April 7, 2025 • 50 mins
What happens to mental health when independence is lost? Steve Lamonaco, President and CEO of Thrive Behavioral Science, pulls back the curtain on the often-overlooked psychological challenges facing nursing home residents and their families.
Drawing from his remarkable journey spanning four decades in elder care—from nursing assistant to CEO—Steve shares how his firsthand experiences shaped Thrive's innovative approach to providing psychiatric and psychological services to over 9,000 elderly patients monthly across Florida's nursing homes and assisted living facilities.
The conversation takes a deep dive into the profound adjustment disorders many seniors face when entering long-term care. "Nobody sits back and says 'I can't wait to get to the nursing home,'" Steve notes, highlighting how depression and anxiety often accompany the loss of independence, financial control, and familiar routines. Particularly moving is his insight into the parallel suffering of caregivers left at home, whose own routines and mental health frequently deteriorate after placement decisions.
Steve's perspective is uniquely valuable because he bridges clinical understanding with administrative expertise as a licensed nursing home administrator. This dual perspective allows him and his team to create systems that effectively address resident needs while helping facilities maintain compliance and quality measures—reaching far more seniors than traditional approaches.
Beyond professional insights, Steve shares personal reflections that reveal his deep commitment to this work, including his habit of working 80+ hour weeks and not taking a vacation since 2004. His advice to aspiring healthcare administrators emphasizes humility, continuous learning, and genuine empathy for both residents and staff.
Want to learn more about supporting elderly mental health or connect with Steve's team? Visit www.thrivebehavioralsciences.com or find Thrive Behavioral Sciences on LinkedIn and Facebook.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
I haven't taken a vacation since 2004.
I mean a real like a week.
So my wife has been, you knowshe gets to go meet me at
conferences and stuff, but Ihaven't taken a true vacation.
I just really about learning onthe job and I just kind of
entrenched myself into learningwhatever I could every day, from
sitting down I'm smiling.
Speaker 2 (00:33):
Real big today.
Real big today.
Yes, I have somebody veryspecial on the show.
He agreed to do the show withno problem.
Welcome back to another episodeof the let's Get Comfy podcast,
brought to you by ComfortMeasure Consultant.
I'm your host, norman Harris.
Right, it's Florida number onehealth care edutainment station.
(00:55):
Yes, that's a manifestationthat I do.
We have a wonderful guest,wonderful guest with us today.
President and CEO, mr stevelamonaco of thrive behavioral
science.
Thank you, sir, for joining ustoday.
So glad to have you.
Thanks for having me.
It's an honor to have you, uh,grace this set here, uh, with
(01:18):
the orange background.
You know I'm not a floridagator fan, by the way.
Just I like to just say thatoff work.
But thank you, sir, for beinghere.
I really appreciate you joiningme in this platform.
I mean, it's an honor to you.
Give me a chance to sit down,have a conversation with you,
one.
I love learning about people ingeneral and this is a great way
(01:42):
for me to to learn you.
But the audience, the community, my audience, audience is
people, the everyday person outthere.
Uh, to hear from someone likeyourself, uh, this is going to
be great and to hear from yourinsight.
I'm just excited for theaudience to be honest with you.
So we're going to start there.
We're going to start presentday thrive behavior science.
(02:04):
Um, what specific services doesyour organization provide, uh,
to support mental health in theelderly individuals?
Speaker 1 (02:13):
thrive.
Thrive is a what we providepsychiatry and psychology and
nursing homes and assistedliving facilities throughout the
state.
Um, we go in.
I have uh 39 practitioners,both psychiatry and psychology.
We do psych nurse practitioners, we have psychologists and we
also have I have three medicaldirectors who are all
(02:35):
psychiatrists, and we go intonursing facilities and treat
patients in the facilities.
We do it in a way that we'rehopefully taking great care of
the resident, making sure theyhave what they need.
We're hoping to make sure thatthe facilities have quality
measures that meet where theyneed to be as well, but
(02:56):
ultimately, it's all about thepatient.
We also try to help thefacilities with compliance and
things like that.
So we go in, we treat patients,we try to see everybody we can.
Our model is something a littlebit different that we created
and partly that's due to mybackground, because I'm also a
licensed nursing homeadministrator and a certified
(03:18):
risk manager.
So for me, setting up theprocedures that we use, the way
you use, how we go about things,is a little bit different than
some of the others.
I just saw a need when the megarule came out in 2018.
The third part of the mega rulecame out in 2018.
I saw a need, something that Ifelt like was being missed in
(03:42):
long-term care in the nursingfacilities was being missed in
long-term care in the nursingfacilities, and so I thought, if
somebody thought about it theway I think about it as a
nursing home, from a standpointof a nursing home administrator
or a director of nursing, and wedid things the way I thought
about it, the way I wanted themdone, we could make a bigger
impact on the facilities andreally on the industry.
(04:05):
Yes, sir, so we've made someinroads, we've done some good
things.
Speaker 2 (04:10):
Right, right.
So I started this episode alittle different.
For followers out there, ourcomfy supporters, I wanted to
get off for people to understandwhat Thrive Behavioral Science
is.
But I just want you all tounderstand, Mr Lamonical, here,
if you could just let them letthe audience know your accolades
, accomplishments, um, just bragon yourself a little bit.
(04:33):
Just take, take about 60seconds just to brag on yourself
, Mr Lamonical.
Speaker 1 (04:37):
Well, I, I don't know Um, I am a nursing home
administrator.
As I said, and I'm very proudof that, I started working in
nursing homes in the 80s, that's1980s, so and basically I
started in nursing homes becausemy grandfather was in a nursing
home.
He actually had a stroke theday we buried my grandmother and
(04:58):
I started visiting him, andwhen I would, I really didn't
like what I saw.
I felt like we could do abetter job.
There could be a better jobdone if somebody really focused
on it.
I shouldn't say it wasn't.
I didn't like what I saw, Ijust felt like there could be a
better job.
I felt like I could run theplace better.
So, that being said, I waspre-med and decided to go this
(05:21):
direction, and so I became anursing home administrator.
I was a nursing assistant tostart, but I wasn't even
certified, because I didn't haveto be certified at the time.
So that's how long ago it was.
Speaker 2 (05:35):
So you were hands-on before.
Oh yeah, so coming out into thereal world.
Speaker 1 (05:41):
Once I got my degree, passed my test um actually had
to take it twice, not because Ifailed, I passed the first one.
But then the obra 87 came outand uh, on the new test in 92,
and so I had to take the testagain well, I failed mine so.
but I passed it both times andthen came out and and I got a
job actually an intermediatecare facility because I was a
(06:03):
probably because I was thelowest priced person out there
but they had just lost theirMedicare cert.
So I stayed there until I gotthe Medicare cert back.
And then I went to a differentfacility and kind of up the
ladder.
In 2000, I was in Atlanta and Idecided to take a little chance
.
Pps was converting.
(06:26):
We were converting to PPS atthe time.
There's a lot of turmoil in theindustry, a lot of sales of
facilities and company, and Idecided to venture off into
pharma.
I went to a dinner with acouple of my medical directors
and pharmaceutical salespersoncame to me and said you would be
really good at this, thequestions you're asking.
So I got into.
(06:52):
It was strictly a long-termcare division for a couple of
different companies.
Speaker 2 (06:55):
And.
Speaker 1 (06:55):
I actually sold psych in those.
So for me it's important to beprepared.
So the only way I could getcomfortable was to learn
everything I could about all themeds not just my own but my
competing products and so when Idid that I realized how deep I
could go and how much knowledgeI could acquire if I really
(07:15):
studied.
So I did that and I did thatfor about six years.
I went from a sales rep and Iactually led the nation for five
out of six quarters Inpharmaceutical sales In
pharmaceutical sales.
What organization was this?
I was with Johnson and Johnson.
I was with Eli Lilly.
Speaker 2 (07:30):
Oh, okay, the big boy .
Speaker 1 (07:31):
Yeah, so when I did it I was very fortunate.
I mean, I really felt that myunderstanding of the space was
really the biggest thing thatmade me successful.
I could speak the language, Icould talk the talk, and it was
all about being honest andgiving them what they needed
information-wise.
Speaker 2 (07:51):
At Comfort Measures Consulting, we're here to help
you navigate the complexity ofhealthcare.
If you're caring for a lovedone as a caregiver, you don't
have resources, you don't knowwhat questions to ask.
You need to have options right.
Give Comfort Measures a call.
Give us a chance.
First consultation is free.
Speak with me Comfort MeasuresConsultant 850-879-2182.
(08:19):
You can also visit our websiteat
wwwcomfortmeasuresconsultingcomvisit our website at
wwwconfrontmeasuresconsultingcom.
Speaker 1 (08:29):
Talk to you soon.
Well, I was selling psych meds.
Oh, you were selling psych meds.
Yeah, I was.
But you know, I mean, one ofyour biggest cost centers in a
nursing facility is meds.
And so I also learned, you know,very early to balance and to
look at medications before thepatients were admitted so that I
could make sure that my costswere where they needed to be,
(08:51):
which oftentimes meanssensitivities or things like
that have to be done at thehospital beforehand.
Also doing that, I learned labs, because I needed to see where
labs were, because if you've gotsomebody who's got a 7.1
hemoglobin and it's beendropping consistently, tomorrow
it's gonna be 6.9.
You're gonna have to send themback out for a transfusion
anyway.
They can keep them anothernight.
Have them do it, then send them.
(09:13):
This way you don't have toworry about it and you don't
have to put them on Procrit,which is expensive, or it was at
least so.
So a lot of different thingsthat I learned in this time
frame that I was a sales rep.
Then I was put into managementdevelopment, which didn't last
very long because I did so wellin it Not a little bragging on
(09:35):
myself.
I did very, very well in itafter the first visit.
So they promoted me to districtmanager and I moved to
California.
Okay, life in.
Cali.
Yeah Well, you know what it wasdifferent.
I was up in Northern Californiabut I ran seven states because
of the size of the territory andgot to meet a lot of great
people out there and we were topfive out of 28 districts for my
(10:00):
entire tenure, the four yearsout there.
Speaker 2 (10:02):
And then I became an interim regional director before
they downsized due to theeconomy in I think it was 07 so
look, let me ask you this, andI'm sorry to cut you off, please
on this was this where you, umuh, you are familiar with, or
met or work with I should saysean, uh, denine, yeah, sean was
(10:24):
of my.
Speaker 1 (10:25):
Sean was one of my best.
Speaker 2 (10:27):
Well, just me researching you.
This is what he said about you.
This is during yourpharmaceutical, where you was
the sales manager.
Right, he said I have workedwith a number of managers in
life and I look at I'm lucky tohave worked with Mr Steve hands
down, one of the best salesmanagers have worked with uh, mr
(10:48):
steve hands down, one of thebest sales managers loyal,
honest, patient and passionate.
Speaker 1 (10:49):
Passionate, that's what he said about you.
Yeah, I still stay in touchwith sean and sean was a great
guy.
The funny part I messed yourlast name up.
I'm sorry, but yeah, sean, sean, it's funny.
I I met sean at a job fair andsean was very nervous.
He had never worked in pharmabefore.
