helpful learning opportunities even as part of my nonprofit administration degree as well because one of the courses that was part of the curriculum at the time was effective in ethical leadership. And of course, in order to be effective in ethical, you have to listen. So that came up in the various leadership modalities that I learned about whether it be servant leadership, transformational leadership, and so on. And then just practical experience, you know, as I've done different positions and worked in different places, I've tried to pay attention to sort of the patterns of what worked and what didn't work and try to extrapolate that into ongoing strategies that I continue to employ whenever I can. And no real surprise, but actually taking the time to sit down and listen to people and hear what they have to say in earnest. Shown to be effective. So I think I'll keep doing it.
Speaker 1:That's a great plan. Kinda switching gears pivoting to more of like the general aspect of the aging space outside of these podcasts for me, LinkedIn is, like, my number one resource for understanding changes in the health care space, the senior space. Like, where do you get most of your information from how does the Redwoods keep up on what's going on? Where's that?
Speaker 2:Oh, sure. Yeah. From a variety of since LinkedIn is definitely one that I use quite frequently to try to get pieces of news about what's happening in the industry. And there are certain things on there. Where I try to get updated on things that aren't necessarily directly involved in the industry, but could have sort of an indirect effect. So that's one source. Thankfully, there are different organizations that have various educational conferences on different topics, and that, you know, high and others tend to participate in, not just for networking, but also for that educational component on new and exciting things. There are certain email listservs that you can get on. So for example, here in California, skilled nursing facilities are overseen by the California Department of health assisted living is overseen by the California Department of Social Services, and you can go to their websites and you can sign up to be part of their email distribution list so that you'll get different letters and publications that they put out around different guidance to follow or changing regulations, things like that. So there's a lot of different ways that you can get the information. I I would say the bigger challenge is finding the time to read through and synthesize all of it.
Speaker 1:Yeah. That's true. There's a lot. I'll see a post and it'll be like a fifteen page article. And I'll try and maybe attach GPT it. Anything to get a quick summary, but that's true. You just mentioned earlier how skilled nursing is one of the most complex environments within the senior care space that there is. Do you think in five years that'll change or where do you think the senior space will be at? What developments do you foresee cover?
Speaker 2:I don't claim to have a crystal ball, so I take this with a grain of salt. My take on it based off of the things that I'm seeing there have been two sort of macro trends in skilled nursing that have been around for a number of years, which is regulations are increasing. And accessing sources of government reimbursement, whether it be through Medicare or the Medicaid in California, it's the medical program, that's becoming more difficult. For example, the government switching from a prospective payment system to a value based system, essentially rewarding skilled nursing facilities for outcomes. From different perspectives, that sounds like a very good thing. And I'm not necessarily advocating against it, but it does have other challenges that skilled nursing facilities all have to contend with. So essentially, what these two trends mean is that skilled nursing facilities are a lot of times in a position where they have to do more with either the same and in some cases less resources than they had before. I don't really see that changing. I see those trends continuing. Just for example, earlier this week, leave on Sunday or Monday, the federal government published a new federal staffing minimum for skilled nursing that requires, among other things, that an RMB present for every shift in a twenty four hour cycle seven days a week. There's already a well published shortage of nurses across the country this mandate, which I don't believe, has any additional funding behind it, only increases that deficit of workers that are needed relative to the ones that are available and want to work in skilled nursing. Again, I'm not necessarily disagreeing with the intent behind that minimum because you can read what CMS and others it. It's all about trying to improve quality of care in nursing homes. Who could disagree with that? I think like many other conversations where we start to diverge is in the execution of the plan because certain things may sound good on paper. But when it comes to the practical application, it's actually quite challenging. So I don't mean to paint too much of a grim picture, but these two trends do seem to be continuing don't necessarily see them going away. I actually am starting to see a lot of these trends, particularly the enhanced regulatory oversight starting to trickle into the assisted lift which historically has been not as regulated as skilled nursing.
Speaker 1:So by regulation, does that mean how your facilities run, what aspects of it are legal, not legal, defining certain things? What does that regulation look
Speaker 2:like? Sure. So to use a skilled nursing exam, because we are currently certified to accept residents that have a payer source with that's either Medicare or Medicaid or medical in California. Because we have those certifications and because we bill those two government programs for services and care that we provide, By virtue of that, we have to follow the federal regulations that are within the state operations manual that comes from the Centers for Medicare and Medicaid Services. So examples of regulations that are within that text, there's a whole section on the resident rights that'll say things like Residents have the right to self determination and to make decisions about the care and service that they have within the facility. Very important to have regulations around these kinds of rights. Another example is as simple as residents having a right to access their medical records. And then on sort of the other end of the spectrum, if you will, There are certain administrative requirements like every skilled nursing facility that is certified under Medicare or Medicaid. As to conduct an annual and as needed facility assessment, which essentially means that we do a head to toe look at to who we're serving in our skilled nursing facility, from a demographic standpoint, from a care needs standpoint, and then looking at our staffing, looking at our equipment, the physical space, the contracts that we have. Essentially, it's an exercise to confirm that we have everything that we need in place to make sure that we can provide quality care and service to the residents that we are actually serving. So that's a pretty exhaustive, interdisciplinary process that is mandated by federal regulation. Then there are other things in there, if that's intense medication management and certain quality of care standards, required physicians, For example, one required physician that we have to have by regulation, of course, is a director of nursing who is a registered nurse by background.
