Caring with Compassion: Emilee Burchette on Leadership in Healthcare

In this episode of Hometown Jax, we sit down with Emilee Burchette, a dedicated healthcare leader who has spent her career running nursing homes and rehabilitation centers with a heart for compassionate care. Emilee shares her journey into the healthcare industry, from unexpectedly stepping into the field to becoming an experienced administrator overseeing the well-being of countless residents. She dives into the challenges of managing a facility, navigating strict regulations, and ensuring that every patient receives the highest quality of care while balancing the needs of families and staff.

Whether you’re interested in healthcare leadership, elder care, or simply want to hear an inspiring story of dedication and resilience, this episode has something for you. Emilee opens up about the emotional realities of working in a nursing home, the lessons she’s learned from her residents, and how she’s making a difference in the Jacksonville community. Tune in to gain valuable insights into the world of senior care, leadership, and the power of compassion in healthcare!

Transcript

00;00;00;00 - 00;00;14;29
Unknown
Where are your hosts, Aaron Backus and Jason Kindler? We like to sit down with our guests to hear their journey, their challenges, and how they impact the local community. So grab a seat. Tune in and let's get inspired by Jacksonville's everyday workforce. Welcome to Hometown Jacks.

00;00;14;29 - 00;00;24;15
Unknown
I am super excited to have Emily Burchard here today. Emily runs a retirement home slash rehabilitation center.

00;00;24;15 - 00;00;44;12
Unknown
And I find that extremely interesting. And I have a lot of questions to ask you. Are you ready? I'm ready. Oh, she looks ready. I love when they come in. Ready. This is going to be awesome because I think my audience really wants to know some of the things I'm asking about a nursing home. I think it's very interesting, but I always like to start off with a bang.

00;00;44;12 - 00;01;06;14
Unknown
So I want you to think what was one of the scariest? Crazy. It could be funny situations don't have to use real names. I'm sure you've seen a few that you can. You can think of when it comes right to your head. I went the scariest route and the scariest route, and I think this is pretty universal in the industry would be an elopement.

00;01;06;17 - 00;01;23;27
Unknown
So an elopement in a nursing home is. Are you familiar with, like, a silver alert? An elderly person has gone missing. And I'm thinking a lot like they just get married and they don't tell anybody, okay. That I find, so it's actually whenever a resident gets out of our building and we don't know it. Yes. So luckily.

00;01;23;27 - 00;01;48;19
Unknown
And they call that that's a local that interesting. Luckily, I've only had a near miss, which is they got out of the building, but we're still on the property and I'm here quickly. But that is still scary because, you know, elderly people, they wander around, they get lost. That's can happen very quickly. And so that is every administrator's nightmare is a phone call that like, we can't find somebody.

00;01;48;22 - 00;02;09;17
Unknown
I would think that would be, extremely terrifying. It's interesting that they have an actual word for it, though. Elopement. So was this particular individual. Was she, have memory issues and not or she or he have issues not knowing where they were or were they just wandering? So he was upstairs on our dementia unit at one of my other.

00;02;09;20 - 00;02;29;02
Unknown
Okay, so there is dementia involved. And, he was smart. That's the thing about dementia. You don't know, right? Right, right. He actually had intentionally pulled our fire alarm. Okay. And it was a second floor. So he went down the stairs and then hid under the stairwell. Oh my gosh. So this was like a calculated yes planned out maneuver.

00;02;29;02 - 00;02;50;21
Unknown
Yeah. That, you know, since we don't we're not using names. We can laugh. That seems actually pretty dang fun. Oh, yeah. No, he was very smart about it. And ironically enough, our staff had gone down the stairs looking for him, and he ended up following the sidewalk back to the front door so he didn't realize when he followed the sidewalk that he was just going back to the front door, like he thought he was possibly getting somewhere and he wasn't.

00;02;50;21 - 00;03;14;25
Unknown
So he had this laid out plan and actually executed it pretty well. But due to, you know, just not thinking it through, he just follow the path right back in the door. Yeah, thankfully, thankfully, that is actually freaking hilarious. I that is that's pretty amazing. So. Wow. Well, I'm glad we had a funny story about that because I'm sure you've had some scary ones, but man, that is.

00;03;14;25 - 00;03;29;26
Unknown
That's pretty funny. I can't remember the movie I'm thinking of, but it's, oh, it'll come to me at some point. So that's great. I'm glad we started out. I always like to start out with a bang, so I think that's pretty funny. What? When did you know you were going to get in this field? You know, I've.

00;03;29;26 - 00;03;51;03
Unknown
I've researched you looked at your, your resume like you didn't fall into this type of work. It seemed like you wanted to do it. Day one. I fell into this type of work. Okay, okay. So good old college days. I was health administration for my bachelors at Auburn Medical. Yeah. And, I didn't want to have classes on Fridays.

00;03;51;06 - 00;04;13;14
Unknown
Nobody wants Friday. It's a three day weekend. So. And within my health administration, there's classes like dementia, aging in place. Long term care. I had no exposure before that. Okay, so those classes fit and so that I didn't have Friday classes. So I really did, like, stumble into the field. I didn't go to college taking that. I thought hospital.

00;04;13;15 - 00;04;33;02
Unknown
Yeah. And then I started taking the aging in place and the dementia. And I did my internship at a nursing home. And I was like, so I consider it stumbling into the field because I didn't have experience before then. And it was, you know, I didn't want Friday classes like he wants Friday classes, right? I mean, I and people in college is a lot of people that don't want Monday or Tuesday classes either.

00;04;33;04 - 00;04;39;22
Unknown
But we're equal. We've got that in common. That's awesome. I love to hear that because. But you were intent on the medical field.

00;04;39;22 - 00;04;52;05
Unknown
You wanted to go into caring for people. Yeah. So do you. Do you have a deep heart for that? I do, okay, I do. My mom's a nurse. You know, industries go with families. Yeah.

00;04;52;05 - 00;05;11;02
Unknown
My mom, my older sister nurses, my, little sister, my dad are in the wood industry. So it's kind of like we we just picked which pair we wanted to follow. Yeah. But I always knew I didn't want to be clinical. Right? I wanted to be clinical. Meaning, like you're doing being anchors and stuff. Okay. Being a nurse and, like, injecting people.