He was in financial side ofthings, but charismatic, and
(11:10):
that's what I.
You know.
When I was hiring, I would lookfor charismatic people, people
who could draw attention tothemselves but also had to be
smart.
Yes, sir.
I met Sean and Sean was verynervous at the time.
Sean sweat through his jacketso much that he was so nervous.
But the funny thing is, onceSean calmed down and realized we
could just talk, I realizedthat I had a winner there.
Sean was number one in thecountry for quite a few years,
(11:33):
along with another guy, kennyPerry.
But we always you know thepeople that we people used to
laugh because I didn't hirepeople who had pharma experience
and I it wasn't that I wasshying away from.
I hired some people who hadpharma, but I also hired a lot
of people who were.
They had charisma, they hadintelligence.
(11:54):
They were just people who could, who could speak.
Sean's got an eidetic memory.
He can remember after readingsomething exactly where it is on
the page Wow.
So for him he would remembereverything he read and he would
be able to spew it back out.
But he was such a honest personthat he would draw people to
them and they believed him.
And so he was and he, like Isaid, he gave off that essence
(12:18):
of being that, that honest,hardworking and just such a
great guy.
Well, he felt similar, similar,very similar uh, to you yeah,
but I've got a lot of you know,a lot of those folks that they
were just so great at what theydid.
They just needed the rightperson to you know to maybe take
their guard down, because somany people when you manage
(12:40):
people, you just have tounderstand each individual and
then know how they need to bemanaged.
Not do everything across theboard the same way.
You cannot, and that's what Itried to do was make sure that
they knew that.
I always told all my team somany times in pharma.
What we saw was people, whentheir district manager would
come in to ride with them,because we would actually go on
visits with them, they would beafraid to ride with their
(13:04):
because they thought they weregoing to be critiqued.
And I always said I want to bethe one that you guys call and
say I need you here because I'vegot a tough one today and if we
can get this over the hump, Iknow you can help me.
And so that's the way I lookedat it and they would.
If they had a tough day or theyhad somebody who was on the, you
know, I could put somethingtogether that when we came in
and we talked, it would beimportant to them, important
(13:25):
enough for them to listen, andwe could get the message across
the way we needed to.
You never talk bad about othermedications or other people.
It all had to do with yourmedication.
We're a team and so when wewould do that, we would we would
normally see success becausethey would understand that we,
we were just trying to.
Here's a specific area that youcan use this medication in, and
(13:47):
if you can try it, maybe you'llsee the results, and if you do,
I want to know about it.
It really worked out well, soyou know.
But we also had focus on theright clients to make sure that
we you know our, ourpractitioners had to be the
right people to focus on, and sowe tried to do that as well.
Speaker 2 (14:03):
Okay, all right, so pause, yep, that's here.
There is a comfy moment, but wedo add a little entertainment.
Oh, yes, sir, I tell you it'sthe edgy.
Now we're doing the education,but now we have a little
entertainment, so we take apause here.
Yes, a moment here.
So I take a pause here.
(14:25):
Just a moment here, uh, so Ihave a couple questions for you,
sir.
Okay, all right, you get it'scalled.
That's my answer.
You get three seconds to answerthis.
Okay, three seconds, all right.
If you could eat one dish dailyfor the rest of your life, what
would it be?
Speaker 1 (14:37):
probably, uh, veal parmesan, veal parmesan, my
dad's favorite.
Well, veal par and bill marsala, but yeah, bill parmesan neil
parmesan.
Speaker 2 (14:45):
Okay, uh, let's see, if you were a, uh, an appliance
or office supply, what would itbe?
That'd probably be arefrigerator refrigerator, all
right.
Um, if you had a superpower,what would that superpower be
and what would you use it for?
Speaker 1 (15:04):
Oh, probably strength , and I like the premise of
being strong.
So I think, without having touse it, you can put that kind of
a vibe off, so that you don'thave to do certain things and
then, when you needed to, youcould be strong enough to do
(15:27):
what needed to be done.
Speaker 2 (15:28):
All right.
Do you have a childhood crush,whether it's a celebrity crush
or from the childhood when?
Speaker 1 (15:36):
I was a kid, all I wanted to do was play baseball.
So I, Steve Garvey, was thefirst baseman for Los Angeles
Dodgers and he was.
I played first base a lot andhe was kind of my idol.
He was always supposed to bethis great guy.
He was an honest guy and he wasa great baseball player and so
(15:56):
I followed Steve Garvey.
I also followed Lin Swanbecause I thought he was a great
receiver and I'm a Steeler fan,Lin Swan.
Speaker 2 (16:03):
I'm talking about childhood, of course.
My childhood question wasBeyonce, oh, like that.
Yeah, childhood crush.
Okay, childhood crush, but it'sentertainment a little bit too.
Speaker 1 (16:12):
Mr Monaco All right.
Speaker 2 (16:13):
So childhood crush, yeah who.
You had a magazine on the wall.
I don't know if your mama letyou put posters on your wall or
anything like that.
Speaker 1 (16:20):
No, farrah Fawcett was big at the time, yeah.
Speaker 2 (16:22):
See, I knew it was somebody you might not want to
share Farrah Fawcett with thered bathing suit.
Speaker 1 (16:28):
Yeah, see, I would probably say that was probably
it, because I'm pretty sure Ihad that on my wall.
Speaker 2 (16:33):
I do it.
Speaker 1 (16:34):
Carol Teagues was another one, I think.
Carol Teagues was in a pinkbathing suit.
You remember the bathing suitAll right, I still got a pretty
decent memory yeah.
Speaker 2 (16:44):
Let's change that topic right now.
I don't want to get over, sir,uh.
And the last one is if youcould be any animal, what would
it be and why a jaguar?
Speaker 1 (16:56):
I, I just, I've always grabbed it.
I love the, the big cats I love, but they're sleek, uh, they're
strong, uh, they're fast.
It was either that or a cheetah, but I, I love the speed side
of of things, but they'rethey're sleek, they fast,
they're strong and I just thinka Jaguar is cool.
Yes, sir.
Speaker 2 (17:17):
Well, thank you for participating in the game.
We will resume, but I want totalk about Thrive as well.
Okay, so can you explain howthe importance of addressing
behavioral health in agingadults and how that impacts
their overall well-being?
Speaker 1 (17:36):
Well, when you look at life, if you work all your
life and you retire, it's timeto retire.
You're looking forward to yourgolden years.
You're going to enjoy the time.
Nobody sits back and says Ican't wait to get to the nursing
home.
You know they may say that.
You know, assisted living is acompletely different animal.
(17:58):
They can go.
There are so many things to dothere.
You know they have freedom.
And you go to a nursing home.
There's a reason why you'rethere and it's normally because
you can't do anything foryourself.
It's very limited.
Let's just say that you've gotconditions that are making it
very difficult for you to liveindependently.
That comes with different risksand some of those are
(18:20):
adjustment disorders.
Coming into the nursingfacility, people are depressed,
people have just lost theirindependence, they've lost their
ability to manage theirfinances, the expense that's
related to the cost of care,which care is expensive and I
don't think everybody realizesthat.
But when you look at all of thedifferent things that happen
(18:42):
when you're admitted to anursing facility, that
adjustment disorder whether it'sdepression, whether it's
anxiety, whether it's both is ahuge impact on how you live
every day going forward For usto be able to come in and give
them peace of mind to help themcope with certain things that
(19:03):
are going to be coming up intheir life while they're there,
whether it's short term so often.
I mean, we always used to sayand back when we had distinct
units, we used to this part ofthe building is only skilled and
this part of the building islong term.
Why did you do that?
Because nobody who's skilled,who's there for short term,
wants to see what it looks liketo be long term.
They don't want to see that.
(19:24):
So when you think aboutnowadays, we skill everybody in
the same.
All the beds are skilled, allthey're duly certified, and you
have a person who comes in andthey have to go in with somebody
who's long term, who can't doanything for themselves, and
they have every intention ofgetting the person who's in the
bed next to them has everyintention of going home.
(19:45):
They need help.
They need to understand that'snot going to be me.
They need motivation Sometimes.
They need to understand thatthey have a chance to get back
out and, uh, they also have tounderstand there if they do have
to go that direction.
There is life in a nursingfacility.
You can live a very productive,have wonderful outcomes, have a
(20:06):
quality of life that that andthey need to understand that,
and oftentimes they don't.
So we try to give them not onlya way to cope through the time
period that they're having, butalso give them an opportunity to
see that there is something onthe other end that they don't
have.
This isn't something where youhave to shut down and just curl
up in a corner and go away.
(20:26):
Nursing homes have an incredibleopportunity to help people and
oftentimes the only thing youever hear about a nursing home
is the bad side.
The bad side Because you've gotmore litigation-happy people
out there.
That that's what they want tolook at.
The focus shouldn't be there,because if you saw what I've
seen in 35, 40 years of being inthe industry, the things that
(20:51):
have been done, the people thathave been helped in long term
care, it's astronomically vast,I mean.
But you never hear about thegood stuff.
You never hear about the goodstuff.
So for us, we're in there andwe're talking with folks and
we're trying.
You know, oftentimes they'reovermedicated.
We try to reduce thosemedications.
We try to make sure thebuildings have their quality
measures where they need to beas well, because so many times
(21:13):
people are overmedicated,they're being given the wrong
medications because they'rebeing used for side effects, so
we try to fix that.
And then we have talk therapy,where they can be given coping
mechanisms so that they know howto deal with what's coming.
We can kind of prepare them forit, similar to what you do,
norman, with your consultingside.
(21:34):
We talk with people on adifferent level because we
understand the space indifferent ways you and I both
and because of that we're ableto give more back to those
people and hopefully give themsome kind of peace of mind so
that when they, if they do haveto stay long-term, that they
have an understanding of what'scoming and then also how to deal
(21:56):
with it If they go home.
Even better, we have a clinicbase as well, so we can take
people once they're dischargedand we can follow them in the
community and make sure thatthey have what they need to
continue to get their meds, sothey don't have to go back to
the hospital because they didn'thave the ability to get their
medications, because on thepsychiatry side so many times
(22:18):
there's no room for them to goto a psychiatrist and oftentimes
primary care doesn't want towrite certain medications
because they're controlled andso they don't want to delve into
that.
So what do we do?
We help them do that.
By having telemed, we follow upwith their.
By having telemed we follow upwith their home health care
agencies.
We can even have medicationsdelivered to their home.
(22:39):
We try to find ways that we canhelp the people once they go in
the community so they don'thave to go back to the nursing
home if they don't need to.
But when they are in need wealso help to get them there, and
then we hopefully can preparethem once they're there to make
sure that they're taken care ofand that the nursing facility
has the the tools to better carefor them as well so um with the
(23:00):
caregivers right um, just fromyour perspective, what are some
early signs they can look for?
Speaker 2 (23:07):
um for potential mental health concerns and an
aging loved one?
Speaker 1 (23:11):
right.
Well, obviously, some of themare forgetfulness, you know, and
that's not necessarily apsychiatric issue.
Sometimes it's neurology.
You have to look at whatthey're suffering from to
understand that.
But depression you're going tofind that a lot of people, even
at home.
