Navigating the Future of Long Term Care

Chapters

• 00:31 Welcome and Jason's Journey to LeadingAge Kentucky
• 01:33 Understanding LeadingAge Kentucky's Mission and Reach
• 03:04 Core Member Services and Pressing Industry Challenges
• 05:49 Demystifying Medicaid and Calming Member Anxiety
• 08:47 Effective Communication and Member Advocacy
• 13:17 Enhancing Quality of Care Through Alternative Funding & Vetted Services
• 17:08 Technology's Role in Workforce Support and Caregiver Well-being
• 22:03 Proactive Leadership, AI in Strategic Planning, and Personal Balance
• 28:02 Conclusion

Podcast Transcript

[H2] Welcome and Jason's Journey to LeadingAge Kentucky

Todd Schmiedeler: Welcome to our podcast. Thanks for being here. I'm so excited. Today I am going to go into a subject that many of you all probably haven't dealt with before, but it is a health care trade association and we're going to talk to an expert in it. I'm so happy to have my friend Jason Squires here. He serves as the CEO of LeadingAge Kentucky and Jason's been the CEO now for how long, Jason?

Jason Squires:  Going on about four months.

Todd Schmiedeler: Four months. Welcome to the role. I'm sure it's been enlightening and engaging.  Before we get started on LeadingAge Kentucky and the role that trade associations play, tell us a little bit about what brought you to LeadingAge Kentucky and your background, Jason.

Jason Squires: Well, I began my career in traditional long-term care back in the late 90s and then moved over into the developmental disabilities field.  I worked for a local intellectual and developmental disability nonprofit for about 25 years and we were a member of LeadingAge.

Todd Schmiedeler: Oh wow.

Jason Squires: So I’ve been involved with LeadingAge off and on for nearly 30 years and then when this opportunity became available decided to take a look at it.

Todd Schmiedeler: Well that's great. And that leads me to the question. Can you give us some information about LeadingAge Kentucky, because of the fact that you're talking about it in terms of not just the senior living space, but intellectual disabilities. That's an interesting thing. Tell us a little bit about LeadingAge and kind of where it focuses its energy and its advocacy.

Jason Squires: Well, LeadingAge Kentucky is part of a national group. So, there's LeadingAge National and we're primarily focused on the nonprofit long-term care sector. So, that's your traditional nonprofits with senior living, nursing homes, assisted living, things of that nature. But then also the intellectual and developmental disability side where there's also long-term care services being provided there. And so LeadingAge is mostly nonprofit, long-term care for people with and without disabilities both, but mostly in in the traditional senior living space.

Todd Schmiedeler: And you're covering the entire state.  About how many members do you have?

Jason Squires: We've got about 70 members. We're as far west as Paducah. We're as far east as Ashland, Northern Kentucky, and then down to Bowling Green, Scottsville, that area. So we are all over the state.

[H2] Core Member Services and Pressing Industry Challenges

Todd Schmiedeler: And what would be some of the major services that a LeadingAge Kentucky would offer its members?  Why they would be a member in your organization?

Jason Squires: Well, several things. So, advocacy when it comes to state and federal legislative issues and regulatory issues.  Advocacy, that's number one. Education, we have an annual conference every year as well as education going on throughout the year.  Anytime there's an issue going on, in Frankfort, a regulatory issue or something that our members need help with from state officials or elected officials. Also just networking.  Being part of something, being part of a group, you know.  We've got CEOs that share among each other. We've got directors of HR that share among each other and just that collaborative feel knowing that you're not alone.

Todd Schmiedeler: Yeah.

Jason Squires: There's a lot going on right now in the field. So, to not be alone right now is a good thing for our members.

Todd Schmiedeler: Yeah. Tell us a couple of things that are kind of hitting your members and that are kind of the top priorities for what they're facing.  I always talk about it in terms of what's keeping you up at night.  I'm sure that you talk to the CEOs across the state and other members.  What are those things that are keeping them up at night?

