January 16, 2024 • 39 mins
This week, we are speaking with Jonathan Fleece, President and CEO of Empath Health. Empath Health is a $380m, 3000+ employee hospice, home health, and senior care oriented organization serving 60,000+ people from central to southwest Florida.
Jonathan shares with us how he came to be the CEO of Empath Health, the needs of a CEO from their board members, and merging nonprofit organizations.
“The two most important days in your life are the day you are born and the day you find out why.” We are grateful Jonathan found out why, and is helping make our community a better place as CEO of Empath Health.
Timestamps:
00:00 Introducing Jonathan Fleece, President and CEO of Empath Health
06:20 Stepping off the board to interview for the CEO position
08:25 Compare the roles of a board member and CEO
11:40 For an organization of your size, what do you need from the board?
17:15 Communication between the CEO and the board
22:20 Merging organizations and nonprofit boards
27:00 What was the process of merging organizations?
30:20 Differences between running a nonprofit and for profit?
33:55 Biggest learning curve?
37:10 Recapping with Read
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
On this week's episode of I501cYouthe podcast four nonprofit board members
I interviewed Jonathan Fleece, President& CEO, what is now called Empath Health.
Jonathan is a health careattorney by training, he sat on Tidewell
Hospice’s Board for up to ten yearsuntil he put his hat in the ring
to become president and CEO of Tidewellnow which is Empath.
(00:21):
So please join me as I interviewJonathan, please.
Hey, I want to jump in real quick.
Somebody asked me other day,what does the Corley Company do?
Well, we do three things for nonprofits.
One, we facilitate meetings.
Yes, like board retreats
where we discuss governance and strategywith all the members of the board member
to advise CEOs and help themas they make decisions
and implement actionsto drive their mission.
(00:42):
And then finally, we produce podcastssuch as this one, but also
for a number of nonprofits to help youget the word out, get your message out.
So if you're interestedin any of these services,
please feel free to reach outto Michael@thecorleyompany.com.
Now back to the podcast.
Well, I'm very excited for this week'sepisode of the i501
See you the podcast for nonprofitboard members.
(01:03):
My guest is a longtimefriend, Jonathan Fleece,
now president and CEO of Empath Health.
Jonathan, I know each other from way backfrom from our church days together
before we both movedand had to go attend different churches.
But Jonathan's just a
he's a health care attorney, as I saidin the intro and is now President CEO.
So Jonathan, welcome.
(01:24):
And if you would, would you just sharea little bit about your background
and how you got to become presidentand CEO of Empath Health?
Well, thank you so much, Michael,for having me.
A part of this this perspectiveand and I know very worthwhile podcast.
So it's really a pleasure to be herewith you and the audience today.
So a little bit about myselfand background.
(01:47):
I am the son of a minister and a nurse, so
social service sector was part of mymy youth
and part of my, my growing up experience.
I was honored to attend
Emory University as an undergraduateand knew sort of early on, as a
as a young man that I wanted to pursuehealth care in some way
(02:09):
but didn't know exactly how that would fitand feel
So evaluated really various pathsfor that new
clinical medicinewas not really the path looked at.
Masters of Health Administration'sprograms, looked at law,
ultimately settled on getting my healthlaw degree, and was really very,
(02:30):
very honored and privileged to graduatefrom Saint John's University.
And it was universitiesknown for having one of the nation's top
health law programsand certainly a very proud Billiken
for those who might know ofof this little bill, kids out there
started my career in the health carepractice,
working with large health care systemsprimarily across the Midwest.
(02:54):
I worked onsome fairly large integration deals,
and then ultimatelymy wife and I had a personal tragedy,
and that really changedthe course of my life.
We lost our first daughterto a fatal heart defect,
very, very, very challenging timethat ultimately created really
a reset opportunity for me and for
(03:17):
for my my wife, Amy, now 32 years.
So we came home to Florida.
I had roots in the Florida area.So did she.
And I started my own health carelaw practice when we moved here
and sort of hit a reset button,grew that to really a statewide
platformand sizable health care law practice
(03:42):
coincided with that all through the bookwith coauthor David Houle,
a nationally known
futurist, called The New Health AgeFeature of Health Care in America.
That book we published in 2010around the Affordable Care Act
that opened doorsto consulting alongside law, but
really felt like throughout this processthat something was missing in my life.
(04:04):
So along the way,I started volunteering for tribal hospice.
At the time, it was a hospice,
a not for profit in the Sarasota-ManateeCharlotte, DeSoto County area.
And that really changed the trajectoryof where I now sit today,
work for that organizationas a volunteer board member,
(04:25):
really put together a strategic plan
that included diversifying,growing, expanding And at some point
when the CEO retired,that was sort of my moment to,
I think, embark onwhat is now my life's work.
I resigned from the boardwith my name in a national search
and then was ultimately selectedas as the CEO.
(04:45):
Little bit of a side turn.
During that journey.
We did merge with another organization nowcalled Empath, but it's the new empath.
Although we merged with the Legacy Empathand did enough holding on to that name.
So during that process went througha succession plan of their prior CEO.
So I'm sort of been CEO,step back to president and CEO again.
(05:09):
And really we're full steam aheadwith continued growth at Empath Health.
So I'll spend a very brief overviewof what is Empath Health
just for the benefit of your audienceand sort of know that perspective.
We are a hospice home help
as well as senior careoriented organization.
(05:29):
We serve about 60,000 people a year now
as far north as Ocala, Florida,or more central Florida,
all the way down to Naplesin the southwest Florida area.
And then in the process of hopefullygrowing and bringing on a new organization
in the Palm Beach and Broward areathat will make us the largest
(05:51):
not for profithospice in the country will serve one out
of five Floridianswhen they need hospice care.
But we have certainly broadened that,as I've mentioned, to what we call
full life care.So it's much more than hospice.
It's home based care.
It really helps people during that serious
terminal illnessand often post acute doubt.
(06:11):
So that may have beenmore than you wanted, but that's sort
of the 56 years of job in place in.
And what was that, 5 minutes.
That's what that's Well, well-stated,Jonathan, what an amazing career
you've hadand certainly didn't even do it justice
because I know you better than that,
but we just don't have timeto get into too many of the details.
But it's interesting,as you were talking to things,
(06:33):
I want to highlight and ask you about one,clearly your humility, the humility.
And this is a big organization.I mean, this is a whole nother level.
And for you to step into that role of CEO.
But going back to tied was very,very impressive.
But you said somethingthat may be governance related.
I want people listen toyou were on the board.
You expressed an interest in CEO positionor you had an interest.
(06:55):
You resigned from the board,throw your hat in the ring.
So you literally stepped off the boardduring the search process.
Yes. So
certainly felt like that was appropriate,wanted the board
to feel fully independentand the process to be independent as well.
So it was a separate committee
(07:16):
that was formed,that was a search committee of the board.
And then I stepped back from my board.
Responsibilitycertainly did that for two reasons.
One, I wanted to make sure if I wasthe best fit for the CEO position,
that the organization itselfand the community
could see that we went throughan independent process
(07:36):
that was really no different
than the other candidates,and it was a very competitive process.
They narrowed it down,I think about 150 applicants
to a pool townand then ultimately a pool of three.
And then I was one of the finalists.
But yeah, I felt like it was important toto really establish that independence
during the process.
(07:57):
And a lot of people would not have donethat.
I like
I like that because a lot of this podcast
is about good governance,that is excellent governance
and put in the organizationahead of the individual.
Sometimes people will not do that.
So I commend you for that, Jonathan.
And I think a series certainlythat made your selection
even that much more valuable, important
because it really meantyou were the right person for the job.
