How Illinois Froze Nursing Home Rates for 26 Years While Piling on 900 Pages of Rules

Vance Crowe [00:00:04] As the crow flies on the Vance Crow podcast, Jeremy Osh, welcome to the podcast. Thanks

Jeremy Lakosh [00:00:12] For having me, Vance.

Vance Crowe [00:00:14] Jeremy, you are one of my more unusual guests right now in the middle of a global pandemic and rioting, looting all of these problems. You and I had a chance to cross paths and what you were telling me about senior assisted living facilities in the United States, specifically you're in Illinois, was mind blowing. And I thought, man, I wanna get Jeremy on as quickly as I can because everyone, everyone, everyone in our society is touched by senior living. These are our elders, these are our wise people, these are our ancestors, the people that, that brought us to this place. And it sounds like it is very, very difficult to care for them now. So I wanted to bring you on and talk all about it. Jeremy, tell me a little bit about yourself. Who are you and what is your role in, in senior living right now?

Jeremy Lakosh [00:01:04] So I was born and raised in Canton, Ohio. I grew up there, went to high school there. I graduated from, came to Eureka, Illinois in 2001. Graduated from Eureka College, bachelor's degree in history in political science. Went on, went back to Ohio, got an MBA at Kent State University in oh seven and didn't enter the senior living space until 2010. When I moved back to Illinois, I became director of finance at a not-for-profit retirement community in Bloomington. Was there for five years, and then came back to Eureka as the chief financial officer of a faith-based not-for-profit retirement community in 2015. And I'm still there today in the capacity of CEO of what is the remaining entity, which takes care of independent living seniors, residents.

Vance Crowe [00:01:59] So what is going on right now in the, in the state of senior living? All I know is that it's very expensive. People seem to, you know, you want your elderly people taking care of, but that it's just, just growing rapidly on how difficult and expensive it is to, to manage it.

Jeremy Lakosh [00:02:19] So a lot of people will look at a, a consumer will look at the cost of skilled care in a nursing home and they'll see, you know, $180 a day or, you know, 6,000, $7,000 per month. And they'll say, man, why is this so expensive? Well, a couple of reasons why it is expensive. You are asking staff to take care of your loved 1 24 7. So it's very labor intensive. That's the first aspect of it. But the second aspect is that it is also heavily, heavily regulated. The government has so many requirements for skilled care facilities that I consider the government to be a nursing home's largest customer, because not only are they paying the biggest bills in Medicare and Medicaid residents, but they're telling you how to staff the facility, how many hours, what are the qualifications staff must have. And to give you just a a small example, Vance, the CMS Medicare regulation book for skilled care facilities is right around 900 pages. So you've got all these regulations that you have to follow and, and each one costs money.

Vance Crowe [00:03:32] So, so tell me about this. When you say they're the largest customer, I didn't even realize if, if Medicare and Medicaid that covers senior living.

Jeremy Lakosh [00:03:42] Yes. So just in skilled care. So in a, in a nursing home setting, Medicare, they're, they're two different situations. Medicare and Medicaid. Medicare would be, if a loved one of yours fell and broke their hip, for example, and the doctor says you need rehabilitation therapy before you go home. They would go to a nursing home for a period of under a hundred days. They would get physical therapy, they would get skilled care that is paid for by the federal government through the Medicare program. Medicaid is federally subsidized, meaning the federal government pays part of it, but it's actually state run. So in Illinois we have a separate Medicaid system that is for people who have long-term care needs, maybe they're diagnosed with Alzheimer's dementia, they're going to be in a nursing home for the rest of their lives, and they don't have the money to afford it. So they go through a Medicaid application process and they end up becoming residents who the, the state government, the Medicaid system covers the difference between what they can pay and what it costs to have them.

Vance Crowe [00:04:56] And what sort of care is that, are people that can't afford to pay for it, are they, you know, eating every day and, and things are well taken care of?

Jeremy Lakosh [00:05:05] Yeah. In, especially in faith-based, not-for-profit nursing homes. You can walk through and you would not notice the difference between somebody who is a Medicaid resident and somebody who's there on private pay. It, it there they could be roommates. They receive the exact same care. The only difference is, is the payer who's writing the check. And, and for the, from the facility side, I should add, the amount of revenue they're getting from the Medicaid resident is usually substantially lower than the amount of revenue they're getting from the private pay resident.

Vance Crowe [00:05:42] Wow. How is that possible?

Jeremy Lakosh [00:05:44] Well, it's, it's a combination of things. So in Illinois, the Medicaid rates for skilled care facilities have been frozen since 1994. So for 26 years we've had the same Medicaid rates, even though we've had 26 years of employment raises, 26 years of increased regulation saying you need more and more staffing, 26 years of additional costs for administering care, but no additional state support. So what do you do? You charge your private pay residents more and more and more to cover that cost. So you have a situation where a Medicaid resident, and I'll give our facility as an example, we had Medicaid residents who were giving us as little as $108 a day and we had private pay residents up around $200, or no, excuse me, $230 a day. And again, that's the, the payment difference. And you're getting the exact same care and services.

Vance Crowe [00:06:43] So, I mean, this is mind blowing to me because it, there's no situation where people would work for 26 years at the same rate. I mean, inflation itself would just eat that away. If you're, if you're looking back in the early eighties or whatever, maybe mid eighties for the payment schedule, when, like, do you have people that you complain to? I can't imagine that a, that a business or even a not-for-profit just takes this lying down. How do you respond to this?

Jeremy Lakosh [00:07:11] So unfortunately, my, my prior employer really did take it lying down. I mean, they just kind of, they kind of put bandaids and, and glue together as much as they could for as long as they could until I, until I came in and when I got in, things were so bad, Vance that we had maxed out our line of credit. We had no cash left. We basically had six weeks of solvency remaining in the, in the operation. So I was forced to not take it lying down essentially. And so what you do is you have to play, you have to play this game where you put pressure on, in our case it was Macon County Medicaid. They're the ones that review the applications, make the determinations. You go to your political leadership and you say, look, this, this Medicaid rate isn't sufficient to cover the cost of, of a resident. You know, I used that $108 a day rate earlier. We did a study and found it cost us 106, $168 per resident per day. So we had a $60 gap and we didn't have enough private pay residents to cover that gap gap. So, you know, you, you, you play this game of essentially hardball with people where you guys say, Hey, look, I'm making the best of what I can with this situation. And if you think I can do better with these same rates, I'm all ears. The suggestion box is wide open as to how I can provide better care while losing money.

Vance Crowe [00:08:48] I, I mean, this is such a tough spot. I, I knew that this would be a good conversation, but I really didn't realize just the moral hazard that you run into right here. Because, you know, as I'm sitting here thinking, well, it's not fair for the private pay person to have to pay double and for the business to have to handle this. But then at the same time, you turn to the person that doesn't have anything and you want them to get care. We, we live in a, in a wonderful country. We have bountiful food, we have electricity, we have shelter, and so you want everybody to be taken care of. But how in the world do you navigate this?

