269 - Navigating the Challenges of Elder Care: Insights from a Leader in the Field with Assisted Living Services' Mario D'Aquila

Welcome to Listening with Leaders. I'm Doug Noll, lawyer turned peacemaker. I teach executive leaders how to listen to emotions rather than words so that they can become the leaders everyone wants to follow. And I teach those same leaders how to be authentically present, available, and connected to their families despite being insanely busy. I have learned that we are 98% emotional and only 2% rational. Learning how to listen to emotions is, in my experience, the foundational skill of life. Stick around to the end of the show, and I'll reveal how you can be on our next guest in 15 to 20 minutes. So let's get started. Mario D'Aquila, welcome to Listening with Leaders. You are the chief operating officer and co-owner of a company called Assisted Living Services, Inc., and you're based in Connecticut and the website is assistedlivingct.com.

And welcome to Leaders.

That's right.

Thank you for having me today.

So let's start off with a little bit about your backstory. How did you get, where did you start with and how did you get to where you are today?

Sure. First and foremost, born and raised in the city of Meriden, Connecticut. That's essentially located city in this, in our state. After, you know, high school, I went to school actually up at Central Connecticut for business administration. I popped over to construction management, got my degree from Central in construction management, went on to work at a few different project management, assistant project management jobs for a few different construction companies, doing bridge repair and doing steel fabrication and things like that. And one of my coworkers was, I don't know, he had some homework or something. I'm like, what are you doing with homework? I work at a full-time job. He said, I'm going for my master's in business. And I said, oh gee, that seems interesting. What, why are you doing that? And he said, just for better opportunities later on. And so I went home and I talked to my girlfriend at the time, actually, and now she's my wife. This guy's going for his master's. I think I want to go for a master's in business. And she said, if you're gonna go for that, I need to go for it. Cause you can't have a higher education than me. She was an accountant.

No, no competition in the relationship, huh?

No, it was just, it's, hey, I guess that's a good thing. And I said, okay, let's go together. So we both went to Southern Connecticut State University for a master's in business administration, graduating, competing all along the way. That was a, it's very difficult to compete with your girlfriend and fiancée for grades. It's difficult going home and just— I never got better grades in my life. Let me tell you, that competition drove me to success. And she won, by the way, she won. She graduated with a better GPA, which she never lets me live that down. At that time, I had gotten that degree and I had my project thesis was to build a business or build an expansion on a business that, that is of interest to you. And at that time, I took a, a, a model business that actually my dad started called Assisted Living Technologies. And it was really small business. It was a startup from the ground up. And essentially the best way I could describe that business was it's like Best Buy for senior technologies. So for medical alert systems and medication devices and remote monitoring systems. And essentially the concept in that business was have it all under one roof and, and so that people can come into your marketplace and buy it because there was no companies that did that. And I took that business idea and I expounded on it to become a multi-state business. That was my project for my master's. So I did that. My teacher said, my professor, he's like, you, this is actually a really good idea. You should do this. So upon graduating, I approached my parents and I said, hey, this concept that you have, dad, I, that it's kind of, wasn't really making money at the time. I'm like, I have this business concept that is gonna take this to the next level. I'd really love to leave the construction world. And launch this thing, see what we can do. And so he took my offer. He said, yep, we'll start you off. And from literally the ground up, you were going to be doing installations for products. You're not going to just run this thing and you're going to go out and wear a polo shirt and go and meet seniors throughout the state. And you're going to install the products and you're going to build this business literally from the ground up, hire some employees and go to town. And business is hard. It was hard as a young man. Graduating school with really no boss. I had supervisors at the time in the construction world and to just have a blank slate and have a business plan in front of you and just textbook knowledge is so much different than, yeah, go do it now, hire people and here's the real world. So through that, I learned the elder, elder care space, which is both a heartwarming environment and industry, and it's also stressful, but it's also a great industry with lots of good market share. All the way from M&A opportunities now to shaping actually legislation and the entire industry for not just Connecticut, but hopefully for the United States someday. That'd be great.

The big growth industry is people like me get older.

Yeah. And they call it the silver tsunami, right? So the baby boomers becoming of the age where they're starting to need care. It's an interesting space to be in and it's a challenge that isn't just facing our company, but it's going to be facing the whole United States at some point soon.

How did you move from the technology and offering up products to offering up services where you're actually having in care, in-home care?