Speaker 1:Do these regulations like impede work at all? Or have you found that they help? Because you're following the regulations, you're actually seeing benefits within the home, or do you find that they kind of slow operations down? Where do you where do you stand
Speaker 2:on that? I think it's missed. And I think kind of like what I was getting at before is there are many regulations where I look at the intent and I completely agree with the intent. There's not necessarily an argument there. The challenges come from what's in the specific guidance around how to effectuate this regulation because it could create additional administrative challenges, if you will. So for example, there's a relatively new federal regulation that mandates that to skilled nursing facilities send a standardized document. It's called a notice of transfer and discharge to the long term care ombudsman saw is every time there's a facility initiated, a transfer or discharge, and by regulation that includes transfers to the acute hospital. Now I understand the origin of this regulation, which is that unfortunately, there have been some nursing homes reported in the news that or, let's say, improperly discharging or transferring residents out of their facility. Let's just say that. So as a remedy to that and as an additional layer of oversight, this regulation, possibly for other reasons as well, was put into effect so that there would be a mechanism for nursing homes to report any time they do a quote unquote facility initiate a transfer discharge. That sounds like a great plan. And again, I don't disagree with the intent, but I'll be honest with you, when that regulation was rolled out, long term care on Butsman's office where I was working at the time. I was very surprised by the regulation and was quite overwhelmed because in that particular facility where I was working, we would discharge some two hundred people every month because it was a very large robust organization. And that was just one skilled nursing facility in the city. And so their question was how could we possibly sift through all of these notices with any degree of detail for every nursing home and every time we get them. So I guess that kind of leads me to say that a lot of regulations have great intent. They make sense. They do seem to address certain challenges. But then, like anything else, they create other challenges that providers like us have to figure out the best way to move forward. And then there's some regulations where I just have a lot of fun working on them, like from the federal regulation side. There's something called quality assurance and performance improvement, which essentially is using process improvement methodologies like Lean Six Sigma, for example, to try to improve the overall quality of resident care. And that's one of my favorite things to talk about. And it's, you know, a regulation that even though it's quite complex, it's very challenging, it's a lot of work to do it properly. But I'm happy it's there, and I I personally have a lot of fun with it.
Speaker 1:Wow. That's pretty cool with the growth and an improvement. You enjoy it because you enjoy in like, measuring growth and then measuring that growth and then watching it grow again? Like, what aspect of that regulation do you enjoy the most?
Speaker 2:I'd say that's certainly part of it, but it is sort of going back to the intent. The whole purpose of it is to make sure that we're doing everything we possibly can to maximize the quality of care for the residents that we're serving. That's just sort of my boiled down very simple background for it. Yeah. And Gosh, who couldn't get behind that?
Speaker 1:Seriously. My last question is actually I have two more. If you had a magic wand, and you were to wave a problem away in the senior care space or or bring a problem to light, what what would that be?
Speaker 2:If I could wave a magic wand and wipe a prop of a cave. Well, gosh, so many things are coming to mind. What what would I choose? Kind of going back to what you said earlier about caregiver burnout and just extreme emotion that can be very difficult to contend with. I wish that there were a way for that not to be the case. There are so many wonderfully compassionate empathetic people that are out there in the world and they often don't get the credit that they deserve and somewhat cliche to say that a lot of times the job can be without any gratitude and that only contributes to the burnout. And I I wish that that were not the case.
Speaker 1:But an ideal world to live in if that were the case. My last one is this. Was there something that you wish we had covered or asked you about maybe a sports team, maybe a hobby, maybe an interest. Is there something that we missed today that you wanted to go over?
Speaker 2:Nothing comes to mind really. I think, you know, one thing I'll I'll share about myself that everybody who knows me and definitely knows this. This might be a controversial statement, but I'm a Superman Mega fan, and I retained to this day that he's appointed as a comic book superhero. At the very least because he was the first. My opinion, I'm sticking to it.
Speaker 1:I love I love Superman. Well, everyone, thanks so much for tuning in today. It's been the Senior Care Academy with Kyle Ruth Eastless, chief operating officer and an administrator. For the Redwoods community for seniors. I'm your host, Alex Alteryx. It's been a pleasure to talk to you today, Kyle. Thanks so much for having
Speaker 2:issues
Speaker 1:for being on the show.
Speaker 2:Thank you.