00;05;11;05 - 00;05;31;10
Unknown
Oh, okay. So you're more of, like, the, the helping kind of thing, not the injection kind of. I like to be able to be like, oh, you want pickles because you love pickles. I'll go get you some pickles. So but but seriously though, because this is, this is something a lot of people talk about. But and then they probably say they do and they don't.

00;05;31;10 - 00;05;38;22
Unknown
But like, you really have a heart to help older people like it. Really. It fires you up. I love old people. That's awesome.

00;05;38;22 - 00;05;54;22
Unknown
That's awesome. Well, we're going to get into that because I have some questions. You know, about potentially your grandparents and things along those lines. You know, that was really interesting to hear. So I see you had undergraduate in, healthcare administration or what was the call.

00;05;54;24 - 00;06;26;06
Unknown
Okay. So you have a master's in legal services for health care. I thought that was really interesting and really niche. So did you. I saw that was Oklahoma. Did you do that online or I did I do that online? Okay. Tell me about what that means. So it's a master's in health care law. Okay. So I know way more information about stark law and things like that, which is very fancy regulations we have as far as, like, I can't refer a patient to a specific doctor and then that doctor, like, compensated me back somehow.

00;06;26;07 - 00;06;47;04
Unknown
Okay. So we have all those same regulations within the health care field, and then there's of course HIPAA, everybody knows have. Yeah. I can read a statute about health care law and I can decipher how to apply it in the real world. So you're not a lawyer? No. Okay. Well, is that like, is that a fine line where you go up to this, like, do you want to be a lawyer?

00;06;47;04 - 00;07;13;16
Unknown
Here's another four years or how does that pay. Yeah. Yeah. Okay. So you're probably more of the practical aspect of it. Yeah. Applying our regulations changed so much every year. You're regulations change. So just having, that master's really helps me be able to decipher and understand and make sure that we're executing the regulations correctly. But why do you I mean, who drives the regulations is state the federal both health both both.

00;07;13;20 - 00;07;38;15
Unknown
And why are they why do they change so much. Like is it just why I mean some of it's knowledge. Yeah. You know learning things that are good and things that are bad. Some of it is, technology changing, right. That has been great. Like but hip is a challenging one because an easy example for technology changing and how it's good and bad for us is like, everybody wants to text.

00;07;38;17 - 00;07;59;27
Unknown
Yeah, okay. But in all reality, I should not text my doctor for my iPhone saying like, hey, patient A needs this, this or this or their labs came back with this, isn't this that's happened. Permission. It's not a secure way to send that. So they're that changing. And technology is good on communication. But it's also creating like some intricate challenges.

00;07;59;27 - 00;08;15;03
Unknown
Sure. Because you and most people just don't think about it. Right. We text everybody all the time, but it's like that's a line. Yeah, that's actually a problem, right? Right. No, I get that. It kind of reminds me when you still go to the doctor, these days and they like, would you fill out all these five forms? Oh my.

00;08;15;03 - 00;08;36;02
Unknown
Oh my gosh, can't you get this from somebody else? Because I think that privacy technology thing is still kind of being sniffed out. Figured out. That's really interesting. That's really interesting. Well what is your what's your typical day look like? I imagine there's probably no such thing as a typical day in your career, but I'd like to know what it close to being.

00;08;36;05 - 00;08;55;19
Unknown
Yeah, there's not much of a typical day. Yeah, you've got yours. The typical part is just your routine meetings. So I like to go in in the mornings. I like to around my building, see what it looks like, make sure it smells okay. And you know, when you say that, like you're physically going around the building, looking in people's rooms, things along those lines.

00;08;55;22 - 00;09;21;18
Unknown
Okay, okay. Yeah. Then at 930, I do my morning meeting, so all of my different department heads come together. We talk about what they've got planned for the day. And in an ideal world, we do, unit utilization review meeting at 10 or 1030, which means we're going over all of our people on our skilled rehab when they're protecting, believe what the paper is, how their therapy's going.

00;09;21;21 - 00;09;45;06
Unknown
And then after that, the chaos usually ensues. And it's just whatever fire is currently the biggest fire, you know, you start there and work your way down to the smallest fire. Right. And then somewhere in there, Financial Review Monthly and, lots of paperwork, lots of regulations, lots of federal reporting. Then at some point, you know, I go home.

00;09;45;08 - 00;10;03;17
Unknown
Well, I mean, how old are you? I'm 31. I mean, that is a just a huge job at 31. I mean, how did you how did you progress so fast? Are you just like, like, amazingly smart and, I mean, you have to be, I mean, 31 and you have that responsibility. That's crazy. You have to tell me.

00;10;03;17 - 00;10;20;15
Unknown
I had to be honest. How did you get to that? So quick? I took my first building. It was a 65 bed facility in Alabama a week after I turned 21. Wow. And that was when you were in Auburn. I saw you were. It was an internship kind of thing. No, I graduated from Auburn in three years.

00;10;20;15 - 00;10;36;18
Unknown
And then I took about I took a building as the administrator. So I started running it at 21 while I was at that building for seven years. I was very fortunate. I had a wonderful company. It was a privately owned company. I had an amazing support system. The staff had been at the building for like a very long time.

00;10;36;18 - 00;10;54;20
Unknown
So even though I was green, they knew what they were doing and they. I always joke like they have trained me on what I'm supposed to do, right? But it was at a very, very small town in Alabama. So it was rural, and it was just that country filled and it made you feel like family. Yeah. So I was there for seven years until we to.

00;10;54;20 - 00;11;12;24
Unknown
We came here to Jacksonville. How did you how did you win them over to get that job? I mean, did they like, you just graduated like go, go take out the trash or something. You're not going to run the facility. It's pretty amazing. My internship, the assistant administrator at my internship had actually worked for that company, and she was very high up.

00;11;12;24 - 00;11;33;19
Unknown
She was, working on retiring, so she sent my resume over. And then I went through the interviewing. I didn't even know what I was interviewing for. Right. And they were like, what position do you want? And I was like, bookkeeper, social worker, like, give me anything that'll just get me in the building, like, get me through the door, get me in the industry, because it's a relatively hard industry to break into.

00;11;33;20 - 00;11;55;07
Unknown
Interesting. And they're like, okay, we have a 65 bed facility we want you to run. And I was like, are you sure? So they they threw me in there and, you know, sink or swim and I swam. Wow. Wow. That that is just incredible. Like, where you I mean, you had to be a little bit nervous.

