Sharon Gabrielson, CEO of SRG Associates

Episode Transcript

David Pardo (00:00.878)
Sharon Gabrielson, welcome to the show.

Sharon Gabrielson (00:04.665)
Thank you. It’s great to be here, David.

David Pardo (00:07.246)
It’s exciting for me. This is just so, we’ve spoken before and this is so interesting, but the kind of questions I’m gonna ask you now probably wouldn’t make sense over lunch. So a casual lunch, certainly. And what I wanted to ask you over casual lunch, and I got to now is, I could say you have, like, a remarkable story and just the career path, sort of the kind of thing, it’s hard for me to imagine.

Someone wakes up in the morning when they’re little and says, I want to go from RN to the boardroom. So could you tell me listeners a little bit of your, um, your path in your career path through healthcare.

Sharon Gabrielson (00:51.705)
Yeah, David, it’s a great question because I’m often asked that by people I mentor who say, I want to be like you. I want to be a board director. I want to have a seat at the table in the boardroom. How did you get there? Can you help me get there? And one of the things I always tell them is my path was not a linear one. And we can, you know, I’ll share a little bit later as we get into the program, how I moved from the bedside to the boardroom.

The fact that I wanted to be a nurse from the time I was a little girl really drove where I was focused and I went to nursing school and I graduated with a BSN and I went to work at the bedside and that whole focus on the holistic approach to the care and nurturing of patients was critical to my foundation.

As I thought about and worked through my career process. I moved from the bedside into administrative operations in the clinical practice after I received my master’s in healthcare administration and a master’s in management. And I actually wound up leaving Mayo Clinic at that time and going to work for a startup organ procurement organization, which gave me some great experience into startups, into innovation, creativity into negotiating and facilitating with members of a care team that was focused on a common goal, but didn’t have the relationship of reporting and accountability. And that piece was really critical to me as I continued to move through my career. I moved from that operations executive and the business side and portfolio management and improving efficiency and effectiveness of the care that we provide in addition to developing new product and service into then the commercialization arm. And that’s where I ended my career was taking that research and evidence -based knowledge from Mayo Clinic to the commercial market in the form of products and services. So.

Sharon Gabrielson (03:12.729)
I went from, you know, bedside nursing to operations and all of that, you know, in not -for -profit world, and then moved into the last stage of my career, which was commercialization and performing in the for -profit market. And so that whole continuum is not one I would have planned for myself if I was mapping out my career path in my 20s, my 30s, my 40s.

But it was an opportunity to see the healthcare system from all aspects across the continuum.

David Pardo (03:53.614)
Okay, so you actually answered my next question. At what point did you foresee the future? But even forget the for -profit commercial part at the end, the part in the middle, did you know when you were in school to be an RN that eventually you wanted to move up the administrative chain? Or was that, and this is the part I suppose is transferable really to anybody, is that you just.

Sharon Gabrielson (03:58.105)
Yeah. Yeah.

David Pardo (04:22.862)
Accepting opportunities as they came your way. How much pre -plan and how much catching the sailwinds.

Sharon Gabrielson (04:25.401)
Yeah. Yeah. So the whole focus for me in school was on delivering care and being a caregiver and being a nurse, a bedside nurse. And when I first entered into the bedside nursing aspect, I didn’t have any aspirations to move into management. I wasn’t thinking about that.

I was really focused on being a hands -on care deliverer. As I continued to be a bedside caregiver, I saw that there were so many opportunities within the healthcare system that could really improve the outcomes for patients, could help drive down the cost of care, could help improve the experience and the outcome of the clinical care that we were delivering. And so,

If you will, I was thinking about the triple aim long before the IHI triple aim actually articulated all of those things. But as I started to think about and saw that I could add to the organization by also helping not just identifying the challenges that I faced as a caregiver, but also bringing solutions, potential solutions to the table.

That’s when I really decided I wanted to go back to school, get a master’s in management, get a master’s in healthcare administration, and be part of that solution on an operational level going forward. And then I got into operations, operations administration, after finishing my degree, and really liked having a seat at the table with other leaders to help bring the needs of the patient, bring the needs of the staff together and to achieve those larger goals as an organization versus just in that narrow vertical that I was in when I was a bedside nurse. So as a result of that really liked found that I liked management and I liked leadership and continued to look at how I could.

