When Speaking Your Truth Changes Lives: Manda Ayoub’s Leadership Philosophy

Anthony Codispoti: Welcome to another edition of the Inspired Stories podcast where leaders share their experiences so we can learn from their successes and be inspired by how they’ve overcome adversity. My name is Anthony Codispoti and today’s guest is Manda Ayoub, Chief Operating Officer at Pomeroy Living. Founded over 30 years ago in Michigan, they provide compassionate and innovative senior services which includes assisted living, memory care, skilled nursing, short-term rehabilitation, and more. Their mission is to deliver adaptable, high-quality care that celebrates life at every stage. Amanda has been part of the organization since 2011, bringing over 30 years of experience in the healthcare industry. She oversees the operations and outcomes of the clinical team while ensuring regulatory compliance. Among her many responsibilities, Amanda is particularly passionate about team building, system implementation, and education. Amanda has played a pivotal role in opening two state-of-the-art assisted living communities and integrating newly acquired properties into the Pomeroy portfolio and business model. She also spearheaded numerous healthcare initiatives that have significantly improved patient outcomes. And in 2023, Amanda earned recognition for completing the reducing implicit bias in healthcare workshop from Electric Cal. Now, before we get into all that good stuff, today’s episode is brought to you by my company, Add Back Benefits Agency, where we offer very specific and unique employee benefits that are both great for your team and fiscally optimized for your bottom line. One recent client was able to add over $900 per employee per year in extra cash flow by implementing one of our innovative programs. Results vary for each company, and some organizations may not be eligible.

To find out if your company qualifies, contact us today at addbackbenefitsagency.com. All right, back to our guest today, the COO of Pomeroy Living, Amanda. I appreciate you making the time to share your story today. Thank you.

Manda Ayoub: It’s great to be here. Honored.

Anthony Codispoti: So, 30 years of experience in the healthcare industry, what first drew you in?

Manda Ayoub: Oh, that’s a good question. So I got into healthcare because of my grandfather. I was a very young child. My grandfather was foreign speaking, and he was sick and in the end of his life, hospitalized almost monthly. So my siblings and I and my parents all took turns staying in the hospital with him. And one night after sleeping in a chair all night, there were some interactions, some amazing, some not so amazing. And one of those interactions kind of set a bit of a fire in me that people needed amazing care. So at the young age of I think 11 or 12, I decided I was going to be a nurse and then became a candy striper.

I think somewhere around 15. And then in high school, we had a health occupations class in which we became nurse assistants. And I did that in my senior year. One first place actually in a national competition for nurse aides, my bed making abilities, the ability to take blood pressures, et cetera. So it started really early for me. There was a question of health care.

Anthony Codispoti: What was the negative experience? Your grandfather just wasn’t receiving the kind of attention that he deserved?

Manda Ayoub: You know, I think there’s negative experience in everything, right? But there was tons of positive. But the negative was my grandfather was a tall man. He was about six foot and didn’t speak English and he had diabetes and his legs were affected. And so he needed help getting up to the restroom. And he was a very dignified person.

And this nurse instead of helping him kind of pushed him back in bed. And I’m sure it was a timing and a moment. I’m hoping it wasn’t who she was all the time, but it hurt my soul to a level I didn’t think could be hurt. So I just knew at that moment that wasn’t going to happen under my watch. So I needed to be that nurse and show him how it was done.

Anthony Codispoti: And so you became a nurse became a nurse. And you started early.

Manda Ayoub: The candy striper, candy striper, nurse aid, nurse, tack, nurse. Yeah, long time.

Anthony Codispoti: And then and then when did you get involved in more of the administration side of things?

Manda Ayoub: You know, that was funny. So as you work up every position you’re in, right, you can’t wait to be in that next position because you realize you can impact more. So when I was a nurse, I couldn’t wait to be a nurse so that I could not just take care of them, but like make sure their meds were right and answer their questions and be by their bedside. And then when I was a nurse, then I wanted to be a unit manager because I wanted to make sure all the nurses that work on the unit were great. When I was the unit manager, I wanted to be the director of nursing because then I could make sure all the nurses were great. And then when I was the director of nursing, I wanted to be the administrator because at the end of the day, the decisions the administrator make all the patients. And it’s that crazy drive to affect as many people as possible that kind of drove me. I just wanted more. I wanted to make the decisions that affected the patient outcomes.

Anthony Codispoti: So we hear about the inspiration for getting into healthcare in the first place, the experience there with your grandfather. Did you have role models that sort of gave you the confidence growing up that you could aspire to these higher levels of responsibility?

Manda Ayoub: Oh, God, yeah. Along the way, everywhere. When it started as a candy striper at Bikini Hospital, there was a nurse I worked for who showed me things that maybe candy strippers weren’t supposed to see.