Jason Squires: Right.  There's probably three or four things and while none of it's a surprise, it plays out differently in our field.  So, the workforce is a major issue and we’re not alone there. But when you think about the primary demographic in our field, generally speaking, it's women between the ages of 25 and 45. That demographic is shrinking.

Todd Schmiedeler: Yeah.

Jason Squires: While seniors are living longer.

Todd Schmiedeler: Right?

Jason Squires: Those two lines are going the opposite direction. So, the workforce is a big one. Medicaid, it hasn't hit yet. It's coming with the budget reconciliation act that was passed and signed on the 4th of July.  That's going to have a major impact on our field.

Todd Schmiedeler: Okay.

Jason Squires: Some of that we know what's going to happen at the federal level. At the state level, we don't know yet how that's going to trickle down and we'll know more hopefully in 2026 as our legislature gets into the session and starts dealing with those things. But Medicaid is going to be a major issue for us. And then number three is probably technology.

Todd Schmiedeler: Oh, okay.

Jason Squires: You know, when we talk about AI, that wave is coming, as well in long-term care. And so, I think there are actually some benefits to that. A lot of people are very skeptical. A lot of people are afraid of what AI could do. And I think maybe that's justified, but I think there's also a lot of benefit that can that can help our field as well.

[H2] Demystifying Medicaid and Calming Member Anxiety

Todd Schmiedeler: Yeah. You know, on the AI topic, and for that matter, the Medicaid situation, I've got to believe that there's some opportunity to demystify those things, with your leadership.  Because sometimes a lot of rumors and fear get spread really quickly in most industries, but I know it does in healthcare a lot.  People read something and then they're sharing it, but they don't necessarily have a depth of it or really know how to utilize it yet.

I would think that LeadingAge Kentucky serves as a conduit by which you can actually not only understand things a little bit deeper and get the truth of it from the sources that have credibility, but also my guess is, based off of what you said, there's a lot of best practices shared.  Are you seeing that?

Let's take one of those issues.  Let's take Medicaid, because it sounds like that that's going to be a hot issue.  It's been one, but I'm sure it's going to be one in the future.  Your members are kind of a diverse group.  Are all of them going to encounter Medicaid challenges or is it just most of them?  Where does that kind of kind of break within your membership?

Jason Squires: The majority will feel the impact one way or another.

Todd Schmiedeler: Okay.

Jason Squires: So, when it comes to the skilled nursing, the intellectual and developmental disability side, they're going to feel it because they rely, to one extent or another, on Medicaid reimbursement.

Todd Schmiedeler: Okay.

Jason Squires: Some of the other areas, not so much. But primarily when you think about your traditional nursing home and your traditional intellectual disability services, they're going to feel it in different ways and to different degrees.  That's where the impact going to be felt.  

In terms of helping our members sift through all this stuff that they're hearing and you know, a lot of our leaders are so wrapped up in the day-to-day of making sure that people are coming to work, making sure that their census is up and making sure that all the quality of care, all of all of the things that are critical every day. They're so wrapped up in those things that sometimes there's there can be some irrational fear about what might be coming.

And so part of our responsibility at LeadingAge Kentucky and LeadingAge National is to help temper some of that anxiety. Not to say that we want to be pollyannish about it.  Not to say there's nothing wrong, but to take a measured approach, right? So, for example, with this Medicaid thing, when the bill was signed, I had members calling saying, "Do I need to cut my budget in half or do I need to start?"

Todd Schmiedeler: Wow.

Jason Squires: And it's like, "We're not there yet."

Todd Schmiedeler: Yeah. Yeah.

Jason Squires: You know, let that take a slow and methodical pace. I'm not telling you you're never going to have to deal with the budgetary problem, right? But now is not the time.

[H2] Effective Communication and Member Advocacy

Todd Schmiedeler: So, what are some of the ways that you get that information out? I mean, you mentioned that you do a conference.  You also mentioned that you're communicating with the state and with other kind of sources, and you're part of a national organization.

What are kind some of the key ways that you get that communication out to your members and how do you engage them in making sure that they're where they need to be, so that they can make good business decisions?

