Episode 08: Small Senior Care  Homes, Big Opportunities with guest Susan Ryan (The Green House Project) – Presented by Senwell Senior Investment Advisors

On this episode of The Investment Opportunity Podcast, we welcome Susan Ryan (Senior Director) with The Green House Project. The Green House Project is radically transforming the traditional nursing home by providing facilities that are much more similar to a large home than a traditional nursing home.

In this episode, we cover the following topics:

1. What is a Greenhouse home and what does it look like?
2. What’s the atmosphere like and what’s the type of care provided?
3. Why does this model work?
4. The differences between the traditional nursing home setting and The Greenhouse Project model.
5. How COVID has affected Greenhouse Homes.
   1. This is our most recent snapshot representing 254 homes (229 licensed as skilled, 24 as assisted living, and 3 as family care). Here is what was reported:
      1. 28% of respondents reported 100% occupancy
      2. 20% of respondents reported 95-99% occupancy
      3. 18% of respondents reported 90-94% occupancy
      4. 12% of respondents reported 80-89% occupancy
      5. The rest were below 80%. The mean average for occupancy is 89.7%. Those homes that offer short-term rehab were impacted by their inability to admit during COVID-19 restrictions, but overall the model has fared well in the pandemic from both a quality perspective (95% were COVID free) and occupancy perspective (89.7% occupancy rates).
6. The makeup of a who a greenhouse owner is.
7. What’s your relationship with owners? How’s your model set up?
8. The level of experience required to begin investing.
9. The Elevate Eldercare Podcast.

You can learn more about, and contact The Greenhouse Project:

• Website: https://www.thegreenhouseproject.org/
• Email: inquiries@thegreenhouseproject.org
• Twitter: https://twitter.com/GreenHouse_Proj
• Facebook: https://www.facebook.com/GreenHouseHomes/
• Greenhouse Blog: https://blog.thegreenhouseproject.org/
• Instagram: https://www.instagram.com/the_green_house_project/

The Investment Opportunity Podcast is presented by Senwell Senior Investment Advisors, a mergers and acquisitions advisory firm specializing in skilled nursing and seniors housing. The show is hosted by Ben Bohland and Brandon Bohland.

Want to watch the show? Visit our website: www.senwelladvisors.com/podcast

If you have suggestions on topics or guests that to invite on the show, questions or comments, please contact us. You can get in touch with us the following ways:

• Website: www.senwelladvisors.com/podcast
• Email: info@senwelladvisors.com
• Linkedin: Senwell Senior Investment Advisors – https://www.linkedin.com/company/26199139
• Facebook: Senwell Senior Investment Advisors – https://www.facebook.com/Senwell-Senior-Investment-Advisors-105891937461351/
• Twitter: @SenwellAdvisors – https://twitter.com/SenwellAdvisors
• Instagram: @SenwellAdvisors – https://www.instagram.com/senwelladvisors/

Contact Senwell Senior Investment Advisors for mergers, acquisitions and dispositions. Senwell specializes in working with owners and operators of skilled nursing (short-term rehabilitation and long-term care) facilities, assisted living and memory care facilities, independent living facilities, continuing care retirement communities and owners of bed licenses in Certificate of Need (CON) states or states with a moratorium on bed licenses.

Thank you for listening to The Investment Opportunity Podcast!

Susan Ryan, Senior Director of The Green House Project, is a leader in the strategic development of innovative thinking and cultural paradigm shifts. With international speaking and project management experience, she has served as an integral part of The Green House Project for 12 years and has led the team through key transitions. In the quest for quality long-term care environments that are accessible and affordable to all, Susan has sought to leverage lessons learned from research conducted on the Green House model to develop protocols and metrics to ensure growth and sustainability.

A social entrepreneur with a passion for improving quality of life for elders and those working closest to them, she offers a unique combination of skills in Nursing, Gerontology, Alzheimer’s and Dementia, and strategic marketing.
Susan has a background in nursing, with over 30 years of experience serving elders in a variety of settings across the continuum of care. She has been featured as a speaker many times at LeadingAge, The Pioneer Network and other high-profile conferences.