Jeremy Lakosh [00:09:24] Yeah, it's it, and, and unfortunately Vance in Illinois, things were even worse. We, we were notorious nationwide for waiting 6, 7, 8 months to pay nursing homes. So you'd provide care for 6, 7, 8 months and it'd take that long for the state to pay you. But it gets better. It gets better. We had, we had over a dozen residents when I walked in the door who their applications were pending with the state of Illinois for more than three months in one case, or no, excuse me, two cases. We had been waiting over a year. So you have to wait. So the state doesn't process the applications in a timely fashion. You're waiting maybe a year, and then if they approve you, you gotta wait another six months to get paid. And so you, you'll give 40, $50,000 worth of care to somebody and literally just cross your fingers in the hope that the state gets around to, to approving them and paying them. And if they die during this process, everything gets dropped and you never get paid a cent.

Vance Crowe [00:10:32] No way.

Jeremy Lakosh [00:10:33] Yeah.

Vance Crowe [00:10:34] So, so what happens then, if you start getting super behind on getting payments from the state, you have these people that are either not paying or not paying the full amount. Do you turn them out? What, what happens?

Jeremy Lakosh [00:10:49] So, no, to my knowledge, no skilled care facility has involuntarily discharged a resident because of this. But we almost became the first, you know, things financially were so bad for us. The state owed us so much money, we were losing the equivalent of a million and a quarter per year. So easily, easily a hundred thousand dollars a month. We had no credit line, no cash. And so we, and then we had a resident die who was about 18 months waiting for an application. So we were out almost a hundred thousand dollars on this person. And that's when I went to our CEO and said, enough's enough, we've gotta come up with a way to fight this. And the way we thought it was, the regulations actually state that if somebody hasn't paid in a four month period, you can remove them from the facility. Now you gotta do a lot of things in that 120 day period. You can't just say, okay, bye, you've gotta do a lot of things. So we started that process with approximately six residents In an effort to get the state to, to basically do their job. And, and ultimately vance ultimately, like in the case of one resident 18 months, we had waited a Korean War veteran advanced Parkinson's disease. We had waited 18 months.

Jeremy Lakosh [00:12:22] We started the involuntary discharge process. Two days before he was set to leave the facility, the state came back and said, we, we have approved him for all, but I think it was four or five months. And I said, that's not good enough. We need to be paid in full. If we cannot be paid in full for the services we're rendering, our business model is completely destroyed. We, we have to close the facility. So I told them, you've got two days to figure this out. And she said to me, the, the caseworker, she said, if you give me two more weeks, I'll have this for you. And I told her, you've had 15 months to solve the problem. I can't give you any more time. The statute says, if I give you another day, I've gotta give you four more months. We can't afford to do that. And so if you don't have it done by Friday morning, this resident is gone. She called me back an hour later with the full approval. But that's the game you've gotta play with the state of Illinois in order. And this is again, just to get approved for the application, not to get paid for the services. The service payments have to come later on.

Vance Crowe [00:13:31] So is this going on just in Illinois, because that is a fiscal nightmare, catastrophe state, or is this going on in other parts of the country as well?

Jeremy Lakosh [00:13:42] This is going on in other parts of the country, but in Illinois it is by far the worst. And it started after the financial crisis. When the government ran outta money, they, you know, they had about $10 billion per year, more in promises than funding. And so they had to stop paying certain entities and nursing homes were on the list, schools were on the list. Schools filed a lawsuit in one. So the state just took from one bucket and gave it to them. And so for about eight years, between 2010 and 2018, nursing homes were the perpetual stepchild of the state of Illinois. In 2018, the state lost a series of federal lawsuits in regards to Medicaid payments because the Medicare law, the federal Medicare law states that states have to approve Medicaid applications in 90 days or less. So the state of Illinois been violating that for seven or eight years, and nobody really seemed to care. But finally they lost a federal lawsuit. So the state passed presumptive eligibility, which means that after 90 days, if your application hasn't been reviewed, you're automatically approved. And unfortunately that just

Vance Crowe [00:14:56] Opens the door. This is, this is like the worst bureau bureaucratic decision you could make. Yeah. Because it's saying get in line, and if you're willing to wait in line long enough, we'll just assume that it's correct and not read the document. Like, what kind of bizarro world is this?

Jeremy Lakosh [00:15:09] Well, it's a world where Macon County Medicaid, those, those office employees who review applications, they're dealing with outdated technology, outdated processes. My state representative visited their office and there were stacks of paper from the floor to the ceiling. Macon County Medicaid has a history of losing applications. In one case we had a resident, they lost their application twice. And that all comes back financially on the facility. And, and when you have a state, and it's sad to say, but you have a state where the state employees union is the largest political donor to the majority party that runs the state. They're not gonna come down on those departments and hold them accountable for their behavior. They're just gonna pass new rules and regulations to try to skirt the problem.

Vance Crowe [00:15:59] Whoa, whoa, whoa, whoa. What, what are you talking about? This is a whole new layer of Illinois politics. I didn't understand the state workers Union. Tell me more about this.

Jeremy Lakosh [00:16:09] So AFSCME is the state workers union. They, they represent nationally, state and municipal employees, but they're the largest labor union in the state of Illinois. They contribute more money to the Democratic party of Illinois than any other donor outside of our current governor who contributes to his own campaign. They provided more money to the Democratic party of Illinois in the last legislative election than the Republican party of Illinois was able to raise on their own. So they are this huge, huge, huge political process in and of themselves where they fund the very government that's responsible for holding them accountable.

Vance Crowe [00:16:55] So these are people that are employees of the state that are then saying, take a portion of my paycheck to put in as political donations. And then those political donations go into the system and, and lo and behold, the laws that get put into place, the prefer like the, the treatment slants towards, in your opinion, the, the, the state workers. And so this really further complicates your ability to be able to muscle your way in and say, Hey, how, how can I get my problems answered? 'cause you're, you're never gonna be able to raise as much money as they can.

Jeremy Lakosh [00:17:27] Exactly. And I'll give you an example of how bad it got. When I started the involuntary discharge process for the Medicaid pending residents that I couldn't get approved, I had employees at the Macon County office telling me on the phone that I legally could not do this. They said to me, you cannot do this. And so, and it got so bad, Vance, I put a copy of the statute next to my telephone and I would read it off to them word for word. And I would say, I have the legal authority to do this. Now I want you to read from your statute and tell me what gives you the legal authority to tell me I can't do this. And then they would say things like, well, it's just my job here to answer the phones. I I don't, I don't do any of that. But it was amazing how these frontline employees could all of a sudden become bullies to, to the private sector saying, you can't do these things. When in fact the law was very much on my side. So they're allowed to, some of these bureaucrats are allowed to be legally illiterate and get away with it,

Vance Crowe [00:18:33] You know, for people that can't see you. A lot of my viewers are listeners and so they might not be able to detect, you're a mild mannered guy, you're wearing a plaid shirt, you've got your hair combed to the side, you have an MBA and you studied finance and worked at a retirement community or senior living facility. This has to be way outside of what you anticipated was gonna be happening when you, when you got into this world. 'cause you're, you're fighting over dollars that in effect or keeping people alive or not.