Sharon Gabrielson (06:47.437)
Climb the ladder, continue to climb the ladder from a leadership position and didn’t really have a path for that other than I was making it known to my boss and my boss’s boss. And what I found was that there were opportunities then that started to come to me based on the knowledge and experience I had at the bedside, but also, the leadership capabilities that I was growing and experiencing and scaling.

David Pardo (07:20.526)
And then in terms of the transition to the commercial markets, maybe an over, I’m sure I’m not the first person to ask you, what was most surprising for you in your nonprofit career transition to the for -profit? Like, I know a lot of people live in the nonprofit world, have a little bit of a chip on their shoulder. Like, can you tell me what was the most surprising part?

Sharon Gabrielson (07:35.979)
Yes.

Sharon Gabrielson (07:39.595)
I’m sorry.

Sharon Gabrielson (07:43.289)
Yes, the most surprising part was that my boss came to me and asked me if I would consider the opportunity to lead one of our for -profit arms at Mayo Clinic. And my background, as you said, was totally in the not -for -profit space. And my reaction to her was, oh my gosh, are you sure you even want me to consider that? I have no commercialization experience. I have no for -profit experience. And what she said to me, and she was an amazing mentor.

She said, Sharon, you have the skillset that we need through the work you’ve done in integrating the clinical practice. At the time I was the chief operating officer of the Mayo Clinic Health System. So the 17 hospitals and 72 clinics located throughout Minnesota, Iowa and Wisconsin. And what I’d been working on the entire time I’d been there as COO was integrating the community based practice with the destination practice, tertiary, quaternary.

Medical Center in Rochester, Minnesota. So the integration of front end and back end office functions to support the practice, the integration of the clinical service delivery among those then 13 sites was really what led my boss and the leadership to say that’s exactly what we need. As we look at the commercialization arm of Mayo Clinic, there needs to be a tighter integration.

Between what we do as a core competency as a business, i .e. the clinical practice and this commercialization arm. And so I wound up to our earlier conversation around it wasn’t a linear path for me. I would have never considered that. But it was brought to me and never one to turn down an opportunity, right? Moved into that role. And I think that one of the most important lessons I learned very early on, is you have a transferable skill set that almost any job that you think about is part of an ecosystem. So understanding what that ecosystem is, what role you play, what role the marketplace, what role, for instance, the payer plays or the customer plays, right, is really important. And that is transferable across.

David Pardo (09:39.47)
We’ll see what happens.

Sharon Gabrielson (10:05.125)
Across industry. The other thing that I learned was that it’s important to do a portfolio analysis right away to understand the assets you have in the portfolio, the products and services, and to be very diligent about doing that and understanding what’s your core, what’s not your core. And as a result, as you think about that long term strategy, leveraging those things, understanding where it’s maybe time to divest yourself of an asset because that isn’t core and somebody else can do it much, much better because that’s what they do as a core. So really doing that portfolio analysis then and, you know, and taking the approach of the systems thinking is really important. So those are probably biggest lessons.

David Pardo (10:56.878)
Just to be clear, when you say portfolio analysis, you mean of yourself.

Sharon Gabrielson (11:04.473)
Of the organization and the assets that they have as an organization. Yep. Yep. So when I took the role of global business solutions chair, right, we had about 12 products in our portfolio. And when I left, we had really honed that down to a handful based on where our market where the market need was, what the customer needed and what our core competency was as far as being able to deliver that.

David Pardo (11:06.114)
Of the organization. Okay.

David Pardo (11:36.59)
Think it’s just so interesting how you could listen to what you’re talking about portfolio analysis and easily could be talking about like people analysis. And I imagine like when VCs meet founders, it’s very similar. They’re thinking about like the core competency of the people. And you could really look at yourself as a portfolio and say like, what are my assets? Like, where do I want to shed?

Sharon Gabrielson (11:55.289)
Yeah. Yeah, that’s a great translation. Yeah.

David Pardo (12:00.814)
I love that. Speaking of translation, in your extensive experience with the Mayo Clinic and subsequent experience, global healthcare solutions, what are the most critical innovations that you believe need to be implemented in long -term care facilities, which is where we’re focusing on this pod to improve patient outcomes?