When you look at a certain agegroup, you're going to realize
that it's about that time whenyou start seeing people, that
(23:36):
you lose your friends, you loseyour acquaintances, you lose
some of your independence.
You're not going out of thehouse as often as you used to
because you can't.
You may be afraid to drive atnight, you may be afraid to
drive altogether.
You don't have publictransportation and you don't
have the people that you used tohave to get you where you used
to go.
Oftentimes even family getsmore.
(23:58):
In this day and age we can, wecan operate from different areas
and we don't have to be in thesame area all the time and still
stay in touch.
So oftentimes families kind ofspread apart a little bit and
they don't have theaccessibility to do that and you
lose touch with some of yourfamily and if that happens you
start to become a shut-in.
(24:20):
I often say in some of my emailnot emails, but on some of my
social media posts that you knowyou will see people.
It's a great idea to make sure,if you've got a neighbor, a
friend, reach out to them atleast once a week, make sure
that they know you're there,make sure you talk with them and
just kind of even if it's fiveminutes maybe invite them to
(24:43):
dinner once in a while.
If they're your neighbor andthey don't have somebody else
and they're home every night,and they're home every night all
by the, invite them over, right?
Um, when you look at people whobecome shut in, they become in
completely isolated because theydon't have the friend base they
used to have.
You know, maybe you used to.
And I'm just going to throw whatif they go golfing on a regular
(25:03):
basis with with friends andthey lose some of those friends
now they don't have the groupthey used to have, right?
So now do you go golfing byyourself or do you stay home?
That's a decision you have tomake.
Same thing you know anythinglike that.
You used to go to the movieonce a week with someone and now
they maybe passed on or theyended up moving away, or they've
gone to an assisted living or anursing home and now you're in
(25:24):
the community by yourself.
How do you bridge that gap?
What do you do?
Oftentimes you're going to seepeople in your own community
that are isolated becausethey've lost friends, they've
lost family.
And you know, if you can thinkabout and I used to you ever see
the movie Up.
(25:45):
It's a cartoon movie with EdwardAsner.
Ed Asner is the guy and they's.
They have the balloons and theygo okay.
So I used to make some of myteam watch that, because up is
about two people met in highschool, met in grade school and
they ended up going through highschool.
They ended up getting married.
They spent 50 years together,married wow, and she passes on.
(26:09):
Now he's all by himself.
He has nothing.
He has no one, because all heeverything revolved around their
, them by themselves.
So just think about the routinesthat used to go on because
everybody stayed in the same jobfor a long time.
They used to have a routine andyou have somebody who comes
into your facility who now has.
(26:32):
Or you have somebody who youlose and you were used to a
certain routine.
Every day it was go to.
It was get up in the morning,have breakfast with that person,
go to work, come home, havedinner with that person, watch
certain tv shows with thatperson, go to sleep with that
person, wake up the next day.
Everything was the same everyday.
Now, all of a sudden, you don'thave that person.
(26:53):
Now what do you do?
That's what happens when ahusband or wife, a caregiver,
has to put their loved one in anursing facility.
They're separated from them now, so what does their routine
look like now?
They are suffering, as well asthe person who's in the nursing
facility, and those people arethe ones that you need to reach
(27:15):
out to and make sure that theyhave everything that they need,
that they have someone that canreach out, because, I'm going to
tell you, we see declines inthose people as well, and they
end up coming into the nursingfacility as well.
Speaker 2 (27:25):
The ones that were at back home.
Yes, right, so what would beyour advice?
Just a couple of tips for acaregiver that's in that
situation a daughter or son thatsay they just had dad go to
nursing home, right, and mom isstill back at home, empathy.
Speaker 1 (27:42):
Those individuals I'm going to tell you are are
struggling, they're sufferingand they're.
Some people are strong enoughto make it.
And there are some people arestrong enough to make it, you
know, but oftentimes there's,there's not.
They are.
So their routine is soingrained that they are
(28:03):
disheveled because they are soused to that routine.
And I have had people who Ihave had family members, ocd,
and I'm going to tell you thatthis individual used to be there
in the morning at the same timeevery day.
By the minute she used to leaveat the same time.
By the minute.
If she couldn't leave, shewould become anxious to the
point of mania.
Almost Everything had to be,because that's how her life
(28:29):
always was, because that's howher life always was.
And I'm going to tell you thatshe could not.
This woman couldn't leave theparking lot one day because the
ambulance was behind her.
So she rammed it just so shecould get out and then denied
that she did it and everybodysaw her do it.
But that was part.
She was so manic about being ona routine and mind you that her
(28:51):
husband was in our facility andhe was obviously he needed to
be there.
She couldn't care for himanymore, but you could see the
decline in her because herroutine was broken.
She could not do the same thingevery day.
When you have people like thatwho need outreach, you have to
be so empathetic about helpingthem cope with when they're in
(29:11):
the building even yes, they'reprobably the most detail
oriented.
They are going to be soempathetic about helping them
cope with when they're in thebuilding even yes, they're
probably the mostdetail-oriented.
They are going to be the oneswho are the most anxious about
the care that's being provided.
But if you can help them tounderstand and show them and be
empathetic towards them, they'llalso be your number one
advocate.
And that's one of the things asan administrator I used to try
to make sure I could look at.
(29:33):
I got to know every patient inthe building, know them by name.
I'd know why they were there.
I'd know their meds.
I would know their conditions.
I would also know theirfamilies, and there was a big
deal about that.
It made it so that they couldcome to you without being
concerned.
They wouldn't have to just pickup the phone and call somebody
else.
They would call you, they wouldcome in and see you.
(29:57):
They know that I would walkdown and I would see what was
going on and I would fix it.
And when you do things likethat, I rarely had complaint
surveys, knock on wood.
I rarely had complaint surveysand I never had an annual survey
, not in the state of Florida.
I had more than four tags, infact, I actually begged for my
last one of my buildings.
I actually asked them to giveme a site because they didn't
want to give me any.
And listen, there's no buildingin this country.
That's perfect, even if we get azero, you know no tag there is
(30:20):
no building that's perfect, yeah, but and I never thought of
mine I got perfect surveys inalmost every facility.
I was in One, not across theboard, but when I did I was very
thankful for it.
But I was also nervous about it, because you never know what
comes behind it, and that's partof the problem.
(30:40):
You get a federal look behind.
Or even the next time somebodycomes in, I don't want to say
they have a vendetta, but theykind of want to show you're not
perfect.
I never thought of it.
Listen, you always strive forperfection, but they kind of
want to show you're not perfect.
I never thought of this.
You always strive for perfection, but you can never get to
perfection, but you alwaysstrive for it and so doing the
(31:02):
things that I used to spendminimum of 80 hours a week in my
nursing facilities when I ranfacilities because I wanted to
see breakfast, lunch and dinner.
I wanted to make sureeverything was the way it was
supposed to be.
I wanted to meet with families.
The way to do that is to spendmore time there.
I worked weekends and so Iwould go in on the weekends and
I oftentimes would do my ownadmissions, not because I didn't
have wonderful staff takingcare of it.
(31:25):
I just wanted the hospitals toknow who are you sending these
people to, and can you pick upthe phone and call that person
anytime and if you have aproblem you'll fix it, and
that's.
I kind of look at myself as afixer, but I also think if you
give people the right tools, youdon't have as many things to
fix.
And so trying to be present allthe time made it so that I had
(31:47):
less to do.
I could help to.
I mean, yeah, I was a nursingassistant.
I could change people, I couldhelp people.
I could move people from onepart to another because I knew
how to transfer people.
And so, when you look at doingthings, I would never ask
somebody to do anything that Iwasn't, I wouldn't do myself,
(32:11):
and when I would go out to thehospitals, it was more about
making sure that they knew thekind of person they were dealing
with, who they were sending itto the patient to, and that I
would be responsible andaccountable for everything that
happened and so that gave.
I feel like that was a big partof my success as an
administrator.
I just felt like in the role ofThrive, I saw an opportunity to
(32:33):
provide, to actually impact,more people.
You know, when we first started, you know I was taking care of
120 people in a nursing facility, which was I loved the job.
I now, you know my team sees9,000 patients a month and
that's something that I'm reallyproud of, because we get to
impact the lives of 9000 peopleacross the state every month.
(32:55):
It's amazing, and because ofthat, we're hoping that we are
providing them with what theyneed to not only have a better
life, better outcomes and betterquality of life, but also given
the facilities what they needto.
Hopefully, because of myexperiences, I will point things
out when I'm in a facility notcall it in, Go talk to the
(33:17):
people who need to know so thatthey can make changes or take a
look at it and come up withtheir own ways of impacting that
.
So that's that's kind of theway I look at things.
Speaker 2 (33:28):
And that's and you always been involved.
And, speaking of involvement,like you say, you've been hands
on, but it also you also arepart of Florida Health Care
Association as well.
Speaker 1 (33:40):
Yeah, florida Health Care Association I got involved
in when I was an administratorand I saw an opportunity to
bring people together there.
I was always good with myvendors and I always tried to
stay in touch with all of thepeople who were administrators,
because it's a it's a bigcommunity but it's a small
community all at the same time.
We all go through the samething.
(34:02):
Nobody, as an administrator ordon, is.
Everybody thinks that I've gotthis difficult building and
nobody else has it.
You all got the same things.
Okay, I'm in, I'm in hundredsof buildings a year and of those
buildings, everybody thinksthey've got it more difficult or
different or something else.
And I'm gonna tell you, everysituation, almost always every
(34:23):
facility has almost the samesituations.
You may think you've got abigger psych population and then
, all of a sudden, you realizethat the place down the street
has two times what you have andyou had no idea why.
You just have to be able totake what you're given and you
have to look at it in a way thatyou can bring it together.
Now, that being said, I wasable to bring vendors and both
(34:48):
the vendors and the facilitiestogether, and I also wanted to
be on the forefront and find outmore and find it out earlier
about, say, legislative issuesand things like that.
So I became district presidentfor District 5 and got to meet
(35:08):
it was funny my first time atone of the board meetings.
I didn't know what to expect.
I brought, you know, pull outtwo suits, I mean and it's a
little more laid back than thatbecause they're all so close
People at Florida HealthcareAssociation, from Emmett Reed on
down to Kristen and Jenny andTom, and these guys are so smart
and they are so caring and theyreally put their time in to
(35:33):
understand everything that'sgoing on.
Even you know they don't work innursing homes, they're just
advocates for them and I'm goingto tell you there aren't better
people out there, and so itmade me get even more and more
entrenched in it.
So you go to lobby wednesdaysand you go see legislators and
when you're doing that and youcan passionately explain it to
them because you're living itand then getting them to
(35:56):
understand what what's going on.
And these folks up there aredoing the same thing and they do
a great job and their advocacyhas made it so that this
industry in the state of FloridaI'm probably the most stringent
with regard to OCA regs.
I'm probably the most stringentwith regard to Ockerregs and I
say that with regard to.
I think that they take it soseriously from Kim Smoke on down
(36:24):
in this area they're justtrying to do the best they can
to make the outcomes for thesepatients as good as they can.
So trying to come together onthat is a big deal.