You were not influencing the decision.
(08:19):
So I wanted to note that.
So you've been a board member Tidewell,pre Empath Health, which is used
the Empath Health name, but with Tidewell,and now you're CEO.
So can you talk a little bitabout comparing
and contrasting those rolesand responsibilities?
I just find that fascinating governance,governance, oversight.
And now you're the guyanswering to the board.
Just curious how thoseif you can compare those roles, please.
(08:42):
Sure. Happy to do so.
You know, it's
you often you've heard that phrase,you don't know what you don't know.
And while I certainly took my boardresponsibilities
seriously and have been on the tide, well,eventually the parent company board
and some of our other committees, etc.,for about ten years
(09:03):
felt like I knew the organizationreally well.
Shifting into management is absolutelya completely different dimension.
And even though looking backfor our organization,
I truly feel that the boardand the prior CEO
always had a very harmoniousand transparent relationship.
(09:25):
I think probably the biggest eyeopener for me is, is
the board can truly never know 100%
of what's going on day to dayoperationally
and across the various segmentsof the organization.
So what is that lesson?
I think the lesson isthat I cannot underestimate enough
(09:47):
how criticalthe selection process is for the right CEO
and also having enough of that oversight,if you will, of the CEO's team
that the CEO is ultimatelybringing in, too, because
organizations, as theygrow, certainly it's not a one man band
or one person band operationand having board oversight of the CEO
(10:11):
and that leadership team isis is so important because the board has
to have tremendous amount of trust,faith and confidence in their CEO.
So I think that was certainly a big eyeopener to me is just
what the board doesn't knowand therefore leading to the importance
of having trust because there'sjust too much going on day to day.
(10:33):
I think probably the other big shift
is you hear it a lot,but until you actually live it
and experience it, I think it means
something different in contextand that is that the board's role
ultimately is governance oversight,helping with big picture
strategy, mission, vision setting,sort of the foundation for core values.
(10:56):
But but it's it's so important,I think, for the board and for the CEO
to respect the boundariesbetween the board's role, governance,
oversight versus the CEO's role around
operational leadership decision making.
Certainly it's importantto have accountability and connectivity
to the board,
(11:16):
but ultimately the operational leadershipand management responsibilities
is is the CEO's and respectingthose boundaries is super important.
Well, very good.
I can only imagine that transitionand probably
drinking from a firehose,I mean, it maybe continues to be that way.
So an organization your size andyou could share the numbers that you can
you said 60,000 people that you serve,but number of employees and revenue,
(11:40):
if you're able to share that churn,what do you need from a board?
You're the CEO.
What do you need and hope and expectfrom a board of directors?
Sure.
So little sort of facts and dataabout about Empath Health.
So from a gross revenue perspective,we're in our our fiscal year 24 already.
(12:02):
We're on the Medicare fiscal year,which is October to September.
So we have at $380 million grossrevenue budget for fiscal year 24.
If we are able to bring the organizationtogether over in the Palm Beach,
Fort Lauderdale area,we will top 500 million
will be our annual revenueby the end of the year.
(12:25):
So I'll talk through sort of where ourcurrent state is pre integration there.
So 380 without the East Coast expansion
380 million,we employ about 3000 colleagues today
and have close to 3000 volunteerswould certainly this is very important
for not for profits to pluginto that volunteer community as well.
(12:49):
So that's a little bit of the data datametrics for us.
And then shifting to
really what can a CEO really value
and benefit from the mostwith their board relationship.
So first,I think it's really important that
that the CEO and the board are alignedand communicate regularly.
(13:10):
What what's the vision and ambition
and strategic directionfor the for the company?
We are of a follower of the John Doerr
sort of manage what matters and measurewhat matters philosophy.
John Doerr was certainly a famous
and well-regarded leader for companieslike Google and Intel and others,
(13:32):
so we built our entire strategicplan off of John Doerr.
Okay, our system,which stands for objectives,
goals,setting sort of under that strategic plan,
and then measuring those key resultsall the way down from your organizational
top leveldown to your front level management.
So it's it's mission criticalthat all of those are in line
(13:56):
between the CEO and the doorand the board, rather.
What are your top level objectives?
What are your top level goalsthat you're trying to get to?
I think once you set that harmonious
relationshipand make sure that the strategic plan
is certainly embracedand supported by the board,
then you really move into ensuringthat your board
(14:19):
supports giving you the resourceallocation that the organization
needs to achieve those objectivesand to get your key results.
So getting resource allocated
and resourceallocation is mission critical for sure.
A board relationship that sort ofI think coincides with making sure that
(14:39):
that the board and the CEO and leadership
team is that weare all aligned with resource
and fiscal responsibility decisions.
So certainly the CEO doesneed some financial responsibility
and authority,but it needs to be in lockstep
(15:01):
with the boardbecause the CEO certainly should never
step outside of those boundaries,if you will, of of
of what the board's comfortablefrom a fiscal responsibility perspective.
So making surethat the budgets are approved
and we stay within those budgets,that's a big one.
Policy and governance.
That's generally certainlysomething that the board would set,
(15:23):
making sure that the CEO and leadershipteam stays within policies and governance,
evaluation and feedback.
We're right here at the beginning ofa fiscal year end of our our last fiscal.
So we just recently here at Empathfinished our annual review cycle.
My reviews are doneby the executive committee every year.
I think getting that performanceevaluation or feedback is
(15:45):
is super helpful.
We do that through a pretty objectivesurvey process
which which I sort of would support
advocacy that working across the communityand in the state
or nation, depending upon the size,that's a great board responsibility,
helping with stakeholder relationshipsto open communications.
(16:08):
And then ultimately,while I certainly don't have any plans
to retire soon, having that successionplanning is is always important.
So an organization our size,but really frankly, any size.
I do have unnamed successorin both an emergency situation.
So the board always knowswho I would designate to sort of
(16:30):
be the interim CEO of somethingurgent or unexpected
would happen with meand my abilities to serve.
So succession planningcertainly is a big deal.
And then certainly at the point where
I might be closer to that retirement
phase, certainly as an organization grows,
it's it's important that you havesuccession planning ahead of time.
(16:53):
So we like to do that, frankly,
up to two yearsin advance of a planned retirement.
I threw a lot out there, probably more.
But I'll I'll pause there, Michael,and see if you want me to keep going
or ask questions? Well,I think that's really important.
Everything that you said,very important for an organization.
Your side.
I want to I want to zero in onsomething that always seems to be
(17:15):
quite a balancing act,
and that's communication betweenyou and the board, you in committees.
And do you have a structuredcommunication approach, Jonathan?
Is ityou talk to the board chair whenever?
How do you approach that?Because you're super busy guy.
So how do you keep all thatyour arms around it and also ensure to
back and forthcommunication with the board?
(17:37):
I'm a believer that
whether it's board communications, collegecommunications, community
communications, thatthat the lack of communication
can often bethat you know, that the root of all evil.
So I'm a believerwe can't overcommunicate.
In fact, I have a running jokewith the organization and the colleagues
(17:58):
until they tell methat they are sick of hearing it.
Every meeting we open with a recitationof mission, vision, values.
And until everybody acrossthe organization
is just so tired of hearing it,you know, we're going to keep doing it.
Because I think communicatingis just so mission critical
(18:19):
to building the culture and the foundation
fabric, if you will, of ofof the organization's heartbeat.
So that sort of as a sort
of a comprehensive philosophy of mine
when I came in as the new Empath
CEO, which franklyI'm about to celebrate my
(18:41):
my one year anniversary,there was a whole plan.