Sharon Gabrielson (12:19.609)
Yeah, I think, so I mentioned the tripling. Really now it’s the quadrupling. So it’s improving outcomes. It’s improving the patient experience. It’s bending the cost curve of care delivery. And it’s also improving the lives of the healthcare team and healthcare providers. And there’ve been several innovations that we’ve recognized in a very short period of time, right? Telemedicine, digital health, those components that we can provide allow us a mechanism to provide care and services to the end user without having them physically have to come to a specific location. So those innovations like remote monitoring at home, you’ll hear the term hospital at home, acute care at home, where we bring those tele and digital solutions to the patient in an effort to be able to keep them in their current environment as long as possible and free up those hospital beds and free up those acute care settings for those that really need to be in the hospital or in the acute care setting. The components around building of platforms, right? The movement from point solutions to integrated platform solutions. Things like your call center being, you know, interacting with the electronic health record, for example, which allows you to have a seamless, warm transfer of the information you’ve provided to the rest of the care team without having the patient have to be the one to repeat that information every time they’re handed off to another individual on the care team.

Things like cockpits in the hospital that utilize a single care team to geographically care and provide input into the care of patients that are located in different cities and different states. So, you know, those are some examples.

David Pardo (14:38.574)
A cockpit, sorry, a cockpit in any facility or across facilities. Okay.

Sharon Gabrielson (14:42.105)
In a facility. So think about it as the hub and spoke model where the cockpit is actually the team of, for instance, let’s use EICU as an example, right? Electronic ICU, keep being able to keep the patient at home in their hometown hospital, as long as possible when care can be delivered through that care team.

With the assistance and the knowledge of subject matter experts like intensivists that are located in a tertiary or quaternary facility have that next level of knowledge and experience and skill that they then can provide to the team at home and in the home hospital in order to be able to keep the patient there. Same thing with e -delivery room. So again, local hospital delivery room.

Mom or baby run into a little bit of challenge, not that they need to be transferred, but that with the expertise at their fingertips that can use the camera to see what’s going on can tie into the electronic monitoring system to see those vital signs and the heart rate and those kinds of things actually have eyes on the patient.

Be able to provide that next level of subject matter knowledge and expertise that can keep the patient in that facility versus having to transfer.

David Pardo (16:12.846)
I hate cutting you off. I so many things to backtrack on. In terms of remote monitoring, telehealth, I think the examples you mentioned were more from the hospital system. Have you seen those kinds of digital leaps, progression in the long -term care space? If you haven’t, what’s stopping it? Does it have to do with incentives or who pays or what are your thoughts there?

Sharon Gabrielson (16:41.529)
Yeah, so it’s probably a host. I would say long -term care, assisted living facilities, just kind of senior facility organizations in general are behind what the hospitals have been able to do for a variety of reasons, right? One is, as you mentioned, right, reimbursement. As we know, long -term care facilities, senior facilities oftentimes are

David Pardo (16:51.438)
Sure.

Sharon Gabrielson (17:09.881)
Very, very limited in the extra revenue that they’re able to put into the innovation and creativity simply because reimbursement rates are far below what they need to be in order to just even compensate for the day -to -day costs. The second is the staffing challenge, right? We continue to have over, you know, a turnover.

In the long -term care facility and assisted living facilities. And it’s not unlike the challenge that any service organization has, right? In that there aren’t enough people to do the work. There’s more need we have, right? The demand is greater for our workforce than the capacity of our workforce.

And until we find out, you know, we haven’t figured out how to manufacture people yet. So that’s not going to go away. But how.

David Pardo (18:09.582)
Sure, but usually technological progression and use of capital over labor is easier when labor is scarce. So wouldn’t that suggest telehealth should be more plenipotent? I mean, there’s a way of dealing with labor shortages.

Sharon Gabrielson (18:24.185)
Yeah, so there’s a couple of things, right? The first is based on the premise that you’re not spending that capital, you’re not spending that financial resource on the staff. But actually, that’s not true. If we look at, for instance, the nursing shortage, we were spending much more on nursing staffing.

Than organizations had budgeted for. And the reason was we were using traveling nurses. And that cost was very expensive compared to what the cost of employing that individual as part of the healthcare organization would have been. So it actually put many organizations in a worst case situation and long -term care.

You know, is no different than every other organization faced. In fact, I sit on the board of a long -term care facility, a senior living facility, and we were experiencing a 10X increase over what we had budgeted for our nursing staff because we were hiring from temporary agencies because we didn’t have the internal staff.

