A 20 YEAR TRACK RECORD OF PROJECT SUCCESS
MEET DOUGLAS CLEGG
Founder and President of Spring Creek Enterprise
In 1991, I graduated in construction management and was hired as a project manager for a residential development company in Northern California. A year later, I relocated my new family and ventured into site development and general engineering.
There is an art of creation and an euphoria that comes with visualizing, drawing and then physically building something. It’s an unbelievable feeling that never leaves your system once you have tasted it. Deep down I knew there was something more to my career than tasting dirt and making money.
A CHANGE IN CAREER
I spent the next three years creating a new corporation, obtaining a commercial general engineering license and meeting bonding requirements. During that time, we had a beautiful baby girl.
One night I received a phone call from a friend. He was working as a home health aid in the new concept of “Assisted Living.” It was unregulated comparative to skilled nursing facilities, and it represented a new paradigm for long-term care; “A life like home, without the institutional feel.”
He told me to come up and take a look. I flew out and spent time touring facilities. That is when I discovered my new love, my new career. Together, we spent months developing plans, looking for locations and establishing our business model. We commenced construction and opened our first facility in Soda Springs, Idaho in 1995.
It was a new start, an adventure and then came the truth – we were fully occupied and still loosing money. After 18 months and sleepless nights, we realized that our seniors needed more care and we needed more staff. We knew we needed to do something different. We introduced a negotiated services agreement (an NSA).
We developed descriptions for three levels of care. Each level had different needs; which became known as the need for adequate care, the need for adequate compensation, and the need to compensate the owners for the risk and time that it takes to manage a business. Shortly after this, we began construction on our second facility in Montpelier, Idaho. This time time we knew we needed to start with more rooms and our newly created NSA.
We heard rumblings of a new HCBS waiver program through the Idaho Assisted Living Association (IDALA). We were approached by the commissioner of health and welfare and asked if we would pilot this.
We accepted the invitation and used our NSA and some very basic excel spreadsheets. These simple practices became the data that the state used to create a point system, which became their now universal assessment instrument (UAI), which is still used to establish a care rate for acuity after rent, food and utilities (RUF) have been considered.
We learned a lot these first three years. We realized we had a newly introduced care model that was not only in demand but a blessing to those that we provided services for.
A CHANGE IN DIRECTION
Finally we were paying the bills. Then three years and three children later, my wife and I determined we needed to relocate our family to Boise, Idaho.
Shortly after relocating to Eagle Idaho, I purchased a map of the state of Idaho. I then pasted it on an office cork-board. The next day I purchased three colors of thumbtacks and posted the two facilities we currently owned in red on the map.
I then went to the states’ websites and printed a report that showed every assisted living facility in the state. I began putting thumbtacks on their locations. This visual allowed me to understand what the State of Idaho meant for our future. We then began by placing yellow thumb tacks for facilities over 16 beds and green thumb tacks over facilities with less than 15 beds.
We realized that if there was no hospital our chances of survival were weak. Based on the map, we began construction in American Falls, then Eagle, Saint Anthony, Meridian, Boise and the list went on. Our communities began training to provide care for Alzheimer and Dementia and then independent living. We began buying larger properties to create campuses. By 2010, we became one of the five largest Assisted Living providers in the State of Idaho.
SOMETHING HAPPENED ALONG THE WAY
During this adventure we got involved with initiatives that included The Department of Health and Welfare and the ongoing need to change rules and regulations, reimbursement rates and other legislative initiatives that are essential to staying in tune with a healthy ever changing industry. Our association became affiliated with a national organization, the Assisted Living Federation of America (ALFA). We attended national conventions that gave us access to leading edge practices, technology and quality assurance initiatives.
We became affiliated with the National Investment Council (NIC), which has a broader base and involves not only assisted living, but skilled nursing. We learned a lot, but then something happened. I was at a convention in Florida. There are usually several keynote speakers, like a Colin Powell or a Newt Gingrich. Once in a while, these keynote speakers will be what we call an “unknown.”
I do not remember the name of the individual this day, but I do remember he started out by introducing himself as a fellow operator who was running our large CCRV in the state of New York. He began to give us a history of evolutionary change in the American Economy.
We started as farmers and hunters, then goods and services, then we began mining natural resources through the gold rush, then manufacturing and then the industrial revolution and then he introduced the… “experience” industry. I was taken back for a minute as he began sharing the evolution of Broadway, which eventually led to Hollywood and the film industry; then, a guy by the name of Walt Disney who created a “theme park” and then the hotel and hospitality industry. He went on and on and began to explain how goods and services were no longer marketed through needs but experience and desires.