But she incited passion and told me it could be more. And then as a nurse aide at Holy Cross Hospital, I worked under amazing nurses who were constantly teaching me and telling me how great I could be in this industry. There was tons of amazing clinicians who inspired me. One of my biggest inspirations is a woman named Angie Shomlinsky who heads health cap, which is an insurance program. She was my administrator once upon a time in nursing. She did it with style and grace. This woman would be at a patient’s bedside in one minute because she was also a nurse and a nursing home administrator.

And then the next minute I would find her in the kitchen with a hair net on the food line. And I was inspired by so many amazing, amazing nurses. So many mentors. Couldn’t even name them all if I wanted to. I was very lucky. I’ve been surrounded by amazing humans.

Anthony Codispoti: And then how did the opportunity at Pomeroy first open up for you?

Manda Ayoub: That’s a good one. So I was working for a company that managed one of Pomeroy, Mr. Pomeroy’s first nursing homes. He owned multiple but didn’t manage them. Every one of them was managed by a different organization. So he had a building. It was in a little bit of trouble. And the management company that I worked for said, we really need you to go into this building.

It needs you. And I then met with Mr. Pomeroy and his president at the time and talked about who I was and what I could do. And then after some conversations they gave me an offer to come out and run their building in Rochester.

And it wasn’t a little bit of trouble at the time. The management company that was managing it that I worked for was having a hard time really getting the right leader in that community. And so that’s where it started. I went in and just started working.

Anthony Codispoti: And so what was the biggest problem you needed to clean up first?

Manda Ayoub: I think most health care problems are tied back to validation and the tough conversation. We have a lot of leaders who want to be liked and want to be friendly. But that’s not what a leader really is. A leader is a person who’s okay with the tough conversations, who is fair and consistent, who holds people accountable, who can love you even when they have to let you go. So leadership is tough. And it’s not for everyone. And a lot of people strive to be leaders and get into these roles but aren’t really ready to do what it takes to make it work.

Anthony Codispoti: Where do you think your comfort with having these hard conversations comes from?

Manda Ayoub: That’s my parents. So I am born of a woman who has no filter. God love her. And she was a tough mom. And my dad was tough growing up as well but very loving.

So there was a little bit of both. But my dad also promoted debate in our house. If my siblings and I were arguing, he wouldn’t really stop us. He wouldn’t make us debate it out, which was nice. We got comfortable being uncomfortable.

And that’s a lot of people don’t get that same practice at home. They’re silenced. Their opinions don’t matter. Our opinions mattered from an early age. We had family dinners in which we debated politics. I mean, what 10-year-old has an opinion about politics? Well, most 10-year-olds had opinions of their parents. We had our own and we were promoted to have them.

Anthony Codispoti: So that’s really interesting. You mentioned I’ve got a 10-year-old son and an 8-year-old son. And man, they go at it like cats and dogs. And my wife and I are reflex is, guys, just knock it off. It doesn’t just please be quiet. Stop arguing.

And now I wonder if we’re taking the wrong approach, right? This conversation with you today, just yesterday, I had a conversation with another strong woman, a CFO of a 1,000-person company. And she had similar comments about how her ability to have these difficult conversations is her superpower.

It’s like a big reason for her success. And I wonder if by sort of shushing the kids all the time, if we’re sort of robbing them of sort of developing that skill themselves.

Manda Ayoub: I think sometimes there’s a need to be shushed, right? I think sometimes there’s a need for debate. So you’ve got to decide, is this the time in which you want their debating skills to come out? You want them to be able to defend themselves and to defend their theory on why they’re arguing.

Anthony Codispoti: And so with your dad providing coaching during these debates?

Manda Ayoub: Sometimes it was just a, hey, speak kindly. Are you your point? And then there were times the shushing came along because we weren’t getting anywhere, but he really did promote our debating. And yeah, I kind of have a passion for debate.

I love it. I tell my teams here, if you just yes me, I’m not going to appreciate it. I need, because I think greatness comes from debate. I think we’ve come to great things in this organization because I do have a team who debates me. And I love that.

Anthony Codispoti: Okay. So you come into this one building. People had been afraid to have the hard conversations. Amanda is not. So you come in, you’re having the hard conversations, probably letting some folks go, probably telling folks you’re doing the wrong things. How long before you kind of saw things start to shape up? Less than 90 days. That’s pretty fast.

Manda Ayoub: When there’s fairness and consistency and you teach your teams to do the exact same thing you do and you lead by example, you can make change really quickly. So we turned this building around from a one star to a five star and under six months.

Anthony Codispoti: And explain that rating system. What is one star? I mean, obviously it’s an improvement.