David Pardo (19:39.886)
You’re saying that the spend on labor means that there’s less room in the budget over the past three, four years since COVID started to spend on R &D, which is where you’d expect the dollars to go, but there just isn’t. Wouldn’t you expect, let’s say, I don’t know, like in the assisted living world where it’s not about reimbursements, everything’s private, for the most part, for there to be more of a push to invest in remotes?

Sharon Gabrielson (19:51.641)
Right. Right.

David Pardo (20:09.998)
Are there other disincentives there?

Sharon Gabrielson (20:10.687)
It depends on what the focus is of the private entity that owns them. So if the if the focus is purely financial, and how do we increase our operating margins? And how do we increase our net operating income, there will still be the constraint of where you spend the money within that goal and objective, right? So

I think many would argue that at this point in time, the privatization of the assisted living and independent living, even facilities have not necessarily bend or have not necessarily helped achieve the triple aim, right? We hear customer satisfaction has not improved. We hear that the cost of care has not gone down. We hear that the burnout of the staff, for example, is no better. In fact, it’s even heightened. And that the outcomes of the population, we don’t have a healthier population. We don’t have a decrease in hospitalizations of assisted living and long -term care. And I’m not saying that there aren’t organizations that have had some.

Improvement in those areas. I’m just saying as a whole, we haven’t seen the long term care and assisted care facilities have better outcomes, better patient satisfaction, lower costs.

David Pardo (21:54.026)
Interesting news news to me. I didn’t know one way or the other, but you’re saying that the assisted living with private dollars is not not outpacing specialized nursing facilities where you have public one.

Sharon Gabrielson (22:08.345)
No, and if there are those that are, then, and I think this is part of the challenge, right, is industry best practices. How do we know what we know? How do we share that? How do we spread it so that everyone is adopting those best practices or has access to them? Right now, it’s still pretty siloed in that organizations are trying to internally.

Make these changes, improve things. But again, as I mentioned, from a privatization perspective, unless the improvement in operating margins and improvement in that operating income, if there’s not more of that being directed toward innovation and capital allocation, then it’s the private groups that are benefiting and you’re not seeing the benefit then of those additional dollars going into the improvement of the long -term care assisted care delivery system.

David Pardo (23:20.632)
Interesting. Is anyone working on building some vehicle to share what are they called communities of practice?

Sharon Gabrielson (23:29.081)
Yeah, I think there, I mean, definitely there are and I’m not as familiar with them, but there are many trade organizations that are out there that are there, there are, you know, facilities like Brookdale and those kinds of organizations that have, you know, resources that they are allocating right to that. But the majority of the long -term and assisted living providers that I talked to, the provider groups are still struggling with those razor thin margins, as well as now increased legislature or legislative and regulatory requirements that when those are put in place, they cost money. It’s not that, you know, if you’re having to generate reports and report measures that you haven’t reported before. It’s just taking time and energy to do that. And if you already had staff that were stretched thin, adding more work and responsibility, it comes at a price. The focus is then on those things and not necessarily things that need, you know, the innovation and the creativity and the focus on to really move the needle.

David Pardo (24:56.782)
Which regulations do you think are most harmful and the industry should be lobbying against?

Sharon Gabrielson (25:02.425)
Well, I wouldn’t say I’m not going to use the term harmful. I’ll use the term and I’ll give you, I think that they are, when you have mandates without the funding that comes along with those, that’s when you run into challenges. So the mandates themselves may be very, very important, right?

David Pardo (25:06.062)
Okay. Deleterious?

Sharon Gabrielson (25:30.009)
Again, seeking to improve outcomes, lower the cost of care, improve the experience, keep people safe. But if they come without funds and they’re accretive to the work that’s already being done, then you have to figure out how you’re going to be able to comply with those. And it you know, for most of the healthcare organ, or most of the long -term care and assisted living facilities who are making razor thin margins right now, it’s how do we add that into what we know we already have to do with a limited workforce, with limited funds, and it’s kind of a cycle that you get into. So.

David Pardo (26:23.894)
Patient-centric care models was the second thing that you mentioned in your list. Bookmarking going back. So what does a patient-centric care model look like in a long -term, in an LTC, in a SNF, in an ALF, in home health, and maybe not home health, but the former two, facility -based medicine. What does it look like and what’s the impediment to us getting there?