Episode 08: Small Senior Care Homes, Big Opportunities with Guest Susan Ryan (The Green House Project) – Presented by Senwell Senior Investment Advisors

Ben: [00:00:00] On this episode, we talk about small homes in senior care with big opportunities.

Intro/Outro: [00:00:07] Welcome to the Investment Opportunity podcast. We’ll educate you on the latest investment trends happening in one of the hottest real estate classes, skilled nursing and seniors housing. We will point out the risks so you can reap the rewards of investing in this growing and complex industry. And now your hosts, Ben Bohland and Brandon Bohland.

Ben: [00:00:31] Welcome to the Investment Opportunity podcast presented by Senwell Senior Investment Advisors. I am Ben Bohland, joined by my brother Brandon Bohland. As I said, we are presented by Senwell. Senwell is a skilled nursing and seniors housing mergers and acquisitions advisory firm. Today on the show, we’re joined by Susan Ryan. Susan is the senior director of the Greenhouse Project, the Greenhouse Project partners with senior living providers to create homes for elders that demonstrate more powerful, meaningful and satisfying lives, work and relationships. Their model homes include homes for 10 to 12 people with private rooms and bathrooms, and it harmonizes with the neighboring community. Susan, thank you so much for being on the show.

Susan Ryan: [00:01:20] Thank you for having me. Appreciate it.

Ben: [00:01:22] So if we can just get started. I’m excited to have you here today just because I feel like we talk about the greenhouse project a lot. But if you can just tell us a little bit about yourself and what you’re doing over there. That would be great.

Susan Ryan: [00:01:34] Sure. I lead what I think is probably one of the most innovative initiatives I’ve ever been a part of. We’re radically transforming the traditional nursing home and even assisted living. I really changing up the paradigm, really creating that physical environment we call real home. It’s really taking a look at the philosophical culture which we call relationship rich elder directed care or elder directed living. I should say. And that’s meaningful life. And last but not least, it’s the human architecture and really making sure that the locus of control is there with the elder and the staff working closest to that elder. So, it’s a paradigm shift. I happen to be a nurse, and I can tell you in all of my career, I have never seen anything so radical hit long term care as the greenhouse model.

Brandon: [00:02:34] That’s a good explanation. I have a question. So, Ben and I deal on a daily basis with operators, real estate owners, lenders, appraisers, all in the skilled nursing and senior care environment and the seniors housing environment. A lot of times when we mentioned the Green House project, there’s a lot of question marks that ensue from that point forward. So, I guess if you could walk me through a scenario where I go to a site of where a greenhouse project exist. What am I looking at on the outside? And then when I open the door to one of these houses and one of these homes, what am I looking at on the inside as well?

Susan Ryan: [00:03:24] You know, I wish we could go do a tour right now, because I think there’s nothing like seeing is believing. And it won’t look anything like the traditional nursing home. In fact, it would look pretty similar to a large home that would have ten or twelve private rooms. You walk in, it’s an open concept. I think that’s what I like in my home is my open concept, which has a fireplace on one end and my open kitchen on the other.

Susan Ryan: [00:03:52] Similarly, that’s a greenhouse home. So, the elements of real home, it looks like feels like it is real home. And I think that’s part of the magic of greenhouse. And we’ll probably get into talking about COVID-19 and the impact of COVID in a traditional environment vs. the impact of COVID in a real home environment with private rooms. They’re all on suite bathrooms within each of those rooms. Everything is decentralized so all the cooking is done in the home. The laundry is done in the home. So, when you think about it from that perspective, it looks like feels like is real home. But the magic in terms of the outcomes for elders, the outcomes for staff, with regards to turnover, staff, satisfaction, elder satisfaction, occupancy rates. I mean, I think that to me the proof is in the outcomes, whether you’re a nurse or you’re someone in finance. And it’s important that they’re not mutually exclusive to one another. We want high quality care, high quality of life, and we want a good return on the investment. And I think that’s what’s so powerful about this model, is that it enables both to happen. That’s win win.

