The New Path

So much for consistency in posts. Much has changed and there is much to tell - I'll do my best to mix it up.

In 2005, a good friend of mine [dN] and I were chatting about a mutual friend of ours [bP] who had left a very cush job @ a Fortune 500 company for a small upstart company in the long term care industry. The job: administrator of a skilled nursing facility ... err, a nursing home. dN and I were puzzled (and humored) at the change - however, after watching bP for a while, we discovered he was 1) happy and 2) not doing too shabby. So, in May/June 2006 the curiosity overcame us and we decided to check it out. Long story short, we both interviewed (dN before me - I wanted to see his reaction) and were amazed by the plentitude of opportunities. For me, I saw endless possibilities to do fulfilling work and to potentially change the long term care landscape.

So, in late August 2006 I resigned my post at Microsoft. I had a cush job in pricing management, and before that had been the sales / business controller for Microsoft's US small & medium biz sales & partner group. Only $4.x billion in revenue, over 1,000 employees, and a team of outstanding employees scattered from Boston to San Francisco. There were opportunities to go ex-pat and work for 3-5 years in Microsoft's emerging markets (e.g. Russia, India, China) as the controller for the country, etc. Nice income, outstanding benefits, and the stock was accumulating in ever bigger piles as I passed the vesting milestones.

Earlier in my career at Microsoft, I was present at a business plan presentation by the company's HR VP to Steve Ballmer (CEO). During the presentation, Steve went off on a rant about employee attrition - he wanted visibility to the "good" (people who need to be pushed off the boat) and the "bad" (people who we want on the boat but jump of their own accord). Still ranting, he complained about the bad attrition, and said something to the effect of "Why would anyone ever want to leave Microsoft - the opportunities to do everything are right here in this company?"

That question was ringing in my head as I sat in my manager's office and explained that I was leaving the gucci world of Microsoft to run a skilled nursing facility. Yeah, the jokes were great, especially the ones about bed-pans. But the answer to the question is actually quite simple - when you're doing work that isn't fulfilling, or feels shallow in terms of its contribution to mankind, it's actually an easy jump off the ship. And that's how it was for me - after five years of long hours, leadership development, outstanding performance, and helping the company add millions upon millions to the bottom line, I felt used and empty. There was nothing coming back from my work that motivated me to go even further.

Today I work for a small company in Texas called Keystone Care, a subsidiary company of the Ensign Group. The Ensign Group was formed in 1999 by a group of entrepreneurs and industry veterans who felt there was a better way to deliver long term care services, namely by eliminating the bureaucracy of corporate structures and focusing on leadership at the facility level. The premise: insert a CEO minded leader as the Executive Director of the facility, and let that person call the shots and build an outstanding leadership team. Once in place, let the leadership team determine what they need to do to become the facility of choice in the market they serve. The result: an impressive track record of buying struggling facilities and turning them into successful operations - both clinically as well as financially.

What was the attraction? It's too hard to put my finger on any one thing, but here were the main factors:

• Oddly enough, the first thing on my list was the humility level of the leaders. So many of the "leaders" at Microsoft were inflicted with a rockstar mentality - it was as if they never made it beyond the syndrome of all 2-3 year-olds where the world revolves around them. I wanted to see leaders who were genuinely humble - and I did.
• Fulfilling work: something beyond the intellectual busy work and Power Point games. Who really cares if Microsoft makes another $50 or $500 million? Bill Gates doesn't need it, and the stock is so diluted and moved by so many factors that financial performance doesn't do much for it anyway. Look at the stock price history vs. financial bottom line results over the past 6 years - see what I mean? No, there had to be more to my work than making money for Bill - it had to be real.
• Entrepreneurial opportunity: I wanted a long leash - room to take risk and develop new services, products or companies. So far, I've had the freedom to do all three.
• Outstanding partners: I wanted to see stellar business partners - other facility CEOs with a committment to each other's success. I wanted to know there would be help if I needed it, that I could reach out and get a hand anytime, anywhere I needed it.

I found all of this and more. For me, there was a natural fit.

What will follow in subsequent blogs are my experiences, as well as my thoughts as they've developed over the past 7 months. It is time for the entire industry to be overhauled - and I mean the ENTIRE industry. I have seen so much mediocrity and bureaucracy that gets in the way of delivering outstanding care. The prevailing long term care philosophies are archaic and sad - and that is why people are scared - scared of placing a parent or loved one in a facility and even more scared for themselves.