Jeremy Lakosh [00:19:03] Yeah, I'm fighting and, and I'm fighting for a 92 or 93-year-old World War II veteran who has advanced Alzheimer's who didn't sit down after World War II and think, yeah, I'm gonna live to be in my nineties and I need to financially prepare for an $8,000 a month bill. And now they're sitting there with no voice, no representation in a nursing home. And every single government factor that's in this is pushing for poor care because they won't fund it. They won't approve it, they won't do anything. And yeah, I mean, there were moments where, you know, I, I would get off off the phone and my staff would look at me and say, your face is beat red from just the, the sheer cliff of bureaucracy that you would have to climb to get somebody to listen to what the problems were.

Vance Crowe [00:19:57] The people that are setting up these rules and the bureaucrats that you're talking about speaking with, surely they don't imagine themselves as the villain in this scenario. Right. Surely the story that they're telling themselves is that they're doing something right and righteous from your, from your perspective, what do they think that they are doing?

Jeremy Lakosh [00:20:17] So I actually had one of the social workers at Macon County talk to me about this. And she said to me that we're, we're horribly behind because we had a large number of retirements a few years ago and we're understaffed. And so we're just trying to do the best we can with what we have. And I explained to her, I I asked her, I said, do you think better technology would help you? Yes. Do you think better processes would help you? Yes. Why don't you say something to somebody and, and I would get this befuddled answer about how nobody would ever do anything. And it goes back to something we talked about earlier. When your labor union is the largest contributor to your state government or your political, the political party running your state government, they want the largest amount of headcount they can get in each government office because it maximizes their union dues. They're not gonna come in and say, yeah, go ahead, bring in artificial intelligence, bring in scanners, bring in computers, you know, do all this electronically so that we have a lower headcount and more efficiency. They're not gonna want that.

Vance Crowe [00:21:33] Oh man, I had really not even put that together. And the, and the fact that the, you're talking about their union dues. I didn't, the you're, a lot of the people that are donating money, they don't have a choice. They have to be a part of the union. Is that right?

Jeremy Lakosh [00:21:48] There was a Supreme Court ruling a couple years ago, Janice, the Janice Case where, and this came out of Illinois. The US Supreme Court said that state employment unions could no longer forcibly mandate dues, but they are working ways around that in terms of trying to still power arm their way. They'll, they'll essentially, if you, if you decide not to pay your dues, they'll essentially freeze you out in terms of being a union member. So they still have the strong arm political power inside their circle to, to enforce those dues. So even though they lost that Supreme Court case, they, they haven't been hurting.

Vance Crowe [00:22:34] I, I have heard about Illinois running outta money and different states. I even had a guy on to talk all about what happens if a city runs outta money? What do, what do you do if a state can no longer pay their bills? And this whole time I've been sitting there thinking like, yes, stick it to those states. Right. Stick it to 'em, get, you know, if, if they run outta money too bad, deal with your problems. But it's dawning on me in this conversation. The people that will actually feel the pain of that experience are, are people that you're right. Are a 90-year-old Alzheimer's residents that, that didn't, didn't ever anticipate living to 90 years old. What in the world, like how, how do you make the people feel pain that, that need the pain to change? How do you, how do you make this real for the people that are in power?

Jeremy Lakosh [00:23:24] So I'm gonna say something that is probably gonna come across a little insensitive and it's a, it's a, it's the way I think our politicians are, are somewhat viewing the situation. They'll never admit to it, but it's the way the situation is right now, Illinois is also near the bottom of states in terms of funding to adults and children with developmental disabilities. We're near the bottom. And I think that the poor funding in elder care and the poor funding with adults with disabilities is linked in the fact that there is little to no voter influence in that area. You know, a nine 92-year-old gentleman in the nursing home isn't gonna turn around and vote differently because of something that is done for him. The adult, the developmental disabilities sector isn't all of a sudden going to be, become politically different if a politician comes in and solves their problems. So our politicians here in Illinois are gonna focus on areas that generate more votes, such as, you know, benefits for undocumented citizens. We just recently passed a measure that gives Medicaid funding for, for low income people who want gender assignment surgery. So those are the things that they're gonna focus on because the social justice mindset and the voter, the voter growth mindset don't intersect at elder care developmental disabilities, these areas where voter influence can play a role.

Jeremy Lakosh [00:25:00] So it's gonna take, it's gonna take public outrage and righteous indignation from the public in order to generate so much buzz that politicians now have to handle the issue.

Vance Crowe [00:25:15] So you're in the town that I grew up in, which is kind of this perfect blend between agriculture and rural and just getting enough population density that you have restaurants and you have activity, you can go into the bigger towns. This, this concept of funding say something like gender reassignment surgery versus elder care. It has to be so far away from their culture as to be something that that is difficult for people to take seriously.

Jeremy Lakosh [00:25:46] Yeah, it is. You know, a lot of people think of Illinois as just Chicago and in fact, Illinois is also a, a rural agricultural hub with significant agricultural footprint to the United States. And the there there's 102 counties and Chicago is in one county, cook County, and Cook County has 40 some percent of the population. And the areas around Cook County as well also influence state government. But the viewpoints that are shared up there and the viewpoints that are shared down here are completely different, completely different. There have been bills put in the Illinois state government to ban gas leaf blowers. Well, people down here in the rural part of the state need gas leaf blowers to run their

Vance Crowe [00:26:36] Their landscaping. Yeah. Whatcha gonna do run a power cord four miles? Like what?

Jeremy Lakosh [00:26:40] Yeah, yeah. You, you, you, you need those types of things down here. So the disconnect has, has just continued to grow even more wider over the last 10 years.

Vance Crowe [00:26:53] It's this problem of people living in the city wanting to have their one vote count the same as it does for other people. But then people living in the countryside saying, look, if it's only population density that you care about, I end up becoming a peasant that just serves the, the rights of the majority. And in this case, you know, you think about how much voting power is in a place like Cook County, you really do have a tyranny of the majority because if you have all the power and you can vote, you guys have to deal with these problems or you have to keep your retirement community open, even if we don't give you money. But we're gonna have these requirements. I mean, people begin to become extraordinarily disillusioned with their government and how they think that they should interact with really the rest of the world. I would say things like this are what caused the stress that leads to moments like the one we're in right now.