Brandon: [00:05:13] And it does resemble Ben and I have both been on the inside of some of these homes. And it does really resemble you feel like you’re inside someone’s home, which is a great feeling and a great change of pace from the traditional skilled nursing model. Talk to me a little bit about some of the differences between what you would see in a home and versus one of these greenhouse projects. So, there’s rehab going on in the building. Right. And then there’s communal dining area where all of the patients and residents get together to eat and really enjoy meals together. I think that’s a little bit different today, my guess, than it was, you know, six months ago of how they interact with each other. Maybe, but maybe talk to us a little bit about the atmosphere on the inside and the kind of care that they’re getting.

Susan Ryan: [00:06:02] Sure, where everything is really focused on the individual.

Susan Ryan: [00:06:06] And I think this is where you get your efficiencies. And I think in my past life and again, I’ve been a nurse for a very long time, done long term care and home care. And I can tell you that economies of scale efficiencies were all around the building and how many people you could serve kind of at one point of entry, whereas at a greenhouse home, it’s so different and it’s family feel. And by knowing each individual person, by having consistent staffing support each of those elders, it really helps you to have those better outcomes. So, people typically in a non COVID where there are dining restrictions and they would be pulling up to a family table. That’s one long table with elders and staff sitting around the table. So, they’re smelling the aromas of the food cooking if they don’t like what’s being served. The kitchen is right there and they’re better able to address some of those preferences and they’re better able to take a look at weight loss then and how to prevent that from happening by offering all sorts of real food supplements that they might prefer eating at a point in time. Laundry is done there in the home.

Susan Ryan: [00:07:25] Every elder has their own room. They have direct access to me. This is this is huge and would be very important to me if I were in one of these homes. And that’s access to outside. So even in the pandemic, I think what was so exciting to me is that elders were able to get out in the courtyard. They were able to get some sunshine, social distancing, of course, but they were able to not be still confined to their room without feeling fresh air or sunshine on their face. And, I think that’s powerful. We had a community in Mississippi, actually, they described the quar-N-queue. They had instead of a barbecue where they really had a wonderful time getting the elders outside. Family members were on the periphery outside by the fence, but family members were able to see their loved ones. They were able to really socialize and have an event outside instead of being. Kind of sequestered or quarantined to the room in a traditional nursing home, which unfortunately that was the case for many. And I think researchers is telling us that social isolation is a huge problem with regards to COVID.

Ben: [00:08:42] Go ahead.

Brandon: [00:08:43] Oh, I think he did a great job of painting the picture of the inside. Now, you kind of let us through the outside. If I’m at a greenhouse project site. And so you had mentioned there’s typically 10 to 12 rooms per home. Are there typically more homes on the same street or in the same neighborhood? What’s the average mix that you that you typically see?

Susan Ryan: [00:09:08] So greenhouse homes are we are our largest community. We’ve got 16 greenhouse homes at one location, under one nursing home license. And that’s in outside Albany, New York. That was where they transitioned all 192 beds into greenhouse homes. And then we’ve got other communities that have determined they were just going to take ten or twelve beds out of their traditional nursing home. I always call it kind of the toe in the water. We’re going to test it to see what it’s like. And so, they built one greenhouse home or two greenhouse homes. If I would say an independently standing greenhouse home would be, I would say six is kind of our recommended under one license. That’s where to your thinking about economies of scale and efficiency. It’s where you’re going to have nursing staffing work better between six homes. You’ll have the costs, the overhead costs of an administrator, director of nursing spread over 72 beds. I personally we don’t typically recommend going lower than that. Some have. We have a couple homes in Penfield, New York, two homes, 10 people in each home, and they’re doing marvelously well under one license. So, it’s you can gain efficiencies. You work hard to figure out how do we gain those efficiencies and how can we make it work.

Ben: [00:10:43] So, Susan, for you, you mentioned economies of scale. So, I’m playing devil’s advocate here. So, if I am a traditional operator and I’m operating 60 to 100 bed nursing homes in a traditional environment. It’s tough for me to wrap my head around this because, A, this this model is smaller than what I typically work with and then B you mentioned economies of scale in that you have multiple roofs. You have to staff each individual home. Why does this model work?