Jason Squires: Well, one of the advantages to being a LeadingAge member is LeadingAge National and the policy team are very strong at the federal level.

Todd Schmiedeler: Okay.

Jason Squires: So, we get a lot of our information from the national headquarters. That helps us to understand what's going on at the federal level. At the state level, we're blessed, that we've got relationship with the people in Frankfort.

Todd Schmiedeler: Yeah.

Jason Squires: In fact, this morning I have another phone with somebody at Medicaid, talking about what could what could the impact be? And so, we've got those contacts at the national level and at the state level.

As far as how we get that out, I've got a weekly newsletter that goes out every Friday with whatever the highlights are for the week. If there's something that pops in the meantime, then we can send out an advocacy alert, just letting people know what's going on so they don't have to wait. So if something pops on a Tuesday that needs action, we don't wait until Friday for your normal email newsletter.

And our members are very involved. You know, when I send out an advocacy alert, call your senator, call your congressperson, email them, they do that. They respond. And it's about the numbers. It's about making sure that we're heard. We're a pretty large group when it comes to the senior living space. Think about all the seniors in your own life. So, we're a large group and we’re are heard.  So, we can count on a members for that.

Todd Schmiedeler: Well, you know, this has actually impacted me this weekend as a matter of fact. One of my uncles actually got a wound on his foot. So, we had to take him to the emergency room. And then they said, "Well, we need to do some grafting onto his foot because of the wound." He actually called me today and said, "Hey, I'm going to need to go to rehab. Can you suggest a couple places that I could go to rehab?"

Sometimes we forget, because we may not deal with it every day, how important it is to take care of our loved ones in that moment.  We need to have good resources in our communities because he may be there for a few days or weeks. I'm not sure because I'm not an expert on wounds.  But I do know that my aunt and my mom and the my other aunt, we're all concerned about making sure that we got them into the right place.

Jason Squires: Right?

Todd Schmiedeler: You know, I think it's critical for us to make sure that we don't overlook those places where we may not need it today, but all of us are probably going to need it to a certain degree tomorrow.

Jason Squires: Good.

Todd Schmiedeler: Your advocacy is important. If you've got 70 members, do you have a rough idea of a range of the number of employees that are in those groups?  Would you say that there's an average of 50, 100, 150, in most of your members? Any idea about those numbers?

Jason Squires: Well, it's really all over the board. In some of the rural part parts of the state, we've got these small standalone nursing homes that have been there forever. They might have 50 or 60 beds.

Todd Schmiedeler: Okay.

Jason Squires: And so they might have just a few dozen employees.

Todd Schmiedeler: Okay.

Jason Squires: Then we've got some of the larger communities where you've got several hundred. So it really is kind of all over the board.

Todd Schmiedeler: Okay.

Jason Squires:  I want to go want to go back to something you were talking about when it comes to a family member who all of a sudden needs long-term care.

Todd Schmiedeler: Yeah.

Jason Squires: You know, even though we all have parents and grandparents and aunts and uncles and we're all seeing them age.  We don't think about it until we need it. Right?

Todd Schmiedeler: Right.

Jason Squires: And so then how do you know where to go?

Todd Schmiedeler: Right.

Jason Squires: How do you know where the good nursing homes are or the ones that you might stay away from and having those resources? Obviously, we're available. But then there's also the ability to get online and you can go to the Medicare website and you can search for facilities in your areas. It gives you their rankings, how they've done on their census surveys and things like that. So, there's resources out there, but we just don't think about it until we need it.

[H2] Enhancing Quality of Care Through Alternative Funding & Vetted Services

Todd Schmiedeler: Yeah. Absolutely. Let’s shift gears for just a second. You know, you talking about everything going on with Medicaid and the potential that whenever those things change, it's typically a tightening of the budget. You and I talk frequently about alternative funding for organizations, so that we continue to elevate the quality of care and the quality of life for the seniors that are there.