I always thought if I could bemore entrenched in Florida
Healthcare Association, that Icould impact even more people
and be a greater influence inthe community, and so I do try
to attend a lot of the districtmeetings in different districts
(36:45):
and help out where I can.
But it's been wonderful.
Because they are such, the moreyou work with them, the more
you want to work with them.
Because they are such, the moreyou work with them, the more
you want to work with them.
Because they're just such.
They're hard workers, they'reso passionate and caring and and
and they just do such a greatjob.
I I would you are recently wonan award as well I, I did I I,
I'm currently, I'm on the boardfor uh, amsc, uh, and it's, it's
(37:09):
the affiliated members.
We call them vendors, partners,whatever.
Yes, sir, and I kind of overseethat.
So, that being said, I won AMSC, amsc, yes, sir.
Member of the Year.
Speaker 2 (37:24):
Congratulations to you, thank you.
Speaker 1 (37:26):
I was very honored Humbling.
I just tried to do what I canand somebody, I guess, saw that,
so that's very hard.
Speaker 2 (37:34):
That's really good.
You have other accolades but Isee you don't like to brag on
yourself very much, I understand.
But I do want to take just togo back a little bit about you.
If you briefly just just sharewhere you're from family, if you
like to share, you know familydynamics just a little bit.
All right, just what inspiredyou to become just a nurse home
(37:59):
administrator?
I know you touched on that, butwas there anything from your
youth to sort of inspire that?
Speaker 1 (38:07):
All right.
So I'm originally fromManhattan, new York, queens area
, but we moved out of the cityat an early age and moved to
Ohio.
So I grew up in Ohio, a smalltown, pickerington, ohio.
I have three younger brothers,so I was kind of the lead.
My parents I couldn't haveasked for a better childhood.
My parents were wonderful,always cared and always showed
(38:30):
us that they cared and I'll behonest, you know it's they cared
for others as well.
It was not because they had to,you could just see it was
genuine.
I think that's where itprobably stems from.
Is is I've always been a personwho wanted to help somehow, some
way.
So I ended up becoming anursing administrator.
(38:51):
I was, I was looking at pre-medand I don't know that I could
have done that Wasn't asdedicated to studies as I am now
.
So my grandfather was in anursing facility, like I said,
and I thought, well, this couldbe a good avenue and I took it
and, honestly, school can'tprepare you for what you see
once you get in the nursingfacility.
(39:12):
It's really about learning onthe job.
I just kind of entrenchedmyself into learning whatever I
could, every day, from sittingdown in AR to DLN, and I always
tell my DLNs I'm going to askyou a lot of questions, not
because I'm questioning whatyou're doing, I just want to
learn.
Not because I'm questioningwhat you're doing, I just want
(39:33):
to learn.
I feel like if people take thatpremise, they understand it,
you know, and stop thinking thatthey know everything, that they
can learn a lot more if they'reopen.
And I learned a lot, a lot.
I do the same thing with mydocs.
I would try to understandeverything.
So going about that that's youknow, kind of when I started
thinking about an area thatneeded help, I saw behavioral
(39:55):
health and said you know, overthe last 15 years I ran
buildings you could see anincrease in the number of people
who are coming in withbehavioral issues.
You could also see an increasein the number of medications
they were on and we were alsobeing asked to reduce those and
take care of those people.
Being asked to reduce those andand take care of those people.
(40:15):
I thought if I could put a teamtogether that could do that and
I've got a wonderful team withthrive that you know, between
advisors and and, and the teamthat I have out there with with
being able to explain rules andregs from my side and being able
to have them apply the, the youknow, the the clinical side it
makes it so that we've got anice little balance.
Speaker 2 (40:36):
That's what led the startup of Thrive.
Speaker 1 (40:39):
That's exactly right Understood, and so that's what
we did and we followed thatmodel.
I think a lot of people havehad to follow that model, in
fact, because I know that oncewe got out there and some groups
weren't doing it, and we'veseen some new groups come in,
the groups that weren't doing itnow do it.
They kind of follow it and andthe new groups have taken to
(40:59):
doing it that way.
And you know, I can't sayanything bad about any of the
other groups out there.
I think they all try to do thebest they can.
Uh, I think we've got a a legup in some of them, but they've
got a leg up on us too.
So we all balance out.
I'm friends with all of themand I think they're all
wonderful people and I just, youknow, from a standpoint of
providing care, as long as we'redoing we're all doing what we
(41:21):
can to impact the long-term careindustry, I think the industry
will be better for it.
Yes, sir.
Speaker 2 (41:26):
Yes, sir.
Well, that's good, and I dohave to ask this question and I
will say it's like you,following right down my question
list here, by the way,answering it.
So would you do it all again?
Speaker 1 (41:41):
In a heartbeat.
I almost wish I would havestarted the started Thrive
earlier, but I'll be honest, Iwouldn't have had the knowledge
base because I learnedeverything from the different
roles that I've played and thedifferent people I've worked
with.
You know, you learn how tomanage oftentimes, or how not to
manage, because of the peoplewho have managed you in the past
(42:03):
and you've seen how they did.
I had a boss at one point inpharma that was so afraid to
work he was afraid because of myknowledge base coming into that
long-term care division thatpeople called me and asked me
for information that he he wasalways adversarial.
I always looked at it as let me, let me help you.
(42:26):
You learn to manage byoftentimes, not only the good
but the bad, and oftentimes,when you have a person who isn't
a great manager and you see it,you know how not to do things.
It's better.
I mean, I've had success andfailure I've learned from.
I've tried to learn from anyfailure I've had and I've tried
(42:48):
to learn from the successes I'vehad, and I think that it's
important to look at both sidesbecause nobody's 100% perfect
and you're never going to havesuccess on everything you do
right out of the gate.
You've got to have the bumps inthe road that you navigate and
then hopefully get better whenyou do?
Speaker 2 (43:09):
Would you have any in your early stages?
Was there anything you wouldhave tried to avoid?
Anything that?
Was there anything you wouldhave tried to avoid?
Anything that you possiblywould have done you would have
tried to avoid With Thrive Notwith Thrive, just in general,
whether it's becoming anadministrator or during college
or anything you tried to avoidat all you know.
Speaker 1 (43:27):
like I said, I think everything has been a learning
experience.
I think had I not gone throughsome of the things that I've
gone through whether they weregood or bad.
I learned from all of them.
Speaker 2 (43:36):
And so.
Speaker 1 (43:36):
I think overall I can't say anything.
I've had a wonderful life.
I hope it lasts a lot longer.
I'm figuring 120, I'm shootingfor 120.
But you know, I don't know ifI'll have enough money to do
that.
But you know, I think you knowof all the things that have
happened throughout my life I'vetried to learn from and it's
only made me better for what itis, whether it was good or bad.
Speaker 2 (43:59):
So, as we conclude here, uh, I want to go back to
thrive, of course.
Uh, what advancements or futureinitiatives, uh, you guys
coming up or pursuing withthrive?
Speaker 1 (44:14):
You know there are.
There are a lot of things outthere that we're looking at.
I don't know that I cannecessarily put my finger on one
, because some of them I'm stilltrying to research and see if
it's actually a viable option.
We I've got some things in myhead and some things that I'm
talking with some of my you know, my medical directors about
some of my team, about that.
That hopefully, you know, andwe're just looking to impact the
market in a different way or orprovide more than than uh, than
(44:38):
we currently provide, uh, if,if we can figure out a way to
provide more for the facilities,for the people that operate the
facilities.
You know we, we do education,we do training, we do things
like that already, uh, butcoming up with ways that can, I
don't even want to say take moreoff of them, but give them more
tools to work with so that theycan do a better job and then
(45:00):
also help the residents.
There are patients, but yourresidents, that's really all I'm
trying to do is just make theirdays better every day.
Speaker 2 (45:11):
A message to an up-and-coming just a A message
to a up-and-coming, just a briefmessage to an up-and-coming
nursing home administrator orsomeone that's going to be in
healthcare administration rightnow if they want to pursue
becoming an NHA.
Speaker 1 (45:29):
Don't think it's an easy job, because it's not,
although I still think the DONjob is harder than the
administrator job.
Yes, I agree, but you need tohave the right people in place.
You need to be humble enough toaccept not criticism but
criticism.
It's not so much criticism asit is just some helpful tips on
(45:51):
how to do things better.
Don't think you know everythingbecause you don't.
I still don't, and I've donethis a long time.
Take it and know that you'regoing to have to put in a lot of
hours if you want to do it.
Well, I don't.
I haven't taken a vacationsince 2004.
I mean a real, like a week.
So my poor wife has been.
(46:11):
You know she does conferences,she gets to go to conferences
and stuff, but I haven't taken atrue vacation.
I just don't.
I don't shut off very well.
That's something I need tolearn.
I don't shut off as well.
If you can find a way to shutoff and go away for a little
while as an administrator, Ithink that's a big deal.
I've never been able to do it,but I see that there are some
(46:33):
people that are able to do itnowadays and more power to you,
more power to you, but I'venever done it.
I just can't.
I'm I guess it's a neuroses ofsome sort, but but I think you
(46:55):
know, if you understand, goingin, you're going to have 80
hours a week, you're going tohave weekends, you're going to
have call 24-7.
There's going to be a strain,probably, on your relationships,
but preparing for that ahead oftime is a big deal.
And then throw yourself into it.
Do everything you can Learn,ask questions, because the more
you learn, the better you'll beat it and the better you'll be
able to help not only yourresidents but your team.
Speaker 2 (47:14):
Yes, sir, able to help not only your residents but
your team.
Yes, sir, and for our familiesout there, for other providers,
vendors, uh and organizations,if you can share with them where
they can find you, your website, uh social pages yeah, uh,
we're on facebook.
Speaker 1 (47:25):
Uh, thrive behavioral sciences.
We're on, uh, linkedin thrivebehavioral sciences.
You can follow me.
Steve Lomonaco yes, sir, orSteven Lomonaco, I'm not sure.
On LinkedIn Website iswwwthrivebehavioralsciencescom.
A little long, but we want tomake sure people can find it.
And you know, if there'sanything we can ever do to
(47:49):
assist facilities, vendors, fromthe Florida Healthcare
Association standpoint and I'llbe honest, if you ever anybody
that has questions aboutoperations, I mean if you just
want to reach out, I have noproblem giving you a little
small tidbit of time so that Ican help you if you've got
(48:09):
questions.
I do attend a lot of thedistrict meetings for Florida
Healthcare and so when I amthere, you know I do have people
that want to stop and talk oncein a while.
I never have a problem withthat.
I think it's really importantto for all of us to share
knowledge, share experiences, sothat we can do a better job for
those residents who are comingin and help each other out,
because it is a tight community.
Even though it's big, it is atight community and you're all
(48:31):
going to face the same things.
So if I can help and impartwisdom to anybody, I'm happy to
do it.
I want to yes sir.
Speaker 2 (48:39):
Yes, well, I will say , mr Monaco, he is responsive.
I met him on LinkedIn.
When I've seen him in person,always greeted, very
approachable.
I know he definitely looks likeyou know he the man, so, but he
is the man right, but he's verykind.
