SPEAKER_02 0:00

Hey everyone, Charlie Day from Day to Day Senior Care. Welcome back. Uh, first again, as always, I just want a quick shout out. I'm so grateful for all the new subscribers that came on over the last week and and everyone that's been on since uh since we started back in February. Um, and to all the those that are coming by to view, thank you so much. Really appreciate it. But tonight we have a very special guest, uh, personal to me on our On the Road series. Now I didn't technically I said I was gonna stop in and visit people on the road, but this one it's a little too far because he's he's in the Bronx. His name is David, and David and I worked together uh for I guess close to a year at the uh at one of the casena buildings, um the East Neck. And uh he uh was the assistant administrator and he joined me. And uh there was just so much we wanted so much that we both learned from each other. Um, but more importantly, the reason why I reached out to him is because of where he where he was when I started and where he is now. Okay. Now I'm gonna use a little script here so I don't because I tend to go all over the place, but I want to um I want to uh first say that um today's guest is someone who defines what it means to wear many hats, and that is for sure. And and look good in all of them. He's been in the trenches of operations, he's mastered the cloud complex world of regional culinary services, and he's climbed the mountain, so to say, to become a New York State licensed nursing home administrator. A very, very uh tedious task indeed. Um please welcome my former right hand and longtime colleague, David Koskovich. Hello, hello. How are you, David? Not bad, not bad.

SPEAKER_00 1:59

Thanks for having me.

SPEAKER_02 2:00

Yeah, absolutely. Um so for our listeners who don't know uh our history, you and I go way back. We weren't just um you weren't just my assistant administrator, you were simultaneously juggling a regional director role for colony and food services across multiple facilities. So a question that I wrote that I wanted to ask you tonight is looking back at at those double duty days, how did managing the kitchen, the heart of the facility, prepare you for the administrative side of healthcare?

SPEAKER_00 2:34

So the food service side of things definitely prepped me on, you know, learning customer service, you know, in whatever facility you're in, whether it's a hundred beds or a thousand beds, you know, dealing with food, you're always gonna deal with complaints. You know, we never when it comes to food, you're never gonna please 100% of everyone. But you know, the best we can do is just, you know, our best. Um, so you know, juggling families, patients, um, listening to concerns, doing what we can to, you know, ultimately make the patient happy, um, you know, kind of paved the path for customer service and really just trying to hammer that down with myself, my colleagues, and you know, everyone in my facility now.

SPEAKER_02 3:17

Yeah, how how how big is this facility that you have there in the Bronx? How many beds? We're uh up over uh four uh 524. Wow. For your first role as an administrator. I was all nervous when uh I got my first role was a 280 bed, and I was like, oh boy, this is gonna be some challenge.

SPEAKER_00 3:36

Yeah, luckily for me, it wasn't any uh it wasn't a new facility. Um I started here back in 2017 in the kitchen. Okay, so I was familiar with the layout, the staff, um, you know, even some patients. So, you know, it was it was a nice transition for me to come back to pretty much where it all started. Um, okay.

SPEAKER_02 3:58

Yeah, so that's where you actually were in the in the you know in the trenches with the food service personnel at the time and learning that modem that mode of of operation in the department. Exactly, and all the moving parts involved. Yep. Nice. Um yeah, I mean, I know food service in a nursing home facility is um one of the most scrutinized departments by both uh residents and surveyors, as as us administrators know. But um you were managing that a regional um at you you're managing that at a regional level while learning the ropes of administration. Can you discuss um like um the transition from plates to policy? In other words, you know, how you were uh doing that role and then starting to encompass through uh education and experience, real life experience, to the role of an administrator.

SPEAKER_00 4:58

Yeah. So, you know, ultimately I went to school for hospitality. So food service was always something that I wanted to do. Um never never thought that I would be in long term um this soon or ever get my nursing home administrative license, but you know, here we are. Um, so yeah, I started as a dietary aide, um, worked my way up, supervisor, director, um, and then regional um before doing my you know AIT and ultimately taking my exam. But you know, juggling both, you you you kind of learn what works, what doesn't work. Um, you can take the good, take the bad, and kind of run to the different facilities. Every every building's different, every kitchen's different. Um, but there are things that work, and you know, ultimately the biggest thing that I I've learned is just you know being present, being able to speak to the patients and you know, not just you know, pass pass the buck, you know, be be be the face, whether any department, you know, even uh good mornings, hello, smiling, be out and about, um really helps. And then a good team around you ultimately. I mean, I'm lucky enough to have a really, really good bunch of food service directors that I was able to work with throughout the years, um, who I you know still work with daily today. Um ultimately wouldn't really be able to do the job that I was able to do without without them. So, you know, it's all a big team effort, and that's it.