Manda Ayoub: So CMS rates our homes. And the system has changed over the years, right? So the CMS star rating system has changed. They’ve added other triggers and other indicators at the time. You know, it was basically about care, survey outcomes, staffing, et cetera. And this building had some survey issues.

Licensing was there constantly due to complaints. And listen, overall the care was really great. It was the communication that was faltering and failing. And it was not consistency in the accountability.

So there was some staff that was performing on point every day. And then there was others who people weren’t touching because they felt like, you know, they wouldn’t be supported. And so they allowed the bad behaviors to continue. And so we just, we started addressing it. And I think when the staff saw that managers were being held to the same standard as staff, that changed everything very quickly there. Because I think that was probably our biggest issue in that community.

Was there was almost like a two-tier system, you know, frontline staff and then management staff. And they were not held to the same standard. Well, that changed pretty quick. And everyone kind of fell in line. And we worked together.

You know, when you see your administrator answering call lights or passing food trays, you know, like I said, I learned from Angie, I’ve been found in the kitchen with a hair nut, you know. We had a cook who had a family emergency and there was a group tax and I sent him on my way. And two of my nurses from another building met me there and we ended up cooking and serving dinner. I mean, might not have been the best dinner in the world, but nobody missed a meal that day. Nobody was going hungry. That’s right. There wasn’t, actually there wasn’t any complaints. I think we did okay. So yeah.

Anthony Codispoti: So, okay. So you come in, you help to turn this one facility around and it kind of been in bad shape. Obviously, your work gets noticed and they say, okay, Manda, we’d like for you to take on some more responsibility. What did that next step look like?

Manda Ayoub: So the next step was Keith deciding that maybe he didn’t want a management company managing his businesses anymore. So we started with just one and it was the Rochester community and we brought it on and it was really, it was functioning beautifully and we then started building our system living in Northville. And Keith said, I think it’s time to let go of the management company here and I want you to come to the corporate office and be my VP at the time.

Anthony Codispoti: That sounds like a pretty big transition. Like for somebody who’s on the outside of healthcare and senior living looking in, what exactly is the management company doing? Everything. Everything.

Manda Ayoub: We did everything. So the management company, and I worked for the management company and I came from that company to the building that they were managing. I had been with them for- This is an outside third party.

Anthony Codispoti: Yes. That owns not only their own homes, but managed other homes. So I was working with them mainly in their own homes as a kind of a senior admin training new administrators for them, helping with calls and questions. But when they put me here, I don’t know that their intention was ever for me to leave them and work directly for Mr. Potmarian. It wasn’t my intention, but when it came up and I talked to them, they were like, man, this is a great opportunity. They were such a great employer. I learned so much from them.

Anthony Codispoti: The management company was supportive of you making this transition from being an employee to almost a competitor.

Manda Ayoub: Okay. And to this day, I still have a great relationship with them. They’ve sold their businesses since and they’re both retired, but we still have the utmost respect for one another. But they were like, you have something, do this. And had a little boy and viage for me, sent me a beautiful plant that I still have all these years later.

They’re great humans and it was fun. But a management company does so much. They handled our IT, our HR, our billing, our collections, the day to day they oversaw our legal compliance.

Anthony Codispoti: This is a lot. You’re right. And people in processes.

Manda Ayoub: So it started just by hiring the administrator and then taking myself out of that role and then starting to detangle us from each one of those management level contracts. So I had to become and listen, working for the management company for as long as I did, I knew our operations. I knew HR. I knew IT. I knew our billing. Was I the expert in them?

No. But I knew who to contact and I knew how to build the team to support the communities. So and in this industry, it’s kind of interesting. We do support each other, even if we’re in separate organizations. You know, there’s some pretty big nursing home organizations in Michigan, you know, two to three really big ones.

And I know the ownership and management of each of them and they know me and we call each other. We support each other. Because at the end of the day, if you really care about seniors in the industry that you serve, you don’t want them to have bad outcomes either because it affects those seniors that live with them. When we raise a bar, we want our raised for everybody, not just us.

Anthony Codispoti: And so when you call folks at some of these we’ll call them competitors that you’ve got a good relationship with what kind of things are you talking about?

Manda Ayoub: We talk about everything. For example, there’s a new Earn Sick Leave Act that just rolled out in Michigan in which employers have to give so many hours of sick time for each employee that works 30 hours. And so that was new and the rule kept changing.

And in the final hour, it changed again. And so we’re all like panicking to get it done. Well, we’ll call each other and sometimes we’ll even do group texts of, hey, you know, this act. How are you guys handling it? How are you handling it? What are you doing for your contingent staff?

Are you front loading it or back loading it or is it accrued? And so you share how you’re handling it. You debate with one another and you realize at the end of the day, we all have the same regulation. And if we can help each other, we should.