Sex sells beer and cigarettes, beauty sales clothing and cosmetics, Hollywood sells emotions. Then he asked what we were? Where did we belong in the continuum of the economy? How were we classified as an industry? Were we goods with our food? Were we services with our care plans? Did we fall under the hospitality industry with our elaborate real estate as we tried to one up each other with new designs that had curb appeal?
I personally thought we were a health care industry and fell under the direct line of services. I stood corrected, and realized that we as a company were falling short of our potential. We do have an obligation to provide an experience. We went home from this convention and fired our marketing directors. We called in all of our Executive Directors (Administrators) who formed our board of leadership and redefined their role. It required us to create new job descriptions for them, for their nurses and for their staff supervisors.
Our activity directors became life coaches and when they planned events and activities more than just the resident was considered in the planning. We hired Meredith St. Clair who was working on her doctorate in Gerontology and teaching troubled teenagers in the Boise School System. We spent the summer of 2006 writing the curriculum for what we eventually called “Ohona” which in the islands means family and within the family unit – that we are bound together as a community.
This curriculum was brought to our newly energized life coaches. We began to infuse the community and school with the knowledge behind our residents. The story of the sinking of the titanic was told through the grand daughter of the lead finish carpenter who still had some of her fathers’ tools. We told the stories of the WWII conflict with fully dressed decorated veterans. Children learned of these experiences firsthand in the classroom. The educational value behind our residences’ experiences was invaluable to the community.
We developed personalized software system that utilized retail scanning technology with picture images, electronic scanning bars and medication distribution. This became to be knows as “AutoMar” and is sold today nationally as one of the leading medication management software systems known as “QuickMar”.
It will take another time for us to share all that we did, but suffice it to say that the need to go and find people to live with us no longer existed within our organization. The health of our seniors improved, the culture in our communities transformed and we began receiving letters from extended family who had been a part of this experience for our seniors.
We began to see within our facilities a culture change. The need to discipline for endless peer criticism and backbiting diminished. Caregivers and cooks began to work together. Activities became a family event and our mothers’ day, fathers’ day and other similar days of recognition became a family event, not only for the residents, but for the staff as everyone united.
A TIME TO SELL
As all stories have a beginning, they also have an end. As we became one of the larger long term care providers, it soon became a reality that I was spending most of my time dealing with lenders, investors, attorneys and insurance adjusters. I knew that we had grown to the point that we needed a fresh start and a new set of relationships.
We spent six months developing an offering memorandum with all of the details required to attract larger investors and operators. It took us a year following this offering memorandum to finally sale our organization to a REIT.
We entered into a non compete for three years and since our sale in September 2011 have used our investment and development skills to create single family developments, multi family apartment projects, fast food establishments, convenience stores, reclamation projects, and other commercial retail and business ventures.
It has always been our intention to return to the senior market and begin the journey we started in 1994 in South Eastern Idaho. We have learned much over the past 22 years as owners, operators, developers, and investors in the senior long term care industry. It is our belief that there is something to be done in the State of Alaska. The condition of the long term care industry is almost what we felt when we started in Idaho, and the seniors along with their families are seeking for something more than just quality care.
All of us as we reach the age when the pendulum shifts from being children to being a primary care provider for our parents has a new set of decisions to make. The tools for long-term care are closely tied to these decisions, and what it means to us as individuals and our interactions with our parents.
Our role as long-term care providers is much deeper than just documentation, adequate training, clean facilities and good meals. It is tied to the ability to counsel with the public about the decisions they need to make individually since every family, every individual and every health care condition is a private matter and vastly different.
We have found that the decision to accept long-term care services is not an event but a process even after it has been made. Creating and using the tools to keep our seniors involved with their community, with their family and with the greater world which they are a part of is what transforms this decision to accept long term care from an event and keeps it a healthy and evolutionary process.
These tools are not in addition to providing excellent care, but a change in how that excellent care is administered. Every individual has a song to sing or a dance to engage in, and discovering this within our seniors and then giving them the instruments to play at their level of talent and ability is what is needed for them until their final breath.
We are looking forward to working within the State of Alaska and hope we can offer what we began to experience those that we intend to serve in the Matanuska – Susitna Borough.