SPEAKER_02 6:30

Yeah, no, I mean, and you know, working with you for that, you know, even though it was about a year before I went to uh another facility, um, you know, I even though, you know, we we of course we banged heads sometimes. I'm old school and I'm I'm slowing down in my you know my career. It just comes with age, I guess. But um, you know, I I was a lot chippier back in my 30s and 40s working in uh administration in assisted living buildings and everything else. Um, but you know what? I I looked at you and I said, this this guy is gonna this guy's gonna do well because I've seen a lot of people, they try, they come, they even back in the days when I was growing myself up, working as a case manager and um eventually a director at another assisted living facility. But I've seen people that tried over the years and decades and they just couldn't do it. It is a special breed. Doesn't matter how much education, right, David? It's what yeah, exactly.

SPEAKER_00 7:26

How well it's it's not a paycheck. It's you gotta wanna do it, you have to wanna, you know, make a difference in everyone's lives around you. And you know, it's not something you can just come in, punch in, and punch out and not take it home with you. Uh, you know, we're dealing with a population that, you know, this is their home and we have to treat it as such. So this is a 24-7, you know, position, and you know, it's got good, it's got it bad, it's got its ups and downs, but you know, it's very rewarding.

SPEAKER_02 7:54

And so you have you must have at least uh I hope so, at least two admin assistant administrators under your uh leadership.

SPEAKER_00 8:02

I do have two. Um yeah, both of them are really, really great. One, believe it or not, today we actually just celebrated his uh 20th year anniversary in the facility.

SPEAKER_02 8:11

Wow. Okay.

SPEAKER_00 8:13

He's another one that worked his way up. He was um security for a long time. Uh head of security, um, and then assistant administrator for you know five, six years now.

SPEAKER_02 8:24

Nice, nice. Yeah, that that's that's great. And the other the other person is uh is he uh um someone new that's gonna go under your wings and learn the uh yeah, he's a new hire, started about a month ago.

SPEAKER_00 8:35

Uh young young guy, uh hard worker. Um, you know, started out the same way I started out with working. He was uh working in the the local gym, you know, so his customer service is is great. Um he deals with a uh all age groups, and you know, so far he's been a rock star.

SPEAKER_02 8:54

Nice, nice. And and you know, to take on that role too, and and then to be able to train, you know, assistant administrators brings you more more knowledge, gives you more um, you know, more of that resilience to go on and on with your career. And you've got a you know, you've got many decades to continue to grow. I'm just it's just great to see you at the in this role now. Um and uh yeah, so I'm trying to think of something that we used that we uh we shared that I know it was very intense. Yeah. I know one thing was um was learning the um like catching up with the times, you know, a lot of the uh uh quality assurance, uh quality control programs that you and and Mike, Michael, and everyone else had set up, although it was a lot of a learning curve, I still respect all of that because with you know, seeing that in a place as opposed to going in and trying to wing it with you know different um things. You want could you want to share a little bit about um just the way um quality control is is helps to um you know to do all those other things in the building to maintain compliance?

SPEAKER_00 10:10

Yeah, of course. I mean, you know, we're we're we're set up where you can come from the outside, you can come as brand new first time working with us. Um and and the structure that we have set up, uh this building and all buildings, it's really just set up for success for yourself and for your staff and patients. Um, you know, there's not a single part of the day that you won't have a task or an answer. Um, and if you don't have an answer, there's how many people to reach out to. The support is unbelievable. Um and you know, everything that we do, we do it for a reason, there's a purpose. So, you know, they they really just set everyone up to succeed, and it's just been great.