We called it Building the future.
And the plan was very
well thought out,but written out and methodical
so that over my first year as CEO,we had constant
check ins on on what the buildingthe future planned
(19:01):
look like as as a new CEOunder under new leadership.
So we do it through those kind of formatswhether it be for a written
special project oriented, but probablystepping back at a higher level.
We believe annual meetings are very,very important.
We do those now with the size and scalemore in a hybrid environment.
(19:22):
So some people can be in-person,but we have the technology
and resources where people can come inthrough hybrid environments.
But annual meetings are really important,sort of State of the Union, if you will.
Then on a quarterly basis,we have what we call
our quarterly affiliate reportswith so many different entities
and different service linesand different leaders across each of these
(19:43):
service lines, we always want to make sureon a quarterly basis
that we're reporting out how we're doingon our objectives and key results.
So we report that out quarterly.
Then we also have quarterly boardmeetings,
generally have bi monthlyexecutive committee meetings.
That's the chairman,vice chairman, past chairman and the
(20:06):
and the Treasurer of the boardand the corporation with me.
So we're all we're doing that on a bimonthly basis.
Try to alternate that in between regularmeetings, certainly lots of committees.
I don't always attend the committees.
Certainly some of the management team
can have responsibilityfor some of the board committees.
(20:26):
I'm a big believer in onlinedigital communications.
I do a lot of email communicationand then in special meetings that can be
just with the chair executive committeeor even full,
full board ad hoc as needed.
So very intentional.
Your communication is very intentional.
I share that with clientsthat it can't be haphazard.
(20:47):
Haphazard.We just we're all just too busy.
You've got to develop a planand be very intentional
to ensure that the communication linesfrom the top and the bottom,
because it's not just going to happen.
Completely agree in
fact, every yearwe even will send out surveys
to the board to try to always stay intouch with what times do they prefer
(21:08):
to have meetings because you can oftenget different opinions there.
We try to get them deaf of of statistical
sampling or preferenceto set the times for the meeting.
The frequency of the meetings.
Some now are all in person,but most of them are hybrid.
A few of them,especially on the committee side.
(21:28):
We've kept completely remote
to resume after the pandemicand getting used to that kind of format.
But yeah, we're very intentional about it.
Set the schedulewell in advance of each year
and then we're advocatesand I don't mean to be endorsing products,
but we're advocates too, of having onlineresources that can help the board,
(21:48):
both from a meeting perspective,but also have access to information.
So we use Board Effect and everything
sort of goes through board effectis our code also calendars for meetings,
all the documents,even for prior meetings,
they can get access to it, our bylaws,things like that, policies, charters,
all of that's onlineto really give the tools of the board.
(22:11):
Very good.
Let me let me change direction
a little bit
because there's always talk aboutin the world we got too many nonprofits.
They ought to merge.
Well you've been through well, at leastone now, possibly another nonprofit.
And oftentimes when when there's a hiccup,it's because of board dynamics.
And how do you bring two boards together?
How do you have those discussionsand integrate those?
(22:34):
So having experienced itand having course experience in
previous life as an attorney,
could you outline some best
practices and nonprofit board integration,maybe even weave
even some stuff that you all didand maybe would do differently now?
Yes. So I don't think I had any gray hair,
by the way,before we started all these growth
(22:57):
initiatives coming together,because I think I would be remiss
if I didn't acknowledge our
our really a firm it's hard
merging not for profit or consolidatingnot for profits,
bringing not for profit organizationstogether very, very hard.
(23:18):
And having that experience,as you mentioned, both as a health care,
higherhealth care attorney and consultant,
doing a lot of integrationdeals as a profession
and seeing it on the for profit sidecompared to not for profit,
I would venture to say it's it'smore challenging,
generally speaking, on the not for profitside than it is the for profit side.
(23:41):
And I think there's several reasonsto really support that.
One is often times
not for profits,especially successful ones.
They're so deeply
rooted in the communitiesand they have such amazing board members
that are committed to the mission,committed
to the organization,dedicated to the community.
(24:04):
So the concept ofhow are we going to create something new,
how are we going to
bring to community organizations togethersometimes in the same community,
sometimes different communitieswith different values or different
focus is how are we going to bring thistogether and create create something new?
It's just it's emotional.
There's there's a lot ofof just of of that emotion.
(24:24):
There's a lot of that loyalty.
There's a lot of that sortof sense of pride and an on board
connection to the organizationthat just makes it harder.
And I certainly don't want to imply that,you know,
that humans are always money motivated.
But I do believe when you compare
(24:44):
that to the for profits,
usually in a merger and acquisitionor some sort of an affiliation,
there is a big paycheck involved and
and that's a driver of getting thingsdone.
And can sometimes I'm not saying it takesall the emotions out of a transaction,
but when you've got a buyer and a sellerand a for profit
(25:07):
environmentand there's going to be a big paycheck
at the closing table,that's a driver to get stuff done.
Whereas as in a not for profit world,
it's it's more intrinsic,it's more emotional, if you will.
And I think that whole complexityadds, adds a lot.
Just picking the Empath namewhen when our legacy Tidewell
(25:31):
organization came togetherwith what was legacy Suncoast
and Empath is sort of the parent systemname.
Just the name selection was was super
super hard for for us too.
I think analyze andand get consensus around so
so those areI think some some big some big differences
(25:54):
but at the end of the day whatI would always encourage your audience
not for profit membersto to remember and take heart
of is
is the why why are the organizations
coming togetherand if the why is for the right reasons
which ultimately is to better servethe community, better serve the mission,
(26:17):
better ensure the financial success,sometimes viability of the organization.
If that's your why,then you can't ignore the noise.
You can't ignore these other issues.
But but bring the organizationback to that. Why?
Because that that'swhat we continue to do.
Continue to do even today is
(26:39):
why we're doing this.
And we're doing this to preserve thenot for profit
hospice, homebased care mission for the communities.
We don't continue to grow our our
our sector in health care is really
getting harder and harder to survive.
And when you when the mergerwas even posited, whoever brought it up.
(27:03):
So I'm thinking through the machinations,you you've got to work with your board
chair.
I assume that you two representingthe initial discussions
and then in Suncoast in this case, same,the CEO and Board chair.
So you have those discussionsthen at some point you let the board.
Now can you just,
you know, lift up a tent a little bit?
So what was that like?
(27:24):
Do you recall?
I mean, what were the conversationsand then where did you go from there?
Sure.
So you've outlined it,I think, very well from a
I think a best practice,if you will, perspective
where the CEO boardchair relationship is is
is very, very important to to support
(27:46):
and make sure is is strong.
We have a two year term for board chairs.
I think that's importantjust to give enough longevity,
if you will, to building the relationshipand then
sort of performingunder that relationship.
So we we have two year board chair terms
and and then we did
(28:07):
build a middle layerand as well through our growth
and integration processesand that's with the executive committee.
So we we really would sort ofgo in that order first
making sure that the that the CEOsand the board chairs were all aligned.
Then we would move,then our executive committees.
That's generally, again, as I mentioned,the leader, the current chair, vice chair
(28:30):
or path and or past chair with thenanother officer or secretary treasurer.
So we would have our executive committeesand then we would use that group to
then sort of go outand make sure that we had broader
board alignmentfor, for the integration opportunity.
(28:51):
So there is a balancebecause we currently now
have a 12 person board
and eventuallywe'll probably get that to 15.
So it's not an even number,although thankfully we've never had to
deal with a tie vote.
But, but we have a 12 member board now
and certainly even at a 12 member board
(29:14):
at the parent levelbecause we also have affiliate boards,
but at the parent level,it's impossible to be effective
in transactionsand in coming together with 12 voices.