Anthony Codispoti: You’re all trying to navigate the same complexities. We are. And we are high. And I remember hearing about this law. Where did it end up? Like what are the new requirements?

Manda Ayoub: Well, it changed the day before it was supposed to be implemented, which is like that night at midnight. It is crazy. So you have to notify each of your staff in English and in Spanish about this new or in sick time rule, but the flyer has changed. So we had already started having our staff sign the flyer and give them copies and now we have to start over.

Fine, fine, fine. And they have to start accruing. And so we are working with our payroll companies.

The accrual started on the day of the event. The time clocks are not yet ready, but we’re in process. So even though they can’t see it yet, it’s working in the background. And so we’re going to get it so that they can see that they’re earning it. But we’re also revising because as a company, we had combined time off.

So our CTO timer combined time off was really generous. It actually overcompensates this law. But the problem is our contingent staff don’t get that. But in this law, your contingent staff who aren’t really full time, they just pick up a shift here and there.

They need to earn it as well. So now we have to adjust our policy. Right. And so we work with lawyers and spend way too much money. But it is what it is. This is regulation. And we have to look at it.

Anthony Codispoti: Well, hopefully you spent a little bit less money by sharing notes with your colleagues.

Manda Ayoub: It does help that. Yes.

Anthony Codispoti: We had this idea. What do you guys think? Oh, we were told this.

Manda Ayoub: And most of these things would turn me, which is interesting. Okay. So yeah, the attorney kind of pushes out this one policy to most of us, right? With specific changes between us.

Anthony Codispoti: Gotcha. It’s so great that you’ve got sort of that network of support. People that are doing the same thing that you’re doing at a high level. They’re seeing the same kinds of things running into the same issues. And you can pick up the phone and say, hey, you know, how are you guys dealing with this?

Manda Ayoub: Yeah. And you can tell the better companies aren’t afraid to share, right? So we share, we work together. We compromise. It really is for the benefit of the industry.

Anthony Codispoti: Yeah. Like you said, if you really care about taking care of seniors, you want to take care of everybody. That’s right. With the aging population that we have, you know, the boomers getting older, there is no shortage of…

Manda Ayoub: No, the shortage for us is really staff. And we have to figure out how to overcome that shortage. Yeah.

Anthony Codispoti: What do you do? Like what are some effective strategies you’ve found to recruit and retain folks?

Manda Ayoub: That’s a million dollar question there. We are constantly changing things. There’s really no cookie cutter answer. I have seven buildings in different areas and different things work in different areas. You know, it’s about the culture of the area, the community. Is there a community?

Are they coming in from other communities? You know, I wish there was a one size fits all answer to that question. There isn’t. People’s love languages are different. How they feel inspired and driven is different.

Anthony Codispoti: Different by geography. Definitely. This part of Michigan versus that part of Michigan, folks are looking for something. Can you give me one example of a difference between two areas?

Manda Ayoub: I have one building that is only driven by cash. Only cash. I have another building because our wages are pretty set across the board. It doesn’t matter what location you work at.

If this is what you do and this is your years experience, this is what you get paid. One building is like this one building, it’s never enough. My other buildings, it is ample and they appreciate the employer appreciation and all the other things. That kind of feeds their love language because we’re always celebrating our staff. This one building, it doesn’t matter how much you celebrate, it doesn’t matter what the wages, it’s never enough. It’s a community thing.

Anthony Codispoti: Speaking of community, how do you find yourself and Pomeroy getting involved in each of the communities that you’re located in?

Manda Ayoub: Oh my God, I don’t know. We’re so deeply involved. I don’t know how not to be. Sometimes I think we’re too in the weeds, which stops our high level thinking sometimes because we are so involved in the day to day.

Anthony Codispoti: Tell me about the ChildSafe program. What is that?

Manda Ayoub: ChildSafe, that’s a Keith Pomeroy passion project. So him and our president Nick Perino are very active and both active members of the board. ChildSafe is a Michigan foster care program that Keith drove or built up and it basically, it’s a passion project. It’s about taking care of Michigan’s children in the foster system.

And Keith worked really hard. We actually partnered with the Judson Center, which is a national organization. And every year we honor Michigan’s foster kids.

We have a ceremony. We raise tons of money, at least a half million at these events for Michigan foster care. These, you know, it’s getting them supplies, backpack, school supplies, Christmas presents, you know, things that you need for just day to day life that people take for granted.

Right? But these kids really do need love and support. They have a mentor program.

They have, they just do so much, so much for them. And actually this year at our annual event, we’re honoring Keith Pomeroy. I don’t know if he knows that yet, but he’s going to be our honoree because he is done. And I keep saying it should be a lifetime achievement award because he really, he has started the foundation. He’s amazing.