Where do you see kind of the future for those opportunities? Are your members thinking about, “Hey, how do we think about how we could continue to elevate what we're doing, even though we know that certain funding sources may be a little bit more of a struggle?”

Jason Squires: Right. You know, one of the things that and again being new in the role, part of what I'm learning about is how to best support our members. So, one area is looking for ways to get money back in their pockets.

Todd Schmiedeler: Yeah.

Jason Squires: That can be done through combining with other facilities to leverage buying power.

Todd Schmiedeler: Oh, yeah. Good idea.

Jason Squires: You know, when it comes to medical supplies, food, office supplies, things of that nature, we can leverage our buying power and that's something we're starting to develop within the association. Looking for ways for LeadingAge Kentucky to bolster its revenue. So, this is a long-term goal, but being able to reduce our dues with our members.

Todd Schmiedeler: Yeah. Because that's a cost that they're facing right now.

Jason Squires: If we're generating revenue, then we can offset some of the cost of dues from our members, right? Again, that's a long-term goal, but definitely I think it's the direction we need to head.

Todd Schmiedeler: Yeah. So have you gotten to a point where you're brainstorming some of those ideas to generate some additional revenue that might cut their fees down?

Jason Squires: We're getting there.

Todd Schmiedeler:  Well, I know you're only four months in.

Jason Squires: There's a concept where you can if you're utilizing a certain company's services and you're introducing them to your members, the members are utilizing the services, there's some revenue sharing that can go on.

Todd Schmiedeler: Yeah, absolutely.

Jason Squires: You know, whether it's for marketing dollars, education dollars, things like that. That's an opportunity for us to partner with a vendor, say, you know, insurance or capital investment to draw in potential revenue for LeadingAge Kentucky. And again, that impacts our members, because if we can get those dues down, that's something that they don't have to worry about.

Todd Schmiedeler: Yeah. And introducing them to vetted services, I got to believe, is a member benefit that is actually probably really appreciated, because they are so busy with the day-to-day of taking care of so many people within their buildings and facilities that sometimes, I got to believe, it's difficult for them to always be able to vet multiple providers within whatever it is that they might need, but they need it.

Jason Squires: Exactly. Well, a couple weeks ago, I had an administrator of a facility in the western part of the state, and they needed to buy some new hospital beds. So, she called and said, "Can you suggest a vendor?"  A medical supply company to buy beds from. So, I gave her a couple that she could call them both and look at the numbers. And so, we’ve got members that utilize us just for that.

"Can you give me a vendor that that you trust?" And so, fortunately, we've got that experience with all of our members. We know the vendors that can deliver. We know they're the vendors that that overpromise and don't do what they say they're going to.

[H2] Technology's Role in Workforce Support and Caregiver Well-being

Todd Schmiedeler: Yeah. Well, I mean, vetting I think is critical.  When you think about workforce, and you highlighted that the intersection between the traditional work force which is female somewhere between I think you said 25 and 45 years of age.  You commented how that's a declining population generically across our country and yet the increased number of seniors that are going to need services because people are living longer.

I remember back like 20 years ago, a silver tsunami coming from the baby boomers and I know we're right in the middle of that.  When you think about that and you also mentioned technology, is there any overlap of workforce and technology that you could see that might present opportunities that will help overcome the that kind of really negative outlook with regards to workforce?

Jason Squires: Well, there can be some things with technology when you're providing services to people, you can't replace that personal touch. We all know that. But when it comes to certain environments, where we have people who are prone to wandering; people who try to get out of the building. There are some creative ways where technology is being used to help alert staff to somebody.  You can't you can't necessarily lock down all the doors.

Todd Schmiedeler: Right?

Jason Squires: But if there can be some sort of a monitoring system where, for example, if someone is prone to falling, then there's some AI software out there where it can identify when that person’s getting up and walking around.  We know that that person is at risk for falling and then the staff can get a notification. It's things like that so that the staff don't necessarily have to have constant eyes on.

Todd Schmiedeler: Right. Right.