The company Assisted Living Technologies, interestingly enough, was a subsidiary of Assisted Living Services, which is great. And a lot of the elderly folks that I was doing installs with also had some home care too. Through that experience, I was able to learn a little bit about what caregivers go through on a day-to-day basis, as well as interestingly enough, we being a Medicaid waiver provider for the technologies company, meaning we were able to install products in Medicaid recipients' homes, right, and get reimbursed contractually through, through that mechanism. That contract actually was also held by the home care company. So I was able to learn the contractual obligations with Medicaid. I was able to learn and help transcend into the home care space through that, just through osmosis and experience learning through the past decade or so. I was able to take that knowledge from technologies and apply it to the home care space. We're serving the same market, right? So it really helped to know your customer and then be able to go to that different vertical, which had a nice synergy.

So I take it then you started hiring employees who would provide the in-home care for your customers, your clients.

Sure. Yeah. So that company, I made the leap. Once Technologies was able to stand on its own feet and actually start producing some profitability and, and allowing us to grow it, I was able to loosen my management reins on that company and then use some of the same concepts that I learned managing that company to transcend over into the home care space where we hire caregivers, lots and lots of caregivers, by the way. To help folks all throughout the state. And it turned from a product business, which I was familiar with, to a people business now, which is the home care side, which has tons of different facets as opposed to just, hey, press a button and you get help. Because that's what we were selling at the time.

A little more complicated.

Absolutely. Learning everywhere from employment law to to laws with providing the care for Medicaid recipients, to learning our regulator, the Department of Consumer Protection, right? They have their own particular regulations. EEOC, OSHA regs. It just, it was so expansive. And I'll tell you, textbooks do not teach that.

But you obviously are successful. How many employees do you have now working in working with clients?

Yeah, great question. So as of today, we have approximately, I would say, about 350 to 400 W-2 caregivers on staff. And the reason why I'm saying W-2 caregivers is because we also have a separate class of worker that's actually considered a foster caregiver. It's a unique program in Connecticut. Where we have about 300 of those employees. Actually, they're technically considered independent contractors under the IRS definition. But so all in all, about 700 or so employees and caregivers.

Wow.

Throughout the state.

Pretty good organization to manage.

It's a large organization, but I'll tell you that having really excellent management in place to help run this is paramount. I know it sounds cliché, but investing in your people is the number one takeaway that I got from this business, just investing in their education and growth.

You're not the first leader that I've interviewed that says that. In fact, every, almost every successful CEO, especially in the startup and small growth area, say the most important thing is our people and the most important decisions you make are who you're gonna hire as your managers and leaders.

For sure.

And they talk about, I've learned a lot in listening to that. So now you got this organization and presuming you're growing and scaling a little bit, what is it today that gets you up in the morning and gets you excited to go to work?

We have an interesting framework. That we've adopted actually. And this gets me excited and it also gives me headaches, by the way. So this is the reason why I can't sleep at night. And it's also the reason why it gets me excited to wake up from my 5 minutes of sleep that I get when I finally fall asleep. I'm joking. I actually sleep really well. But so we use a framework called Objectives and Key Results. And I'm not sure if you're familiar with that, but that was popularized and created back by Andy Grove back at the Intel days. Intel.

Mm-hmm.

Yep. And we adopted that framework. We read the book Measure What Matters by John Doerr, and we adopted that framework that generally is saved for Silicon Valley type companies, right? Software type companies. And we took that framework and we said, what if we apply it to the elder care space, the senior care space? What can we do that would use that to launch our company into the next realm, right? And in doing so, first of all, it's diff— it was difficult for everybody to grasp, right? So it actually took about 1 year for people to really start the jargon of OKRs, what it really means to, to create an objective, why that's different than a key result, why I should care as an employee about these things. And align the actual vision of the company to it all. So that framework took about a year to implement. We did that in about, I think, 2018, if I'm not mistaken. And when we implemented it, it's slow, but it took us to new heights. We were able to get the Inc. 5000, I think, a while back after implementing it. We were able to win all different types of, of awards and also achieve really fantastic growth for our company, not just in revenue, but growth in employing a lot of folks throughout Connecticut.

Wow. What is it that gets you up in the morning now that gets you really excited to, to, to do all this work? What motivates you?

Yes. Like what my vision is for the company?

