• January 13, 2016

    Meet Zeke Turner, founder and CEO of Mainstreet. Turner left Wall Street at age 25 to pursue the launch of Mainstreet and has not looked back. As the pioneer in reinventing the post-acute care experience, Mainstreet is considered a major innovator of senior housing and care. We sat down with Turner in his Carmel, Indiana, office to learn about what risk means to Mainstreet, why entrepreneurship isn’t everything, and how today’s leaders can attract the next generation to senior living.

    Describe your “typical” day.

    It’s changed a lot over time. In the past, it was frontline work—working and building the company, an entrepreneurial venture. I’ve never been a huge fan of the word “entrepreneur,” particularly in today’s environment, because entrepreneur tends to have the view that in today’s world, you built something, and you’re looking at an exit—and I never wanted to be that. I never wanted to be [creating] something that was just building towards some sort of near-term exit, IPO or sale, or private equity backed. I wanted to build something that was going to last for the long term, to have real value. So early on, you do all the work, and then you bring on a few people.

    Over time, that changed. Now, I’m at the point where my days are somewhat atypical, in that I travel quite a bit. All the time I spend in the office is speaking to people to help lead them or empower them to go do the job. In a sense, I’m kind of making myself obsolete over time, or at least, hopefully stepping up to a different level of leadership rather than being the one that’s doing all of the work directly.

    I think I read somewhere that you started with $10,000. Is that right?

    That’s right.

    Were there two or three moments in Mainstreet’s journey from that starting point that were really important?

    Three jump out for me.

    First, we decided that we were going to reinvent the skilled nursing licensure category. Originally, we wanted to reinvent long-term care. As it turns out, we found a great opportunity in the short-stay environment—what’s called post-acute or transitional care today. For me, that was a big moment, from when we went from just acquiring existing properties to deciding that we were going to go create value. That was a key moment. It was a bit daring, to go out and do something that everybody in the industry said could not be done.

    And Mainstreet is now the nation’s largest developer in the transitional care category. What was the next key moment?

    The next key moment was when we lost our debt financing on our first project. Great idea, great business plan, everything was going well. We started construction in October of 2008, and at that point in time, when we were ready to move, we decided to try and beat winter weather to get moving forward with construction. Then the bank called us 10 days before the loan was supposed to close and said, ‘We’re changing terms on you.’ They were trying to get out of the deal. We didn’t know what to do. The $3 million that went into the project didn’t have any debt financing, and this was our first project. This was it. This was what was supposed to make it happen.

    So we had to shut down the project, we paid out all the small subcontractors, and for the big subcontractors we said, ‘Hold on, we’re good for it, we’ll get there.’ We had to go through 120 lenders to get our debt financing back to place on that project. The 120th lender said, ‘Yes,’ after 119 said, ‘No.’ We got it. Six months delay, a lot of anxiety, and we ultimately got it back in place.

    And the third moment?

    The launching of our REIT, our IPO in 2012, was a [third] key moment. That was the moment where we really said, ‘OK, now we’re kind of growing up.’ We had a financing source and a development arm, and were really making these things work together. We did that for two years, until October of last year when we sold that REIT to Health Care REIT (NYSE: HCN), Welltower now, and that was another key moment in which I think we came of age. That was when the industry, for the first time, looked on us as somebody that was credible. Not just a start-up, not just a kind of a niche business play, but really somebody that could really speak to the landscape of what was happening in health care.

    Part of the reputation of Mainstreet now is that it’s very savvy at raising capital. Did your pitch change over those 120 lenders that you were going to?

    When you hear ‘no’ more than 100 times, you have to at least ask yourself, ‘Are we doing the right thing, or is everybody else right?’ So I think there was some organizational confidence that was built during that time period. We know what we’re doing. We do it well. This is going to work. We just have to find the people who believe in us.

    Mainstreet Headquarters, Carmel, Indiana

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    Another thing I learned at that time is the value of partnership. That same bank that said yes to us, which was Centier Bank out of northwest Indiana…we’ve now done more than $200 million worth of business with them. I believe we’re their largest commercial client by a margin. Those types of relationships we keep over a long period of time, so when we do need to go back and raise more capital, they’re there. I believe that if you treat people well, and you do the right things over time, those relationships continue for you.

    Do you think Mainstreet takes more risk than other companies in the post-acute, long-term care, senior housing industry as a whole?

    I do. Where I think we take the most risk is on a day-to-day basis. We take the risk of being wrong.