Anthony Codispoti: And he’s, he’s guessing by the name, he’s the founder of Pomeroy.

Manda Ayoub: Yes, he is our boss and he is.

Anthony Codispoti: And you get to work closely with him on a regular basis?

Manda Ayoub: You know, not so much. I work closer right now with Nick Perino, who’s our president, who, who drives Keith’s dream, right? So Keith and Nick are the gentlemen that I am honored to work for. And they both have a true passion for seniors having scale living. And so when Keith is in town, I love working with him.

But on the day to day, it’s, you know, me and Nick and like we were here last night till 6 30 at night, just kind of catching up and talking about what’s next for Pomeroy living. And I love working for people who allow me to have my passion and let me drive the healthcare side and support it. And it couldn’t be in a better spot.

Anthony Codispoti: So let’s talk a little bit about the services at Pomeroy. What kind of sets you guys apart from some of the other senior living facilities? What do you do that’s done here?

Manda Ayoub: You know, I don’t, we all do a lot well. I never want to downplay what my peers do. But we’re, we’re a little different. Like our homes are beautifully stunning. We think about every approach. And I think because we are smaller than some of our competitors, we can do things a little differently. For example, we have an essential oil program, right? So we’re trying to treat patients without medication first. Essential oils have been found and we have years of case study of our own, right? So behaviors, we use this essential oil and we give them hand massages and how does that affect their behavior? Using certain smells and essential oils prior to meals helps increase appetites. How is that helping with weight loss, right?

Instead of giving maybe, for example, there’s a medication, may case, that they use as an appetite stimulant, which wasn’t why it was intended to leave made, but we use that to help patients who aren’t eating, right? Well, before we do that, let’s try this. And if it doesn’t work, then we can go to the medication and sometimes we avoid meds. So I think it’s pretty cool that we do these things, right?

We also, we use science. We have patients who are on antipsych meds and they have to go through gradual dose reductions because it’s a requirement. But we have this gene site testing where we swab the inside of a cheek and we can see this med will work for them. This med won’t, right? And then because we have the proof of it, we don’t have to do the gradual dose reduction. So we’re not messing, you know, because with a gradual dose reduction, you get them to a certain level. They’re functioning.

They’re great. But now you have to take them off of it to see if they’re going to be okay. Well, with this testing, it really does take the guesswork out and it helps you be better at care, right? So I mean, it’s, it’s… What’s the name of that testing? Gene site testing. Gene site. We use it with our site group and it really…

Anthony Codispoti: I can see how that means super helpful. Right? Yeah. You get patients… You know, what’s a good fit for that person? What’s not?

Manda Ayoub: The blindfold is off. You know exactly what to do. And there’s more and more of that. More and more science is coming to the forefront. So, you know, we, we use technology and AI to scan our charts to look for trends that we may have missed.

You know, we’re putting technology in our patient rooms that lay over beds that will count respirations and trigger to our staff. Hey, breathing heavier. Hey, some temperature is changing.

Hey, something is not right. So I think, you know, just even from our inception, when Keith started our communities, these skilled buildings, even though they were managed by other agencies, he built them different. You know, we had antique cars in the common spaces and just the most beautiful communities and, you know, wood-carved bars where they had happy hour. This was 30 years ago. Who was having happy hour in their nursing homes 30 years ago? Keith Palmer. was.

Anthony Codispoti: He’s ahead of his time. He definitely was. Tell me more about the AI tech that you guys are using.

Manda Ayoub: I’m going to tell you the names because that’s all secret.

Anthony Codispoti: But tell me what you’re doing with it. Like I want to hear how people are actually using it in their industries.

Manda Ayoub: We’re using it. So you never want it to take over. You want it to supplement, right? Because it’s technology and it’s imperfect, right? So, but if you can get it to help scan a chart to look for change and just let it flag you, it sends you in the right direction.

So for example, your nurses go in, they take vitals, temps, blood pressures, etc. They’re putting it in the MAR. MAR is the medication administration record that is now in the chart. The chart sees that this person normally runs, let’s just say 120 over 80. All of a sudden today, they’re 168 over 90 and they pick that up automatically. 160 over 90 isn’t an alarming blood pressure. It’s a little high, right?

But it’s not alarming. But it is for that person because they normally run completely different. So when you’re doing so many of them, are you always as a nurse thinking about, well, what’s their norm? No, sometimes you’re doing the task. And so AI will help you go, hey, alert, this is not the norm.

Anthony Codispoti: And it’s looking for real time. Exactly.

Manda Ayoub: It’s not like a day a week later. It’s looking as it’s happening and you’re getting notifications and pings about, hey, something’s wrong here. So it is helpful. And listen, sometimes it sends you on a goose chase, that’s wrong, but it’s okay. Because all it’s doing is having you look at your patients a little bit more.