00;11;55;07 - 00;12;16;01
Unknown
I mean, starting on day one, I mean, yeah, yeah, I was very nervous. Do you feel like the three years of school really prepared you for that? Oh, no. Right, right now, I can't imagine not for that type of responsibility. And this is before you had your master's in the legal stuff. So you're trying to probably wade your way through that on what to do.

00;12;16;04 - 00;12;34;23
Unknown
I actually just did my Masters when we moved here to Jacksonville, so about three years ago. Wow. So I ran that building without it. That's incredible. Well, you know, when I heard that you were going to come on the podcast, it's just the amazing amount of responsibility for running a facility like that. I mean, that's just that's just phenomenal.

00;12;34;26 - 00;12;58;22
Unknown
That's amazing. Well, we're going to get into more of that. So do most what this paint the picture. Like what type of facility are you in now? Is it a high end facility? Low end. And what I mean is like, is it super expensive? Is it on the lower end? Like. Like what? What would you categorize the facility you're in now?

00;12;58;24 - 00;13;22;00
Unknown
It's definitely not the newest. And it's not the prettiest by any means price wise. Believe it or not, most facilities throughout the whole Jacksonville area are about the same. Interesting. A lot of our pricing is actually controlled by the federal government according to cost reporting and okay, very technical financial stuff. Your facilities are more judged so by the location they're in.

00;13;22;00 - 00;13;40;07
Unknown
Okay. And the demographics. Yes. Right, right. So I'm in a little bit more of a challenging demographic right now. But the same could have been said for my Alabama building. So it's what I'm used to, right? Right. So where you're building is places generally the type of people you're going to get in. Yeah. Your demographic one, your people in that live closest to you.

00;13;40;07 - 00;14;06;13
Unknown
Okay. Okay. Okay. So do most of these people have family that are visiting them or not? It's a pretty big mix. You've got some that have very, very involved families, which is a blessing and a curse sometimes. Right. And then you've got some that don't have as much family. And we are their family. Right. See that's what, that's what struck me like kind of was one of my things I was thinking about.

00;14;06;13 - 00;14;34;14
Unknown
I mean do you have a lot of people that literally have nobody that visits them or calls them or anything. Yeah. Wow. Wow. That's really sad. And do you find with those people that they actually have family? They're just kind of just been this nobody's paying attention to them. It's a mix. Yeah, it's a mix. We've actually we have one resident that his child's voicemail says if you're calling about and it says his name, don't bother leaving a message.

00;14;34;16 - 00;14;53;21
Unknown
So that's sad. But then it also it makes you think, like, how poorly must he of treated that child for that to have to fill that way. Yeah. It's almost like the whole full circle thing really comes around. Yeah for sure. And the you know, just the generation that that was, it was very different than what it's now.

00;14;53;23 - 00;15;09;04
Unknown
So I'm a little worried that that means I need to start treating my kids better. Is that what you're saying? Oh my gosh. Thank you. And they unload the dishwasher. You know? Wow. Well, you know, that's interesting because I was curious on how that broke down. I had a feeling that was probably going to be the answer.

00;15;09;04 - 00;15;28;09
Unknown
So on the other end of the spectrum, do you have families where they're literally visiting all the time, visiting, checking their residence out? You can take them out overnight. You can take them out just like you can just depends on their, you know, functional level or what you can do with them and stuff like that. But yeah, we've got some that are very, very involved.

00;15;28;11 - 00;15;53;09
Unknown
Yeah. And I imagine that's great. But other times that can be kind of conflicting because they probably want things their way. And you're trying to run, a big operation, right? Yeah. Yeah, yeah, it can be. Well, what, like, what would you say, when your, residents are sitting down and having dinner and, like, what? Or you talk to them about what makes them happy, like

00;15;53;09 - 00;15;57;05
Unknown
when you're at that age, you're in the in a nursing home facility.

00;15;57;05 - 00;16;05;11
Unknown
You're older. Talk to me about the mentality, what makes them happy.

00;16;05;14 - 00;16;24;18
Unknown
I think the biggest thing that people end up getting out of nursing homes, that they don't expect, that helps them is the companionship. Okay. Is because a lot of our rooms are semi-private. So there's two people in each room and, you know, describe what a what a semi-private room looks like. Is it like two you have two bedrooms and then a common area or.

00;16;24;18 - 00;16;48;01
Unknown
No. Okay. One room with two twin size beds. Okay. Curtain down the middle. Okay. And you've got like kind of your a little area. Because we have to be able to move your lives and medical equipment and the rooms to care for the residents depending on needs. But a lot of people, well, I won't say a lot, but there's always a group of people that have been at home, and they've been alone all the time and stuff like that.

00;16;48;04 - 00;17;06;16
Unknown
And then the decision, and it's a hard decision to put someone in a nursing home is very hard is made. And then they get roommates and they have somebody talk to you and they start participating in activities even. It's a lot of bingo. They love bingo. Don't you dare typing away. And but they start participating and yeah, it kind of rejuvenates.

00;17;06;16 - 00;17;06;25
Unknown
Then

00;17;06;25 - 00;17;38;05
Unknown
it's like, oh, I have someone instead of I mean, we all know we love our grandparents and stuff like that, but when you have children and stuff like that, you get busy. Yeah, it doesn't mean you don't love them, but you get busy in that time to spend with them. But then when they end up in, even if it's not a nursing home, an independent living community, that gives them that companionship that everybody needs, well, is it a I'm feeling like it's kind of ironic that I would imagine there's some people that don't want to come in and they're put in there because they've been living by like, I don't want to share a

00;17;38;05 - 00;17;56;15
Unknown
room. I don't want to talk to people all day long. But you're you're seeing kind of the human spirit feels like it kind of turns it around. It does much, especially the ones that are really dug in about not want to be there may take a few roommates because we like to look at roommate compatibility. We like to put people that get along with each other and go together.

00;17;56;17 - 00;18;20;09
Unknown
Okay. And once you get that right pairing. Yeah, it can just like, turn them around. Right. Well, that makes me think. Is there romance and facilities like, I mean, I'm assuming, you know, not within the room, but I mean, I'm talking about, like, you know, wherever now we are a home like environment. So we have to make accommodations for all.