So it's it's important to have that
sort of unificationand consensus at the chair level.
Then you're executive committee level,then you broaden it out.
(29:37):
Did our
board agree on every single principle,every single term?
Of course not.
So I think ultimately it's not about
having 100% unanimity on decisions.
It's more about getting that consensuswhere everybody
can at least support itenough to move forward versus
having a board memberor more that would just outright veto it.
(30:00):
So we fortunately never got to those.
So that was sort of our our process.
boy, I could do a whole dayinterview on that.
I just find that absolutely intriguing.
Thank you for for sharing that.That gives us some insight.
And anybody out there who is interestedin merging organizations,
that's a solid approach.
So so, Jonathan,a little bit your background
and I want to tap in to thisbefore we end the interview.
(30:22):
You were an attorney.
You worked for a number of for profithealth care companies.
You watched as CEOs ranthose organizations.
You're a CEO of a nonprofit.
Are there major differencesbetween, at the end of the day,
running the organization,a nonprofit and a for profit?
So I'm asked that question a lot.
And I think it's ait's a it's a fabulous question.
(30:43):
So here's how I always answer this.
I believe that that
an organization's tax status
does not define good for great
failure for average.
It's not whether you're for profitor not for profit or your tax status.
(31:06):
I think ultimatelythere are examples of great
for profit organizations,very solid mission.
There's a lot of values,very active in the community,
great cultures, and certainly,you know, same for not for profit.
Certainly we all have paths in highregard there.
But you can look to the other endof the spectrum and they're they're poor,
(31:28):
poorly run and operated, managefor profits and poorly run and operated,
not for profit.
So I really don't believethat the tax status is sort of
what defines good from great or average
from poor because of this reason.
At the end of the day, our Michael,you and I certainly have used this phrase
(31:50):
together in other contextswithout a margin,
there is no mission for any organization,regardless of your tax status.
I think the difference is ultimately
when thereis margin that successful companies
really need to produce,where does that margin go?
(32:11):
And and fundamentally behind
that is who does the organizationanswer to?
Who is the fiduciary duty obligated to?
And certainly thethe fundamental difference is in a
for profit,your fiduciary obligations are to return
investor dollars of shareholder
(32:34):
dividends or partnership returns.
So it's ultimately who you answer tothat is the fundamental difference.
Compare the for profit then to not forprofit, ultimately not for profits.
We answer to the communitynow by being tax exempt
on all of our assetsas well as our income.
(32:56):
We have a charitable obligation to them,
answer to the communityand serve those charitable needs.
So at the end of the day,it really fundamentally boils down
to who do you answer to?
We have to and do answer to the communityto make sure we're
fulfilling our charitable purpose,providing charity care, providing
(33:16):
programmatic supportsto areas of the community
that may be underserved,ensuring access to health care.
That may be sometimes the for profitsdon't always focus on
because they may not have revenueassociated with it.
And that's sort of the big difference is
we answer to the communityfor profits, answer to investors.
And and I would would sort of say that'sthat's the big difference.
(33:40):
But at the end of the day,both organizations
have to have a marginor we want to survive and thrive.
Well stated.
That was the best explanationI've heard. Thank you for sharing that.
So before we go, onelast question, Jonathan.
And so as you moved into this role,what's been the biggest
learning curve for you?
The biggest learning curve,
(34:01):
I think, has probably been driven
by external factors,
and that is the ability to be
valuable, adaptable, flexible
and and and embrace change.
You know, none of us know sometimes
(34:21):
what we take on opportunities,what the future is going to bring.
And I certainly never, everwant to put myself in the categories of,
you know, the historical
leaders that we all have learned aboutand read about that faced,
you know, global challenges,you know, the Winston
Churchill's of theWorld with World War Two and
(34:45):
US presidents that, you know,
certainly to have faced economic meltdownsand other,
you know, just earthchanging and global changing events.
But but I came into this organizationand within the first 12 to 18 months,
we were facing our global pandemicthrough COVID 19, we deliberately decided,
(35:08):
to continue on with our growth, continueon with our merger.
And frankly, we ended uphaving to do much of that over Zoom
without even meeting in person,which was a whole new experience.
I think probably the biggest learningcurve for me
and I would think this is truefor many of your audience
(35:29):
and maybe society as a whole
is, iswe just need to be adaptable to change.
That's just the realityof the global world that we're living in.
And if we if we resist changeor if we reject change
and if we don't stay openminded to all of the changes
that are going on around usand make sure that we as leaders
(35:53):
aren'tleading the organization with the change
and to take advantage of the changeand to seize the opportunity.
Because what the world looks like today
will be potentially completely differenttomorrow.
It certainly will be very differentnext month and next year.
So that's probably beenmy biggest learning curve
(36:14):
is just adaptabilityand being open to rapid change.
Jonathan Fleece, Ladies and gentlemen,president and CEO of Empath Health.
Today, a $380million organization tomorrow
probably closer to a half billionwith well over 3000 employees.
Jonathan,you have been a blessing to our community.
I'm so glad you moved into this roleand you really gave up a career to do it.
(36:36):
Your humble and it is much appreciated.
And thank youfor being a guest on this podcast.
Well, thank you, Michael.
I'll end with the great MarkTwain quote, The two most important days
of our lives, the day we were bornand the day we learn why.
It's just a blessing and a privilege.
And though I was born indoing what I was meant to do
(36:58):
and why I was born,so that it's fulfilling every day.
So thank you for having meand blessing to your audience, too.
All right.
We just heard from Jonathan Fleece,
and now we've got recapping with Read,Read's three observations there.
We can limit it to three because that wasjust packed with information.
Read, what stuck out to you?
Yeah.
So as we go through these interviews, Itake notes and I try to highlight what I.
(37:20):
Want to talk about afterwards.
In almost the entire notesis highlighted for me right now.
But I want to start with Jonathanstepping.
Off of the board.
During the hiring processto make sure that. The.
Process was truly independentand that he had no influence
on if he would be end upgetting that role as CEO.
Yeah, just think about that.
(37:41):
Set the tone for trustin the organization.
People watch that.
There are a lot of people that would nothave stepped off the board to do that
and people thought something was shady.
So I commend him for thatbecause he could have been out
of a volunteer board positions.
Perhaps they would have taken him backor he could have your re-enlisted,
so to speak.
But I commend him for that
because that sets the tonefor how he's going to operate.
Number two, Read.
(38:02):
So Jonathan saidthe board's role is governance.
Oversight, big picture vision.
But it's so important for the boardand the CEO to respect the boundaries.
So the board sticks with oversightand the CEO sticks
with the role in operational leadership.
Yeah, and sometimes those lines do blura little bit
because they are subjectto interpretation. So talk about it.
(38:22):
Establish a boundaries, a guidelinesfor how we're going to operate.
If you're the board in the board chairin the CEO, because there is a concern
that there might be some creep,if you will.
And a lot of times it's honestand not intentionally to be anything
alternative to that. So number three, Read
number threeis going to be about succession planning.
So I thought it was really interestingthat Jonathan does have a named successor
(38:46):
in an emergency situation,but in the situation.
In which he knows he'sgoing to retire, he.
Knowsthat he's going to give about a two year
for the organizationto find that next successor.
So the actual succession plan forthat is not made yet,
but he knows the time linethat he needs to give and Ben,
they'll develop the planfor hiring that next CEO.
(39:07):
Sure and they are already talkingabout it, but certainly every organization
will have a successionif if the CEO or the executive director
gets hit by a bus, who's going to run it?