No, just, you're obviously working really hard and you've got this company that's growing. Every leader, something is inside you that motivates you to do the work. To put up with all the, all the complexity, all the difficulty and all the success. And I'm just curious what it is for you.

I first wanna say, of course, it's my kids and my family. Like I get up to, to say, hey, that's the real purpose here. And that's the, the light at the end of the tunnel. It's, hey, I'm doing it for them to have sort of somebody to look up to, some framework that they can say, hey, dad did this, I could do this too someday. That type of thing to be a good role model. But at this point, it's what gets me up is to really strive for that next thing, which actually is a little bit like torture. But have you ever heard of the threshold of control? Like it's a circle that you actually put a dot in, right? And it's like the hardest thing that I've ever done is right within that, that threshold of control, right? So once I achieve that thing, That stuff's not hard anymore. What gets me up in the morning is what's the next hard thing that I could do that gets me outside of that threshold of control, right?

Part of you, that's part of your competitive spirit too.

That's it. And that's why I probably have a, looking at my lip this morning. So I did my Brazilian jiu-jitsu class this morning. I got knocked in the lip.

I'm a second black belt, so I know what that's all about.

Oh, no way. In what?

Uh, I'm in a, I'm a 2nd-degree black belt in a Northern Chinese animal style called Shoshu, and I'm also a Tai Chi master.

So, okay.

Yeah.

Oh, that's awesome. So I, I have my black belt in Choi La Fut.

Okay.

So Southern Chinese martial art, kung fu style.

Yeah. Small world. Yeah, absolutely. So a couple of things, but I'm gonna ask you anyways. What do you think it's unique about you, Mario, that you bring to the table that's made all this work?

Question to answer. I'd say that it's my competitive spirit, but at the same time, I really get a kick out of getting other people to be successful. So in other words, uh, I have a few folks here that are like folks that I've been mentoring for quite a long time, and they were my hires. And right when I hired them, I'm like, this person's going far. And they just say, The sort of like your kids, you see 'em grow up and you're like, man, look at what I did. And I, I find that to be really rewarding with a lot of my staff.

You get a lot of joy out of seeing people succeed and grow.

I do. And I, and, and it's not everybody. Keep in mind there, there's some real special people that take to learning that when I see it in them, I'm like, I see a little bit of myself in them and I, I really want to show them my knowledge and, and things. And actually, I want them to do better than me someday. I don't want— I don't want to be the best in the room. I want them to one day to go, okay, Mario, like, I'm your boss, or actually, I'm leaving here to start my own company, and thanks for teaching me what you've taught me, right? Actually, I, I don't want everybody here to stay. I want them to go and start their own company and then show others, right?

That is, that is another attribute of a great leader, where you are constantly Training the people below you to take your place.

That's exactly right.

That's critical. And many leaders don't get that.

No, it's sad to see people go, but when they do, because they're going to something else that they really want to pursue, you get, you let them, you're like, that's why I trained you to leave, right? At some point and that's right. Fly out of the nest and go and do your thing, which I find that to me is rewarding. That's what gets me up in the morning.

That's right. I imagine that you're probably a pretty good listener. I don't think you could be successful where you are today with all the different things that you've done unless you've learned how to listen. Tell me how you learned how to listen.

So I learned how to listen by actually taking a DiSC profile. Yeah, so I did the DiSC, and what I learned is that I'm a high D, and according to that, that means I'm a bad listener. And I have this very direct way of speaking and we got to get this done, guys. And X, Y, and Z. I don't want to hear about your weekend. I don't want to hear about this, that, the other thing. And that, according to this DiSC profile, which I took a few times, by the way, because I thought it was wrong, was my communication style. And what it said about high Ds is they're not great listeners. They have a mission and they need it accomplished and you need to listen to them. That's what it said, essentially. I said, gee, I don't like that. That means that I have something to work on. And through that, through being a bad listener, at least my profile says that, I took to really rewiring my brain to listen to people. And actually very painstaking, by the way. And, and that's how I know I'm a high D because it's, it's a challenge for me to do. But by knowing my fault, It forced me to do that, right? So that's how I learned to be a better listener, by being a bad listener initially.