Jeremy Lakosh [00:27:49] You know, prior to, prior to coronavirus, different counties here in Illinois County boards started entertaining the idea of separating themselves from the state of Illinois. And I didn't take a position on it. I've kind of sat back and watched Woodford County, which is the county I'm in, has not taken a stance yet. But right now we're going through this situation where our governor is saying, Hey, if you violate my public health orders, I will withhold federal funding for for your county. I will withhold money if you violate my public health orders. And I'm waiting for a county, counties have responded saying, we don't care, we're gonna do our own thing anyways. But I'm waiting for a county to step up and say, you know what we're gonna do, we're gonna do a sustainability study about how well we can function on our own as a county and how much state dependency we actually have. I think if a county stepped forward and said they were gonna do that and started that process, it would generate a lot more attention than just saying, you know, we're not gonna do it.

Vance Crowe [00:28:56] Yeah. I mean, you think about the amount of tax dollars that are brought in by Illinois farmland. I mean, that is some of the richest, most abundant, powerful farmland in the entire country. Those people are generating money. And even when I was there, they really, there was a sense that all of our money that we put into this system gets sucked up by the state system and they get all the value out of it while, while we're paying all those bills. And it would be interesting to find out if the impression that people have, look how much money we give up to the rest of the state is actually on par, that if they kept it themselves or they, or they at least kept some part of it, if they could run their own things. What do you, what's your natural intuition there? Do you think somebody could survive without state money?

Jeremy Lakosh [00:29:40] My natural intuition is a little bit of a surprise. I actually think that the current model slightly benefits the rural communities. And I will tell you why Illinois has more municipal units of government than any other state in the country. We are completely overlapped in terms of you've got a township, you've got a city, you've got a county, you can be a member of all these things. When I, where I grew up in Ohio, you could not live in a city and a township. It had to be one or the other. And each handled its own business the same way, but not in, and that blew me away when I came to Illinois. Wait a second, I'm in Eureka. I'm not in Oleo Township not,

Vance Crowe [00:30:22] Oh yeah. And to give an example to, for people that are listening, when I grew up, I lived in a dry town, so you couldn't buy alcohol inside of Eureka. It was a very religious, very devout community, very conservative. But the, the way that the township was made up, it was actually two townships that came together to make up the city of Eureka. So there was one township that just happened to come right along the main road and there you could get a liquor license, so you had the outposts. So everybody knew this was the one place in town and in the city that you could get alcohol because it followed these rules. And I just grew up thinking that's the way everybody worked with these like weird municipalities. And it's not, it was very, very different than the rest of the world.

Jeremy Lakosh [00:31:06] Right, right. So in order for Woodford County, in my opinion, to be more efficient than the model we have right now, they would need to consolidate all their townships into one. They would need to consolidate all their school districts into one. And by doing that and, and that, that the school district issue is a

Vance Crowe [00:31:26] Topic never gonna happen.

Jeremy Lakosh [00:31:27] Yeah, yeah. It's not gonna happen. That's exactly right. You know, my wife was born and raised here. She was, she was raised in Toluca and they deal with the same school issues that we're dealing with down here that's going on throughout rural Illinois. People are so sentimentally attached to their community school that they're not going to give it up for, for consolidation. But unfortunately, if we were to separate ourselves from the state of Illinois, we'd have to support four, four school districts. Right now in a, in a county of 35,000, that's gonna be expensive. That's gonna be very expensive. And it's where frankly it's where the state has us, if we, if we decide to pick a fight with them, they can turn around and point to the inefficient layers of government that are right in our own backyard and, and say it's the pot calling the cattle.

Vance Crowe [00:32:21] Well, this is fascinating. I mean, you, you have the first original idea about this subject that I've heard in many, many years. Granted, I'm not on the ground in Woodford County, but I think most people hit the impasse of the state and is divided by Chicago and the rest of the county and kinda leave it there. I'd never even heard anyone propose that you should, you could integrate all of the school districts. What I am struck by was a couple of years ago, I went with my buddy, he goes by Chubby imu, he's a famous YouTube star. We went to Kansas, we went to Manhattan, Kansas to give a talk to a group of rural farmers from a co-op there. And during the weekend that we were there, we stayed, we listened to other talks, we sat in on dinner, we counted between the two of us, 14 different families that had all said on their own, I'm pulling my kids outta school and they're gonna be homeschooled

Jeremy Lakosh [00:33:14] Or

Vance Crowe [00:33:14] They're going to be schooled in a collection of homes that we have where we consolidate this because we don't want anything to do with the education system. My sense is that's also going on in Woodford County, is that right?

Jeremy Lakosh [00:33:27] To some extent it is. My wife and I are friends with families that do homeschool, and so it is happening. But I will say that the, the school district here is superb compared to some of the urban school districts that you have throughout the state of Illinois. But the fear, the fear that we have and, and it's gonna exist I think for a while, is that all of a sudden these social justice warriors down in Springfield who actually come up from Chicago to Springfield, will come in and say, you need to start teaching these values to students. And those values won't match what my wife and I have. And some people already feel that way and have pulled their kids. But you know, I, I shared with my wife the other day, I said, I, I foresee our children going to public school, but I think it's more likely that somebody like me as a grandparent might homeschool our grandchildren, you know, 50, 60 years from now. Because I think the value system is, is gonna go through this radical alteration that is just gonna make me personally more uncomfortable over time.

Vance Crowe [00:34:37] So as somebody that has to deal with the realities of every day, how long before the, you start to have a day of reckoning with, with Medicare, Medicaid and your ability to pay? I mean, I guess you already have had that day of reckoning. Yes. Is there another one coming?

Jeremy Lakosh [00:34:53] So, so the coronavirus gave our political leadership the latitude to say that this is the reason why we're having financial problems. They, they ignore the fact that we operated with 18 consecutive deficit budgets. They ignore the fact that actuaries have come in and ramped up the state's unfunded pension liabilities from 35 billion now over $140 billion. So, so now they're using the coronavirus as the, the straw man and saying that this thing has caused all of our financial issues and we need the federal government to help us. So the day of reckoning has, it's officially here, but we're not gonna feel it and see it in the media for probably another two or three months when the payments slow down and stop. But yeah, it's, it's, and and I've said to you, do

Vance Crowe [00:35:51] You want federal government intervention? Do you think that's the way to go?

Jeremy Lakosh [00:35:54] No, no. I think that the way, the way it needs to go is a large group of people need to get together. Some state legislatures, legislators, but also some business people with good business acumen need to get together and they need to restructure how state government runs in Illinois and they need to restructure the operating model that is state government and they need to develop strategies to fund some of these unfunded liabilities. And doing that and then presenting that and maybe doing it in exchange with, for a little bit of federal help would be a good way to go. But we are operating so dysfunctionally right now that giving us money would be the equivalent of throwing gasoline on a house fire.

Vance Crowe [00:36:47] Really? You think it'd make it worse?

Jeremy Lakosh [00:36:49] It'd make it worse. It'd make it way worse. I'll give you an example. Already it's happened, the CARES act. So state of Illinois got money for the CARES Act and our leadership took that money and they spent $14 million on a vote by mail initiative, a vote by mail initiative. We have restaurants who, who were forced to be closed for three months. And you would think that the state would say, Hey, why not take the last six months of sales tax revenue we've collected from them and send that money back to them. They haven't paid a dime to these struggling businesses yet that they forced to close, yet they have the audacity to prioritize vote by mail and spend $14 million on federal stimulus money to push that initiative.