Susan Ryan: [00:11:24] So let’s talk about how you make it work. And the first thing you need to think about is how do you control your development costs? And so we work really hard to make sure we’re looking at square footage. I’ve got square footage, greenhouse homes that have been built for, let’s say, 10 people there, about six thousand square feet. I have greenhouse homes built for 10 people that are over eight thousand square feet. And so, by smaller is better. You’re really able to control some development costs there. Your FFNE. What’s going in to really furnish those homes will be important. Obviously, where you build what you build, those sorts of things are going to be important considerations. The second thing is how you’re financing or funding your homes. And we’ve had the majority of greenhouse partners are not for profit and they use tax exempt bonds. But we’ve had some that are have been built in rural areas and they’ve used USDA financing. We’ve had some that have just gone to conventional banks and really been able to get a compelling rate with their conventional bank. Others have used capital campaigns as a nonprofit. They’ve brought a lot of equity to the table through fundraising. So that’s kind of the second thing.

Susan Ryan: [00:12:51] The third thing is really taking a look at the revenue and thinking about the three payor sources typically are Medicare, Medicaid and private. And so achieving the right payor mix is really important. We have folks that have been able to increase their private pay rate. We did a survey one time. There were some organizations and they said we didn’t increase our private pay rate at all. Others on the high end said, oh, we increased it like 55 percent. We increased it. They were getting a private room with an on-suite bath. It was a totally different model from what our traditional nursing home had been. I would say roughly it was more of about 11 to 15 percent average increase in private pay. If you think about occupancy and what occupancy rates are going to do, we did that survey. We were about 97, 98 percent occupancy rate at a time when the national occupancy rate was. I think it was eighty-eight at the time. That’s lower than that now. And the last thing to consider is your operating cost and where you will gain efficiencies there. So, it’s really interesting in the greenhouse model. It’s about a flattened hierarchy, which means that we are going to and it’s a universal worker.

Susan Ryan: [00:14:16] So the direct care staff they are doing the care. They’re doing the cooking. They’re doing the cleaning. They’re doing the laundry. And that means all your dietary staff and your laundry staff, and your housekeeping staff will go down. But your direct care staff goes up. Your nursing will also be going up. Your direct hands on nursing, but middle management, nursing goes down. Some other administrative functions will go down. We don’t want layers of hierarchy. We really want to just put our money where our mouth is or where the elders are and really make sure that we are resourcing them with the people that are working closest to them and able to support them. So development cost your operating costs, your financing. And looking at your revenue and your your payor mix, those in every state’s a little bit different in terms of Medicaid reimbursement. We have in that same survey; we have 42 percent of elders that were supported on Medicaid. It was an average across all greenhouse homes. And so it shows that, you know, even with Medicaid reimbursement in the right state, you can make this work.

Ben: [00:15:37] So it sounds like the staff outside of nursing.

Ben: [00:15:42] They are more generalists rather than specialists, and they take care of everything outside of nursing. Is that right?

Susan Ryan: [00:15:50] Generalist is one way of putting it. Yeah, so they have been equipped with one hundred and twenty-eight additional hours. They spend a week in culinary training. They spend a week just really kind of learning the home, learning the technology that supports the home, learning the equipment, the ceiling lift and, you know, the dishwashers especially. It’s a commercial type dishwasher. And so, you know, learning all of those things. Learning, budgeting, learning how to order their food and that sort of thing. So, they’re essentially they’re like a household manager. And that extra education, 48 hours are really spent around the greenhouse model and the philosophical shift, dementia care, communication, teamwork, so that you really are developing a team, a high performing team that will be in consistent, dedicated relationships with the people in that home so that they’re able early detection for any sign of illness. They’re able to know who likes what to eat. You can control the food costs. I mentioned weight loss earlier. They’re able to really make sure that people are eating. And by having the aromas in the house, it’s usually not a problem.