00;18;20;10 - 00;18;39;23
Unknown
I got you, I got you. I guess I kind of meant like, Oh, my. Is it called The Notebook? That's what I'm thinking about. Have you ever seen that movie? Yes. Like, what I mean is, like, somebody's wife or husband dies, and then they get to be friends with, another person, and then they strike up a really good relationship.

00;18;39;24 - 00;18;58;16
Unknown
No happy boyfriend and girlfriends. I've had married couples living in the facility that stayed in a room together and that didn't, That's funny. Yeah, yeah. No, we I didn't even think about that dynamic, you know, because I it's like the top of my head. I'm feeling like a nursing home is one person, but now it could be two.

00;18;58;18 - 00;19;21;02
Unknown
Yeah, yeah. Are you, you know, on the morbid side, are you dealing with death a lot? Like. I mean, are people dying in your building? I mean, that a lot is the word. But that's the last spot, right? It's the last destination. Early? Yeah. Early. Death tends to go in cycles three, five, seven or nines. They go in spells, which is just something.

00;19;21;04 - 00;19;46;23
Unknown
If you're in the industry, you kind of track it and it's like if like one death, we know that we'll have two more or possibly four more, like they bunch in odds for some reason. And then we can go a spell with no deaths. Interesting. That's really interesting. So it's like that's really interesting. Like when you say a spell like would do you have how many times a year do you think you have those 3 or 4 events?

00;19;46;25 - 00;20;11;18
Unknown
A lot, a lot. You might go like six weeks without any. And then you may go like four weeks with several, and then you'll go a little bit without that. We just call them cycles. Yeah, yeah. And we know when one happens I mean that's got to be pretty tough. Because I would think the alternative to that is that if somebody is deteriorating, they go to hospice from your facility or you kind of hospice.

00;20;11;25 - 00;20;34;24
Unknown
We allow hospice in our building. So we generally have a lot of them that choose to stay with us. Interesting. So hospice facil states your building and let some stay there and comes and helps and help. Man that's amazing I I've always liked whoever invented hospice. I mean that's just an incredible thing. I mean, you know, it's just a common it's a thing that's super needed.

00;20;34;24 - 00;20;56;06
Unknown
Well that's really interesting. Do you allow dogs? You do allow dogs, cats. I've never had anybody ask to bring a cat. Okay. What? What's the most unusual pet that somebody is asked to bring in? Oh, no. As far as I know, only dogs only. That's as far as I know. Because, you know, weekends happen. I mean, I can't tell you what might be stuck in a purse.

00;20;56;08 - 00;21;12;18
Unknown
I mean, iguana, for all I know. It's funny, the same guy that, you know, went on the same path. He picked up something outside and brought it inside. So if they have dogs, is that something? How does that work? I mean, because I'm assuming your team is helping taking care of the dog at that point, they get to come for visits.

00;21;12;24 - 00;21;29;19
Unknown
Okay. Live with us. Oh, okay. Okay. They can come for a visit. Okay. Okay. So, I would imagine that's kind of a popular event when the dogs come in. Yeah. As long as they. They just have to have their shots. Okay, so we always tell people, just bring a copy of their shot record just on the off chance they bite somebody.

00;21;29;19 - 00;21;47;14
Unknown
And then we have to do our paperwork. Yeah. But we let them in. I used to bring my dogs to work all the time. Yeah, I would think so, because I would think as a general thing, like, I mean, you know, most people are dog. They like dogs. I like it just it just brings a, positivity and fun ness to it when you have a dog in there.

00;21;47;17 - 00;22;08;12
Unknown
Yeah. What are some other. You said bingo. Like, what's another popular activity? Believe it or not, church. We have a lot of church groups that come in okay. For different denominations. Yeah. And, karaoke. I have a karaoke dance is hilarious. He sings wonderfully. Yeah. And our residents love karaoke. Interesting. We're going to bake cookies for the holidays.

00;22;08;13 - 00;22;26;27
Unknown
Okay. We've got a full kitchen so we can do cookies for the holidays and activities room. Yeah. So when a church comes in today, like, do you say, hey, the Methodist church is coming in today. If you want to go talk to them, there be here kind of thing or how does that work? Our calendars, our activity calendars are planned out for the whole night.

00;22;26;27 - 00;22;44;04
Unknown
Okay, okay. So everybody knows who's coming in when. Yeah, we've got some entertainers that come. Okay. Play guitar and sing a lot. So a lot of music a lot of times. Yeah. And then we have an activities room that's just always open with puzzles. Believe it or not, coloring is a popular thing to do as a pastime.

00;22;44;04 - 00;22;56;17
Unknown
Yeah. We have a beautiful courtyard. Yeah. So a lot of people will just sit outside when the weather's nice. Oh, yeah. Absolutely. Well, it's it's a blessing to be in Florida when it's nice. A lot of the times is,

00;22;56;17 - 00;23;03;01
Unknown
What about technology? Do we have people on laptops and phones and or do they, is it not?

00;23;03;07 - 00;23;26;29
Unknown
Has the generation not evolved to that point where they don't really care or what? What's the deal? Lots of cell phone, lots and lots of cell phones. Not quite as many laptops and tablets. Yeah, yeah. Plenty of cell phones. So. Yeah. Which is good. Yeah. Well, the funny thing is, is I've always thought that, social media is a wonderful thing for your older.

00;23;26;29 - 00;23;43;07
Unknown
I mean, you can just flip through it, you know, some older members in my family still feel like when they see a photo on social media that I sent them the photo. So, you know, I'm just kind of like, well, I'm just not going to explain it. Yeah. Yeah,

00;23;43;07 - 00;23;47;11
Unknown
well, that's really cool. How do you get how do you get a spot at your facility?

00;23;47;11 - 00;24;13;20
Unknown
Is there is it hard? Is there a wait list? Like what? How does that work? Most of our people come straight from the hospital. Okay, so they've been saying they've, you know, enjoy themselves somehow fracture to heaven or something like that. And they come to us for generally rehab. And then if they don't really have to the point that the family can take them home or the family decides home is not the best place for them, then we discuss them staying with us.