Vance Crowe [00:37:40] How would you go about recommending that people gauge how upset people are, right? Because this is one of the biggest challenges of our age. I can listen to somebody living in the city, they can give me their perspective. I could, I can see what happens when people are angry. I can hear your one voice, like how in the world should people come to terms with, I hear all these different perspectives, which one to believe, which, which one to think is right?

Jeremy Lakosh [00:38:09] That's a tough question, but it's a good one. You know, I see my role here as that, of being an informed citizen. That's, that's what I am. I go out and I gather the information and I make an opinion based on what I'm seeing. A lot of people don't take that approach and they emotionally react to a snippet here or a snippet there or, you know, so I think you have to, to, you have to engage people and, and not only do you figure out how they feel about things, but you have to figure out how in tune are they to the factual information that's coming out. Is somebody upset because they put up a win wind power plant, you know, in the township next to you and everybody's saying that that power's gonna go up to Cook County, but we don't actually know that, you know, what are, what's driving the anger, so to speak, you know, and, and that's, that's a tough, a tough thing to get through. But I tell people all the time, there's tons of public publications out there that the state of Illinois puts out. Read them, read them and get the information and then decide, you know, is is this something I'm gonna support or not support?

Vance Crowe [00:39:22] I think when I was younger, well, not, I think I absolutely know I loved getting caught up in the emotion of a moment. So if somebody came to me and got in front of me and they were really riled up about something, I I actually would be like, all right, flip the system on. Give me all of this emotion. I wanna take it on. And now over time I've developed probably because I spend a lot of time with engineers. My, my wife is an aerospace engineer and scientists, and they've essentially trained me to be like, when you feel your emotions triggering, you know, you feel some, some form of rage or anger or sadness or whatever stop. Like that is the moment not to take action, but actually to pause and say, this is why we went through the enlightenment. This is why we have reason I'm feeling something that's okay. It's a signal to say something's going on over here, but really how do I reason through this? As opposed to just saying, I wanna match my level of emotion with the other person or people that I see doing that. And I think our natural human tendency is to, is to gather up in a herd and try and match what other people are feeling and thinking. But it's a very, very difficult thing to change in your life.

Jeremy Lakosh [00:40:34] And what you just said is why I follow very little media and I take everything I get from mainstream media with a grain of salt because I know they're trying to get the righteous indignation rise outta me, or they're trying to scare the hell outta me, one or the other. Because those are the only two reactions they can get that grow revenue. You know, you, you can't calmly inform somebody of something and it it doesn't work in their business model.

Vance Crowe [00:41:08] Right? Your out will be monetized. That's a, there's a guy named Matt Staggs who I I, he said this right around the Budweiser high fructose corn syrup ad that came out last year. And the farmers got all really upset and he was like, look, this was in the model of the, of the advertising company. They knew that a group of people would be so outraged that you insulted corn farmers. That corn farmers will pick up that rage and carry it with them everywhere they go, throwing it around out into social media, argue about it. And then what that will do is take your message and just spread it out like seeds, like dandelion seeds or something. And, and it's so hard to resist it when it's in your face. I know the last couple of days I see things and I think I, I just, I wanna go take action. And as soon as I do that, I'm like, okay, let's set this phone down. Maybe don't have an opinion for a little while.

Jeremy Lakosh [00:42:02] Yeah, yeah. I'm, I'm, I'm right there with you. And I'll, I'll tell you, my, my experience in my, in my prior life with the nursing home helped me to take a more tempered response because of some of the things we discussed. You know, at one point Vance, our mortgage was insured by the federal government through hud, HUD ensures the mortgages of one eighth of the nursing homes in the United States. Not a lot of people know that. And we were so outta money that we had to decide between defaulting on our mortgage or caring for our residents. And here's what HUD said when we told them we are gonna, we are gonna probably default on our mortgage soon. The head of risk mitigation for HUD's 2 32 program said, if you default on your mortgage, we will sue you and your board of directors personally for civil monetary penalties personally. So,

Vance Crowe [00:43:05] And there's no way, there is no way that a single decision that any one of them make is, comes back on them personally. Like that is the very definition of what it is to be a government bureaucrat. The more bureaucracy that's there, the more decentralized the blame can be. So they will never be on the hook for anything. If they shut off money, then it's, it's not, they're not gonna have to kick residents out. That's crazy.

Jeremy Lakosh [00:43:31] Well, and if you don't do what they want you to do, that's where the threat comes. And my predecessor called it heavy handed government, and he was absolutely right. If you don't do what they want you to do, all of a sudden here's this threat that we're gonna put on the table. It turns out after the fact, I went back and looked at this, the HUD had never sued a not-for-profit board or their corporate officers ever, ever for anything. So the threat was to try to get us to do what they wanted to do, not to actually follow through and, and sue us. And it, it got so bad that HUD had this group of attorneys, they were called, oh, the enforcement center. The enforcement center, this group of attorneys. They would join on the conference calls with us every time to discuss what was going on. And my, my predecessor, God bless him, he said on one of the calls, he said, you know, we do not appreciate this heavy handed government and anybody who tries to be heavy handed will not get the result they want. And that risk mitigation manager stepped up and he said, you know, I, I kind of feel responsible for this. And he said that at the time that he said that to us, he was only advising us of what could possibly happen. He wasn't threatening us.

Vance Crowe [00:44:57] And I said, and

Jeremy Lakosh [00:44:58] My response was, I am I, at the time, I was 32 years old, I said, I'm 32 years old, I'm the chief financial officer of a retirement community. I'm the first person in my family to get a four year degree, let alone a graduate degree. I did not fall into this position because I wasn't smart enough to figure out when somebody was threatening me and when they were threatening me. And I basically plainly said, you were threatening us, there's no doubt about it. And, and, and so one of the enforcement center attorneys Vance spoke up and she said she apologized, which, which is very interesting for this group. She said that the worst thing that could possibly happen to me is that my name would go on a list of people who could no longer get government insured financing. And I responded to her by saying, I'll volunteer to go on that list. Yeah. I said, I'll volunteer to go on that list. And I, and this, this is verbatim what I said, do you people think I'm stupid enough to leave this opportunity when it's all said and done and land in another situation where there's government insured financing involved. You've gotta be outta your mind. I don't wanna ever deal with any of this ever again. So yeah, put me on the list, but I have one condition in parentheses next to my name. You put the word voluntary so that people know it wasn't by some nefarious action that I ended up there.

Jeremy Lakosh [00:46:30] And it was interesting. After that moment, anytime after that moment, they would not speak with me one on one. They never did again, because my name was not on any of the regulatory documents. My predecessors was. So, and I'd only been there for, for four months at the time. So I mean, what were they gonna do? Throttle me to death over, over things that had happened years ago. So they wouldn't speak to me one-on-one anymore. And the one time that they had to, there was an attorney present on, on the line as well. So yeah, the, the threat of HUD and their civil monetary penalties was an additional layer to, to this three ring circus that we were in.