Sharon Gabrielson (26:47.705)
Yeah, so I think that we are focused now focusing more from away from the patient centric model to a whole person care kind of health and wellness model. We for example, know that social isolation and loneliness have been linked to increased risks of cardiovascular disease, diabetes, dementia, depression, and increased overall cause of mortality. So I think that the whole person model, personalizing the care and services that are delivered to that individual, to that resident of a long -term care facility, assisted living facility, even those that are in an independent living facility. And you’ll find many campuses, senior campuses across the country, that have all three on their campus. And you see the resident move along the continuum of their lifetime from, for instance, independent living to assisted living and maybe memory care or long-term care. But emphasizing, for instance, the patient or the residents’ relationship within the community, right? So you’re seeing more.

communities really try to understand and leverage the individual interests, the capabilities, the experience, the knowledge that their residents have to come together within the community and utilizing those to improve the community as a whole. It keeps those seniors engaged. It keeps them feeling a vibrant part of the community and everyone’s a little bit different, but you’re starting to see more organizations really focus on understanding the resident as a whole person, not just based on the clinical care they need or the services that they need, but what can they bring and how do you engage them to make them a vibrant part of the community? Yeah, go ahead.

David Pardo (29:05.398)
No, I’m just digging deep into the question. Are there technological solutions that you’ve seen to assist the vision you’re describing? Is that on the horizon? If not, why not?

Sharon Gabrielson (29:20.537)
So I haven’t, I personally haven’t seen those. I think right now it’s been, it’s, you know, it’s being done on a facility to facility basis. It’s a lot of human interaction, right? From staff at the facility really trying to understand and learn about the resident as a whole person. But I think that, you know, those things that are being worked on, things like, you know, the dementia room of the future, the dementia residents of the future, where there are actually studies that are being done and prototypes that are being built and Mayo Clinic is an example of this, of tailoring and designing from a systems thinking perspective, what that what that residency looks like for the future. Knowing that, for example, it’s hard for many of our seniors and people with dementia to use a small iPhone.

So putting, for instance, a wall, an interactive wall in that facility or that room and allowing, right, tailoring it and designing it around the senior usage, having, you know, large, large interactive user interact user interface, for example, they want to make a phone call, right, they go and they push a button. They want to lower, you know, they want to turn on their TV.

Right? They don’t have to have a separate remote control for that. All of their activities of daily living, right, tailoring some kind of interactive screen that they can easily navigate through design specifically for seniors. So I don’t know if you’re familiar with the GrandPad, but my mom has had a grand pad for about five years now.

It’s a tablet like an iPad, but it’s been designed specifically for seniors. The user interface is very easy to navigate. It has automatic answer on it. So I don’t have to worry about whether my mom can find her phone because that’s always a challenge. And right, and she’s not picking it up or whatever, but there’s auto answer on this grand pad. So when I call,

David Pardo (31:37.006)
She’s on the other side of the room and to run over and she’ll get hurt, God forbid.

Sharon Gabrielson (31:46.681)
it immediately connects me to the grand pad and my mom’s apartment.

David Pardo (31:51.342)
Right. It’s a cute play on words too. Like grandpa, grandpa. I was going to say, I was thinking my grandfather passed away in 2000, but in like, the nineties, we got him, “we,” I know, my parents got him like a phone with very, very big buttons on it. And just thinking like it’s 20 plus years later and the elderly are worse off now with technological advances.

Sharon Gabrielson (31:55.097)
Yeah, yeah, exactly, exactly.

Sharon Gabrielson (32:08.217)
Yes, yes.

Sharon Gabrielson (32:17.273)
Right, right. My mom has trouble with her iPhone, right? It’s just to, oh, what is this? How do I get to my messages? Right? How do I get to my pictures? How do I get to, I can’t remember, you know, I don’t know this person’s phone number. How do I find it? Right? Those are just things that seniors navigate very differently than we do. So those are some of the innovative models that we’re starting to see in the design and systems thinking for delivery of the services that our seniors need, whether it be independent living, assisted living, long -term care, memory care.