SPEAKER_02 10:58

Yeah, Cosena Care has a great, great program. Um, and they have quite a few facilities too throughout uh Suffolk and Nassau counties. Um, a lot of our clients and uh families. I mean, we you know that there's you know, when it comes time to choose a nursing home, um, you know, they they want to know, you know, they want to know uh how well, you know, the inside, how well the uh the right from the nurses' aides to leadership, very important for them to know. And many families don't even know really anything about the nursing home environment. So I get questions asked by my clients, families. Well, I don't know if if dad's gonna have to go in a nursing home, what's it like, and this and that, you know. So education is very important. Um, so that's what we're trying to do also with our Care with Confidence podcast series. We try and get into the assisted livings and and and the nursing homes just to let families and future clients of families know uh you know what to expect. So if your loved one is at that point where they're going to move on from home care back into a nursing home, you know, rest assured having that knowledge is so much better when you make that transition. So I just you know wanted to share that. Um so let's see here the achievement. Um oh yeah, yeah. The the administrator and training uh process and the New York State boards are no joke. You've you've officially leveled up on that. Um but uh can you just share with our audience just uh because there are a lot of people that are at that point where they want to decide whether they want to go assist a living director or they want to go into nursing home. Do you want to uh explain a little bit about how you prepared for that exam? The exam and and anything else?

SPEAKER_00 12:47

Yeah, yeah. I mean, the exam itself is a lot. It's you know a two-part exam. Um really just hammered down all sorts of studying. Um, there's a ton of books. I I did a lot of um training modules, the courses and prepped like that. Um, a lot of which you'll be surprised of what you know without even you know studying too much into it just by doing the administrator training. Um you just learn a lot on the fly, and then as you read it on the exam, you're like, oh, I know I I know that, I I know this, I know that. Um and then it just reflects into the real world. Like when you finally get your license, you get your job, and you see what the day today is like. Um and it is a lot of studying, it's not an easy exam. Um, I I think I studied for about six months prior to my exam leading up to it. Luckily, I only had to take it one time.

SPEAKER_02 13:50

So I'll always admit I had to take it twice. The first time I didn't make the score, I was off just and it it was it whatever. But I went I studied again, and then I then I actually the the numbers were much higher than the original. Yeah, so I think I I just missed something the last time, you know. But yeah, it's it's not you know, you definitely have to have some education before you prepare and experience before you take that test. Oh, absolutely. Yeah, absolutely.

SPEAKER_00 14:20

A lot of life safety, a lot of I got lucky. It was a lot of life safety, you know, housekeeping, dietary questions, and you know, those three are what I was doing prior to. So it was, you know, a good exam for me. Um, and you know, once you pass the exam, you you you kind of just put that knowledge to the test every day, and you know, you continue to learn and just grow.

SPEAKER_02 14:43

Yeah, absolutely. Absolutely. So, um what's the biggest piece of advice, David, that you would give to an aspiring um assistant admitter uh administrator looking to take the next step?

SPEAKER_00 14:58

If you're looking to take the next step and and you're already an assistant administrator, you're you're you've taken your classes, you have completed your AIT, your you know, your next step is to take the exam. I you know start start hitting the books, um, schedule your exam, give yourself however many days you need. If you're a good test taker, I'm not a great test taker. So I I I was the week prior, just tons of practice exams. Um, but if you're you're considering doing this and you're looking into an AIT program or you know that you're thinking about this field, I I I would recommend it to anyone. Um, I would definitely recommend doing a little bit of everything. Um the way that you know we train our assistant administrators here is we'll we'll pair them up with each department so you have an idea of everything uh from top to bottom. Um, you've done it all, you know it all. Um and you just ultimately know A to Z what goes on in a day. That's that's you know ultimately the only way you'll have a better idea of what to expect and what you are expecting of everyone else. Okay.

SPEAKER_02 16:14

All right. No, that's good advice to know. That's good advice to know. So I'm trying to think one of our uh one of the times that we uh we had some good laughs together. Um I remember uh when we had that, uh there was a uh was it the holiday party? Yes, I believe it was the Christmas holiday party. And it was just it was great to see all the residents, you know, partaking and in in, you know, in um all the festivities. And I remember you running around and trying to make sure that not only you had to make sure, you know, your assistant administrator stuff, but then you also had to worry with the food and and making sure they're bringing up the right uh presentation for the food that was being put out. So um all right, let me let I'll ask you a last question. Oh yeah, was there anything that you remember too that we had done together that uh trying to think about it? I know we did, I know I remember, oh yeah, yeah. Do you remember the a very memorable moment, okay? Is when uh David got the assignment from from above from the ownership, and uh I was shared with the news too, but it was time to do some renovations, remember? And we had that one floor that we had to concentrate on, the first 10 beds. Yeah, see people don't know. Everyone thinks, oh yeah, yeah, it's roll rosy, I'm gonna be a leader, and I'm gonna, but you and I we had to roll up our sleeves.