Brandon: [00:17:14] Could I think I just want to change directions a little bit and just really address the elephant in the room, which is COVID. We’re seeing a lot of the nursing homes get the negative attention in national media and I think a lot of questions people are having with their loved ones are should we move them into a nursing home setting? If we can avoid it, let’s figure out ways to avoid it or if there’s another solution, let’s start to look and do our research as a family and decide where we should be putting our family. Now, in the traditional setting, we are starting to see operators do a phenomenal job of mitigating a lot of these risks. However, with the model that you described, I think given the current COVID environment, there are so many benefits in the smaller home setting. So, do you have any figures or numbers that we can kind of walk through the talk about some of the differences between the traditional nursing home setting and the greenhouse project model?

Susan Ryan: [00:18:25] Absolutely.

Susan Ryan: [00:18:26] So we just did we’re starting a research study. We’re working with a research advisor, Dr. Cheryl Zimmerman, with out of University of North Carolina. She’s going to be our COVID research advisor. And so we’ve done our first round of data.

Susan Ryan: [00:18:44] I think it’s literally kind of hot off the press. And we took a look. We have a total of 300 homes. Those are active and in active greenhouse homes. We were able to hear back from 84 percent of them. So, it’s a total of.

Susan Ryan: [00:19:07] See, 200.

Susan Ryan: [00:19:09] 256 homes and of those we have. 11 homes that had cases in skilled nursing or individual elders, 32 elders.

Susan Ryan: [00:19:25] Had a diagnosis of COVID one death and and I’ll send you this afterwards.

Susan Ryan: [00:19:33] In the event that you want this. That was that that was licensed as assisted living. So. Ninety five percent of greenhouse homes were COVID free is what that data’s telling you. In assisted living, which to me, I find this kind of really interesting. We heard from 24 assisted living homes and there were fifteen cases and three deaths in assisted living. And then we’ve got two homes licensed as family care. It’s a unique designation in Washington State. And they were 100 percent they were COVID free.

Susan Ryan: [00:20:15] So that’s the data and that’s compelling, and I think it just it goes to show you how important environment is, how important, consistent staffing, and it really speaks to that versatile worker instead of having dietary folks coming in, laundry, folks coming in, housekeepers coming in. You have the staff that are going in and they’re doing it all. They’ve got that versatile household management kind of experience. And because they know who the elder is, they can pick up very quickly if somebody is not themselves. Maybe we should be, you know, in doing a COVID test or really certainly screening for symptoms.

Ben: [00:20:59] Yeah, I mean, that makes a lot of sense. There’s not a ton of people going in and out of these homes. There’s only very few that makes complete sense. And during all of this, where you’re taking any additional precautions, because you, Brandon, mentioned we’ve actually been in some of these homes before and it’s like you’re walking into a home but open concept and you walk in and then there’s a long dining room table where everybody congregates and eats. Are they just eating in their their own rooms?

Susan Ryan: [00:21:30] Yeah. Every state’s a little different in terms of what they would allow. We had some states where they would bring with that long table, they had an elder at one end of the table, an elder at the other end, and then they kind of staggered a couple on the other side. There’s typically a counter on the side of the open kitchen facing into the hearth area. And so, they had a couple elders there. So, there you’ve got six people that are able to have some sort of communal dining situation. They had a table they put outside so that some elders, if they wanted to have their breakfast outside or a meal outside, they could get outside and do that. So, they got really creative.

Susan Ryan: [00:22:16] And I think that small home environment that was so contained, they were able to do some things that a traditional building, they just didn’t have the luxury. Just private rooms with their own bathroom is huge. And if you’re sharing a room with someone breathing the same air and if it’s a centralized bathing area or you’re sharing the same bathroom, I mean, you know, you’re just you’re doubling your risk by having someone in that same room.

Ben: [00:22:46] Right.

Brandon: [00:22:47] Could you tell us a little bit you had mentioned before that a lot of the owners are nonprofit. Could you tell us a little bit about the makeup of who a greenhouse owner is and maybe why their focus? I guess why are there a lot of nonprofits in this space versus for profits? Is there any reason for that?