And it may be that boardchair steps in for a second,
should resign from the board.
If to do that, it
depending on the size of the organizationor it could be somebody else
in the senior leadership roles.
But that should be definedbecause in the heat of the moment
when emotions are highand there's sadness,
(39:29):
if something were to happen,
you don't want to have to be thinkingthrough that process.
So there you go,ladies and gentlemen, recapping with
Read his three observations.
I don't know how he limited it to three,but he did a good job with that.
And so
we will see you next week on the 501CYouThe podcast for nonprofit board members.
On this week's episode of I501cYouthe podcast four nonprofit board members
I interviewed Jonathan Fleece, President& CEO, what is now called Empath Health.
Jonathan is a health careattorney by training, he sat on Tidewell
Hospice’s Board for up to ten yearsuntil he put his hat in the ring
to become president and CEO of Tidewellnow which is Empath.
(00:21):
So please join me as I interviewJonathan, please.
Hey, I want to jump in real quick.
Somebody asked me other day,what does the Corley Company do?
Well, we do three things for nonprofits.
One, we facilitate meetings.
Yes, like board retreats
where we discuss governance and strategywith all the members of the board member
to advise CEOs and help themas they make decisions
and implement actionsto drive their mission.
(00:42):
And then finally, we produce podcastssuch as this one, but also
for a number of nonprofits to help youget the word out, get your message out.
So if you're interestedin any of these services,
please feel free to reach outto Michael@thecorleyompany.com.
Now back to the podcast.
Well, I'm very excited for this week'sepisode of the i501
See you the podcast for nonprofitboard members.
(01:03):
My guest is a longtimefriend, Jonathan Fleece,
now president and CEO of Empath Health.
Jonathan, I know each other from way backfrom from our church days together
before we both movedand had to go attend different churches.
But Jonathan's just a
he's a health care attorney, as I saidin the intro and is now President CEO.
So Jonathan, welcome.
(01:24):
And if you would, would you just sharea little bit about your background
and how you got to become presidentand CEO of Empath Health?
Well, thank you so much, Michael,for having me.
A part of this this perspectiveand and I know very worthwhile podcast.
So it's really a pleasure to be herewith you and the audience today.
So a little bit about myselfand background.
(01:47):
I am the son of a minister and a nurse, so
social service sector was part of mymy youth
and part of my, my growing up experience.
I was honored to attend
Emory University as an undergraduateand knew sort of early on, as a
as a young man that I wanted to pursuehealth care in some way
(02:09):
but didn't know exactly how that would fitand feel
So evaluated really various pathsfor that new
clinical medicinewas not really the path looked at.
Masters of Health Administration'sprograms, looked at law,
ultimately settled on getting my healthlaw degree, and was really very,
(02:30):
very honored and privileged to graduatefrom Saint John's University.
And it was universitiesknown for having one of the nation's top
health law programsand certainly a very proud Billiken
for those who might know ofof this little bill, kids out there
started my career in the health carepractice,
working with large health care systemsprimarily across the Midwest.
(02:54):
I worked onsome fairly large integration deals,
and then ultimatelymy wife and I had a personal tragedy,
and that really changedthe course of my life.
We lost our first daughterto a fatal heart defect,
very, very, very challenging timethat ultimately created really
a reset opportunity for me and for
(03:17):
for my my wife, Amy, now 32 years.
So we came home to Florida.
I had roots in the Florida area.So did she.
And I started my own health carelaw practice when we moved here
and sort of hit a reset button,grew that to really a statewide
platformand sizable health care law practice
(03:42):
coincided with that all through the bookwith coauthor David Houle,
a nationally known
futurist, called The New Health AgeFeature of Health Care in America.
That book we published in 2010around the Affordable Care Act
that opened doorsto consulting alongside law, but
really felt like throughout this processthat something was missing in my life.
(04:04):
So along the way,I started volunteering for tribal hospice.
At the time, it was a hospice,
a not for profit in the Sarasota-ManateeCharlotte, DeSoto County area.
And that really changed the trajectoryof where I now sit today,
work for that organizationas a volunteer board member,
(04:25):
really put together a strategic plan
that included diversifying,growing, expanding And at some point
when the CEO retired,that was sort of my moment to,
I think, embark onwhat is now my life's work.
I resigned from the boardwith my name in a national search
and then was ultimately selectedas as the CEO.
(04:45):
Little bit of a side turn.
During that journey.
We did merge with another organization nowcalled Empath, but it's the new empath.
Although we merged with the Legacy Empathand did enough holding on to that name.
So during that process went througha succession plan of their prior CEO.
So I'm sort of been CEO,step back to president and CEO again.
(05:09):
And really we're full steam aheadwith continued growth at Empath Health.
So I'll spend a very brief overviewof what is Empath Health
just for the benefit of your audienceand sort of know that perspective.
We are a hospice home help
as well as senior careoriented organization.
(05:29):
We serve about 60,000 people a year now
as far north as Ocala, Florida,or more central Florida,
all the way down to Naplesin the southwest Florida area.
And then in the process of hopefullygrowing and bringing on a new organization
in the Palm Beach and Broward areathat will make us the largest
(05:51):
not for profithospice in the country will serve one out
of five Floridianswhen they need hospice care.
But we have certainly broadened that,as I've mentioned, to what we call
full life care.So it's much more than hospice.
It's home based care.
It really helps people during that serious
terminal illnessand often post acute doubt.
(06:11):
So that may have beenmore than you wanted, but that's sort
of the 56 years of job in place in.
And what was that, 5 minutes.
That's what that's Well, well-stated,Jonathan, what an amazing career
you've hadand certainly didn't even do it justice
because I know you better than that,
but we just don't have timeto get into too many of the details.
But it's interesting,as you were talking to things,
(06:33):
I want to highlight and ask you about one,clearly your humility, the humility.
And this is a big organization.I mean, this is a whole nother level.
And for you to step into that role of CEO.
But going back to tied was very,very impressive.
But you said somethingthat may be governance related.
I want people listen toyou were on the board.
You expressed an interest in CEO positionor you had an interest.
(06:55):
You resigned from the board,throw your hat in the ring.
So you literally stepped off the boardduring the search process.
Yes. So
certainly felt like that was appropriate,wanted the board
to feel fully independentand the process to be independent as well.
So it was a separate committee
(07:16):
that was formed,that was a search committee of the board.
And then I stepped back from my board.
Responsibilitycertainly did that for two reasons.
One, I wanted to make sure if I wasthe best fit for the CEO position,
that the organization itselfand the community
could see that we went throughan independent process
(07:36):
that was really no different
than the other candidates,and it was a very competitive process.
They narrowed it down,I think about 150 applicants
to a pool townand then ultimately a pool of three.
And then I was one of the finalists.
But yeah, I felt like it was important toto really establish that independence
during the process.
(07:57):
And a lot of people would not have donethat.
I like
I like that because a lot of this podcast
is about good governance,that is excellent governance
and put in the organizationahead of the individual.
Sometimes people will not do that.
So I commend you for that, Jonathan.
And I think a series certainlythat made your selection
even that much more valuable, important
because it really meantyou were the right person for the job.
You were not influencing the decision.
(08:19):
So I wanted to note that.
So you've been a board member Tidewell,pre Empath Health, which is used
the Empath Health name, but with Tidewell,and now you're CEO.
So can you talk a little bitabout comparing
and contrasting those rolesand responsibilities?
I just find that fascinating governance,governance, oversight.
And now you're the guyanswering to the board.
Just curious how thoseif you can compare those roles, please.
(08:42):
Sure. Happy to do so.