00;24;13;20 - 00;24;43;23
Unknown
Long term care. Do you have an age minimum? I do not okay, well, I guess technically 18 would be your age minimum because here's the legal stuff. Yeah, yeah, they're actually facilities that are. Yeah. For pediatrics. Yeah. So I guess 18 would be the end. Well, right. So is there is there a condition in, if you have certain conditions and you're in certain shape, you will not take them on the other side of the coin.

00;24;43;26 - 00;25;05;18
Unknown
Yes. Okay. Yes. All your ventilators if you're on a vent and if you're trade dependent on the ventilator. Right. That's something we can accept. Right. That's more of an L tech. Right. Ryan. Because I noticed on, on the website you have three types. You have specialized short term rehab and long term. Tell me kind of what those mean.

00;25;05;19 - 00;25;30;25
Unknown
Like the differences. So specialized care is more so going to be bariatric. We do have the accommodations of up to 600 pounds on a patient. Okay. So that's definitely a specialized. Yeah. Right. Because that challenge, depending on how much they can actually help you. Yeah, sure. Their own care. Sure. And then wound care wounds are actually a pretty big part of the nursing home industry.

00;25;30;28 - 00;25;50;12
Unknown
Because they get they have them very easily in the hospital when they're sick and they can't move, and they deconditioned and, once bed sore kind of thing. Yeah. Yeah. Okay. They happen quick and they get big. Okay. Way faster. Yeah. Right. Yeah I would, I would think so. The short term rehab that's our people that generally come in and they plan to go home.

00;25;50;12 - 00;26;11;21
Unknown
They have a safe discharge plan. Okay. Technically that can be anything from the homeless shelter to an actual place to go. It's just whatever the person chooses. Okay. Because we do get people that were homeless, and then they got sick, and they need I.V. antibiotics. Okay, so then they'll come to us, they finish, and they choose to go back, right?

00;26;11;21 - 00;26;33;01
Unknown
So we let them know it's your choice. Short term care, though. It's five days a week of therapy. OTS all in house at our gym, and then long term care. Your intents are not to go anywhere. Still have therapy that we can offer them. Yeah. So wound care still all the things, right. Just are hanging. Yeah.

00;26;33;07 - 00;26;54;14
Unknown
Interesting. Three different types. Well, this is one of the big things. And I saw this on your resume and, very tough time. And nursing homes were ground zero for this. Was Covid like, I mean, ground zero. I mean, I don't even know where to start because I had I had to be so complicated. But you were in the thick of it, right?

00;26;54;16 - 00;27;14;20
Unknown
Oh, yes. You were managing a facility at that point. Yes. Okay. Yes. So let's just try to talk about this. Go back to the beginning when you first heard about it and it's just first coming out. Is that like okay we don't really know what's happening. Yeah. That's kind of wait and see. Or were you immediately like I there's something wrong in or how did that look.

00;27;14;22 - 00;27;48;25
Unknown
We see what Covid technically started like December of a year in California and was not even on our radar, right? Like, didn't even hit our radar. Ironically enough, my husband and I were in Scotland for a ten day vacation. Okay. When Covid really started, infiltrating the nursing home industry. So I was actually in Europe when my corporation did the first Covid call, and then whenever I got landed in America, I got the phone call.

00;27;48;25 - 00;28;05;10
Unknown
You're going to have to shelter at your home for two weeks. You can't come to your building because I just been in Europe and that's where Covid started, you know, so complicated. Thankfully, we did not get our first Covid case at that building till like, June. Okay. But even then, you're like, okay, I guess I need these supplies.

00;28;05;10 - 00;28;25;22
Unknown
But then the CDC gave guidance that ended up being not great. Right. And and it was that was the without a doubt, the hardest part about Covid was the ever changing. Today this is the rule. But tomorrow this is the rule. And then you can do this or this. But if you do this one I might get mad at you for not doing that one right.

00;28;25;23 - 00;28;53;23
Unknown
And you might get in trouble for this one, when that one should have been the choice. And that that was probably the hardest part is we're already dealing with something unknown, and we're supposed to be following CDC guidance. But the CDC is also unknown. And some of their guidelines that they put out initially. Now it's like that was the dumbest thing I for sure like they meant well, but it ended up being wrong.

00;28;53;23 - 00;29;19;27
Unknown
Complete wrong. Yes. And we can certainly debate that for sure. And yeah, I guess that's really interesting what you said, because you just told me earlier, you're used to a lot of rules and changes during the year, but this was like an avalanche every day, something different. Well, okay. So this kind of get through that. So you two weeks in quarantine come out, then you're allowed to go to the facility.

00;29;19;27 - 00;29;38;10
Unknown
Right. Okay. So at that point, was it like in the throes of it or you had a mask. It wasn't to that level yet. No, we weren't to that level. Yeah, yeah I remember I say I sometimes joke that there's like a little bit of PTSD and trauma. Yeah, for sure. I don't remember everything, I don't remember. Yeah for sure.

00;29;38;10 - 00;30;00;19
Unknown
It was I'm sure it was very hard in large cities, but to be in a small rural demographic, helped probably, I would actually say made it worse. Oh, interesting. Because it got to the point, you know, a lot of your lot of your nursing home staff, they're hustlers. Yeah. They were to rent two facilities. Shift here, second shift there in the city I was in.

00;30;00;19 - 00;30;21;15
Unknown
There's only two nursing homes. Well, then when Covid really started rolling, we both agreed, okay, we're going to have to split our staff. So our staff had to pick. Which facility did you want to continue to work at? We're not firing you at the end of Covid. You know, you can come back and you can have your two jobs, but like, you can't be at my building and then go to theirs.

00;30;21;15 - 00;30;44;07
Unknown
Yeah. And that put like an immediate staffing strain without anybody being sick. Just the fact that I had a group of people that had to like, split. Yeah. And like, I can't even imagine that. Well did it, did it progressed to where you didn't allow families to come in? Oh yes. Okay. We didn't have a choice. Okay. That's what the guidance was.

00;30;44;07 - 00;31;05;12
Unknown
That's what you had to do. So that probably lasted for several months. Right? A long time. Right. A very long time. How did you facilitate it was all video. Was there a window they could come up to? How did it look? We did a lot of window visits. Yeah. Because that ended up kind of being the easiest thing because you can just crack the window and they could see each other and they could talk, was there.