I can just tell you this uh, um, just meeting him in person
(49:02):
just as well, so, um, he alwayshad the jury on two, like me too
.
Speaker 1 (49:07):
you see him over there these are actually all for
ptsd in support.
Okay yeah, veterans with PTSD.
It's an organization I support.
That's where I get those.
Speaker 2 (49:18):
So thank you for joining us here, our comfy
supporters.
We have our wonderful guests.
You heard from a president, ceo, mr Stephen Lamonaco, so happy
to join us.
Please like, share, subscribeon on youtube.
You also can find us on spotify.
Visit thrive behavior sciencesto learn more for regarding
(49:41):
supporting your facility, yourresidents and clients.
Thank you so much for watching.
Please visitcomfortmeasuresconsultingcom.
We're here to support you andyour loved ones.
Speaker 1 (49:54):
Thank you.
I haven't taken a vacation since 2004.
I mean a real like a week.
So my wife has been, you knowshe gets to go meet me at
conferences and stuff, but Ihaven't taken a true vacation.
I just really about learning onthe job and I just kind of
entrenched myself into learningwhatever I could every day, from
sitting down I'm smiling.
Speaker 2 (00:33):
Real big today.
Real big today.
Yes, I have somebody veryspecial on the show.
He agreed to do the show withno problem.
Welcome back to another episodeof the let's Get Comfy podcast,
brought to you by ComfortMeasure Consultant.
I'm your host, norman Harris.
Right, it's Florida number onehealth care edutainment station.
(00:55):
Yes, that's a manifestationthat I do.
We have a wonderful guest,wonderful guest with us today.
President and CEO, mr stevelamonaco of thrive behavioral
science.
Thank you, sir, for joining ustoday.
So glad to have you.
Thanks for having me.
It's an honor to have you, uh,grace this set here, uh, with
(01:18):
the orange background.
You know I'm not a floridagator fan, by the way.
Just I like to just say thatoff work.
But thank you, sir, for beinghere.
I really appreciate you joiningme in this platform.
I mean, it's an honor to you.
Give me a chance to sit down,have a conversation with you,
one.
I love learning about people ingeneral and this is a great way
(01:42):
for me to to learn you.
But the audience, the community, my audience, audience is
people, the everyday person outthere.
Uh, to hear from someone likeyourself, uh, this is going to
be great and to hear from yourinsight.
I'm just excited for theaudience to be honest with you.
So we're going to start there.
We're going to start presentday thrive behavior science.
(02:04):
Um, what specific services doesyour organization provide, uh,
to support mental health in theelderly individuals?
Speaker 1 (02:13):
thrive.
Thrive is a what we providepsychiatry and psychology and
nursing homes and assistedliving facilities throughout the
state.
Um, we go in.
I have uh 39 practitioners,both psychiatry and psychology.
We do psych nurse practitioners, we have psychologists and we
also have I have three medicaldirectors who are all
(02:35):
psychiatrists, and we go intonursing facilities and treat
patients in the facilities.
We do it in a way that we'rehopefully taking great care of
the resident, making sure theyhave what they need.
We're hoping to make sure thatthe facilities have quality
measures that meet where theyneed to be as well, but
(02:56):
ultimately, it's all about thepatient.
We also try to help thefacilities with compliance and
things like that.
So we go in, we treat patients,we try to see everybody we can.
Our model is something a littlebit different that we created
and partly that's due to mybackground, because I'm also a
licensed nursing homeadministrator and a certified
(03:18):
risk manager.
So for me, setting up theprocedures that we use, the way
you use, how we go about things,is a little bit different than
some of the others.
I just saw a need when the megarule came out in 2018.
The third part of the mega rulecame out in 2018.
I saw a need, something that Ifelt like was being missed in
(03:42):
long-term care in the nursingfacilities was being missed in
long-term care in the nursingfacilities, and so I thought, if
somebody thought about it theway I think about it as a
nursing home, from a standpointof a nursing home administrator
or a director of nursing, and wedid things the way I thought
about it, the way I wanted themdone, we could make a bigger
impact on the facilities andreally on the industry.
(04:05):
Yes, sir, so we've made someinroads, we've done some good
things.
Speaker 2 (04:10):
Right, right.
So I started this episode alittle different.
For followers out there, ourcomfy supporters, I wanted to
get off for people to understandwhat Thrive Behavioral Science
is.
But I just want you all tounderstand, Mr Lamonical, here,
if you could just let them letthe audience know your accolades
, accomplishments, um, just bragon yourself a little bit.
(04:33):
Just take, take about 60seconds just to brag on yourself
, Mr Lamonical.
Speaker 1 (04:37):
Well, I, I don't know Um, I am a nursing home
administrator.
As I said, and I'm very proudof that, I started working in
nursing homes in the 80s, that's1980s, so and basically I
started in nursing homes becausemy grandfather was in a nursing
home.
He actually had a stroke theday we buried my grandmother and
(04:58):
I started visiting him, andwhen I would, I really didn't
like what I saw.
I felt like we could do abetter job.
There could be a better jobdone if somebody really focused
on it.
I shouldn't say it wasn't.
I didn't like what I saw, Ijust felt like there could be a
better job.
I felt like I could run theplace better.
So, that being said, I waspre-med and decided to go this
(05:21):
direction, and so I became anursing home administrator.
I was a nursing assistant tostart, but I wasn't even
certified, because I didn't haveto be certified at the time.
So that's how long ago it was.
Speaker 2 (05:35):
So you were hands-on before.
Oh yeah, so coming out into thereal world.
Speaker 1 (05:41):
Once I got my degree, passed my test um actually had
to take it twice, not because Ifailed, I passed the first one.
But then the obra 87 came outand uh, on the new test in 92,
and so I had to take the testagain well, I failed mine so.
but I passed it both times andthen came out and and I got a
job actually an intermediatecare facility because I was a
(06:03):
probably because I was thelowest priced person out there
but they had just lost theirMedicare cert.
So I stayed there until I gotthe Medicare cert back.
And then I went to a differentfacility and kind of up the
ladder.
In 2000, I was in Atlanta and Idecided to take a little chance
.
Pps was converting.
(06:26):
We were converting to PPS atthe time.
There's a lot of turmoil in theindustry, a lot of sales of
facilities and company, and Idecided to venture off into
pharma.
I went to a dinner with acouple of my medical directors
and pharmaceutical salespersoncame to me and said you would be
really good at this, thequestions you're asking.
So I got into.
(06:52):
It was strictly a long-termcare division for a couple of
different companies.
Speaker 2 (06:55):
And.
Speaker 1 (06:55):
I actually sold psych in those.
So for me it's important to beprepared.
So the only way I could getcomfortable was to learn
everything I could about all themeds not just my own but my
competing products and so when Idid that I realized how deep I
could go and how much knowledgeI could acquire if I really
(07:15):
studied.
So I did that and I did thatfor about six years.
I went from a sales rep and Iactually led the nation for five
out of six quarters Inpharmaceutical sales In
pharmaceutical sales.
What organization was this?
I was with Johnson and Johnson.
I was with Eli Lilly.
Speaker 2 (07:30):
Oh, okay, the big boy .
Speaker 1 (07:31):
Yeah, so when I did it I was very fortunate.
I mean, I really felt that myunderstanding of the space was
really the biggest thing thatmade me successful.
I could speak the language, Icould talk the talk, and it was
all about being honest andgiving them what they needed
information-wise.
Speaker 2 (07:51):
At Comfort Measures Consulting, we're here to help
you navigate the complexity ofhealthcare.
If you're caring for a lovedone as a caregiver, you don't
have resources, you don't knowwhat questions to ask.
You need to have options right.
Give Comfort Measures a call.
Give us a chance.
First consultation is free.
Speak with me Comfort MeasuresConsultant 850-879-2182.
(08:19):
You can also visit our websiteat
wwwcomfortmeasuresconsultingcomvisit our website at
wwwconfrontmeasuresconsultingcom.
Speaker 1 (08:29):
Talk to you soon.
Well, I was selling psych meds.
Oh, you were selling psych meds.
Yeah, I was.
But you know, I mean, one ofyour biggest cost centers in a
nursing facility is meds.
And so I also learned, you know,very early to balance and to
look at medications before thepatients were admitted so that I
could make sure that my costswere where they needed to be,
(08:51):
which oftentimes meanssensitivities or things like
that have to be done at thehospital beforehand.
Also doing that, I learned labs, because I needed to see where
labs were, because if you've gotsomebody who's got a 7.1
hemoglobin and it's beendropping consistently, tomorrow
it's gonna be 6.9.
You're gonna have to send themback out for a transfusion
anyway.
They can keep them anothernight.
Have them do it, then send them.
(09:13):
This way you don't have toworry about it and you don't
have to put them on Procrit,which is expensive, or it was at
least so.
So a lot of different thingsthat I learned in this time
frame that I was a sales rep.
Then I was put into managementdevelopment, which didn't last
very long because I did so wellin it Not a little bragging on
(09:35):
myself.
I did very, very well in itafter the first visit.
So they promoted me to districtmanager and I moved to
California.
Okay, life in.
Cali.
Yeah Well, you know what it wasdifferent.
I was up in Northern Californiabut I ran seven states because
of the size of the territory andgot to meet a lot of great
people out there and we were topfive out of 28 districts for my
(10:00):
entire tenure, the four yearsout there.
Speaker 2 (10:02):
And then I became an interim regional director before
they downsized due to theeconomy in I think it was 07 so
look, let me ask you this, andI'm sorry to cut you off, please
on this was this where you, umuh, you are familiar with, or
met or work with I should saysean, uh, denine, yeah, sean was
(10:24):
of my.
Speaker 1 (10:25):
Sean was one of my best.
Speaker 2 (10:27):
Well, just me researching you.
This is what he said about you.
This is during yourpharmaceutical, where you was
the sales manager.
Right, he said I have workedwith a number of managers in
life and I look at I'm lucky tohave worked with Mr Steve hands
down, one of the best salesmanagers have worked with uh, mr
(10:48):
steve hands down, one of thebest sales managers loyal,
honest, patient and passionate.
Speaker 1 (10:49):
Passionate, that's what he said about you.
Yeah, I still stay in touchwith sean and sean was a great
guy.
The funny part I messed yourlast name up.
I'm sorry, but yeah, sean, sean, it's funny.
I I met sean at a job fair andsean was very nervous.
He had never worked in pharmabefore.
He was in financial side ofthings, but charismatic, and
(11:10):
that's what I.
You know.
When I was hiring, I would lookfor charismatic people, people
who could draw attention tothemselves but also had to be
smart.
Yes, sir.
I met Sean and Sean was verynervous at the time.
Sean sweat through his jacketso much that he was so nervous.
But the funny thing is, onceSean calmed down and realized we
could just talk, I realizedthat I had a winner there.
Sean was number one in thecountry for quite a few years,
(11:33):
along with another guy, kennyPerry.
But we always you know thepeople that we people used to
laugh because I didn't hirepeople who had pharma experience
and I it wasn't that I wasshying away from.
I hired some people who hadpharma, but I also hired a lot
of people who were.
They had charisma, they hadintelligence.
(11:54):
They were just people who could, who could speak.