You know, it's
you often you've heard that phrase,you don't know what you don't know.
And while I certainly took my boardresponsibilities
seriously and have been on the tide, well,eventually the parent company board
and some of our other committees, etc.,for about ten years
(09:03):
felt like I knew the organizationreally well.
Shifting into management is absolutelya completely different dimension.
And even though looking backfor our organization,
I truly feel that the boardand the prior CEO
always had a very harmoniousand transparent relationship.
(09:25):
I think probably the biggest eyeopener for me is, is
the board can truly never know 100%
of what's going on day to dayoperationally
and across the various segmentsof the organization.
So what is that lesson?
I think the lesson isthat I cannot underestimate enough
(09:47):
how criticalthe selection process is for the right CEO
and also having enough of that oversight,if you will, of the CEO's team
that the CEO is ultimatelybringing in, too, because
organizations, as theygrow, certainly it's not a one man band
or one person band operationand having board oversight of the CEO
(10:11):
and that leadership team isis is so important because the board has
to have tremendous amount of trust,faith and confidence in their CEO.
So I think that was certainly a big eyeopener to me is just
what the board doesn't knowand therefore leading to the importance
of having trust because there'sjust too much going on day to day.
(10:33):
I think probably the other big shift
is you hear it a lot,but until you actually live it
and experience it, I think it means
something different in contextand that is that the board's role
ultimately is governance oversight,helping with big picture
strategy, mission, vision setting,sort of the foundation for core values.
(10:56):
But but it's it's so important,I think, for the board and for the CEO
to respect the boundariesbetween the board's role, governance,
oversight versus the CEO's role around
operational leadership decision making.
Certainly it's importantto have accountability and connectivity
to the board,
(11:16):
but ultimately the operational leadershipand management responsibilities
is is the CEO's and respectingthose boundaries is super important.
Well, very good.
I can only imagine that transitionand probably
drinking from a firehose,I mean, it maybe continues to be that way.
So an organization your size andyou could share the numbers that you can
you said 60,000 people that you serve,but number of employees and revenue,
(11:40):
if you're able to share that churn,what do you need from a board?
You're the CEO.
What do you need and hope and expectfrom a board of directors?
Sure.
So little sort of facts and dataabout about Empath Health.
So from a gross revenue perspective,we're in our our fiscal year 24 already.
(12:02):
We're on the Medicare fiscal year,which is October to September.
So we have at $380 million grossrevenue budget for fiscal year 24.
If we are able to bring the organizationtogether over in the Palm Beach,
Fort Lauderdale area,we will top 500 million
will be our annual revenueby the end of the year.
(12:25):
So I'll talk through sort of where ourcurrent state is pre integration there.
So 380 without the East Coast expansion
380 million,we employ about 3000 colleagues today
and have close to 3000 volunteerswould certainly this is very important
for not for profits to pluginto that volunteer community as well.
(12:49):
So that's a little bit of the data datametrics for us.
And then shifting to
really what can a CEO really value
and benefit from the mostwith their board relationship.
So first,I think it's really important that
that the CEO and the board are alignedand communicate regularly.
(13:10):
What what's the vision and ambition
and strategic directionfor the for the company?
We are of a follower of the John Doerr
sort of manage what matters and measurewhat matters philosophy.
John Doerr was certainly a famous
and well-regarded leader for companieslike Google and Intel and others,
(13:32):
so we built our entire strategicplan off of John Doerr.
Okay, our system,which stands for objectives,
goals,setting sort of under that strategic plan,
and then measuring those key resultsall the way down from your organizational
top leveldown to your front level management.
So it's it's mission criticalthat all of those are in line
(13:56):
between the CEO and the doorand the board, rather.
What are your top level objectives?
What are your top level goalsthat you're trying to get to?
I think once you set that harmonious
relationshipand make sure that the strategic plan
is certainly embracedand supported by the board,
then you really move into ensuringthat your board
(14:19):
supports giving you the resourceallocation that the organization
needs to achieve those objectivesand to get your key results.
So getting resource allocated
and resourceallocation is mission critical for sure.
A board relationship that sort ofI think coincides with making sure that
(14:39):
that the board and the CEO and leadership
team is that weare all aligned with resource
and fiscal responsibility decisions.
So certainly the CEO doesneed some financial responsibility
and authority,but it needs to be in lockstep
(15:01):
with the boardbecause the CEO certainly should never
step outside of those boundaries,if you will, of of
of what the board's comfortablefrom a fiscal responsibility perspective.
So making surethat the budgets are approved
and we stay within those budgets,that's a big one.
Policy and governance.
That's generally certainlysomething that the board would set,
(15:23):
making sure that the CEO and leadershipteam stays within policies and governance,
evaluation and feedback.
We're right here at the beginning ofa fiscal year end of our our last fiscal.
So we just recently here at Empathfinished our annual review cycle.
My reviews are doneby the executive committee every year.
I think getting that performanceevaluation or feedback is
(15:45):
is super helpful.
We do that through a pretty objectivesurvey process
which which I sort of would support
advocacy that working across the communityand in the state
or nation, depending upon the size,that's a great board responsibility,
helping with stakeholder relationshipsto open communications.
(16:08):
And then ultimately,while I certainly don't have any plans
to retire soon, having that successionplanning is is always important.
So an organization our size,but really frankly, any size.
I do have unnamed successorin both an emergency situation.
So the board always knowswho I would designate to sort of
(16:30):
be the interim CEO of somethingurgent or unexpected
would happen with meand my abilities to serve.
So succession planningcertainly is a big deal.
And then certainly at the point where
I might be closer to that retirement
phase, certainly as an organization grows,
it's it's important that you havesuccession planning ahead of time.
(16:53):
So we like to do that, frankly,
up to two yearsin advance of a planned retirement.
I threw a lot out there, probably more.
But I'll I'll pause there, Michael,and see if you want me to keep going
or ask questions? Well,I think that's really important.
Everything that you said,very important for an organization.
Your side.
I want to I want to zero in onsomething that always seems to be
(17:15):
quite a balancing act,
and that's communication betweenyou and the board, you in committees.
And do you have a structuredcommunication approach, Jonathan?
Is ityou talk to the board chair whenever?
How do you approach that?Because you're super busy guy.
So how do you keep all thatyour arms around it and also ensure to
back and forthcommunication with the board?
(17:37):
I'm a believer that
whether it's board communications, collegecommunications, community
communications, thatthat the lack of communication
can often bethat you know, that the root of all evil.
So I'm a believerwe can't overcommunicate.
In fact, I have a running jokewith the organization and the colleagues
(17:58):
until they tell methat they are sick of hearing it.
Every meeting we open with a recitationof mission, vision, values.
And until everybody acrossthe organization
is just so tired of hearing it,you know, we're going to keep doing it.
Because I think communicatingis just so mission critical
(18:19):
to building the culture and the foundation
fabric, if you will, of ofof the organization's heartbeat.
So that sort of as a sort
of a comprehensive philosophy of mine
when I came in as the new Empath
CEO, which franklyI'm about to celebrate my
(18:41):
my one year anniversary,there was a whole plan.
We called it Building the future.
And the plan was very
well thought out,but written out and methodical
so that over my first year as CEO,we had constant
check ins on on what the buildingthe future planned
(19:01):
look like as as a new CEOunder under new leadership.
So we do it through those kind of formatswhether it be for a written
special project oriented, but probablystepping back at a higher level.
We believe annual meetings are very,very important.
We do those now with the size and scalemore in a hybrid environment.
(19:22):
So some people can be in-person,but we have the technology
and resources where people can come inthrough hybrid environments.