Anthony Codispoti: Brother, I have a few false positives, then actually miss an event that’s really important for you to pretend to do. That’s exactly it. That’s exactly it. So you were catching up with was it Nick Perino, the president the other day, just last night, and you were talking about what’s next for Pomeroy? What’s coming?

Manda Ayoub: I think we’re starting to get to a place in which we might be ready to grow a little bit. But we’re always looking for the right buildings. Nick is pretty dedicated to that part of our business and looking because I can’t.

But when he’s ready, I’m there. So we each have a different skill set and his is impressively different than mine. And maybe that’s business opportunity. He gives me courage and autonomy to drive the health care side. And he thinks about all of my crazy ideas and gives me feedback, right, and never holds back, which is great. He too has no issue being honest and upfront and say the tough things, which is nice, because I don’t have to guess what he’s thinking, right? So if I come up with some crazy idea and he says, Amanda, that’s a crazy idea.

I love it, right? Tell me what you’re thinking. I don’t want to guess. I don’t want to spend time wondering, right? So yeah, it’s just we’re looking to grow.

We’re ready, I think. Our last purchase set of purchases was in 19. And then our crazy pandemic happened. And we’ve been stabilizing post pandemic. And I think we’re kind of in the space now that if the right thing came along, we’re ready.

Anthony Codispoti: So the growth for you would be acquisitions, not kind of like a ground up potential both. Okay, open to both. Let me shift gears on you. I’m kind of curious to understand more about implicit bias and why this is a potential problem in health care. That’s a good question. It was a deep sigh.

Manda Ayoub: You know, there’s, I think in the political environment we’re in right now, I think there’s, there’s some people who go implicit bias is crap. But I don’t think it is. I think there is something to be said about it. I think how patients get treated. I think we all have biases. I think as a woman, I have a very strong opinion about biases about women and their strengths and some of the treatments we get with no pain relief.

Anthony Codispoti: Prior to treatment. That’s interesting. So this is a thing where women are receiving more treatments without pain killers than men would.

Manda Ayoub: Absolutely. Absolutely. And I think it’s real. I think, you know, we can all say that, you know, we’re not biased or we don’t think that way or we don’t work that way. But there are studies to prove otherwise.

Anthony Codispoti: What do you think is sort of going on under the surface sort of subconsciously or consciously to where that’s actually playing out? Not being a good judge ever pain?

Manda Ayoub: I think I would hate to say that I think sometimes things are perceived, right? Like women go through child birth and they’re like, look, look how strong they are. They can do this, right? They do it already. So why when putting in an IUD, for example, should they have pain meds? And then they don’t and they tell you, oh, you’re going to be a little uncomfortable. Well, women have said it’s life altering and they’re scarred and damaged after them, right? But a gentleman will go through a vasectomy, also a very serious procedure, but they will be medicated, put to sleep, feel nothing, right? So is that an implicit bias?

Why is that treatment plan different? It’s very much a bias, right? So and how do you combat it? You teach. You teach. You educate. You get people to understand what an implicit bias is. You go through the training.

You share it. I’m hoping this healthcare administration doesn’t change those trainings and those educations that are required to renew licenses. I think they’re critical. I think as healthcare providers, sometimes we say, oh, the course of action is to do this. But just because it’s to do this without pain meds doesn’t mean we should, right? We need to think about the patient and what they’re going through.

Anthony Codispoti: It’s crazy. It’s really interesting. Things I’ve never thought of. Yeah.

Manda Ayoub: Because we probably don’t live our lives thinking about the biases, right? We do the right things, hopefully. And I mean, being a patient will teach you a lot about how you want to be treated. So if you’re healthy and you never have a hospital experience, you’ll never know what it feels like when someone has to come in and bathe you, for example. And how undignified that can feel if you do it wrong. And so we have these thoughts in our heads, well, they’re here and they’re sick and they need me. So I’m just going to do this. But they’re still human and they still have feelings and they still have dignity. And in your head, you’re doing a test.

Anthony Codispoti: This person’s more than a box to check on your skills.

Manda Ayoub: Exactly. And being a patient is the best thing you could do to be a good caregiver.

Anthony Codispoti: That should be part of the training almost. You would think. I’ll just give you a quick answer. You recently partnered with Chirana Health, I think it’s pronounced, to introduce an institutional special needs plan. Tell me about this partnership.

Manda Ayoub: So Chirana is, it’s kind of its own version of a managed care program, right? So managed care programs are taking off. They’re everywhere. And if you follow me on any social media platform, you’ll know that I am not a big fan of managed care. I think its goal is to save money at the patient’s expense at times. And so my family, who I coach and care for, I always tell them to stay in their traditional Medicare plan. You might pay additional costs, you may have to pay more copays. But at the end of the day, your care is about you. Managed care comes up with criterias and protocols. And if you, this diagnosis, you can go to this community for this many days and then you’re done. But we’re not cookie cutter.