Sean's got an eidetic memory.
He can remember after readingsomething exactly where it is on
the page Wow.
So for him he would remembereverything he read and he would
be able to spew it back out.
But he was such a honest personthat he would draw people to
them and they believed him.
And so he was and he, like Isaid, he gave off that essence
(12:18):
of being that, that honest,hardworking and just such a
great guy.
Well, he felt similar, similar,very similar uh, to you yeah,
but I've got a lot of you know,a lot of those folks that they
were just so great at what theydid.
They just needed the rightperson to you know to maybe take
their guard down, because somany people when you manage
(12:40):
people, you just have tounderstand each individual and
then know how they need to bemanaged.
Not do everything across theboard the same way.
You cannot, and that's what Itried to do was make sure that
they knew that.
I always told all my team somany times in pharma.
What we saw was people, whentheir district manager would
come in to ride with them,because we would actually go on
visits with them, they would beafraid to ride with their
(13:04):
because they thought they weregoing to be critiqued.
And I always said I want to bethe one that you guys call and
say I need you here because I'vegot a tough one today and if we
can get this over the hump, Iknow you can help me.
And so that's the way I lookedat it and they would.
If they had a tough day or theyhad somebody who was on the, you
know, I could put somethingtogether that when we came in
and we talked, it would beimportant to them, important
(13:25):
enough for them to listen, andwe could get the message across
the way we needed to.
You never talk bad about othermedications or other people.
It all had to do with yourmedication.
We're a team and so when wewould do that, we would we would
normally see success becausethey would understand that we,
we were just trying to.
Here's a specific area that youcan use this medication in, and
(13:47):
if you can try it, maybe you'llsee the results, and if you do,
I want to know about it.
It really worked out well, soyou know.
But we also had focus on theright clients to make sure that
we you know our, ourpractitioners had to be the
right people to focus on, and sowe tried to do that as well.
Speaker 2 (14:03):
Okay, all right, so pause, yep, that's here.
There is a comfy moment, but wedo add a little entertainment.
Oh, yes, sir, I tell you it'sthe edgy.
Now we're doing the education,but now we have a little
entertainment, so we take apause here.
Yes, a moment here.
So I take a pause here.
(14:25):
Just a moment here, uh, so Ihave a couple questions for you,
sir.
Okay, all right, you get it'scalled.
That's my answer.
You get three seconds to answerthis.
Okay, three seconds, all right.
If you could eat one dish dailyfor the rest of your life, what
would it be?
Speaker 1 (14:37):
probably, uh, veal parmesan, veal parmesan, my
dad's favorite.
Well, veal par and bill marsala, but yeah, bill parmesan neil
parmesan.
Speaker 2 (14:45):
Okay, uh, let's see, if you were a, uh, an appliance
or office supply, what would itbe?
That'd probably be arefrigerator refrigerator, all
right.
Um, if you had a superpower,what would that superpower be
and what would you use it for?
Speaker 1 (15:04):
Oh, probably strength , and I like the premise of
being strong.
So I think, without having touse it, you can put that kind of
a vibe off, so that you don'thave to do certain things and
then, when you needed to, youcould be strong enough to do
(15:27):
what needed to be done.
Speaker 2 (15:28):
All right.
Do you have a childhood crush,whether it's a celebrity crush
or from the childhood when?
Speaker 1 (15:36):
I was a kid, all I wanted to do was play baseball.
So I, Steve Garvey, was thefirst baseman for Los Angeles
Dodgers and he was.
I played first base a lot andhe was kind of my idol.
He was always supposed to bethis great guy.
He was an honest guy and he wasa great baseball player and so
(15:56):
I followed Steve Garvey.
I also followed Lin Swanbecause I thought he was a great
receiver and I'm a Steeler fan,Lin Swan.
Speaker 2 (16:03):
I'm talking about childhood, of course.
My childhood question wasBeyonce, oh, like that.
Yeah, childhood crush.
Okay, childhood crush, but it'sentertainment a little bit too.
Speaker 1 (16:12):
Mr Monaco All right.
Speaker 2 (16:13):
So childhood crush, yeah who.
You had a magazine on the wall.
I don't know if your mama letyou put posters on your wall or
anything like that.
Speaker 1 (16:20):
No, farrah Fawcett was big at the time, yeah.
Speaker 2 (16:22):
See, I knew it was somebody you might not want to
share Farrah Fawcett with thered bathing suit.
Speaker 1 (16:28):
Yeah, see, I would probably say that was probably
it, because I'm pretty sure Ihad that on my wall.
Speaker 2 (16:33):
I do it.
Speaker 1 (16:34):
Carol Teagues was another one, I think.
Carol Teagues was in a pinkbathing suit.
You remember the bathing suitAll right, I still got a pretty
decent memory yeah.
Speaker 2 (16:44):
Let's change that topic right now.
I don't want to get over, sir,uh.
And the last one is if youcould be any animal, what would
it be and why a jaguar?
Speaker 1 (16:56):
I, I just, I've always grabbed it.
I love the, the big cats I love, but they're sleek, uh, they're
strong, uh, they're fast.
It was either that or a cheetah, but I, I love the speed side
of of things, but they'rethey're sleek, they fast,
they're strong and I just thinka Jaguar is cool.
Yes, sir.
Speaker 2 (17:17):
Well, thank you for participating in the game.
We will resume, but I want totalk about Thrive as well.
Okay, so can you explain howthe importance of addressing
behavioral health in agingadults and how that impacts
their overall well-being?
Speaker 1 (17:36):
Well, when you look at life, if you work all your
life and you retire, it's timeto retire.
You're looking forward to yourgolden years.
You're going to enjoy the time.
Nobody sits back and says Ican't wait to get to the nursing
home.
You know they may say that.
You know, assisted living is acompletely different animal.
(17:58):
They can go.
There are so many things to dothere.
You know they have freedom.
And you go to a nursing home.
There's a reason why you'rethere and it's normally because
you can't do anything foryourself.
It's very limited.
Let's just say that you've gotconditions that are making it
very difficult for you to liveindependently.
That comes with different risksand some of those are
(18:20):
adjustment disorders.
Coming into the nursingfacility, people are depressed,
people have just lost theirindependence, they've lost their
ability to manage theirfinances, the expense that's
related to the cost of care,which care is expensive and I
don't think everybody realizesthat.
But when you look at all of thedifferent things that happen
(18:42):
when you're admitted to anursing facility, that
adjustment disorder whether it'sdepression, whether it's
anxiety, whether it's both is ahuge impact on how you live
every day going forward For usto be able to come in and give
them peace of mind to help themcope with certain things that
(19:03):
are going to be coming up intheir life while they're there,
whether it's short term so often.
I mean, we always used to sayand back when we had distinct
units, we used to this part ofthe building is only skilled and
this part of the building islong term.
Why did you do that?
Because nobody who's skilled,who's there for short term,
wants to see what it looks liketo be long term.
They don't want to see that.
(19:24):
So when you think aboutnowadays, we skill everybody in
the same.
All the beds are skilled, allthey're duly certified, and you
have a person who comes in andthey have to go in with somebody
who's long term, who can't doanything for themselves, and
they have every intention ofgetting the person who's in the
bed next to them has everyintention of going home.
(19:45):
They need help.
They need to understand that'snot going to be me.
They need motivation Sometimes.
They need to understand thatthey have a chance to get back
out and, uh, they also have tounderstand there if they do have
to go that direction.
There is life in a nursingfacility.
You can live a very productive,have wonderful outcomes, have a
(20:06):
quality of life that that andthey need to understand that,
and oftentimes they don't.
So we try to give them not onlya way to cope through the time
period that they're having, butalso give them an opportunity to
see that there is something onthe other end that they don't
have.
This isn't something where youhave to shut down and just curl
up in a corner and go away.
(20:26):
Nursing homes have an incredibleopportunity to help people and
oftentimes the only thing youever hear about a nursing home
is the bad side.
The bad side Because you've gotmore litigation-happy people
out there.
That that's what they want tolook at.
The focus shouldn't be there,because if you saw what I've
seen in 35, 40 years of being inthe industry, the things that
(20:51):
have been done, the people thathave been helped in long term
care, it's astronomically vast,I mean.
But you never hear about thegood stuff.
You never hear about the goodstuff.
So for us, we're in there andwe're talking with folks and
we're trying.
You know, oftentimes they'reovermedicated.
We try to reduce thosemedications.
We try to make sure thebuildings have their quality
measures where they need to beas well, because so many times
(21:13):
people are overmedicated,they're being given the wrong
medications because they'rebeing used for side effects, so
we try to fix that.
And then we have talk therapy,where they can be given coping
mechanisms so that they know howto deal with what's coming.
We can kind of prepare them forit, similar to what you do,
norman, with your consultingside.
(21:34):
We talk with people on adifferent level because we
understand the space indifferent ways you and I both
and because of that we're ableto give more back to those
people and hopefully give themsome kind of peace of mind so
that when they, if they do haveto stay long-term, that they
have an understanding of what'scoming and then also how to deal
(21:56):
with it If they go home.
Even better, we have a clinicbase as well, so we can take
people once they're dischargedand we can follow them in the
community and make sure thatthey have what they need to
continue to get their meds, sothey don't have to go back to
the hospital because they didn'thave the ability to get their
medications, because on thepsychiatry side so many times
(22:18):
there's no room for them to goto a psychiatrist and oftentimes
primary care doesn't want towrite certain medications
because they're controlled andso they don't want to delve into
that.
So what do we do?
We help them do that.
By having telemed, we follow upwith their.
By having telemed we follow upwith their home health care
agencies.
We can even have medicationsdelivered to their home.
(22:39):
We try to find ways that we canhelp the people once they go in
the community so they don'thave to go back to the nursing
home if they don't need to.
But when they are in need wealso help to get them there, and
then we hopefully can preparethem once they're there to make
sure that they're taken care ofand that the nursing facility
has the the tools to better carefor them as well so um with the
(23:00):
caregivers right um, just fromyour perspective, what are some
early signs they can look for?
Speaker 2 (23:07):
um for potential mental health concerns and an
aging loved one?
Speaker 1 (23:11):
right.
Well, obviously, some of themare forgetfulness, you know, and
that's not necessarily apsychiatric issue.
Sometimes it's neurology.
You have to look at whatthey're suffering from to
understand that.
But depression you're going tofind that a lot of people, even
at home.
When you look at a certain agegroup, you're going to realize
that it's about that time whenyou start seeing people, that
(23:36):
you lose your friends, you loseyour acquaintances, you lose
some of your independence.
You're not going out of thehouse as often as you used to
because you can't.
You may be afraid to drive atnight, you may be afraid to
drive altogether.
You don't have publictransportation and you don't
have the people that you used tohave to get you where you used
to go.
Oftentimes even family getsmore.
(23:58):
In this day and age we can, wecan operate from different areas
and we don't have to be in thesame area all the time and still
stay in touch.
So oftentimes families kind ofspread apart a little bit and
they don't have theaccessibility to do that and you
lose touch with some of yourfamily and if that happens you
start to become a shut-in.
(24:20):
I often say in some of my emailnot emails, but on some of my
social media posts that you knowyou will see people.