David Pardo (33:01.102)
Any founders and VCs listening, there’s a growing market, people who need assisted technology or tech centered on this growing age group. You mentioned a couple of times that I want to circle back to it about raise within margins, about a thinning workforce, about getting increasingly difficult to staff. You’ve had a lot of experience, strategy development and human resources. What are, we know the non -innovative strategies, we know sort of like the basics, but what are out of the box, cutting edge ideas, strategies, how LTCs can employ, attract, retain.

Sharon Gabrielson (33:51.737)
Yeah, so there, I don’t think that there are new and innovative strategies. I think that the toolkit that we’ve been using to solve those root problems needs some, some changing up. So like I mentioned earlier, we haven’t figured out how to manage how to manufacture people yet. Right. So the fact that we have a workforce shortage of human beings is not projected to get better over the course of the next many years. But leveraging, how do we leverage those human skills that we absolutely need to be human delivered, right? We’re never gonna take the human component out of holistic care and service delivery. So how can we leverage?

For instance, AI and instead of artificial intelligence, the focus on augmented human intelligence, right? So how do we make the work that humans have to do really focused on that component that only humans can deliver? Yet how do we take, for instance, some of the rote tasks, right? The transcription, the ability to transfer knowledge and information right from one spreadsheet to the other. I’m really simplifying this, but among different applications, right? So that the human doesn’t have to do what the human doesn’t need to do. We call it, you know, utilizing in the practice is utilizing our staff to the highest level of license share education, right? And skill.

And so there’s a lot we can do to remove some of those rote tasks through artificial intelligence. And you’re seeing electronic health records. Tasks like, again, moving, yeah.

David Pardo (35:49.166)
What are non-digital route tasks?

David Pardo (35:55.246)
No, I, I’m sorry. I know the digital ones, but what are like, what, what happens in the life of a CNA and RN? I’m a knowledge worker. So I lean on GPT a lot, but.

Sharon Gabrielson (36:05.241)
Yeah, yeah. So, so I would say to it’s not just the RNs and the CNAs, it’s people like and this is gets back to the whole ecosystem, right of delivery of services in the long term care and assisted living facility, for example, culinary staff, there is a huge shortage of culinary staff that is critical to people’s well being to our residents well being to eating healthy to.

Liking the food that’s prepared for them because if they don’t like it, they’re not going to eat it, right? But what skills can culinary staff be utilizing? You’ve seen robots delivering food, for example. You’ve seen, you know, we can utilize AI to understand a particular residence dietary needs, right? Today we rely on humans to do that.

David Pardo (36:59.15)
Yeah. Yeah.

David Pardo (37:03.246)
Right.

Sharon Gabrielson (37:03.897)
But those are the kinds of skills that you don’t need a person to sit down and ask the person, right? Or log in to the system as they’re interacting with the person, what their dietary needs are. Are they low sodium? Are they diabetic, right? How could we tailor the food that we prepare to individual residents, for example? So that’s part of the culinary staff. Yeah.

David Pardo (37:28.174)
Oh, I love that. No, I’ve had chatGPT tailor recipes to me. I’ve had excellent, excellent outcomes with chat GPT and recipes and giving it constraints. Like I need this done in the next 20 minutes and I have these ingredients. So like you’re right, that could be built into some kind of patient care model.

Sharon Gabrielson (37:40.761)
Right? Right. And that really helps them. So, you know, an example is the senior living facility that my mom lives in was so short of staff of culinary workers that they didn’t have a cook. And so, you know, they had a lot of their operational leaders filling in for those positions.

And so having that knowledge at a fingertip would have been, you know, extremely helpful. Housekeeping, right? Another example, if someone needs new linens delivered to their room, right, needs an additional blanket, you don’t need a person to do that. There are, you know, there are, again, automated robots that can do that kind of thing. So those kinds of picking up dinner trays, right? Those kinds of things that you don’t need a nurse or a CMA to do. That can be done by automated or augmented human intelligence programmed into a robot that can fulfill those services.

David Pardo (38:57.326)
We have, I’m usually the technologist in the conversation here. Do we have robots capable of that yet? Or that’s just you’re painting a picture that that could be. I remember Wegmans. There were a couple of grocery store supermarkets that came out with like these tall robots that they later recalled because it just was the whole thing. A lot of funny articles online.

Sharon Gabrielson (39:05.177)
Mm -hmm.

Sharon Gabrielson (39:10.425)
Yeah, yeah.