No one is the same. And I might be admitted for, for example, a knee replacement, but I also might be a cardiac patient with hypertensive reactions, right? Especially the pain. And so should I go home after a knee replacement or should I be in the hospital? Because my blood pressure likely is going to go through the roof. And my pain control is critical.

And I live in a house with stairs. How does your managed care take into account all of those other things when making its decisions, right? So then it was, you know, everyone’s enrolling in these, can’t stop them from enrolling, it’s their right, right?

And they sell themselves beautifully. Oh, we’re going to save you money and you’ll never pay for out of pocket costs. And Karina helps a little bit different to me. They, they give you the extra perks and they don’t cookie cutter you like a traditional Medicare program. So my seniors can still have grocery spend, right? They’ll bring them specialty foods to the nursing home if that’s what they need.

And they’ll get their ears checked. And that’s a covered expense where under a lot of plans, it’s not a covered expense. So we chose them because they’re just, they’re different. They do more for our clients. And I want my clients to get everything they deserve because it’s the right.

Anthony Codispoti: I know, Amanda, let’s, let’s talk about a serious challenge that you’ve overcome something personal or professional, maybe a combination of the two. What was that like going through it? And what are some lessons that you learned coming out the other side? There’s been so many.

Manda Ayoub: There have been so many challenges. And being a woman in a leadership role is a challenge. Say more about that.

Anthony Codispoti: That’s a whole subject for me. Could I maybe connect some dots on my own here and say, not only are you woman in a leadership role, but you’re a very outspoken woman. Yeah, you know, you’re very comfortable, you know, having that hard conversation, saying the difficult things that need to be said. Yes.

Manda Ayoub: So you can imagine that some people don’t love me. And, you know, I think as a woman, we want to be loved. And as a woman, we still want to be treated like a woman sometimes, but then you take on a very dominant role. And there’s some loss of identity sometimes, right?

So at work, I, I might be a strong force, but then at home, I still want to be a wife and, you know, kind of coddled once in a while. And it’s hard. The division of woman leadership is really, really hard.

And yeah, it’s, it’s tough. I’m actually writing a book. I never thought I would do that. But my life coach has talked me into it. And I’ve started it. And it is a lot harder to do than I thought.

I’m not going to lie. You know, I did the research part first. And that was easy, putting the research on paper, but then sharing all the personal stories that are just that. The coming to terms with how people may feel about you or hearing what people may say about you, you know, if you cut us, we all bleed. And we all have feelings at the end of the day. And for some of us coming to terms with how you’re perceived or spoken about, it’s tough.

It’s tough. And you can try and do all the right things. And you’re still going to be the villain in someone’s story. And you have to come in terms with it. And, you know, you get a therapist and you move on. You work through it. It’s tough.

Anthony Codispoti: Is it your sense that it’s easier for a man to be in this role where the hard things need to be said, the hard conversations have to be had, because, oh, well, he’s a man and he’s a strong personality. Whereas when a woman sometimes steps into that role, there are some terms that are not so nice that are kind of associated with that that authority, that leadership, that power.

Manda Ayoub: Yeah, that B word that gets used about us. Yeah. So there’s actually stats in the book that I’m writing that I’ve done my research on that talk very much about how women are perceived in those roles, where bossy, where, you know, other things.

Anthony Codispoti: Itchy, itchy, scratchy.

Manda Ayoub: Yes, itchy, scratchy. Yes, we become those things. And it’s tough. And, you know, I’ve had such crazy things happen to me. I’ve had people on my team who I have thought were my right hand. Then to find out they’re not, they were undermining me the entire time.

And I was totally not aware. Not aware, because I focus on the work relationship. And I didn’t realize, you know, some of my teams in the past have wanted the personal side of me. And I think they perceived our work relationship as a personal friendship. And then, you know, as I got busier, or was growing, the business, or working on projects and had less time for them, then it was, you know, they took that personally. And then I became the villain in the story. And then that got pushed out, right?

And then not even aware that it was happening, but then having overcome it all. Because you can’t say anything, right? You still, they talk bad about you.

You hear about it. You still can’t defend yourself. Because in defending yourself, you would then be talking bad about the employer, the employee that said that, which then turns you into them. So all you can say is, I need you to judge me on my actions and my actions along with you. Not someone else’s opinion, and hope for the best.

Anthony Codispoti: So you would have other employees coming to you saying, I’ve got a problem with you because this other person has a problem with you. And you want to defend yourself, kind of give your side of the story, but you can’t.