Vance Crowe [00:47:18] When I was living in Kenya. I, I stayed with this family where the father, they go by Baba, he drove a cab and he's a brilliant man. And I would stay up late at night talking with him for hours and hours and hours and hours. And one time I, I said to him, you know, Baba, why is it that you drive a cab? You're clearly intelligent enough to be running businesses. I can see your spreadsheets. I mean, we would go through finances, we would go all kinds of things. And keep in mind this is in a house with no running water. And we were talking over a lantern, a kerosene lantern. And he said, well, I had a construction company. And as the government degraded, they kept coming in and, and putting in rules. And really that was Kiki Dogo give me a little something. And every day they wanted to come by and get something. And at the end of the day, I could probably make more money as a construct owning a construction company and paying out all these bribes. But then I would have to know that every day somebody is gonna come along and take something from me, and I'm not gonna do it. And you shouldn't do it either. And what he was preparing me for was for this culture in Kenya that guards would say, would try and take a little something from you. You know, give me a little something for some chai tea. Give me something for, you know, this thing. And they were, they were imposing. They never held, I mean, they, I actually did have a gun held on me. But normally when they're asking for this bribe, they aren't holding a gun at you. They're just saying, it'd be a little easier if you just follow these rules. And you know, the people that capitulate that to get through today realize, you know, 20, 30 years later, you gave away your life.

Vance Crowe [00:48:54] They took everything from you. So I'm a hundred percent behind you. If you felt like a government agent was threatening you, man, push back on that as hard as you can. 'cause it will never, ever end once you say yes.

Jeremy Lakosh [00:49:08] Yeah, you're, you're absolutely right. And fortunately, our CEO at the time was personal friends with Senator John Thune of South Dakota. He was actually, our CEO is a South Dakota resident. So he flew back to South Dakota and sat one-on-one with Senator Thune to tell him what had happened. And Senator TH's office opened an investigation into the 2 32 section of hud. And when that moment happened, all of a sudden everybody was more cooperative. We just need you to sign something. You know, all of a sudden everybody was more responsive, but it didn't stay that way all the way to the end. There were, there were bumps in the road. The, the personal liability threat did get thrown out at least one other time. But you know, it it, you're right. I mean, you, you have to find ways to hold these people accountable. And unfortunately you have to be very forceful about it. I mean, I, I said things to people through this process in, in, in such a forceful way that, you know, I can't imagine saying that to either a customer or resident, resident family member. You know, I mean, you ha you really had to, even if you were in the most pleasant of moods, you had to really cop an attitude with these people and have a sharp tongue to make sure they were gonna understand that they, they weren't gonna get away with whatever it was they were trying to get away with at the time.

Vance Crowe [00:50:39] Yeah. I mean, I, that's the type of stuff that changes who you are as a person when you're, when you're dealing with people that you think are willing to use state authority or power over you, it, it, it changes you because you think, well, the natural state that I was in puts me in a place where I'm vulnerable. And, you know, as I am saying this out loud, I'm, I'm thinking maybe that is the message that the rioters and the protestors have no matter how you feel about it. It is their understanding that if I continue to do the same thing that I was doing before, you're gonna, you're gonna use this power over top of me. And, and I guess in some way I can relate to that in a way that I hadn't before you and I sat down to chat.

Jeremy Lakosh [00:51:20] Yeah. You know, there, there are, there are people in our society who are definitely feeling marginalized right now, and by, by a, a variety of different events. And when they don't have, I see this whole thing unfortunately from the base level as a failure to properly educate our children when they're in school because people who lack the discourse or the ability to have a discourse or the understanding of where to go to are the people who are more and more likely to react violently or adversely to these situations that are occurring. And I, I think a very good start to this, this conversation needs to be how are we educating our children? Are we educating our children to react emotionally? Are we educating our children to have critical thinking skills, problem solving skills? You know, how are we doing this? Because, you know, the, it it, it breaks my heart a lot of the time to see, you know, marginalized people in this, in this area of desperation. And they've never, never had somebody come along and in any way, shine any light on a, a peaceful way to resolve a situation. It's just, and it's heartbreaking

Vance Crowe [00:52:42] When I, so after college, I ended up working at a camp for inner city kids. And these children were incredibly poor. They came from situations where they were dealing with things that me, as a kid that grew up in Eureka, Illinois, I had never come anywhere close to this. And one of the things that I realized very early on was that the number of words that these kids had to explain how they were feeling about something was really limited. So whereas somebody like you or me, by the time you're done with a college education, you've been given all of these words to differentiate between emotions, you can be frustrated, you can be embarrassed, you could be jealous, you could be envious, you could have all of these different feelings. And so you have this knob that you can turn and finely tune and get adjusted. Now that can still be hijacked. There's, it's not, it's not like it's some kind of proof against that, but it's, it's much more fine grain. Whereas a lot of these kids had just a few emotions, just a few words that they could place. So, so while they had this entire range of motions, they could only express it by very clunky anger, frustration, rage, you know, the, and so you, I I, at first I thought, well, this is their fault. And then you start realizing, wait, no, if I ask him what is he feeling, he does not have the words to explain what is going on in his mind. So of course, if you can't get it out through your mind and say it out loud and have that be something that another person can react to, the only thing you have is the emotion to get it out.

Vance Crowe [00:54:18] And when you really start to understand that, you start to say, well, I don't, I, I am not looking to give anyone that breaks anybody else's property or harms anybody else a pass, but it is damn good. And very important that you understand that if you hold them to account the same way that you would hold that college senior that has years and years of philosophy, training and conversations and, and nuance. It's not, it's not the same.

Jeremy Lakosh [00:54:46] Yeah. I mean, you know, at the end of the day, if, if we, if we hold people accountable, I'm all about holding people accountable for irrational behavior. It's, it's, you know, a cornerstone of a, of a, a law and order society. But if you don't get to the root cause of what is bringing these issues up to the surface, all you're gonna end up doing is being in this cycle of accountability, then, you know you're gonna be, it's, it's like a rinse, wash, repeat cycle. And you know, there, there definitely has to be some discourse in conversation in terms of of, of what's going on at the ground level. And, and I, I, as I said before, I I think it starts with education.