But annual meetings are really important,sort of State of the Union, if you will.
Then on a quarterly basis,we have what we call
our quarterly affiliate reportswith so many different entities
and different service linesand different leaders across each of these
(19:43):
service lines, we always want to make sureon a quarterly basis
that we're reporting out how we're doingon our objectives and key results.
So we report that out quarterly.
Then we also have quarterly boardmeetings,
generally have bi monthlyexecutive committee meetings.
That's the chairman,vice chairman, past chairman and the
(20:06):
and the Treasurer of the boardand the corporation with me.
So we're all we're doing that on a bimonthly basis.
Try to alternate that in between regularmeetings, certainly lots of committees.
I don't always attend the committees.
Certainly some of the management team
can have responsibilityfor some of the board committees.
(20:26):
I'm a big believer in onlinedigital communications.
I do a lot of email communicationand then in special meetings that can be
just with the chair executive committeeor even full,
full board ad hoc as needed.
So very intentional.
Your communication is very intentional.
I share that with clientsthat it can't be haphazard.
(20:47):
Haphazard.We just we're all just too busy.
You've got to develop a planand be very intentional
to ensure that the communication linesfrom the top and the bottom,
because it's not just going to happen.
Completely agree in
fact, every yearwe even will send out surveys
to the board to try to always stay intouch with what times do they prefer
(21:08):
to have meetings because you can oftenget different opinions there.
We try to get them deaf of of statistical
sampling or preferenceto set the times for the meeting.
The frequency of the meetings.
Some now are all in person,but most of them are hybrid.
A few of them,especially on the committee side.
(21:28):
We've kept completely remote
to resume after the pandemicand getting used to that kind of format.
But yeah, we're very intentional about it.
Set the schedulewell in advance of each year
and then we're advocatesand I don't mean to be endorsing products,
but we're advocates too, of having onlineresources that can help the board,
(21:48):
both from a meeting perspective,but also have access to information.
So we use Board Effect and everything
sort of goes through board effectis our code also calendars for meetings,
all the documents,even for prior meetings,
they can get access to it, our bylaws,things like that, policies, charters,
all of that's onlineto really give the tools of the board.
(22:11):
Very good.
Let me let me change direction
a little bit
because there's always talk aboutin the world we got too many nonprofits.
They ought to merge.
Well you've been through well, at leastone now, possibly another nonprofit.
And oftentimes when when there's a hiccup,it's because of board dynamics.
And how do you bring two boards together?
How do you have those discussionsand integrate those?
(22:34):
So having experienced itand having course experience in
previous life as an attorney,
could you outline some best
practices and nonprofit board integration,maybe even weave
even some stuff that you all didand maybe would do differently now?
Yes. So I don't think I had any gray hair,
by the way,before we started all these growth
(22:57):
initiatives coming together,because I think I would be remiss
if I didn't acknowledge our
our really a firm it's hard
merging not for profit or consolidatingnot for profits,
bringing not for profit organizationstogether very, very hard.
(23:18):
And having that experience,as you mentioned, both as a health care,
higherhealth care attorney and consultant,
doing a lot of integrationdeals as a profession
and seeing it on the for profit sidecompared to not for profit,
I would venture to say it's it'smore challenging,
generally speaking, on the not for profitside than it is the for profit side.
(23:41):
And I think there's several reasonsto really support that.
One is often times
not for profits,especially successful ones.
They're so deeply
rooted in the communitiesand they have such amazing board members
that are committed to the mission,committed
to the organization,dedicated to the community.
(24:04):
So the concept ofhow are we going to create something new,
how are we going to
bring to community organizations togethersometimes in the same community,
sometimes different communitieswith different values or different
focus is how are we going to bring thistogether and create create something new?
It's just it's emotional.
There's there's a lot ofof just of of that emotion.
(24:24):
There's a lot of that loyalty.
There's a lot of that sortof sense of pride and an on board
connection to the organizationthat just makes it harder.
And I certainly don't want to imply that,you know,
that humans are always money motivated.
But I do believe when you compare
(24:44):
that to the for profits,
usually in a merger and acquisitionor some sort of an affiliation,
there is a big paycheck involved and
and that's a driver of getting thingsdone.
And can sometimes I'm not saying it takesall the emotions out of a transaction,
but when you've got a buyer and a sellerand a for profit
(25:07):
environmentand there's going to be a big paycheck
at the closing table,that's a driver to get stuff done.
Whereas as in a not for profit world,
it's it's more intrinsic,it's more emotional, if you will.
And I think that whole complexityadds, adds a lot.
Just picking the Empath namewhen when our legacy Tidewell
(25:31):
organization came togetherwith what was legacy Suncoast
and Empath is sort of the parent systemname.
Just the name selection was was super
super hard for for us too.
I think analyze andand get consensus around so
so those areI think some some big some big differences
(25:54):
but at the end of the day whatI would always encourage your audience
not for profit membersto to remember and take heart
of is
is the why why are the organizations
coming togetherand if the why is for the right reasons
which ultimately is to better servethe community, better serve the mission,
(26:17):
better ensure the financial success,sometimes viability of the organization.
If that's your why,then you can't ignore the noise.
You can't ignore these other issues.
But but bring the organizationback to that. Why?
Because that that'swhat we continue to do.
Continue to do even today is
(26:39):
why we're doing this.
And we're doing this to preserve thenot for profit
hospice, homebased care mission for the communities.
We don't continue to grow our our
our sector in health care is really
getting harder and harder to survive.
And when you when the mergerwas even posited, whoever brought it up.
(27:03):
So I'm thinking through the machinations,you you've got to work with your board
chair.
I assume that you two representingthe initial discussions
and then in Suncoast in this case, same,the CEO and Board chair.
So you have those discussionsthen at some point you let the board.
Now can you just,
you know, lift up a tent a little bit?
So what was that like?
(27:24):
Do you recall?
I mean, what were the conversationsand then where did you go from there?
Sure.
So you've outlined it,I think, very well from a
I think a best practice,if you will, perspective
where the CEO boardchair relationship is is
is very, very important to to support
(27:46):
and make sure is is strong.
We have a two year term for board chairs.
I think that's importantjust to give enough longevity,
if you will, to building the relationshipand then
sort of performingunder that relationship.
So we we have two year board chair terms
and and then we did
(28:07):
build a middle layerand as well through our growth
and integration processesand that's with the executive committee.
So we we really would sort ofgo in that order first
making sure that the that the CEOsand the board chairs were all aligned.
Then we would move,then our executive committees.
That's generally, again, as I mentioned,the leader, the current chair, vice chair
(28:30):
or path and or past chair with thenanother officer or secretary treasurer.
So we would have our executive committeesand then we would use that group to
then sort of go outand make sure that we had broader
board alignmentfor, for the integration opportunity.
(28:51):
So there is a balancebecause we currently now
have a 12 person board
and eventuallywe'll probably get that to 15.
So it's not an even number,although thankfully we've never had to
deal with a tie vote.
But, but we have a 12 member board now
and certainly even at a 12 member board
(29:14):
at the parent levelbecause we also have affiliate boards,
but at the parent level,it's impossible to be effective
in transactionsand in coming together with 12 voices.
So it's it's important to have that
sort of unificationand consensus at the chair level.
Then you're executive committee level,then you broaden it out.
(29:37):
Did our
board agree on every single principle,every single term?
Of course not.
So I think ultimately it's not about
having 100% unanimity on decisions.
It's more about getting that consensuswhere everybody
can at least support itenough to move forward versus
having a board memberor more that would just outright veto it.
(30:00):
So we fortunately never got to those.