00;31;05;14 - 00;31;23;00
Unknown
Well, this brings up an interesting thing, though. Like, if my parent is, are my mom or dad are in there and I'm like, I don't like these rules. I want them out. Could you could they do that? Yeah. You can take them home. Yeah. Yeah. Just can't bring them back pretty much. Right. Right, right. It's gotta be ready to take care of them.

00;31;23;05 - 00;31;46;13
Unknown
Yeah. At times they're with us for a reason. Right? Right. Exactly, exactly. Wow. That just seems incredibly complicated, because I'm sure you're trying to explain it to your residents. And that's probably a difficult concept for them to understand and put it all together. Yeah, they got very frustrated. The rate of depression really went up. Oh, yeah. Did you allow them, like you said, you had a courtyard?

00;31;46;13 - 00;32;08;08
Unknown
Did you allow them to go outside and there's nobody there but them or. Yeah, you go out in the courtyard. But then when Covid really hit my building hard, I had 60 residents and half of them had Covid and half to not. So then we're trying to split the building and I had three and four bad wards at that facility because it was it was a very old facility.

00;32;08;11 - 00;32;29;05
Unknown
And initially when Covid hit, the guidance was if I have Covid, but all three of us live together, then I'm the one that has to move. But then the other two don't have to move, which nowadays you're like, but the other two are exposed. That was so ridiculous. But then so little was understood and known. It was like, you just need to take the positive person out, right?

00;32;29;08 - 00;32;52;26
Unknown
So then just the you've got people that have lived together for years in a room and all of a sudden you're breaking up. They're dynamic and like they're not allowed to go to group activities and the residents are not good for change in the beginning, much less this kind of change. It was awful. Wow. I think it set the industry back as a whole quite a bit because activities had to stop.

00;32;52;26 - 00;33;11;27
Unknown
They weren't allowed to congregate together. So all the hard work that was done before Covid get the residents up by 10:00, they need to be in the lunch room for lunch. They need to be at activities. You need to encourage them to participate and like, still thrive. And then Covid happens and it's you can't come out of your room.

00;33;12;00 - 00;33;32;03
Unknown
So then the staff gets used to that. And then COVID's over or lessened and it's like, okay, get them back up by 10:00. Get them back. To just get the staff back on like get out of the room, get them up, get them dressed right, get them to the activities room. Well, so is your your we've talked about how regulated your industry is.

00;33;32;03 - 00;33;48;06
Unknown
So you really with a lot of those things we talked about with Covid you don't have a choice like you're you're getting your email that morning of what you have to do. And the rules are and that's what you have to do regardless of what you think you really need to do. Yeah. Wow. And that had to be incredibly difficult.

00;33;48;12 - 00;34;07;06
Unknown
Did you have any deaths because of Covid? Oh yes you did. Wow. How did you so how did you do with the workers coming in and out, including yourself and your staff and all of that? Did they have to test regularly and how did how did that work? That had to be so complicated at the beginning.

00;34;07;06 - 00;34;23;02
Unknown
We had to test three times a week. Wow. So it's like you've got your testing station in the front of the building to test. And they were like the yeah, the very beginning ones went up to the brain and then had to be sent to the lab. So you've got to focus on checking every single staff member off on their test.

00;34;23;08 - 00;34;45;19
Unknown
And don't forget to take care of the residents. Yeah, yeah for sure. Man, that had to be complicated. Well, I'm glad that's over. No more. No more of that. Less, man. Less. Less. Yeah, I'm sure there's there's remnants there, but, man, what a what a complicated thing. Because, you know, from us in the outside, I mean, I didn't really have any family or anything in nursing home, so I didn't know.

00;34;45;19 - 00;35;05;13
Unknown
But I mean, that was always on the news, like, you know, within the different facilities and what that was super complicated. So switching gears, we talked to that a little bit about technology with the residents. Like has all the developments in technology helped helped your industry like as far as actually the day to day things like, yeah, I don't know.

00;35;05;13 - 00;35;28;10
Unknown
Or is there industry kind of like, man, it's really hands on the whole time. Tech doesn't really help me a lot. I think it's helped as far as not having paper charts, okay. Everything orders and, results and stuff like that. Yeah. It's helpful. Pain point would definitely be there's so many different, like, components of an electronic medical record.

00;35;28;12 - 00;35;48;24
Unknown
And then your labs aren't done in-house. And getting their systems to talk to our system so that we don't have to receive a fax, read it, sign it, and then put it in the chart. So some of the integration between your lab and your, x ray companies and stuff like that can be challenging and a little bit slow.

00;35;48;26 - 00;36;14;29
Unknown
And then, believe it or not, granting access to the medical record, whenever you have new providers that start coming in and you want them to document directly in your chart instead of having to write. So things like that are nice. And sometimes the old school way is messed, right? Right, right for sure. Has there been upgrades in equipment that are better to help you take care of them or not too much?

00;36;15;00 - 00;36;34;20
Unknown
Yeah, stuff. We use the lifts and stuff like that. It's like the less techie and the more basic they are, the sturdier they are. Yeah, right. I can imagine that. Well, that's that's super interesting because that's what I was thinking of through like of course technology probably helps, but there's probably a good part of it that is just the way it is.

00;36;34;20 - 00;36;44;12
Unknown
Like, you really got to get your hands dirty, you know? What what are you what do you see the most? I know we've kind of touched on this, but, like,

00;36;44;12 - 00;36;55;00
Unknown
what's the what's the toughest part about running the facility? I know you can probably come up with a lot of things, but, like, is it regulatory? Is it the residents, is it the staff?

00;36;55;00 - 00;37;03;29
Unknown
Like, what do you what do you think the hardest part is?

00;37;04;02 - 00;37;30;24
Unknown
Some of it can be the staff. Yeah. Is it hard to find people to work in nursing homes? Is just, I'm assuming the words like orderlies, you know, people that take care of the residents. It's hard to find the people that actually want to care, right? Yeah. A lot of the younger people go into the CNA training and stuff like that because they think it's like an easy, you know, whatever, whatever.

00;37;30;24 - 00;37;50;09
Unknown
But then when it comes down to actually taking care of, you know, some of your patients with dementia and that are truly challenging. You have to have a certain degree of patience and a heart for it. And if you don't represent then that that certainly presents, that I would imagine that comes through pretty quickly. Yeah, yeah,

00;37;50;09 - 00;37;57;05
Unknown
man, I just I just can't imagine having to, you know, with dementia and Alzheimer's.