SPEAKER_00 17:45

Yeah, you have to do it because right.

SPEAKER_02 17:47

I mean, some of the people that were doing the job in there just weren't doing it right. And I I've seen you like, you know, you're getting a little, you know, assertive, and it's like, let's get this done. You know what? If we got it, we're gonna move these these this furniture out of here, and we're gonna get them to finish the floor in the kitchen, you know, in the in the bathroom. Because, you know, you're up, you know, you're taking residents off the floor and putting them temporarily somewhere else, and at the same time, you're trying to make sure that the you know the these uh rooms are getting done. You remember that process? Oh, yeah, yeah, yep, very well. I know so people don't people don't know that there's a lot more than just running a uh a nursing home. But um, and uh as a former culinary director, what is the one meal that can actually make or break a residence day?

SPEAKER_00 18:35

The one meal that can make or break a day is a hot breakfast. If breakfast is warm, the rest of the day is gonna be great. If breakfast is not up to par, then you know, it just sets the mood for the day. Um, you know, which is why my biggest meal is push breakfast, make sure breakfast is on time, presentation looks good, it's hot, patients start their day happy. They can, you know, they're on time for their activities, their rehab, whatever they have to do. And then, you know, lunch comes around. Everything, you know, once breakfast is on time, the rest of the day flows through. Um, so a nice hot breakfast to start the day is just best.

SPEAKER_02 19:17

Okay. Excellent, excellent. And I did have something that was off script. I I remembered it earlier, and now I remember again. I wanted to ask you, um, you know, that there's a big shift going on in the healthcare industry. Um, we we're at a point now, I'm noticing more and more of this gray quote unquote wave where people, if they're gonna go into a nursing home, they want certain, you know, certain amenities, they want to um, they're expecting their expectations are much higher. Um, and you know, we're getting a whole new generation of people that are coming in now. So the Frank Sinatra music of the past, all that stuff is changing. Um what would you um as at your nursing home, what are some of the more more modern things that families should know about um you know the way we're able to service our residents? Something that yeah.

SPEAKER_00 20:18

Um it's definitely staying with the times, and you're right, you know, the older generation is now um, you know, like the Frank Sinatras and all this, you gotta keep up with the times. So we actually started to look into um virtual reality for you know our recreation programs with the patients, which is unbelievable.

SPEAKER_02 20:40

Um you ready to start getting some a AI robots to go in and do some with the trays and putting the trays on the residents and coming back, so it's one yeah.

SPEAKER_00 20:53

There's actually a um a sushi spot kind of out by you that has one of those guys, and it's crazy how far we come. It's I know I know so I I I wouldn't doubt it in the future. I don't know how far out we are from that, but I wouldn't be shocked.

SPEAKER_02 21:12

And the other thing, David, I noticed, you know, after all my decades working in buildings, this is all new. My second year, and the need out there is incredible. I mean, we we started, I did my first four clients from April, because January through April was just, you know, paperwork, getting the LC, all that stuff together, getting the you know, the bookkeeping together, all that stuff. And then after that, it just started to we ended the year with 12. We started the first quarter, we acquired more up to like 16, and then we have a few on a not a waiting list, but just as soon as Mrs. Jones gets out of Girwin because the husband wants her back home for 24 hour care, you know, situations like that, it's just there's so much of a Need or I get a phone call. Oh, could you help my dad? It's only going to be two hours uh a week, or two hours, you know, two hours twice a week. It turns out they need they need us in their full time. So what I'm seeing is there's an explosion out there of people that need services from east from Suffolk to Nassau, and people are trying to hold themselves independently in their own homes for as long as they can, even before stepping into assisted living. I have a family right now that's the mom wants to go, but dad does not want to go into the assisted living, and he's 95 and she's 91. So what are we gonna do? We're gonna continue to service companions until that transition may possibly come. Um, and then with the nursing homes as well, people are um if they're going into a nursing home, it's usually they had a fall or an injury or something that brought them from the hospital into the rehab, and then well, you know, right? You you have a subacute uh unit that they're coming. What's your average um you know, stay? Them coming and going, wound care coming in and coming out.