    We encourage our people to make mistakes on a daily basis—not the big catastrophic ones, but daily mistakes so we can continue to learn and grow in our model.

    “We encourage our people to make mistakes on a daily basis—not the big catastrophic ones, but daily mistakes so we can continue to learn and grow in our model.” – Zeke Turner

    We’ll try something different in design. We’ll try a different programming in operations. We’ll try a different financial structure, like crowdfunding. We’re OK if it messes up, because in that single instance, it doesn’t have an impact on the whole.

    Are there a few pieces of advice that jump out from your career?

    One of the early pieces of advice I got was two-fold. One was hire a really great executive assistant, and I have had several over time—invaluable. The second one was never hire family.

    One thing that really has helped me is that we don’t need to be well-rounded people. We don’t need to be good at everything.

    That’s where the idea of an executive assistant comes in. I’m not great at follow-through or follow-up. I’m not great at time management. My executive assistant, Anne, is phenomenal in those areas, so I let her play to that strength and I play to my strength of being able to be innovative and being in the moment and to help teach and coach and those things, while she helps me time manage or follow-up on the things I need to do.

    Can you talk about the role of faith in your life and in your leadership?

    I reject this idea of this balance or that we are wearing different hats. I am who I am, and so for me I’m a follower of Jesus Christ. I’m a Christian. I don’t expect that everybody believes that way, certainly not everyone in my company believes that way, but I try to create an environment that’s built on the idea of love, and truth, and grace—environments that people would like to be in, regardless of their belief system.

    With that then, everything that I do should flow from that place. Who I am as a husband, who I am as a father, who I am as a CEO and as a leader and as a coach and all these different things. It flows from that place.

    What are some your greatest strengths as a leader?

    My greatest strengths as a leader are in the concept of innovation. Seeing how seemingly disconnected sets of information somehow fit together to create new ideas. For whatever reason, God’s given me a brain that collects a lot of information and I see patterns in things. I see how they can fit together. Those are probably my two greatest strengths.

    I’ve been told that when I interact with people or when I speak to people that they tend to get a little more inspired, a little more lifted up, or encouraged to go do things. So I would say that’s probably a talent as well.

    You said you didn’t like the word ‘entrepreneur,’ can you talk about that?

    An entrepreneur, at least I think in today’s culture, tends to be this guy who had a good idea, gets private equity backing, maybe some sort of investment, grows up a business, and then sells it.

    I didn’t build Mainstreet to ultimately exit in a short time frame. I built this to last as long as—God willing—forever…

    The idea of vision is often associated with leadership. Great leaders have great vision. Do you think that’s something innate to leaders?

    The true creation and true innovation happens in the ‘definite optimist’ category, which is: I know things can get better, there’s an ideal there, there’s an idealist mindset, and here’s a plan for how it’s going to happen.

    So there’s this sense of having a vision, but the important part, which has been really I think a true challenge for me in leadership, is getting that vision out of your head and then getting it communicated to others in a way that they can buy into it. My brain actually thinks 15 years out.

    Do you have a particular book that you share with other people about leadership, or are you just constantly reading? Is there a whole book shelf of books you draw from?

    Right now I’m reading three different books. One is Good Profit by Charles Koch—of the second largest private company in the world, Koch Brothers—and Zero to One by Peter Thiel, which has actually been a really interesting read so far. Then a book called Antifragile by Nicholas Nassim Taleb, which is a fantastic read on organisms or organizations that actually thrive in chaos or in unstable environments versus the more of the fragile approach that breaks when under duress. All very good books.

    Can we flip the coin and talk about some of your weaker areas? Or things that you’re working on?

    I’m definitely not great in time management. Those are just recognized weaknesses. I tend to charge ahead on things and not get people fully bought in. I can tend to just say, ‘this is the right solution, everyone should see that, let’s just move it forward.’ I’ve had to moderate that in a larger organization to get more buy in and get the troops really rallied to the cause rather than just telling them where to go.

    I can change too quickly. I can see something that needs to be done, just set things to change, and I can forget that not everybody is as adaptable or excited about change as I am. I like change. I like changing what foods I eat in the morning for breakfast and changing the style of my clothes and things like that. You can see through a series of different photos online that I change my hairstyle all the time. It’s just fun for me.

     

    The next generation of senior living leaders

    We’ve heard that it’s hard to attract quality staff and to keep them there. Are you finding that’s the case? How are you addressing that challenge?