It's a great idea to make sure,if you've got a neighbor, a
friend, reach out to them atleast once a week, make sure
that they know you're there,make sure you talk with them and
just kind of even if it's fiveminutes maybe invite them to
(24:43):
dinner once in a while.
If they're your neighbor andthey don't have somebody else
and they're home every night,and they're home every night all
by the, invite them over, right?
Um, when you look at people whobecome shut in, they become in
completely isolated because theydon't have the friend base they
used to have.
You know, maybe you used to.
And I'm just going to throw whatif they go golfing on a regular
(25:03):
basis with with friends andthey lose some of those friends
now they don't have the groupthey used to have, right?
So now do you go golfing byyourself or do you stay home?
That's a decision you have tomake.
Same thing you know anythinglike that.
You used to go to the movieonce a week with someone and now
they maybe passed on or theyended up moving away, or they've
gone to an assisted living or anursing home and now you're in
(25:24):
the community by yourself.
How do you bridge that gap?
What do you do?
Oftentimes you're going to seepeople in your own community
that are isolated becausethey've lost friends, they've
lost family.
And you know, if you can thinkabout and I used to you ever see
the movie Up.
(25:45):
It's a cartoon movie with EdwardAsner.
Ed Asner is the guy and they's.
They have the balloons and theygo okay.
So I used to make some of myteam watch that, because up is
about two people met in highschool, met in grade school and
they ended up going through highschool.
They ended up getting married.
They spent 50 years together,married wow, and she passes on.
(26:09):
Now he's all by himself.
He has nothing.
He has no one, because all heeverything revolved around their
, them by themselves.
So just think about the routinesthat used to go on because
everybody stayed in the same jobfor a long time.
They used to have a routine andyou have somebody who comes
into your facility who now has.
(26:32):
Or you have somebody who youlose and you were used to a
certain routine.
Every day it was go to.
It was get up in the morning,have breakfast with that person,
go to work, come home, havedinner with that person, watch
certain tv shows with thatperson, go to sleep with that
person, wake up the next day.
Everything was the same everyday.
Now, all of a sudden, you don'thave that person.
(26:53):
Now what do you do?
That's what happens when ahusband or wife, a caregiver,
has to put their loved one in anursing facility.
They're separated from them now, so what does their routine
look like now?
They are suffering, as well asthe person who's in the nursing
facility, and those people arethe ones that you need to reach
(27:15):
out to and make sure that theyhave everything that they need,
that they have someone that canreach out, because, I'm going to
tell you, we see declines inthose people as well, and they
end up coming into the nursingfacility as well.
Speaker 2 (27:25):
The ones that were at back home.
Yes, right, so what would beyour advice?
Just a couple of tips for acaregiver that's in that
situation a daughter or son thatsay they just had dad go to
nursing home, right, and mom isstill back at home, empathy.
Speaker 1 (27:42):
Those individuals I'm going to tell you are are
struggling, they're sufferingand they're.
Some people are strong enoughto make it.
And there are some people arestrong enough to make it, you
know, but oftentimes there's,there's not.
They are.
So their routine is soingrained that they are
(28:03):
disheveled because they are soused to that routine.
And I have had people who Ihave had family members, ocd,
and I'm going to tell you thatthis individual used to be there
in the morning at the same timeevery day.
By the minute she used to leaveat the same time.
By the minute.
If she couldn't leave, shewould become anxious to the
point of mania.
Almost Everything had to be,because that's how her life
(28:29):
always was, because that's howher life always was.
And I'm going to tell you thatshe could not.
This woman couldn't leave theparking lot one day because the
ambulance was behind her.
So she rammed it just so shecould get out and then denied
that she did it and everybodysaw her do it.
But that was part.
She was so manic about being ona routine and mind you that her
(28:51):
husband was in our facility andhe was obviously he needed to
be there.
She couldn't care for himanymore, but you could see the
decline in her because herroutine was broken.
She could not do the same thingevery day.
When you have people like thatwho need outreach, you have to
be so empathetic about helpingthem cope with when they're in
(29:11):
the building even yes, they'reprobably the most detail
oriented.
They are going to be soempathetic about helping them
cope with when they're in thebuilding even yes, they're
probably the mostdetail-oriented.
They are going to be the oneswho are the most anxious about
the care that's being provided.
But if you can help them tounderstand and show them and be
empathetic towards them, they'llalso be your number one
advocate.
And that's one of the things asan administrator I used to try
to make sure I could look at.
(29:33):
I got to know every patient inthe building, know them by name.
I'd know why they were there.
I'd know their meds.
I would know their conditions.
I would also know theirfamilies, and there was a big
deal about that.
It made it so that they couldcome to you without being
concerned.
They wouldn't have to just pickup the phone and call somebody
else.
They would call you, they wouldcome in and see you.
(29:57):
They know that I would walkdown and I would see what was
going on and I would fix it.
And when you do things likethat, I rarely had complaint
surveys, knock on wood.
I rarely had complaint surveysand I never had an annual survey
, not in the state of Florida.
I had more than four tags, infact, I actually begged for my
last one of my buildings.
I actually asked them to giveme a site because they didn't
want to give me any.
And listen, there's no buildingin this country.
That's perfect, even if we get azero, you know no tag there is
(30:20):
no building that's perfect, yeah, but and I never thought of
mine I got perfect surveys inalmost every facility.
I was in One, not across theboard, but when I did I was very
thankful for it.
But I was also nervous about it, because you never know what
comes behind it, and that's partof the problem.
(30:40):
You get a federal look behind.
Or even the next time somebodycomes in, I don't want to say
they have a vendetta, but theykind of want to show you're not
perfect.
I never thought of it.
Listen, you always strive forperfection, but they kind of
want to show you're not perfect.
I never thought of this.
You always strive for perfection, but you can never get to
perfection, but you alwaysstrive for it and so doing the
(31:02):
things that I used to spendminimum of 80 hours a week in my
nursing facilities when I ranfacilities because I wanted to
see breakfast, lunch and dinner.
I wanted to make sureeverything was the way it was
supposed to be.
I wanted to meet with families.
The way to do that is to spendmore time there.
I worked weekends and so Iwould go in on the weekends and
I oftentimes would do my ownadmissions, not because I didn't
have wonderful staff takingcare of it.
(31:25):
I just wanted the hospitals toknow who are you sending these
people to, and can you pick upthe phone and call that person
anytime and if you have aproblem you'll fix it, and
that's.
I kind of look at myself as afixer, but I also think if you
give people the right tools, youdon't have as many things to
fix.
And so trying to be present allthe time made it so that I had
(31:47):
less to do.
I could help to.
I mean, yeah, I was a nursingassistant.
I could change people, I couldhelp people.
I could move people from onepart to another because I knew
how to transfer people.
And so, when you look at doingthings, I would never ask
somebody to do anything that Iwasn't, I wouldn't do myself,
(32:11):
and when I would go out to thehospitals, it was more about
making sure that they knew thekind of person they were dealing
with, who they were sending itto the patient to, and that I
would be responsible andaccountable for everything that
happened and so that gave.
I feel like that was a big partof my success as an
administrator.
I just felt like in the role ofThrive, I saw an opportunity to
(32:33):
provide, to actually impact,more people.
You know, when we first started, you know I was taking care of
120 people in a nursing facility, which was I loved the job.
I now, you know my team sees9,000 patients a month and
that's something that I'm reallyproud of, because we get to
impact the lives of 9000 peopleacross the state every month.
(32:55):
It's amazing, and because ofthat, we're hoping that we are
providing them with what theyneed to not only have a better
life, better outcomes and betterquality of life, but also given
the facilities what they needto.
Hopefully, because of myexperiences, I will point things
out when I'm in a facility notcall it in, Go talk to the
(33:17):
people who need to know so thatthey can make changes or take a
look at it and come up withtheir own ways of impacting that
.
So that's that's kind of theway I look at things.
Speaker 2 (33:28):
And that's and you always been involved.
And, speaking of involvement,like you say, you've been hands
on, but it also you also arepart of Florida Health Care
Association as well.
Speaker 1 (33:40):
Yeah, florida Health Care Association I got involved
in when I was an administratorand I saw an opportunity to
bring people together there.
I was always good with myvendors and I always tried to
stay in touch with all of thepeople who were administrators,
because it's a it's a bigcommunity but it's a small
community all at the same time.
We all go through the samething.
(34:02):
Nobody, as an administrator ordon, is.
Everybody thinks that I've gotthis difficult building and
nobody else has it.
You all got the same things.
Okay, I'm in, I'm in hundredsof buildings a year and of those
buildings, everybody thinksthey've got it more difficult or
different or something else.
And I'm gonna tell you, everysituation, almost always every
(34:23):
facility has almost the samesituations.
You may think you've got abigger psych population and then
, all of a sudden, you realizethat the place down the street
has two times what you have andyou had no idea why.
You just have to be able totake what you're given and you
have to look at it in a way thatyou can bring it together.
Now, that being said, I wasable to bring vendors and both
(34:48):
the vendors and the facilitiestogether, and I also wanted to
be on the forefront and find outmore and find it out earlier
about, say, legislative issuesand things like that.
So I became district presidentfor District 5 and got to meet
(35:08):
it was funny my first time atone of the board meetings.
I didn't know what to expect.
I brought, you know, pull outtwo suits, I mean and it's a
little more laid back than thatbecause they're all so close
People at Florida HealthcareAssociation, from Emmett Reed on
down to Kristen and Jenny andTom, and these guys are so smart
and they are so caring and theyreally put their time in to
(35:33):
understand everything that'sgoing on.
Even you know they don't work innursing homes, they're just
advocates for them and I'm goingto tell you there aren't better
people out there, and so itmade me get even more and more
entrenched in it.
So you go to lobby wednesdaysand you go see legislators and
when you're doing that and youcan passionately explain it to
them because you're living itand then getting them to
(35:56):
understand what what's going on.
And these folks up there aredoing the same thing and they do
a great job and their advocacyhas made it so that this
industry in the state of FloridaI'm probably the most stringent
with regard to OCA regs.
I'm probably the most stringentwith regard to Ockerregs and I
say that with regard to.
I think that they take it soseriously from Kim Smoke on down
(36:24):
in this area they're justtrying to do the best they can
to make the outcomes for thesepatients as good as they can.
So trying to come together onthat is a big deal.
I always thought if I could bemore entrenched in Florida
Healthcare Association, that Icould impact even more people
and be a greater influence inthe community, and so I do try
to attend a lot of the districtmeetings in different districts
(36:45):
and help out where I can.
But it's been wonderful.
Because they are such, the moreyou work with them, the more
you want to work with them.
Because they are such, the moreyou work with them, the more
you want to work with them.
Because they're just such.
They're hard workers, they'reso passionate and caring and and
and they just do such a greatjob.
I I would you are recently wonan award as well I, I did I I,
I'm currently, I'm on the boardfor uh, amsc, uh, and it's, it's
(37:09):
the affiliated members.
We call them vendors, partners,whatever.
Yes, sir, and I kind of overseethat.
So, that being said, I won AMSC, amsc, yes, sir.
Member of the Year.