SPEAKER_00 23:14

It's quick, it could be as little as uh you know a week to a few weeks. And you know, we have a great rehab team, so you know, it's it's it's a quick turnaround for them.

SPEAKER_02 23:26

And that's the thing too. Um, the advance in technology with the rehab now, rehabs uh in nursing homes are becoming more and more, you know, um uh what's the word for it? More and more um a part of the growth in in um medicine and science and all those recreation things to be able to take care of these people, correct?

SPEAKER_00 23:46

Yep, absolutely.

SPEAKER_02 23:48

Okay, so that's what families should know. Well, okay, we're getting close to the end. So one last thing, because I know you did a lot of traveling. What's the one song or podcast that kept you sane while driving between all those facilities? Because you were in Eastnack, you were off, then you're like, I'm over, I have to go into the city, the Bronx, then you're shooting in the Rockaways.

SPEAKER_00 24:13

So honestly, it's one of two things, and it depends on the day and the time. Uh, it would be the Michael K show, okay, or it would be nothing.

SPEAKER_02 24:26

Okay.

SPEAKER_00 24:29

Enjoying the ride. Yeah. I was lucky. Some of the some of the trips were you know very nice, you know, along Ocean Parkway, passing the beaches.

SPEAKER_02 24:38

Um, yeah, I like that too. Yeah, I like that too.

SPEAKER_00 24:41

Some of the drives were nice, and it was uh it's it was nice to just unwind sometimes.

SPEAKER_02 24:46

And before we wrap it up, David, what do you do for R and R? What do you do to escape? Because now you're you're corporate level now. You are an administrator with a assistant administrator too. What do you do to to unwind to get away? And I think I may know one of your answers. I'm hoping you're still that's one of your hobbies or interests, but so still an outdoors kind of guy.

SPEAKER_00 25:08

Nice. I uh well me, my sister and I have some trips planned for this summer to camp out on the beach. Nice. But you know, a lot of I've been mixing in a lot of weekend trips, just getting away. Um, you're never fully away, but it's just good to unwind and slow down a little bit.

SPEAKER_02 25:25

Um but yeah, no, that's that's good. I mean, on a personal note, um for my viewers too, one thing that uh David and I were uh very uh you know enthusiastic about, and we shared a lot of things was the fact that uh we both were avid uh campers. We enjoy camping. I had shared with him something I didn't even know it was going to come to be this you know senior care camping getaway weekend thing. I just told him I want to get a place up in the woods, I want to take a camper up there, and I just want to live in Maine sometime because I, you know, I did a a year and uh close to two years of an assisted living nursing combo up there during the height of COVID, but um I took away that that Maine love for Maine and the camping. So yeah, so you're still uh still doing all the camping, RV or whatever.

SPEAKER_00 26:18

It's hard for me to get away for a week at a time because they haven't fixed the cell service up in the mountains yet. That's true. It's hard for me to not have cell service for that long, but you know, the the weekend beach trips are nice. Um I think I'm gonna be going on a cruise in about a month. Nice, nice little five-day cruise, extended weekend. Um, but yeah, no, it's uh it's been good.

SPEAKER_02 26:44

All right, excellent, David. It was great um having you come on our our On the Road series. You're one of the first of uh yeah, I got a long year ahead of me. Uh, but I have a couple of people that uh this other guy, Glenn, we uh he's coming up on soon. Him and I worked way, way back in the 90s in assisted living. Then we took a night job because I we we worked at the Southside Hospital doing psych aid at night. So we would work, we would leave the island here after working all day, do a six to midnight, get back to work the next day. We were young then. He went separate way. I went with separate, then we went back again when when I took on a uh 200-bed facility in Riverhead. It was called the Henry Perkins Adult Home. And uh we went in there, we were we stayed for a year, fixed up the place, got the plan of corrections done. He sold the place, we moved on. He wound up becoming executive director at benchmark assistant living down south, and he's been in that career since. And me, I'm already semi retired. He was younger than I was, but yeah, I'm gonna have him on soon, too. David, it was great, it was great having you. Thanks for having me. Yeah, I hope to talk again soon.

SPEAKER_00 27:51

All right, all right.

SPEAKER_02 27:52

You have a great evening.

SPEAKER_00 27:53

You too. Take care.

SPEAKER_02 27:54

Take care.