Susan Ryan: [00:23:13] It’s a great question. I think I’ve asked it myself. I’ve worked in for profit organizations and nonprofit kind of a mix, actually, probably more for profits. And I always thought I’m the same person, what’s driving the nonprofit. And I think for many of them, their faith based. And I think there is something in their mission that really resonated when they saw it and they said this is resonating with their mission. This is what we’re going to do. And I remember our first for profit when he came to the table and his feeling was this, he said that I believe that this will give me competitive advantage. And he talked about it used to be whoever has the newest kind of wins from an occupancy perspective. That’s where elders would want to go because it’s the newest it must be the best. But he said, I feel like I can build my greenhouse homes and next week somebody could open a brand spanking new traditional building. And I’ve got competitive advantage. And so, from an occupancy perspective, I’m going to do far better than because of that competitive advantage. He would tell you that he does good and he does well.

Susan Ryan: [00:24:32] And so it’s really that forward thinking provider owner that says there is a better way. And it feels a bit counterintuitive, but I’m going to figure out how to make it happen. And as he would tell you, failure is not an option. I’m going to make it happen and we will figure out how to make it happen. Interestingly, he built his first greenhouse community. He has four communities, 33 homes spread across those four will open another community with another 10 homes later this year. But his first community, he said he was kind of splitting it. He had built five greenhouse homes and then he did a 60-bed traditional new building. It just wasn’t quite sure if it was really going to work. He said that was the. Well, I wouldn’t say he said was the biggest mistake of his his life. But he did say I wish I had done that. And going forward, he didn’t ever do that again. And so he would buy a traditional nursing home and then transition all of those beds into greenhouse homes. His largest community is 11 greenhouse homes of 12 elders in each of them.

Brandon: [00:25:52] Yeah, it’s the old saying that once you have a taste of one, it you can’t just have one, right?

Brandon: [00:25:58] You say that’s a potato chips. It is a potato chip. I remember it well.

Ben: [00:26:06] Susan So what’s your relationship like with.

Ben: [00:26:10] The owners are you guys. How’s your model set up? Are you guys a franchise or how does that work?

Susan Ryan: [00:26:15] We are not a franchise. We are trademarked entity. And what that means is there are quality standards that each of the owners or providers would sign that agreement with us, that they are adhering to the quality standards associated with the mark. And then we have a technical assistance package. It’s our consulting package, if you will. We work with their architects and we have a design manual. We do a financial feasibility model and really help to kind of it’s built in with all of our staffing assumptions and just a ton of years of data that has gone in to inform this model of the financial feasibility model. We do a lot of leadership and team developments so lots of education about how you really embrace a new way of caring, a new way of doing traditional nursing home in a very modern way. So that technical assistance will take us up until they open the home. And then after that, they become part of. We call it the linked-up network, not LinkedIn linked up. And it really is to connect engage and impact. We really believe that we learn more from each other. And by staying together in this type of network, such as our data, our data, I think is one reason that it was a good reason to stay connected because we’re conducting that data and our voice becomes louder.

Susan Ryan: [00:27:50] It’s not just community A that had good data, but it’s all of our 256 homes have some pretty compelling data. 95 percent are really good. So I think that’s part of it. We do lots of webinars for them. We typically have a conference. We would have been in Little Rock, Arkansas, in May except for COVID. And we also have a model fidelity tool. And that tool is kind of this online soft assessment that allows different stakeholders that are engaging in the home to be able to see how well they’re living the core values of greenhouse. So you protect your investment in the brand to really make sure that. You know, you invested millions into building those homes, let’s make sure that you are living the brand and that they are assessed every year. We call them the linked up dues, their membership dues. That gets them the model and integrity tool. It gets them all these webinars. We have a password protected part in our Web site. So they’ve got all sorts of tools and resources we can bring in all sorts of focus groups and study groups and different things to just help help them get better. Help us to continue to innovate.

Ben: [00:29:10] That’s great. So, it sounds like it’s just it’s just a great support system. So, you guys take no ownership under each individual home, correct?

Susan Ryan: [00:29:19] Correct.

Ben: [00:29:20] That’s great.

Brandon: [00:29:22] Is it, I’ll cut in here? It doesn’t sound like if I wanted to invest in one of these, I would need a significant amount of experience. Just based on what you just described, it sounds like I can just partner with you guys and start working with you guys. Then in day one, you guys can help walk me through the process of investing in developing one of these greenhouse models.