    I have two answers to that question. If I put on my ‘old long-term care property’ hat, I see the problem. In fact I just heard somebody earlier today say that long-term care may be the only industry or product out there in existence in which neither the customer nor the staff want to be there.

    In our properties, because they’re new and they’re fresh, and they smell good and they have great ventilation and they have great flooring and all of these other things, staffing is not an issue. We have no problem with great staff in our properties because the people want to work there.

    We can’t just be running out the same product year after year and expect our customers or our staff to all of a sudden change their mind and start liking it. The fact is, in most local communities, the major hospital systems have laid of a tremendous amount of health care workers. Those health care workers are not likely to shift it over and become computer programmers. They’re probably still health care workers. They’re probably nurses, they’re probably aides. So, what’s the desirable place that they’re going to go to work? So, that’s the short-term view.

    And in the long term?

    I think the long-term view is that this industry has got to get a lot better at planning for the future. The fact is, if we’re going to run a model that’s going to be five or six years out in terms of staffing, the people that we’re going to be hiring, right now, today, are in high school. So what are we as an industry, or what is Mainstreet doing, to actually get to those people early and encourage them into a career in medicine? Build better properties, [so] people like to be there, plan ahead for the future, and you’ll start to resolve the issue.

    Maybe the senior care industry as a whole needs to have its own nursing schools. Maybe we need to start recruiting from high schools and junior highs into the nursing field. Maybe some of these larger companies need to have visiting nurse or visiting CNA programs so they can actually adjust staffing around the nation as they see supply and demand imbalances.

    How do you attract great talent at this level on the corporate side, keep people excited, and groom the future leaders?

    This model that we believe can make a positive impact on society, and do it through excellence, has been really attractive to people. Particularly because the workforce culture that we have is one that people feel empowered by, and they know they’re going to be cared for, and things are going to be handled the right way. We do things like very clearly outline the behaviors that we say are unacceptable in our company.

    What’s an example of an unacceptable behavior?

    One of those is gossip. We actually don’t allow for gossip in our company. The Bible calls gossip one of the most destructive forces in the universe, and we’ve all seen that play out—families and otherwise. The way we define gossip is anything negative shared with somebody that can’t do something about it directly. So when you spout off about IT because your email’s down or something like that, we say that’s gossip and that can’t happen here because it undermines what we’re trying to accomplish. It undermines our ability to work together as a team. I’ve actually let people go over gossip. Our preference is that you can stay, and the bad behaviors go. If not, maybe you both have to go.

    What that does on the other side is it creates a culture and a workforce environment, what you call a ‘climate,’ in which people feel that they can really thrive. That’s allowed us to be really attractive to people.

    Attractive to “millennials?” There’s a lot of debate about how to engage this younger talent.

    One of the things you hear all the time in employment is that there’s this whole problem with the younger generation, the millennials. They’re not engaged, they’re not excited, things like this. We actually have quite a few young people working here—in the senior care environment no less—who are some of our most passionate, inspired, engaged people. They drive value. They drive innovation. They can’t help it.

    Just yesterday, we had a group from Cornell University in who had actually taken on our company as a research project out of their Johnson Real Estate School. They were talking to us about new wearable technologies and robotics and all of these different things that are available, but never applied in this industry. Now here’s a real opportunity for us to be able to do that. They get excited about that. They’re seeing us differently than they view some of the large players in this industry, as kind of these dodgy big guys. They’re viewing us as somebody they could actually buy into and believe in.

    You have seven kids, you’re the CEO of Mainstreet, and you say you’re bad at time management. How does that work?

    I as a person am not very good at time management. I’ve created a structure around me that is excellent in terms of time management. Between my family and my assistants, and my leaders around me, they help me to stay on point and focused so that I’m being efficient with my time.

    The other thing is, that you really have to know your priorities, and you have to know the timeliness of priorities, such that when I’m here, I’m focused with you, because I believe my wife and kids are in a good place. If for some reason that changes, I get a call that something’s wrong, I shift there, and I walk out and go there. Instead of work-life balance, I call it counterbalance, which is where we’re in the right place in the right time for as much as needed at that time. Work-life is going to be pretty widely counterbalanced, it’s going to go here and then it’s going to go over here, some weeks are really hard, some weeks are pretty soft. Family life is going to be a little tighter. You can’t just disappear for days on end and come back, ‘Hi, by the way I’m dad.’ You have to stay a little closer to it. In any moment you’re really shifting back and forth rather than this myth of ‘it’s just perfectly passively balanced.’ It’s bogus, and then people are just chasing their own tails.

    by shnleader