Vance Crowe [00:55:38] So speaking of education, I remember one of the only time my father was a country stockbroker, so he was one of the first people that came in and helped farmers get access to being able to diversify their assets, put it into the stock market instead of just investing in land or machinery. And so I remember one time going to a school where he was putting on a presentation probably for like the PTA that that predicted that someday college may cost $20,000 a year, $80,000 a year. And I remember these parents being just shocked and completely appalled by this and worried every single day, probably from that day to the day their children graduated from college, how are we going to pay for this? But that's a totally different gambit than $20,000 a year in perpetuity. As long as a person lives as somebody that is dealing with the finances of a nursing home, seeing what happens with Medicare, Medicaid and full paying residents, how should people think about preparing for living well beyond 70? Yeah,

Jeremy Lakosh [00:56:46] Yeah, great question. So, so there's, there's two roles and responsibilities. There's the future resident, somebody who is gonna prepare themselves for long-term care, and then there's the, the power of attorney, which is usually a child. And so the resident needs to keep their, they need to name one of their children, power of attorney or somebody that they would trust with their finances. Finances and their medical decisions. And they need to keep them in the loop about what's going on. They need to know where the money is, where it's at. You know, because at any moment something could happen like a stroke or any, anything debilitating where that individual ends up in a nursing home and the POA has to come in and take control. So when it comes to assets and savings to go into a nursing home, it is recommended that an individual have at least six months worth of assets to pay for the first six months of their skilled care stay. That would be approximately 50 to $60,000 in today's money. And that would, and I would take it a step further and say, do not include your house in that analysis. Because if you can't sell your home, it's technically worth nothing. If it can't, if you can't sell it to support your stay. When you get down to six months worth of living expenses in Illinois, that's when you need to apply for Medicaid benefits so that you're looking down the road to the moment when you run outta money.

Jeremy Lakosh [00:58:20] The Medicaid application is 17 pages long. There is some redundancy in it. They ask some pretty invasive questions. They also demand 66 0 months of bank statements as, as part of your application.

Vance Crowe [00:58:36] What are the other invasive parts? When you say there's invasive parts of this, what are they asking you?

Jeremy Lakosh [00:58:41] The most invasive part, I believe. I actually believe that this question is unconstitutional. They ask you, have you spoken to an attorney about your financial assets in the last five years? And they want the name and the contact information to that attorney. I think that's a violation of your constitutional rights.

Vance Crowe [00:58:58] Why would they want to know that?

Jeremy Lakosh [00:59:00] Because they wanna see if you've established a trust to hide money anywhere.

Vance Crowe [00:59:05] Oh, that's

Jeremy Lakosh [00:59:06] What they

Vance Crowe [00:59:06] Wanna know. Well, that's the Yeah, that's the concern if you're handing out money. I see. I mean, yeah. And, and frankly, if you're on the other side of that, you're a paying customer. You do wanna know if the person that is in the room next to yours that's not paying has money hidden away somewhere.

Jeremy Lakosh [00:59:21] Right. Right. So, so that,

Vance Crowe [00:59:24] But I can see the problem. You wouldn't want people being asset, but you can also see why somebody would want it asked.

Jeremy Lakosh [00:59:29] Right, right. And, and there's so many loopholes in this situation. I mean, you get somebody with advanced Alzheimer's and they have no power of attorney. How do you do a Medicaid application? You have to go out and find somebody to serve as power of attorney. And, and I'm, so there are some loopholes there, but I would tell people not only, you know, to save your money responsibly so that you, you can live off of it in retirement, but also to share with your, your power of attorney, your loved ones. Not only the financial side, but also what kind of healthcare you want. Too often you see spouses where one gets Alzheimer's and dementia, and by the time it becomes time to put that person in a nursing home, only one person is cognitive enough to make that decision. Wouldn't it be nice if you could sit down with your husband or your wife and say, this is the moment in which I would be comfortable with you putting me in a nursing home. And I've already told my wife what that is. It's the moment she leaves me in the house and her anxiety level rises anxiety and she's anxious to get back here because she's concerned that I might have wandered off or wandered away. I've told her when that moment happens, either you're, you need to be comfortable bringing help into here or sending me to a long-term care facility. So you have to have those health discussions too.

Vance Crowe [01:00:53] Are there people out there that walk families through this type of stuff? I mean, this, this seems like that that piece of advice that you just gave right there seems like, hey, yeah, I want that and I want that for the 50,000 other situations that I may not be able to predict.

Jeremy Lakosh [01:01:09] Not to my knowledge. There isn't. Nursing homes have advocates sometimes, but they're so bogged down with the actual residents that I don't think they could advocate outside or, or inform outside of the nursing home. You know, I, I don't think there really is a, there, there, there are a couple of websites that I've seen pop up. A family had to search for their mother for a nursing home because she had dementia. And so they created a website of resources for other people. So you may be able to Google some of these things like as a question medically, what should I do financially, what should I do? But make sure if you do do that, include the state that you're living in, because in Illinois it's far, far different than in Indiana, Wisconsin, Missouri. And you're gonna need to know some of the, the state differences.

Vance Crowe [01:02:09] So it is the very beginning of June and there's been also, you know, we've just come out of a pandemic. We supposedly are still in it, there are riots going on. I think it's very interesting to hear what people think the world is gonna look like in two weeks. So what do you think, how different will the world look two weeks from today?

Jeremy Lakosh [01:02:33] Good question. Good question.

Vance Crowe [01:02:35] I can tell you that not a single person that I asked, and I've asked 60 people or so, suggested that we would be having racially charged riots and protests and looting. So I won't hold you to it, but it is interesting to see where people think things are headed because I asked all these people and they nobody got it right, including myself.

Jeremy Lakosh [01:02:53] So, you know, two, two weeks is, is is tough. I do think that the, the violence that's occurring in the country will begin to decline. I'm very con I think that the only reason violence would escalate in the next two weeks is if something happens to one of the four police officers. If somebody is not charged or charges are reduced or something like that, I think we could see a resurgence. But Vance, the only thing that I'm looking at in front of me right now, and I don't know if this is gonna happen in two weeks or if it's gonna happen in two months, I do think the stock market is in for another round of major volatility. And it's gonna come when we as a nation realize we cannot put 20 million people back to work simultaneously. This economic recovery is going to be a process that's going to take time. I mean, we will have, I believe we'll have a great recovery. It's just not gonna happen in the month of July.

Vance Crowe [01:03:54] Yeah, I mean, I I completely see what you're talking about. Like the, the, our economy has not yet felt the brunt of people being out of work, or at least it doesn't appear to me that it has. And we've been able to send checks to people, they've been able to, we had the PPP program, so nobody yet has felt that ping or that that real deep pain of sacrifice. That's not correct. There are people that have felt the sting of sacrifice, but the vast majority of people that are getting checks, if those checks stop, we will watch what happens as the gears stop for some, but they keep moving for others. And if we're talking about social instability now, that situation becomes far more volatile in, in my opinion.

Jeremy Lakosh [01:04:39] Yeah, I think there's a real risk here in the United States for additional problems in urban areas. If the economy is slow to restart, you go back through 200 years of American history, crime is a great correlation of economic activity. And when you have an economic drop off, you always have an increase in crime. And so there is, there is a risk there that we're gonna see crime stay up as the protesting declines. But you know, I, I'm watching our stock market and it's behaving a lot like it did in 1931 when we had this unprecedented rally in 1931, the market took off, everybody thought everything was fine, and then it dropped another 60% and we were in the throes of the great Depression. So, and I don't think we're gonna be able, first

Vance Crowe [01:05:36] Have you taken money off the table? Have you, have you been able to pull the money out and, and put it into cash on your, on your own?