Jason Squires: Because you know they've got plenty of other things they need to be doing and we don't physically have enough staff to be one-on-one.

Todd Schmiedeler: Yeah.

Jason Squires: But some of those ways that technology can help, again not replacing the workforce but supplementing it, and reducing the risk of the people that they're supporting.

Todd Schmiedeler: Gotcha. I think you know, I had the good fortune to spend 10 years in long-term care and one of the amazing things that I would have never realized without being in it, was the importance of the different layers of the staff and their teamwork together.

I always cite how important the housekeeping staff was that I didn't really know about when I went into the business. A lot of times the nurses and the CNAs have this need to move, if there's some sort of a medical need. So they might be having a great discussion and talking to one of the residents, but at the same time if there was somebody down the hall that needed an emergency intervention then they needed to take care of that.

But with housekeeping, one of the things that that I found was is that they were really able to have deep, rich conversations with residents and people, because they were yes responsible for doing certain things, but it was they weren't going to automatically have a sweeper crisis or emergency that that would come up.

The depth by which that relationship with that housekeeper or food services individual, it gave me an understanding that the job of senior living, and I assume that same thing for intellectually disabled providers, is it's not just important that those residents feel cared for but it's really important that they feel cared about.

Jason Squires: Right.

Todd Schmiedeler: In your mind, because you know you have this national conference.  What kind of trainings do you all do with the staff and the leadership to be able to really create that environment that allows them to be even more successful when they go back?

Jason Squires: Well, a lot of it has to do with just like what you said, forming those bonds with the people they're working with. We also talk about caring for the caregiver.

Todd Schmiedeler: Okay.

Jason Squires: And not losing sight of, whether it's housekeeping, whether it's dietary, whether it's your CNA, the things that they're dealing with on a daily basis at work or at home. Um, and making sure that they're feeling supported so that they can be present. when they're at work. And so whether it's the national conference and we've got we've got our state conference coming up this fall, focusing some of our education on the caregivers making sure that we're meeting their needs so that they can be present for the for the residents.

[H2] Proactive Leadership, AI in Strategic Planning, and Personal Balance

Todd Schmiedeler: So for you as a leader in this, you've obviously been the industry for decades, but you've been in the role for four months. Are there two or three things that right now you've been focused on with regards to making sure that you're meeting the needs and identifying those needs or even you've identified this need and you want to grow in this way so that you might be able to also add more value as the leader of the organization?

Jason Squires: Well, you know, something I heard the other day, it reminded me there the old story if you're a hockey fan.

Todd Schmiedeler: Oh, yeah.

Jason Squires: Wayne Gretzky.

Todd Schmiedeler: Yeah. Yeah.

Jason Squires: And Wayne Gretzky talks about what made him such a great hockey player. And it's not because he was where the puck was.

Todd Schmiedeler: Right.

Jason Squires: He skater to where the puck was going to be.

Todd Schmiedeler: Yeah. Yeah. Yeah. Love that.

Jason Squires: And so when I think about what LeadingAge Kentucky needs to be, we need to be where the puck is going to be and we need to help our members get there.

Todd Schmiedeler: Okay.

Jason Squires: So whether that's advocacy and legislative issues, whether that's getting ahead of the curve on revenue sharing, so that they can drop their dues. Whether that's helping them be a voice in Frankfort.  Whether that's giving them that sense of connectivity among your peers, all those things, but meeting them where they need to be and not being reactive. You know, being more proactive.

Todd Schmiedeler: Yeah. Yeah.

Jason Squires: And so those are the things that that I'm focused on.  I think the association has a bright future. You know, we we've got a lot of things that are in the works. Again, you know, one of the things of being new on the job is I can come in and ask all the questions, right?

So, working through some of those things, but ultimately helping our members so that they can focus on their residents and not worry about funding and not worrying about reimbursement, not worry about the staffing challenges. We can't do everything, right? We can't be all things for all people. We recognize that. But again, helping our members so that they can focus on why they got into the business to begin with.

Todd Schmiedeler: Right. Right.

Jason Squires: Which is caring for people.