Sharon Gabrielson (39:17.337)
Yeah, yeah. I was at a pizza restaurant the other day. And you go in, you do your ordering right via a tablet. And the robot delivers your pizza to the table, or whatever it is you’ve ordered.

Sharon Gabrielson (39:39.961)
Yeah, and hotels, you know, the service, the lodging industry has been using some of the robots again, call down to the front desk, I need an extra blanket. Or I need more towels delivered by a robot.

David Pardo (39:50.766)
Delivered by Robot. And clearly cost effective at some level of scale.

Sharon Gabrielson (39:58.329)
Yeah, so they’re early in the delivery. And so as you can imagine, they’re not a be all end all. And again, it’s the augmented human intelligence. How do we leverage that opportunity for work that doesn’t need to be done by a particular individual to be augmented and performed by a robot, by a machine, by computer?

David Pardo (40:29.486)
So one way to reduce the cost of care is to invest in capital, especially where labor – where you can’t even find labor. Are there other big bets on reducing it? You mentioned raising reimbursements. They’re not going to catch up.

Sharon Gabrielson (40:33.881)
Mm -hmm.

So, yeah, so yeah, so the, you know, look, we’ve been, we’ve been struggling with reimbursement rates for long -term assisted living, long -term care assisted living for decades. It’s becoming more of a crisis today because we have an aging population. People are living longer. And in addition, we have, because we have razor thin margins, you, we are seeing, long -term care and assisted living facilities go out of business. You’re seeing states have to come in and run, for instance, a nursing home because of the challenges with financial bankruptcy and not enough staff and that kind of thing. So those aren’t gonna change overnight. What I will say is it’s going to take a coalition of guiding forces to bend that.

You know, to make payers, providers, um, ri

David Pardo (41:57.23)
Until “States” you had four Ps in a row. You had four Ps. Your coalition was: pharmacy, patients, providers, payers.

Sharon Gabrielson (42:03.093)
Medical device, right? Private these public private partnerships that are we’re seeing work on the solution to several problems is is you know, it’s going to take payer, it’s going to take the private public partnership to truly, I think, come forward with innovative, but scalable and then expanding the wins to the rest of the industry.

David Pardo (42:42.734)
As we approach the end of our time together, I want to ask sort of the big question, maybe the big takeaway is personal leadership philosophy. Can you share with us if you have one and how it’s guided you and how it’s helped you overcome roadblocks along the way?

Sharon Gabrielson (43:00.601)
Yeah, so I’m a servant leader. And that’s what I tell people that they’re the focus on the greater good. And the goal that we’re all trying to achieve is always how I approach the leadership style. That’s my leadership style involving those that are going to be those that are delivering right the change.

Delivering the service in the design, the identification, the design, the implementation and the follow up on that problem solution. Solution to the problem is absolutely critical. Leading from the top down, I have found does not work. You need to focus on the change management, right? That human or people side of change and never forget that the, what you’re doing and impacts.

A person, any human being, not only the end user of that service, but the deliverer of that services.

David Pardo (44:07.662)
Can I ask you about some of your bigger challenges in your road to leadership and how you overcame them?

Sharon Gabrielson (44:12.697)
Yeah, yeah. So yeah, I would say, you know, many times I was the only female in the room. In the beginning, I was really intimidated by that. And so, you know, my best advice as a mentor is to be intentional, be transparent, have a voice.

And speak up when things really matter. Don’t talk just to talk and to hear yourself talk, but be intentional about what you’re saying and speak up when things really matter. As a female, be aware of the imposter syndrome, right? And that is something that for me was a challenge for many years. I think women, especially women leaders, doubt their skills, their talents or their accomplishments. And oftentimes that holds them back. So be, you know, be aware that you are a subject matter knowledge expert, you bring unique capabilities to the table. You’re not a fraud, right? We often worry that we’re going to be seen as less than right or, or, or kind of bringing bringing, you know, forward, something, without the knowledge and experience to back it up. And that just isn’t true at all. Embrace the challenges, right, of life and work. As a mom, as a daughter, to aging parents, as a family resource that everyone would come to on all things medical because of my nursing background. I was the program coordinator at home. I was the household manager.

And when I first entered into, you know, the leadership role, I kept hearing, oh, you’ll achieve the balance. You’ll achieve the balance. And I’m here to say that the lessons I learned are that there is no balance, right? There won’t be balance. It won’t be equitable. But embrace those changes as they come along and live life as it comes along.