That's a high level of self-awareness. There are a lot of people that don't know whether or not they're good listeners. I teach listening. I think I would— I told you before we recorded that, that I'm the co-founder of the Prison Peace Project, and one of, one of the skills that I developed before we started working in prison was how to calm any angry person in 90 seconds or less. And what I teach people to do is how to listen to emotions rather than to words. And then for 10 years, as I said, we worked in prisons, including Connecticut, training incarcerated people how to stop prison violence by listening to emotions rather than to words. And incredibly powerful work, which is why this is called Listening with Leaders, because I think listening is the foundational skill of leadership. And I know my audience is always interested in learning how you, how you developed it. So did you take any classes or did you just become more self-aware and conscious of how the fact that your mind wandered or drifted, or you were so goal-driven that you backed off of that and took time to be more thoughtful about it?

It was a variety of things. No, no classes.

Good. Because there aren't any, there aren't any good ones out there.

Yeah. You take a class and they tell you do this, that, the other thing, and you know, you go and you try it. And you never get to reuse it, right? So if you take one seminar per se and you don't use that information, it goes in one ear and out the other.

Right.

Lots of books and lots of audiobooks.

Okay.

And actually practicing what you learn. And I understand you're not gonna try every single thing you learned in a book, but if I take one thing away, I try it and I go, that, that works. And then Noticing as well, at least my style, me being like a hard bargainer does not work with me. Like, I, I am a bad negotiator when I'm very like rigid. I've noticed that I've never won a good negotiation being like a steel wall. Like, I cannot steel man something. And actually, some people are excellent at that. That's their style. What I've noticed is that I have to be more pliable. And that helps.

Hey, how much you like spending? Tai Chi, the paradox of Tai Chi, the softer you are, the stronger you are. Yep. The more vulnerable you are, the more powerful you are.

True. And actually, and I'm glad my kung fu background actually helped with that as well. A lot of like circular movements and whatnot to deflect energy.

Exactly. That's what negotiation is all about.

That's it.

I teach advanced legal negotiation and those are the kinds of concepts that underlie everything that I teach in negotiation.

It's an excellent point. And I haven't thought about it till now. That skill actually helped me transcend into this.

One more question and I'll let you go. What's one thing about yourself, Mario, that we would never know about unless you revealed it to us?

Ooh, that's a hard question. I, I think that, pause, cuz I can't think off the cuff on that one, huh? Are you, I tell everybody everything.

Are you an introvert?

So I think I am. But Myers-Briggs does not think I am.

I think you are.

Yeah.

And here's the thing that's really amazing of your 226, 227 episodes, and only one of the people that I've interviewed over the last 2 years out of that group of 200+ was an extrovert.

Oh, wow. Okay.

Every leader that I've interviewed that's enormously successful like yourself has been an introvert. And I'm an introvert. Isn't that interesting?

Tell me a little how you know though. Tell me a little bit about, expand on that a little bit.

So introversion means that the energy that I have comes from within. And when I'm around people, I'm pushing my energy out. For an extrovert, they're pulling energy in from other people. So at 5 o'clock at night, all they wanna do is go out to a crowd and work a crowd. An introvert will say, that is the last thing I want to do. I want to go home and rest. And that's the difference. It's where your energy comes from. Extroverts get their energy from other people. Introverts give their energy out. They can be very dynamic. Uh, but at the end of the day, they're exhausted by being around other people.

Yeah. Yeah. And I sometimes feel, and there's this rare definition that there's introverted extroverts too.

There are people who are ambiverts.

I'll tell you, it just depends on the day for me.

There you go.

Depends how much jiu-jitsu I did in the morning.

I got to say, this has been a wonderful conversation. I really enjoyed meeting you and talking with you. Thank you so much for your time.

Thank you, Doug. This was great. You're welcome.

Doug Noll here. Thank you so much for listening to Listening with Leaders. If you are a successful executive leader who would like to be on this program, please visit podcast.dougnull.com/podcast. If you got something out of this interview, would you please share this episode on social media? Just do a quick screenshot with your phone and text it to a friend or post it on the socials. If you know someone that would be a great guest, tag them on the social media to let them know about the show and include the hashtag #ListeningWithLeaders. I love seeing your posts and guest suggestions. We are regularly putting out new episodes and content. To make sure you don't miss any episodes, go ahead and subscribe. Your thumbs up, ratings, and reviews go a long way to help promote the show and mean a lot to me and my team. Want to know more? Go to my website, DougNoll.com, or follow me on LinkedIn, Facebook, and Instagram. That's @DouglasEnoll. Thanks for listening, and we'll see you on the next show.