Jeremy Lakosh [01:05:43] So I, I invest in high yield debt and I invest in preferred income security. So I don't buy a lot of stocks, but I believe in, I, I don't believe a lot in selling unless I see something I own at an obscenely high price. And I'm not seeing that in my personal portfolio right now. So what I'm doing is I'm building up cash, I'm not buying, I'm just sitting tight and I'm waiting for the next round of volatility. And then I'll, I'll add to my portfolio accordingly then. So I'm not, I'm not dumping anything and I, I advocate to people not to dump anything. If you, if you don't have an active financial acumen in the stock market and you're an investor, you just have to wait it out because in the long term, it, it will work out in your favor. The returns work out in your favor. You would've earned 8% year over year returns if you would've bought into the stock market prior to the crash of 1929. So, I mean, you, you just gotta ride through these volatility pieces. But for me as an investor, I see volatility coming. So I'm going to just kind of hold back from buying until it arrives.

Vance Crowe [01:06:54] Jeremy, I knew from the moment we started talking the other day, we were planning you, you actually run a rotary club and invited me to come back to my hometown and do a talk. I knew this would be a good conversation. You are a very articulate, this was super interesting and I know for a fact that the area that you're in right now is going to continue to be important, probably more important every single year as we go by. So I, I hope you come back on, we talk more about this, we talk more about what's going on in Illinois, how to handle these problems. I'm really grateful you stopped by. Thank you so much. If people wanted to get ahold of you, how would they do that?

Jeremy Lakosh [01:07:32] So there's a couple of things. First I wanna, I wanna note shameless self-promotion, but I wrote a book about what happened in the nursing home. It's called

Vance Crowe [01:07:39] Oh yeah, talk about it. Yeah, sure. Yeah.

Jeremy Lakosh [01:07:41] It's called A Government's Guide to Exploiting the Elderly. And it's, that's the name of the book. I wrote it, I wrote it a year and a half ago, A government's guide to exploiting the Elderly. And it's available on Amazon. So all you have to do

Vance Crowe [01:07:56] Is you send me a link, I'll put it in the, I'll put it in the show notes.

Jeremy Lakosh [01:07:59] Okay, I'll, I'll do that. And I wrote that book about a year and a half ago. I not intending Vance to become a bestselling author, sell a bunch of copies. I wanted this out there in the public. I wanted the public to know and be able to access what I experienced so that if something really bad did happen in the skilled care industry in Illinois, I wouldn't sit here and say, oh, if I would've just said something, you know, I wouldn't feel that, that guilt of not speaking up. And I have been speaking up and this book was one of the vessels of doing that.

Vance Crowe [01:08:35] How long did that take you to write?

Jeremy Lakosh [01:08:39] I sat down and wrote it in maybe two months, two and a half months. I kept, I kept meticulous records, so did my predecessor in my CFO position. So I went through over 30,000 emails to build the chronology of what happened. And there are things that happened that were very interesting, but they were not included in the book because I couldn't document when they occurred. So I only documented when things occurred in this book. And it's a chronology, it's written in third person and, and it excludes specific names because what I want people, I don't want people to finger point at a particular actor in all this, but I want them to see how the system was working at the time.

Vance Crowe [01:09:24] Yeah. And a bureaucracy, it's almost, the person is almost irrelevant. It's the machinery that's built there and certainly people have their own responsibility there, but you take one person out and put another one and you're still gonna get the same result.

Jeremy Lakosh [01:09:38] Yeah, yeah, that's exactly right. And my wife, this is my wife's advice to your listeners, if they buy the book, she says, hang in there through the first 20 pages, the first 20 pages, provide context and then you'll be okay. But since you've listened to this program, you'll be, you'll be already well versed in those first 20 pages.

Vance Crowe [01:09:58] Man, I'm in, I feel like meeting you has opened up the, a whole world of challenges and bureaucracy and parts of us that we as a society would never wanna look back on ever and say we did. We, we did not treat our elderly people, our wise people with respect and dignity and figure out how to care for them regardless of whatever situation they got themselves in. We as a nation, I think want to make sure that all people are cared for. So thank you so much for what you've done, Jeremy, and then any, any other way people can get ahold of you, they've, you've got your book and, and if people wanted to reach out to you,

Jeremy Lakosh [01:10:37] You know what, just search me on Facebook so you can, you can come in on fa I have a, I have a Facebook page dedicated to me as a individual, not as my own profile. So you can come in on there and either like, or follow or write out to me that way as well.

Vance Crowe [01:10:54] Great. Well I'll throw that link in the show notes as well. Jeremy, thank you so much for, for doing this and thanks for coming on.

Jeremy Lakosh [01:11:02] Thanks Vance.

Vance Crowe [01:11:03] Thank you to Jeremy Osh for joining me. This has been a wild ride and the last couple of days I have not been doing my normal cranking out of podcasts, but that's because I've been working on a project for a long time. Listeners have written me and said, how can I support the podcast? How can I get involved? What else do you have? And so I've decided that I'm going to be putting up a few things. I have created a series of classes, I'm not entirely sure exactly the right format to do 'em in. So I've done a formal class on how to get better at, at communicating ideas, both in conversation and in speeches. And then I've done a more informal one where I'm sitting outside with my executive producer and we're just having a conversation. I also have been recording every day or every other day sessions with my intern. And those sessions are, he writes me a question about communication, some challenge that he's had, something that he encountered, and then we sit down and talk about it and then I shave it down to about a six minute conversation to post for you. So if you're a person that wants to support the podcast, if you're interested in taking some of these lessons or if you have an intern and because of the weird circumstances that we're in right now, you feel like, hey, I'm not able to get them the type of support and, and education that I would love to be able to get them. This might be a great way to do that. So I am just a few days away from launching what we call a Mighty network. It's going to be the Articulate Ventures network.

Vance Crowe [01:12:35] And once I have that up, I will be sharing it with all of you and hopefully taking a few, maybe 10 or 15 people to, to be beta testers to check it out, let us know some feedback, and then we'll open it up to everybody else. So if you are interested in joining this Mighty Network, send me an email to Vance at Vance Crowe dot com and, and remember my last name, Crow, C-R-O-W-E. And just put your hand up, say, Hey, I'm interested in joining. I'd be interested in being a beta tester and the first 15 people that do that. I will get you in for an extremely reduced price. And then, and then we'll get your feedback and then I'll make it open and live for everybody hoping to have this whole thing up and running by the middle of June. So your help is greatly appreciated. My email again isVance@vancecrow.com. Thank you so much for listening. And thank you to Jeremy for sharing his story of nursing homes and all the craziness that goes on with government bureaucracies. We'll talk to you later.