So that was sort of our our process.
boy, I could do a whole dayinterview on that.
I just find that absolutely intriguing.
Thank you for for sharing that.That gives us some insight.
And anybody out there who is interestedin merging organizations,
that's a solid approach.
So so, Jonathan,a little bit your background
and I want to tap in to thisbefore we end the interview.
(30:22):
You were an attorney.
You worked for a number of for profithealth care companies.
You watched as CEOs ranthose organizations.
You're a CEO of a nonprofit.
Are there major differencesbetween, at the end of the day,
running the organization,a nonprofit and a for profit?
So I'm asked that question a lot.
And I think it's ait's a it's a fabulous question.
(30:43):
So here's how I always answer this.
I believe that that
an organization's tax status
does not define good for great
failure for average.
It's not whether you're for profitor not for profit or your tax status.
(31:06):
I think ultimatelythere are examples of great
for profit organizations,very solid mission.
There's a lot of values,very active in the community,
great cultures, and certainly,you know, same for not for profit.
Certainly we all have paths in highregard there.
But you can look to the other endof the spectrum and they're they're poor,
(31:28):
poorly run and operated, managefor profits and poorly run and operated,
not for profit.
So I really don't believethat the tax status is sort of
what defines good from great or average
from poor because of this reason.
At the end of the day, our Michael,you and I certainly have used this phrase
(31:50):
together in other contextswithout a margin,
there is no mission for any organization,regardless of your tax status.
I think the difference is ultimately
when thereis margin that successful companies
really need to produce,where does that margin go?
(32:11):
And and fundamentally behind
that is who does the organizationanswer to?
Who is the fiduciary duty obligated to?
And certainly thethe fundamental difference is in a
for profit,your fiduciary obligations are to return
investor dollars of shareholder
(32:34):
dividends or partnership returns.
So it's ultimately who you answer tothat is the fundamental difference.
Compare the for profit then to not forprofit, ultimately not for profits.
We answer to the communitynow by being tax exempt
on all of our assetsas well as our income.
(32:56):
We have a charitable obligation to them,
answer to the communityand serve those charitable needs.
So at the end of the day,it really fundamentally boils down
to who do you answer to?
We have to and do answer to the communityto make sure we're
fulfilling our charitable purpose,providing charity care, providing
(33:16):
programmatic supportsto areas of the community
that may be underserved,ensuring access to health care.
That may be sometimes the for profitsdon't always focus on
because they may not have revenueassociated with it.
And that's sort of the big difference is
we answer to the communityfor profits, answer to investors.
And and I would would sort of say that'sthat's the big difference.
(33:40):
But at the end of the day,both organizations
have to have a marginor we want to survive and thrive.
Well stated.
That was the best explanationI've heard. Thank you for sharing that.
So before we go, onelast question, Jonathan.
And so as you moved into this role,what's been the biggest
learning curve for you?
The biggest learning curve,
(34:01):
I think, has probably been driven
by external factors,
and that is the ability to be
valuable, adaptable, flexible
and and and embrace change.
You know, none of us know sometimes
(34:21):
what we take on opportunities,what the future is going to bring.
And I certainly never, everwant to put myself in the categories of,
you know, the historical
leaders that we all have learned aboutand read about that faced,
you know, global challenges,you know, the Winston
Churchill's of theWorld with World War Two and
(34:45):
US presidents that, you know,
certainly to have faced economic meltdownsand other,
you know, just earthchanging and global changing events.
But but I came into this organizationand within the first 12 to 18 months,
we were facing our global pandemicthrough COVID 19, we deliberately decided,
(35:08):
to continue on with our growth, continueon with our merger.
And frankly, we ended uphaving to do much of that over Zoom
without even meeting in person,which was a whole new experience.
I think probably the biggest learningcurve for me
and I would think this is truefor many of your audience
(35:29):
and maybe society as a whole
is, iswe just need to be adaptable to change.
That's just the realityof the global world that we're living in.
And if we if we resist changeor if we reject change
and if we don't stay openminded to all of the changes
that are going on around usand make sure that we as leaders
(35:53):
aren'tleading the organization with the change
and to take advantage of the changeand to seize the opportunity.
Because what the world looks like today
will be potentially completely differenttomorrow.
It certainly will be very differentnext month and next year.
So that's probably beenmy biggest learning curve
(36:14):
is just adaptabilityand being open to rapid change.
Jonathan Fleece, Ladies and gentlemen,president and CEO of Empath Health.
Today, a $380million organization tomorrow
probably closer to a half billionwith well over 3000 employees.
Jonathan,you have been a blessing to our community.
I'm so glad you moved into this roleand you really gave up a career to do it.
(36:36):
Your humble and it is much appreciated.
And thank youfor being a guest on this podcast.
Well, thank you, Michael.
I'll end with the great MarkTwain quote, The two most important days
of our lives, the day we were bornand the day we learn why.
It's just a blessing and a privilege.
And though I was born indoing what I was meant to do
(36:58):
and why I was born,so that it's fulfilling every day.
So thank you for having meand blessing to your audience, too.
All right.
We just heard from Jonathan Fleece,
and now we've got recapping with Read,Read's three observations there.
We can limit it to three because that wasjust packed with information.
Read, what stuck out to you?
Yeah.
So as we go through these interviews, Itake notes and I try to highlight what I.
(37:20):
Want to talk about afterwards.
In almost the entire notesis highlighted for me right now.
But I want to start with Jonathanstepping.
Off of the board.
During the hiring processto make sure that. The.
Process was truly independentand that he had no influence
on if he would be end upgetting that role as CEO.
Yeah, just think about that.
(37:41):
Set the tone for trustin the organization.
People watch that.
There are a lot of people that would nothave stepped off the board to do that
and people thought something was shady.
So I commend him for thatbecause he could have been out
of a volunteer board positions.
Perhaps they would have taken him backor he could have your re-enlisted,
so to speak.
But I commend him for that
because that sets the tonefor how he's going to operate.
Number two, Read.
(38:02):
So Jonathan saidthe board's role is governance.
Oversight, big picture vision.
But it's so important for the boardand the CEO to respect the boundaries.
So the board sticks with oversightand the CEO sticks
with the role in operational leadership.
Yeah, and sometimes those lines do blura little bit
because they are subjectto interpretation. So talk about it.
(38:22):
Establish a boundaries, a guidelinesfor how we're going to operate.
If you're the board in the board chairin the CEO, because there is a concern
that there might be some creep,if you will.
And a lot of times it's honestand not intentionally to be anything
alternative to that. So number three, Read
number threeis going to be about succession planning.
So I thought it was really interestingthat Jonathan does have a named successor
(38:46):
in an emergency situation,but in the situation.
In which he knows he'sgoing to retire, he.
Knowsthat he's going to give about a two year
for the organizationto find that next successor.
So the actual succession plan forthat is not made yet,
but he knows the time linethat he needs to give and Ben,
they'll develop the planfor hiring that next CEO.
(39:07):
Sure and they are already talkingabout it, but certainly every organization
will have a successionif if the CEO or the executive director
gets hit by a bus, who's going to run it?
And it may be that boardchair steps in for a second,
should resign from the board.
If to do that, it
depending on the size of the organizationor it could be somebody else
in the senior leadership roles.
But that should be definedbecause in the heat of the moment
when emotions are highand there's sadness,
(39:29):
if something were to happen,
you don't want to have to be thinkingthrough that process.
So there you go,ladies and gentlemen, recapping with
Read his three observations.
I don't know how he limited it to three,but he did a good job with that.
And so
we will see you next week on the 501CYouThe podcast for nonprofit board members.
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