Voices: Jesse Marinko, Ceo And Founder, Phoenix Senior Living

This article is sponsored by PalCare. In this Voices interview, Senior Housing News sits down with Jesse Marinko, CEO and Founder of Phoenix Senior Living, to explore why working with PalCare has helped Phoenix make better, proactive care decisions.

Senior Housing News: Please give us an overview of Phoenix Senior Living and your approach to resident care. What challenges were you facing that led you to partner with PalCare?

Jesse Marinko: Phoenix Senior Living is an owner-operator developer of senior housing. We manage, own and operate 45 properties across nine states throughout the Southeast, delivering a highly personalized approach to resident care. Historically, we have had very old habits for blocking and tackling personalized resident care – our residents were on care levels based on an assessment tool that we utilize that captures tasks and creates points that assign people care levels.

Nurse call systems are required in every building in most states, and from the outset of our ground-up developments, PalCare was our chosen nurse call solution. Their cloud-based solution, coupled with great customer service, stood out as a critical tool for enhancing our care delivery.

However, our industry is very much in a cruise-ship mentality where you pay one fee and everything’s included. That was the simplest way to sell to a consumer, but with rising wage pressures, we began evaluating how to ensure we were fairly compensated for the exceptional care provided by our teams.

We’ve been giving away care in this industry since the 1980s. It’s really hard to quantify because the only way you’re ever really able to truly capture care economically in a way that protects the operator is to charge time. And that concept was always very raw for operators. They always proclaimed to themselves that, “We’re nickel-and-diming the families and we can’t do it. Let’s just do a point system, and as needs change, as long as they don’t creep to the next care level, we’ll just keep them here.”

What’s happened is operators have watched their margins absolutely diminish. So I think as operators, my first thought was, what are we going to do to make sure we’re getting paid for the great care and the servitude that these CNAs and staff are giving the residents? When we sit down with Sally and have that conversation, Sally’s like, “What do you mean you’re giving my mom more care? I don’t know what you mean by that.”

We’ve always normally had to lean on things that were extremely subjective. With the number of new technology coming into the space, from fall detection investments and all these areas, we really started to look at some of these firms and say, where are the opportunities that we see within that?

We don’t use half of the tools and systems as an industry we have access to today. I would say most operators, if they were truly honest with themselves, utilize their systems to 30% capacity on a great day. And so when we looked at nurse call, it was like, could this be more? Could we use this for data points to have conversations with families and allow them to do that? PalCare offered a way to harness data for more objective assessments and actionable insights, helping us address these challenges comprehensively. Their impact on Phoenix has been tremendous on multiple fronts, as they feed us information that’s amazingly digestible so that we can lead to action in a quick and decisive manner.

How did PalCare help you monitor nurse call data and identify residents in inaccurate care levels?

PalCare’s system aggregates data into a highly digestible format. This allowed us as the operator and management to look and say, “Sally has had 150 pulls this quarter, and Sally is a level two. That doesn’t make sense.” An average pull response time and interaction can be anywhere from eight minutes up to 20. So you take that and you expound upon that and you start to see, that’s a lot of data points. That’s a lot of time.

Previously, data collection during nurse calls was limited to timestamps without context. For example, when you went and did a nurse call, you just clicked the button and said, “I’m the caregiver. I walked in the room at 8:32 and hit the button and solved it.” You don’t know why she got called. You don’t know the duration of time she was in there. You don’t know any of that. PalCare’s integration enabled us to capture more granular details about each interaction, including the purpose and outcome of each call. This level of detail supports meaningful conversations with families, helping explain why adjustments to care levels are necessary and justified.

So now when I sit down with Sally’s daughter, I have data that I can use to tell her, “Here’s why we need to put your mother on a higher care level.” The insights provided by PalCare gave us the eureka moment that we had a bunch of residents who were not aligned with their appropriate care levels

What key findings and top trends stand out to you from the nurse call data?

I think one of the most impactful findings has been the ability to track system utilization and identify gaps in staffing. When we’re in an assessment and we’re trying to create a staffing schedule based on needs, when you can’t account for 40% of someone’s time, how do you have a staffing platform that allows those services to be done and not burn out your CNAs? They’re basically giving away a lot of free care, and we want to make sure we’re able to put the extra staff on the floor to still execute on care plans. I think looking at the amount of time outside of the care plan that you can gather through the nurse call data will identify more opportunities, but I think we’re still very early on.

Additionally, as we continue analyzing 90-day trends in nurse call data, we are starting to uncover key patterns, such as the most frequent reasons for calls. Currently, we have metrics on response times and call volumes, but PalCare’s capabilities are helping us evolve toward more actionable insights, driving better care and operational efficiency. I think understanding what PalCare had to offer was an even bigger “eureka.”

What measurable outcomes have you seen since adjusting care levels based on the data?

What it forced us to do right away was to analyze our own internal assessment tool. We redid it. We also made a portion of the assessment state-specific to address any state needs that were different. We laid out a pretty strategic plan on how we’re going to reassess through a new tool, and we’ve been able to find a bunch of residents who have been on level one for two years and then you go find out and they’re actually a level three.

Through the assessment tool, we’ve seen that 33% of the residents were not on the appropriate care level. That was just off of two data set assessments. We took 150 residents and were able to say that the average care level is anywhere from nine months to 15. Then you start to see the net effect on revenue, which is allowing us to get back to margins and allows our investors to want to continue to invest in the space. Right now, we’re all still chasing pre-pandemic margins.

How has that 33% impacted your staff and operational efficiency and your overall approach to data driven care?

It’s been amazing to watch the caregivers do a much better job on reporting what they’re doing. I think there were so many things they were doing that they were just kind of doing and not explaining. In their minds, they thought they were doing this great thing. “I’m going to take care of Sally because she’s a great woman and she’s been here three years.”

By allowing us to capture that data that they’re not reporting on, the care they’re giving that’s not being captured anywhere, we can now help support them in their roles.

Our caregivers are yearning for information. These staff members want to be a part of the process. They want to share it, but they need to know the “why.” PalCare’s platform fosters greater staff engagement by providing the “why” behind operational changes, and has created great fringe benefits on their buy-in. We’re still the pilot, right? But the staff have just had great feedback and I’ll even say the word “excitement.” They feel like they’re a part of a process of honing this engine to make it better.

What advice would you give to other senior living operators who are considering a similar solution?

The first thing you have to do is make sure you understand what you’re trying to solve. If you’re just trying to grab revenue, how are you going to reverse-engineer it? There are a bunch of tactical steps to get there. I think you need to look internally at your organization and I think the biggest failure in our industry we have in execution is we’ve got to have a champion of the rollout. Come hell or high water, they’re going to get the training executed.

Second, you need to know that you don’t just do it one time and roll it out. You’re going to have turnover. You’re going to have new staff. This is part of a process. Don’t run away from that.

Third, go into it with an open mind. Do not have a prescribed narrative of what this has to come to be. You don’t know what it’s going to be. We didn’t know it was 33%. We didn’t know it was going to create better communication. This is a time in our industry where you need to challenge a lot of what we’ve been doing. And I think we need to be okay with our model evolving.

In 2025, the senior living space will be defined by…

…consistent execution of your company strategy.

Editor’s note: This article has been edited for length and clarity.

Discover how PalCare can empower your senior living community with actionable insights and data-driven care solutions. Schedule a demo today to see how PalCare can help optimize care levels, improve operational efficiency, and enhance resident outcomes.

The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact sales@wtwhmedia.com.

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