Susan Ryan: [00:29:44] Absolutely. Yeah, that’s, it’s really interesting. I’m finding where it used to be, providers that were coming to the table. More developers are coming to the table and really trying to recognize that we need a solution, that there is a demographic shift as the boomers are coming and we’ve got nursing home model, that it’s a broken system, it’s been a broken system, but COVID has really exposed how broken and certainly all the flaws in that system. So, I think it’s an opportunity for developers to come to the table and say, if I were to do something, if I were to start from scratch, what would it look like? And I tell you, it’s the forward-thinking providers or developers that are coming to the table and saying, I’m going to push against the status quo. I’m going to really figure out what will it take to make this work. And I can tell you, it does work.

Ben: [00:30:46] It’s great. So, you’re also starting a podcast soon, correct?

Susan Ryan: [00:30:51] Yes, we are. We felt that this was an opportune time for us as well to start a podcast. It’s called Elevate Eldercare. And the idea is that we speak up and we speak out and we really want to kind of confront the brutal, honest truth about how did we get here? And what do we need to elevate elder care. And I don’t believe we one person, one organization has all the answers. But I believe by tapping into thought leaders, too, and diverse perspectives to really understand, what do you see from your lens, the way you’re looking, and how can we collectively come together and really create something that I think we have to look at funding, I think we have to look at a lot of regulatory reform. There are so many things, but I want to talk to these thought leaders and gain their perspectives and then listen, learn and call people to action. So hopefully we will do our part to elevate elder care.

Ben: [00:31:59] I don’t know who would ever start a podcast.

Susan Ryan: [00:32:02] Yeah, right.

Ben: [00:32:04] It sounds like a terrible, terrible idea.

Brandon: [00:32:06] If it’s anything like the job you’ve done here as a guest, I’m sure you’ll do phenomenal as the host of that podcast. So, we look forward to listening to that as well.

Susan Ryan: [00:32:16] Well, I took notes from listening to both of you. So, the only thing is I don’t have a twin.

Brandon: [00:32:25] Yeah, video effects and audio effects can do great wonders.

Susan Ryan: [00:32:30] It’s amazing. And I’m glad I have the video because otherwise I I’d be clueless. In fact, I still don’t really know which is which. But anyway,

Ben: [00:32:40] I respond to Brandon. It’s not a big deal.

Brandon: [00:32:44] Susan, what is the best way for people to get in touch with you or or anyone at the Greenhouse Project?

Susan Ryan: [00:32:51] Sure. Our Web site is the best place. It’s thegreenhouseproject.org All lower-case dot org. of course we’re on LinkedIn, Facebook, Twitter, Instagram.

Brandon: [00:33:05] We will put all of that in the show notes as well as if it’s available. Link to your new podcast. And I certainly appreciate you taking the time to be on the show with us today.

Susan Ryan: [00:33:18] I loved it. Thanks so much for having me.

Ben & Brandon: [00:33:20] Thanks, Susan. Thank you. Take care. All right.

Ben: [00:33:23] Hey, thanks for listening to the show. Susan was a fantastic guest, and the greenhouse model, I think, is just something completely unique to today’s environment. And just as a reminder, if you go back to the end of episode two and that what you got segment, we showcased a greenhouse that we currently have available for an acquisition. So, go back and listen to that. But in this week’s What You Got segment; we’d like to showcase an opportunity that’s in Ohio. It’s in a rural setting. It’s a smaller facility. That’s a combined skilled and AL facility. It was built about 20 years ago. Currently at break, even EBITDAR. And it does have significantly lower Medicare Medicaid reimbursement rates for other facilities in Ohio. It does have quite a bit of upside. So, if you would like to learn more about this, feel free to reach out to me directly at Ben@senwelladvisers.com. Thanks for listening. Have a great week.

Intro/Outro: [00:34:25] Thank you for listening to the Investment Opportunity podcast. If you want to hear more about investing in the skilled nursing and seniors housing industry, head to our Web site at www.senwelladvisors.com/podcast.