00;37;57;05 - 00;38;17;04
Unknown
I think that's just got to be so difficult because they don't remember to. And then it probably becomes tense sometimes. And all of that, that's going to be extremely hard. Yeah. You've got your mix. You've got you're like pleasantly demented people. I have one right now that all she does is just walk the building all day. And as long as she, like, hand her snack as she walks by, like she's good.

00;38;17;06 - 00;38;41;23
Unknown
Yeah. But then we have some. The sundown and sun downers are very hard, because in the morning they're good. But then literally, like, as the day goes on in, the sun goes down, they start to get really combative and very confused. And we call that sundowning. Yeah. And so having the right group of people in the building to be able to not escalate the situation but de-escalate and calm, calm down.

00;38;41;27 - 00;38;59;22
Unknown
It's hard. Yeah, I'm sure, I'm sure. Do you? I was seeing it on the other side of this coin. Do you, do you have some residents that are extremely happy like that? They're like, you can tell that they're really in a good place with their life. They're very positive. They're, they they try to be as active as possible.

00;38;59;22 - 00;39;18;09
Unknown
I mean, can you think of some people off the top of your head? Yeah, yeah, yeah. Here in this state in Alabama, it was harder to get into a nursing home. There was more care requirements required in the state of Florida. I've got some that they call the Uber, and they walk out in High hills to go to Walmart and then they come back.

00;39;18;09 - 00;39;37;14
Unknown
And that's funny. So there are residents that can go off on their own. Oh yeah okay. Okay. That's fine. The I mean that's I think that's great. I it's it's kind of like I'm trying to get what's the lesson. And you know, once we get to that stage in our lives, like, how do you stay? How do you stay happy and positive?

00;39;37;14 - 00;39;57;25
Unknown
I imagine religion has a lot to do with that. And I think activity probably has a lot to do with that. Yeah, I think a lot of it's activity and companion shit. Yeah. And being open to, you know, being in a facility, it's not an easy decision at all. And I understand that when people make the decision, it's not easy.

00;39;57;28 - 00;40;20;13
Unknown
But if the family comes in positive and encouraging and stays in communication with their loved one. Yeah. And, because I mean, I had a lot of people go out for Thanksgiving, a lot of people got picked up to be Thanksgiving lunches and dinners with families, and then they come back because they the care just can't be provided overnight, you know, medications and things like that.

00;40;20;16 - 00;40;38;00
Unknown
But for the most part, if you're open minded enough, you can find a happy. Yes. Yeah. Well that's interesting. How do you keep the families engaged and involved? I'm assuming you. I mean, it's as simple as, like an email update that they get it every week or how how does that how do you keep them engaged?

00;40;38;06 - 00;41;06;01
Unknown
We it's always easiest during the holiday season to keep them engaged, because we did a very nice Thanksgiving lunch that we got a lot of compliments on. So families came and we provided a lunch about two weeks before Thanksgiving. And then, in a couple of weeks, we're doing our family resident Christmas party kind of thing. Right. Well, they'll do some snacks and the families can come in and we'll have someone that Santa and, hosting things like that.

00;41;06;03 - 00;41;25;10
Unknown
Then we do, at a minimum, quarterly meetings with our families. That way they also have an opportunity to tell us, like, hey, we really think y'all need to focus on this problem because we see things from our in the residency things. And then the families see things. So it's always good to like come together as a group and be like, hey, this is what I'm seeing.

00;41;25;10 - 00;41;50;04
Unknown
And we're like, oh man, we've been so focused on X, we didn't see Y, right? Right. I imagine that's really, really neat. Well, you know, another thing that pops into my mind, you know, since we talked about you having a heart for it, I imagine you get some of the most amazing stories of history talking to, your residents, like, I mean, because, you know, we are part of the, you know, a lot of the greatest generation.

00;41;50;05 - 00;42;13;08
Unknown
They were in wars like, I gotta believe that's a lot of what you hear. I had one resident in my Alabama building that really touched me. He, was a World War Two veteran. And when he came to our building, it was a very sad situation because mentally he was fully there. He was very cognitive, but physically he was starting to decline.

00;42;13;10 - 00;42;39;11
Unknown
And his wife physically was not declining, but mentally she was very, very confused. Oh my gosh, that's like a sad situation because she wasn't the one with us. But I remember I was in his room one day and we were talking and, he was a very firm Catholic believer. And he was telling me about how when he was in France in World War two, he actually ended up in hand-to-hand combat with several, of the other, you know, Army.

00;42;39;13 - 00;43;01;08
Unknown
And he killed them with, with a knife. And he said that he still had night terrors and he was in his 90s. Wow. From that. And, you know, did I believe God forgave him for that and. Wow. And, and and being 90, like, his generation doesn't get the same PTSD and. Oh, no therapy and like, support.

00;43;01;08 - 00;43;21;22
Unknown
Right? Right. Not that I, not that I can speak on that on how effective it is. Right, right. But that was just definitely not there for the World War Two vets. Yeah. And things like that. It's just like you do realize they know so much. They have seen so much. Right? And it's so valuable to sit down and really give them a chance to tell their story.

00;43;21;26 - 00;43;44;20
Unknown
Have you ever had someone that you've talked to and you realize that they were somewhat famous in their in their life? Did some crazy thing, maybe one hit wonder or whatever the case is? No, I haven't had that pleasure. Yeah, that would be pretty cool. But I haven't had that happen. So yeah, yeah, I think the World War Two veterans and I'm sure you have Vietnam veterans now at this point.

00;43;44;23 - 00;44;05;26
Unknown
Yeah. That's incredible. Imagine that you just have so much stuff that they bring to the equation for sure. What what do you think? Like the the most misunderstood thing about nursing homes are to someone that general public that really hasn't had that experience, they don't have elderly people in it. They it's like they don't know much about it.

00;44;05;26 - 00;44;30;11
Unknown
Like what? What do you think? Misconceptions or not? Misconceptions or what should they know? Oh yeah. No, there's definitely misconceptions. Yeah. I think one of the ones that can be the most challenging for us to get families to understand is we are there to provide care. But if mama fell at home, she is going to fall with us like we can't.