Sharon Gabrielson (46:36.889)
And know that there will be weeks that you spend a lot more time on work because there are, you know, crises or changes or those kinds of things that require your work. And then there are times where you’re gonna need to pull back and focus on family. You’ve got a sick child, you’ve got aging parents that now need medical care and you to be involved in the decision making and those kinds of things. So recognize that, that, you know, that that balance will never be there, but that you are capable of flexing where you need to flex and you can be successful in both.

David Pardo (47:20.472)
Everyone’s looking for the work -life balance. Probably the best advice is it’s not there.

Sharon Gabrielson (47:22.553)
Yeah. Yeah. Yeah. Yeah.

David Pardo (47:30.222)
That sound means it’s time for fun questions. What would you recommend most life -changing under $150 purchase?

Sharon Gabrielson (47:33.559)
All right.

Sharon Gabrielson (47:41.529)
So it was actually a purchase that my husband made for me for Christmas. I am a person that loves heat for relaxation. And he bought me a neck warmer, an electric neck warmer that actually goes down. No, it’s like a heating pad, but it goes around your neck and it goes down the back of your shoulders and you button it. And yeah, I use it about four times a day. It’s just been, it’s been life changing.

David Pardo (47:51.95)
Ooh, with like the massaging? No massaging. Oh, just hot.

David Pardo (48:03.022)
Huh!

David Pardo (48:07.916)
Wow. You wear it all the time or you or no just when you need to relax a bit.

Sharon Gabrielson (48:11.577)
No, nope, nope, I’ll go sit in my chair and exactly exactly. So I found it’s very therapeutic for me for stress, stress relief.

David Pardo (48:16.878)
Hmm.

David Pardo (48:21.806)
If you had a billboard that you knew a million people would see, what would you slap on it?

Sharon Gabrielson (48:30.585)
You are good enough.

Sharon Gabrielson (48:37.355)
I think a lot of people feel like they’re not good enough and they’re always trying to live up to someone else’s expectations and they are evaluating themselves against others’ expectations and we all need to know that we are good enough.

David Pardo (49:01.87)
Meaningful. And where do you get your healthcare news? How do you stay abreast of the industry?

Sharon Gabrielson (49:09.369)
Yeah, so I subscribe to a lot of health care journals, speckers, Harvard Business Review I read on a regular basis. I am.

David Pardo (49:21.55)
Does HPR have a lot of stuff about LTC or just healthcare generally?

Sharon Gabrielson (49:24.919)
healthcare in general, more around leadership and strategic planning and organizational design, but also industry specific. And then podcasts have really become, I spend a lot of time in my car. So podcasts have really become, and I don’t have ones in particular, I’ll just say, play something on Apple podcasts. But now David after participating in this and actually I was on LinkedIn today and I was looking through the podcast that was just posted of yours. So yeah, those are–

David Pardo (50:05.198)
If you want long-term care, you want this industry, I’m happy to welcome competition. I just don’t see it.

Sharon Gabrielson (50:14.553)
The other thing I would say is, you know, my board work, my board and advising work, really being connected with those that are on the front lines, if you will, in trying to, in running the business, right, in looking at alternatives to the workforce shortage, in recognizing the challenges that come, for instance, with, you know, AI is getting a lot of hype right now.

Um, and people expect that it, you know, there are expectations around how quickly it can be deployed, um, where the return on the investment is. And it’s, it’s not a panacea. It’s not a quick fix. Um, it’s something that will require, um, years, um, to really refine. Um, but, um, yeah, being, being, being at the table with the operators.

And those CEOs and management teams that are responsible. Exactly. I get a lot of my knowledge and stay updated from that perspective.

David Pardo (51:15.822)
Ear to the ground.

Always ear the ground.

David Pardo (51:25.102)
So I cheated a little bit. I asked you where you get your news, but a lot of times Sharon, you are the news. So where can listeners who want to learn more, stay connected or find you online, where do they do that?

Sharon Gabrielson (51:37.529)
So I have a website called SRGassociates and it’s https://www.srg-associates.com. So you can follow me there and I’m also on LinkedIn.

David Pardo (51:53.134)
Amazing. Looking forward to connecting with you in the future and thank you so much for joining the pod.

Sharon Gabrielson (51:58.361)
Thanks David, it was great.