Todd Schmiedeler: Yeah. Well, and I think that you know, you and I have had a couple of discussions about the impact of technology, you know, and in particular here recently, you know, about AI.  I do think that there is a lot of questions that go on about AI. And one of the key things that I believe that can help demystify that is by making it more real and relevant to specific roles.  In your role, have you seen or identified one or two things in AI that you have said, hey, I think this could help me be more effective and efficient with my time that I might be able to actually give more value to our members?

Jason Squires: That's a great question. Like you said, we have had a couple conversations. You're much you're much better versed in AI than I am. I'm getting there. You know, when I when I think about that, it's easy to get down into the weeds.  If so, for example, this fall we'll be getting into strategic planning.

Todd Schmiedeler: Yeah.

Jason Squires: And when I think about,  “What does the ultimate strategic plan look like for LeadingAge Kentucky?” I think there's a role that AI can play there.

Todd Schmiedeler: Yeah.

Jason Squires: Not putting together the entire plan, not anything like that, but supporting and kind of bolstering the work that we're doing because I think one of the advantages of AI is it's got such a broad network to draw from where there may be some resources out there that we're not aware of that can that can supplement our strategic plan.

So that's one example where using that tool as someone who's doesn't know everything and again AI can't replace what we're doing as humans. But I do think it can supplement that. And so I think when I think about the future of where we're going to go, I think that can help.

Todd Schmiedeler: Yeah. You know, often, the way I've always heard it over the last like year or so, I'm a fan of Geoff Woods, who wrote The AI-Driven Leader. He talks about it being your “thought partner.”   You know, you still have to be your thought leader.  

Even to the point of like the strategic plan, it can't make your strategic plan for you without context and information that is critical that you and your members add value in, but it can help organize and maybe bring some thoughts around that to help make sure that you have a comprehensive plan that is actually dealing with any of the solutions that might be out there that you might not know at the forefront.

So I want to be respectful of your time, but I want to finish by saying, you've shared a lot about your role and about LeadingAge and I appreciate that immensely.  I'd love to know a little bit more about when you're not doing the LeadingAge and leading a statewide organization, what is it that you like to do with your free time?

Jason Squires: Well, my wife and I have three young men. Men that are children and they're not boys, but they're young men.  But we like to spend a lot of time together.  I'm big on the outdoors, so everything from hiking, fishing, that sort of thing. I love being outside. And I like to read. That's something I do a lot, as well.

I'm a UK grad, so go big blue. Anything that has a ball related to UK, I'm on it.

Todd Schmiedeler: Oh, that's great. Well, I will say that this year, I'm pretty excited about the basketball in our state. And that UL-UK game will be one of the highlights of the year.

Jason Squires: I hope so.

[H2] Conclusion

Todd Schmiedeler: I know that there's so much if you're not from Kentucky, you don't understand the kind of the competition between the two. But I think every state's got those little rivalries. For us, it's about basketball more than anything else. For the most part, I find that it's a good discussion point to break down that ultimately though we might be competitive in basketball, you know, as across our state or across an industry, we really need to be collaborating. Because in the end, we're all trying to do one thing, and that is serve people.  And if we're competing about that, we usually probably aren't as good as we should be at doing that.

So, you know, I want to thank you for your time, Jason. It's been great. I think that Jason's great resource if you know you have some questions or hey maybe you're an organization that wants to join LeadingAge Kentucky. I'm going to put the contact info in the show notes and I want to think about how the audience is spending your time and the fact that you would give us a few minutes of your time to learn more about not just LeadingAge but some of the leadership that Jason brings.  

Thank you as always and come back in two weeks and we'll have our next episode. But for now, thank you so much for coming and I appreciate your time.

[H3] To Learn More about LeadingAge Kentucky:

Website:  www.leadingageky.org

Phone:  502-992-4380

Email:  info@leadingageky.org

Hey, thanks for joining us on the Blueprint Strategy Podcast. We hope today's conversation sparked new ideas and inspired you to take action in your own organization.

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