00;44;30;13 - 00;44;52;13
Unknown
You know, it's like your toddler. You want to bubble wrap your toddler so it doesn't fall, right? We can't bubble like toddlers because they have to be free to go. We can't bubble wrap, mama. So when she falls, she doesn't get hurt. That's right. Because essentially, whatever behavior or noncompliance, you know, if they didn't take medicine at home, in a nursing home, I can't make anybody take medicine.

00;44;52;14 - 00;45;15;01
Unknown
And you cannot make them, so they have the right to refuse. Wow. Interesting. Imagine that is a daily battle. Yeah. So making the families understand like, yes, you're bringing them to us because you can't care for them. But some of the things that they're doing to you will manage it, you know. Well, we'll let them fall because they have the right to fall, which is a crazy thing to say.

00;45;15;01 - 00;45;40;01
Unknown
But if I'm just adamant that I can still walk and I cannot walk, but my brain says I can and I try to get out of that bed. Yeah, you know, you're you're going to hit the floor. Well, yeah. I mean, when somebody is in by their side 24 hours a day, man, that's a really good point. Like, you know, and I think that is really well stated because I think a lot of people think once they send a nurse and I'm like, it's like you're completely responsible.

00;45;40;01 - 00;45;57;09
Unknown
You are, but you're not with them every second they can. And they're still independent people. I mean, it's still a free country, even though you're in a nursing home, if you don't want to take the medicine, you don't take it, you don't take it. Yeah. Wow, that's really good. Do you have, parents or grandparents in a nursing home?

00;45;57;12 - 00;46;17;07
Unknown
I don't I had a grandfather that was in a facility. Okay. For a short amount of time before he passed away. Okay. Okay. So have you ever joked around with your parents about. Hey, I got you. You're good. Oh, yeah. Absolutely. The place my mother was born was a hospital at the time, and now it's actually a nursing home.

00;46;17;07 - 00;46;35;22
Unknown
So I always told her I just put her back in that one so she can be born and die in the same place. That's funny, but that's, you know, kind of. Yeah, a little morbid, but it's it's the humor we have. It is funny. It's funny. And on that same note, I lived in a fraternity house for three years, and we always said the joke was, man, we're going to meet each other back in the nursing home.

00;46;35;22 - 00;46;58;07
Unknown
We'll just we'll just relive it back. Then we'll just gather back. Then. Can the residents have alcohol? Yes, the residents can have alcohol. Actually, we I would imagine if they cannot take their medicine, they can have alcohol. Oh, they can have alcohol. Yeah. Oh that's funny. Well that could probably be a whole podcast itself. What advice would you have?

00;46;58;10 - 00;47;14;16
Unknown
I know you said you didn't go into it and you kind of fell into it, but you had a heart. You were going in a medical. I mean, that's not a lot that a lot of people have. Like what? What advice would you have for that? Like, I yeah, I'd really like to get into this. I have a heart like how do you judge if you really have the heart?

00;47;14;16 - 00;47;37;06
Unknown
Because I think it would be different in reality versus your head. You know, a lot of people think they have the heart for it. Getting in it, just whether volunteering to see what that aspect of it looks like, but like actually spending time in the industry because I took the classes, I thought I liked the content of the classes.

00;47;37;06 - 00;47;59;19
Unknown
But then it was when I did my internship within my degree, and I was four months full time in the facility and one of the hardest parts of the job is you fall in love with the resident, right? So, you know, you think when you're four grandparents passed away, it's hard, but I feel like I've probably had a dozen grandparents passed away because they're my parents age and then they die.

00;47;59;19 - 00;48;17;16
Unknown
And, I mean, my husband can probably tell you the number of times I come home and like, just be sobbing. And he's like, who died now? And I'd be like, yeah, well, you know, and, well, I didn't even think about that. I mean, you're constantly making friends that are dying. I mean, but that's the way the life works, you know?

00;48;17;18 - 00;48;33;23
Unknown
Wow. That's incredible. Like, I imagine that takes a toll on you. It does. I had to take a break after Covid because of that. Yeah, because it was just. It's an emotional hit. I only made it a year and a half out of the industry, though, and then I was like, I got to get back. Yeah. I even tried, primary care.

00;48;33;23 - 00;48;58;09
Unknown
And I was like, I got to get back. It's not it, it's it's well, I'm, I'm assuming on the other side you find it incredibly fulfilling because I, you know, I know we've talked about a lot of challenges, but my guess is that you have a lot of appreciation to. Yeah, that your residents like, you know, maybe some better than others are like really appreciative of you being there and your team trying.

00;48;58;10 - 00;49;17;01
Unknown
Yeah yeah yeah yeah. If you have a good team you can have a pretty good happy facility. Yeah. You just got to get there. Right. It's a good team part. So a four year degree would get you into administration in your in your. So you would need something more at this point I'm licensed okay I have a state license.

00;49;17;08 - 00;49;44;24
Unknown
So how after your college how long. How does it how do you get the license. Typical route. Typical route is a four year degree. I did my bachelor's in three, so, I we've already established you're an overachiever. I did a I did a loophole in the system, though, at the time that I got my license, you could do a bachelor's in healthcare administration and have completed a internship and skilled nursing.

00;49;44;24 - 00;50;03;01
Unknown
Yeah. So I worked the loophole so that I could go straight and sit for my, federal boards. Yeah. And then generally, though, you have to do four years and then 1000 hour. It generally that's unpaid. So that's administrator and training. Then you have to do a federal test. And for Florida you have to do a state test.

00;50;03;01 - 00;50;25;12
Unknown
Wow. So there's quite a a path for that. Yes. Interesting. Well Emily, this has been amazing. And it was exactly what I thought it would be because I think it's super interesting on what you do. And I'm incredibly impressed by the amount of responsibility that you had at such a young age. And you're still young and have a lot of responsibility.

00;50;25;12 - 00;50;31;07
Unknown
So thank you for coming into the podcast. Emily. I really enjoyed it. Thank you. It's been a pleasure. Yeah.

00;50;31;07 - 00;50;45;13
Unknown
The Hometown Jack's podcast is recorded and produced by First Coast Mortgage Funding. Located in the heart of Jacksonville. Do you want to be our next guest? Visit our website at Hometown Jack's podcast.com. We can't wait to hear your story.