Speaker 2 (37:24):
Congratulations to you, thank you.
Speaker 1 (37:26):
I was very honored Humbling.
I just tried to do what I canand somebody, I guess, saw that,
so that's very hard.
Speaker 2 (37:34):
That's really good.
You have other accolades but Isee you don't like to brag on
yourself very much, I understand.
But I do want to take just togo back a little bit about you.
If you briefly just just sharewhere you're from family, if you
like to share, you know familydynamics just a little bit.
All right, just what inspiredyou to become just a nurse home
(37:59):
administrator?
I know you touched on that, butwas there anything from your
youth to sort of inspire that?
Speaker 1 (38:07):
All right.
So I'm originally fromManhattan, new York, queens area
, but we moved out of the cityat an early age and moved to
Ohio.
So I grew up in Ohio, a smalltown, pickerington, ohio.
I have three younger brothers,so I was kind of the lead.
My parents I couldn't haveasked for a better childhood.
My parents were wonderful,always cared and always showed
(38:30):
us that they cared and I'll behonest, you know it's they cared
for others as well.
It was not because they had to,you could just see it was
genuine.
I think that's where itprobably stems from.
Is is I've always been a personwho wanted to help somehow, some
way.
So I ended up becoming anursing administrator.
(38:51):
I was, I was looking at pre-medand I don't know that I could
have done that Wasn't asdedicated to studies as I am now
.
So my grandfather was in anursing facility, like I said,
and I thought, well, this couldbe a good avenue and I took it
and, honestly, school can'tprepare you for what you see
once you get in the nursingfacility.
(39:12):
It's really about learning onthe job.
I just kind of entrenchedmyself into learning whatever I
could, every day, from sittingdown in AR to DLN, and I always
tell my DLNs I'm going to askyou a lot of questions, not
because I'm questioning whatyou're doing, I just want to
learn.
Not because I'm questioningwhat you're doing, I just want
(39:33):
to learn.
I feel like if people take thatpremise, they understand it,
you know, and stop thinking thatthey know everything, that they
can learn a lot more if they'reopen.
And I learned a lot, a lot.
I do the same thing with mydocs.
I would try to understandeverything.
So going about that that's youknow, kind of when I started
thinking about an area thatneeded help, I saw behavioral
(39:55):
health and said you know, overthe last 15 years I ran
buildings you could see anincrease in the number of people
who are coming in withbehavioral issues.
You could also see an increasein the number of medications
they were on and we were alsobeing asked to reduce those and
take care of those people.
Being asked to reduce those andand take care of those people.
(40:15):
I thought if I could put a teamtogether that could do that and
I've got a wonderful team withthrive that you know, between
advisors and and, and the teamthat I have out there with with
being able to explain rules andregs from my side and being able
to have them apply the, the youknow, the the clinical side it
makes it so that we've got anice little balance.
Speaker 2 (40:36):
That's what led the startup of Thrive.
Speaker 1 (40:39):
That's exactly right Understood, and so that's what
we did and we followed thatmodel.
I think a lot of people havehad to follow that model, in
fact, because I know that oncewe got out there and some groups
weren't doing it, and we'veseen some new groups come in,
the groups that weren't doing itnow do it.
They kind of follow it and andthe new groups have taken to
(40:59):
doing it that way.
And you know, I can't sayanything bad about any of the
other groups out there.
I think they all try to do thebest they can.
Uh, I think we've got a a legup in some of them, but they've
got a leg up on us too.
So we all balance out.
I'm friends with all of themand I think they're all
wonderful people and I just, youknow, from a standpoint of
providing care, as long as we'redoing we're all doing what we
(41:21):
can to impact the long-term careindustry, I think the industry
will be better for it.
Yes, sir.
Speaker 2 (41:26):
Yes, sir.
Well, that's good, and I dohave to ask this question and I
will say it's like you,following right down my question
list here, by the way,answering it.
So would you do it all again?
Speaker 1 (41:41):
In a heartbeat.
I almost wish I would havestarted the started Thrive
earlier, but I'll be honest, Iwouldn't have had the knowledge
base because I learnedeverything from the different
roles that I've played and thedifferent people I've worked
with.
You know, you learn how tomanage oftentimes, or how not to
manage, because of the peoplewho have managed you in the past
(42:03):
and you've seen how they did.
I had a boss at one point inpharma that was so afraid to
work he was afraid because of myknowledge base coming into that
long-term care division thatpeople called me and asked me
for information that he he wasalways adversarial.
I always looked at it as let me, let me help you.
(42:26):
You learn to manage byoftentimes, not only the good
but the bad, and oftentimes,when you have a person who isn't
a great manager and you see it,you know how not to do things.
It's better.
I mean, I've had success andfailure I've learned from.
I've tried to learn from anyfailure I've had and I've tried
(42:48):
to learn from the successes I'vehad, and I think that it's
important to look at both sidesbecause nobody's 100% perfect
and you're never going to havesuccess on everything you do
right out of the gate.
You've got to have the bumps inthe road that you navigate and
then hopefully get better whenyou do?
Speaker 2 (43:09):
Would you have any in your early stages?
Was there anything you wouldhave tried to avoid?
Anything that?
Was there anything you wouldhave tried to avoid?
Anything that you possiblywould have done you would have
tried to avoid With Thrive Notwith Thrive, just in general,
whether it's becoming anadministrator or during college
or anything you tried to avoidat all you know.
Speaker 1 (43:27):
like I said, I think everything has been a learning
experience.
I think had I not gone throughsome of the things that I've
gone through whether they weregood or bad.
I learned from all of them.
Speaker 2 (43:36):
And so.
Speaker 1 (43:36):
I think overall I can't say anything.
I've had a wonderful life.
I hope it lasts a lot longer.
I'm figuring 120, I'm shootingfor 120.
But you know, I don't know ifI'll have enough money to do
that.
But you know, I think you knowof all the things that have
happened throughout my life I'vetried to learn from and it's
only made me better for what itis, whether it was good or bad.
Speaker 2 (43:59):
So, as we conclude here, uh, I want to go back to
thrive, of course.
Uh, what advancements or futureinitiatives, uh, you guys
coming up or pursuing withthrive?
Speaker 1 (44:14):
You know there are.
There are a lot of things outthere that we're looking at.
I don't know that I cannecessarily put my finger on one
, because some of them I'm stilltrying to research and see if
it's actually a viable option.
We I've got some things in myhead and some things that I'm
talking with some of my you know, my medical directors about
some of my team, about that.
That hopefully, you know, andwe're just looking to impact the
market in a different way or orprovide more than than uh, than
(44:38):
we currently provide, uh, if,if we can figure out a way to
provide more for the facilities,for the people that operate the
facilities.
You know we, we do education,we do training, we do things
like that already, uh, butcoming up with ways that can, I
don't even want to say take moreoff of them, but give them more
tools to work with so that theycan do a better job and then
(45:00):
also help the residents.
There are patients, but yourresidents, that's really all I'm
trying to do is just make theirdays better every day.
Speaker 2 (45:11):
A message to an up-and-coming just a A message
to a up-and-coming, just a briefmessage to an up-and-coming
nursing home administrator orsomeone that's going to be in
healthcare administration rightnow if they want to pursue
becoming an NHA.
Speaker 1 (45:29):
Don't think it's an easy job, because it's not,
although I still think the DONjob is harder than the
administrator job.
Yes, I agree, but you need tohave the right people in place.
You need to be humble enough toaccept not criticism but
criticism.
It's not so much criticism asit is just some helpful tips on
(45:51):
how to do things better.
Don't think you know everythingbecause you don't.
I still don't, and I've donethis a long time.
Take it and know that you'regoing to have to put in a lot of
hours if you want to do it.
Well, I don't.
I haven't taken a vacationsince 2004.
I mean a real, like a week.
So my poor wife has been.
(46:11):
You know she does conferences,she gets to go to conferences
and stuff, but I haven't taken atrue vacation.
I just don't.
I don't shut off very well.
That's something I need tolearn.
I don't shut off as well.
If you can find a way to shutoff and go away for a little
while as an administrator, Ithink that's a big deal.
I've never been able to do it,but I see that there are some
(46:33):
people that are able to do itnowadays and more power to you,
more power to you, but I'venever done it.
I just can't.
I'm I guess it's a neuroses ofsome sort, but but I think you
(46:55):
know, if you understand, goingin, you're going to have 80
hours a week, you're going tohave weekends, you're going to
have call 24-7.
There's going to be a strain,probably, on your relationships,
but preparing for that ahead oftime is a big deal.
And then throw yourself into it.
Do everything you can Learn,ask questions, because the more
you learn, the better you'll beat it and the better you'll be
able to help not only yourresidents but your team.
Speaker 2 (47:14):
Yes, sir, able to help not only your residents but
your team.
Yes, sir, and for our familiesout there, for other providers,
vendors, uh and organizations,if you can share with them where
they can find you, your website, uh social pages yeah, uh,
we're on facebook.
Speaker 1 (47:25):
Uh, thrive behavioral sciences.
We're on, uh, linkedin thrivebehavioral sciences.
You can follow me.
Steve Lomonaco yes, sir, orSteven Lomonaco, I'm not sure.
On LinkedIn Website iswwwthrivebehavioralsciencescom.
A little long, but we want tomake sure people can find it.
And you know, if there'sanything we can ever do to
(47:49):
assist facilities, vendors, fromthe Florida Healthcare
Association standpoint and I'llbe honest, if you ever anybody
that has questions aboutoperations, I mean if you just
want to reach out, I have noproblem giving you a little
small tidbit of time so that Ican help you if you've got
(48:09):
questions.
I do attend a lot of thedistrict meetings for Florida
Healthcare and so when I amthere, you know I do have people
that want to stop and talk oncein a while.
I never have a problem withthat.
I think it's really importantto for all of us to share
knowledge, share experiences, sothat we can do a better job for
those residents who are comingin and help each other out,
because it is a tight community.
Even though it's big, it is atight community and you're all
(48:31):
going to face the same things.
So if I can help and impartwisdom to anybody, I'm happy to
do it.
I want to yes sir.
Speaker 2 (48:39):
Yes, well, I will say , mr Monaco, he is responsive.
I met him on LinkedIn.
When I've seen him in person,always greeted, very
approachable.
I know he definitely looks likeyou know he the man, so, but he
is the man right, but he's verykind.
I can just tell you this uh, um, just meeting him in person
(49:02):
just as well, so, um, he alwayshad the jury on two, like me too
.
Speaker 1 (49:07):
you see him over there these are actually all for
ptsd in support.
Okay yeah, veterans with PTSD.
It's an organization I support.
That's where I get those.
Speaker 2 (49:18):
So thank you for joining us here, our comfy
supporters.
We have our wonderful guests.
You heard from a president, ceo, mr Stephen Lamonaco, so happy
to join us.
Please like, share, subscribeon on youtube.
You also can find us on spotify.
Visit thrive behavior sciencesto learn more for regarding
(49:41):
supporting your facility, yourresidents and clients.
Thank you so much for watching.
Please visitcomfortmeasuresconsultingcom.
We're here to support you andyour loved ones.
Speaker 1 (49:54):
Thank you.
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