Manda Ayoub: No, because it takes you down to their level. You do need to be the leader. You need to set a better example. And so, while it’s hard, you just kind of have to say, listen, judge me on what I’m doing and our interactions together, not on what you’ve heard secondhand. And that’s tough because, again, at the end of the day, we’re all feeling. We’re all, we have feelings.

We’re human. You cut us. We bleed. You talk about us. We hurt. But again, in our defense, we just, we have the struggle is real and we have to own it. And with leadership comes great responsibility and how you respond defines you.

Anthony Codispoti: Do you also find it difficult, Amanda, to, like on a nightly basis to sort of move from that, that tough leadership role at work to I’m a wife and a mom at home and I want to be a woman and I want to be cuddled sometimes. And like, how do I like make such an abrupt shift in my day?

Manda Ayoub: I struggle. I struggle. I am bossy at home. My poor husband, every day I come home and he’s there. I am utterly surprised he puts up with me. But I think that God gives you exactly what you need. And my husband is exactly what I need. He’s the kindest human alive and he has signed on to the rodeo and amazingly doesn’t complain and continues to show up for me and tries to anticipate my needs.

And I got to tell you, I can’t anticipate my own needs. So this guy’s impressive. It’s tough.

It’s tough because you do want that. You want to go home. But when you wear this job for as many hours as I do sometimes when you walk in the door, you’re still wearing it, right? You still wear the shield and the uniform of sorts, right?

That imaginary uniform of being a soldier and doing what you need to do for your patients and your company and having the tough conversations. And yeah, you don’t need to do that with your spouse, but you get into a mode and I sometimes even do it with my parents. I like I’ve caught my siblings. Like my sister at times is like, hello, can I get Amanda, not the COO? And I’m like, yeah, good call.

Anthony Codispoti: It’s almost like what you need to do is kind of like a reverse Superman thing at the end of the day where you strip away the alter ego and you put the Clark Kent outfit back on as you’re walking in the house and that would kind of help with that transition.

Manda Ayoub: Yeah, I’ve learned that the one thing I do now is I go from my business attire into my home attire, which is very comfortable and that immediate change kind of puts me in that relax set.

And I didn’t do that for many years. I would come home, stay in my work clothes, start preparing dinner with my husband, you know, kind of now I go right into I’m changing, I’m getting into comfy, Amanda, because I have to, like you said, do that reverse superhero thing where I’m reminding myself I’m home now and it’s my space.

Anthony Codispoti: A friend of mine, Todd Herman, wrote a book a while back called the Alter Ego and it talks about kind of that transition the other way sort of like you get up in the morning, you put on your blazer or you know, the glass or like whatever it is that kind of like puts you into sort of, you know, warrior workforce mode so that you can make that transition into the superhero that you need to be for the day. But it’s interesting that what we’re highlighting here is you also need to make that transition back.

Manda Ayoub: Exactly. For me, it’s putting on my face every morning, right? For women, it’s our makeup. And so, you know, you put on your business attire, but your makeup and then the second I get home, it’s the first thing I take off. It’s my makeup. And I get comfy and off comes the mask.

Anthony Codispoti: The real deal of Amanda. Yeah. And again, my husband continually shows up. So I’m grateful.

Anthony Codispoti: Yeah, I’ve got a wife who’s who deserves a similar amount of credit to your husband in the same kind of way. That’s great. We’re very lucky then. Very much so. Thank you, Kayla.

Manda Ayoub: What’s your husband’s name? My husband’s name is Majid.

Anthony Codispoti: Nice, Majid. So do you have a working name for the book yet?

Manda Ayoub: I do, actually. It’s, hold on, I gotta tell you, I want to look it up real quick. Hold on. I have changed it a couple of times.

Anthony Codispoti: And you might change it again before it gets published.

Manda Ayoub: Yeah, I’m looking it up right now. I think what I ended up with, and I wrote it in the notes, where like I put some other options in the notes. I think it was leadership Wonder Woman style. Hold on. Because that was probably one of the first things that I did when leading fiercely Wonder Woman style.

Anthony Codispoti: Leading fiercely Wonder Woman style. Yeah, Wonder Woman’s my favorite. That’s a good one. Yeah.

Manda Ayoub: I wanted to be her growing up.

Anthony Codispoti: Yeah, that’s a good role model too. Yeah. How about some daily habits or practices? Things that help keep you centered on track? Keep you rooted in who you are? Lots.

Manda Ayoub: So start my day pretty early. I, for the last two years, have been working out with a trainer, Monday, Wednesday, Friday. My session started at 6am. I think that’s probably the most critical thing that I do, because it’s the one hour that I am not thinking about work. Wholeheartedly, I don’t have a chance. They don’t give you an opportunity.

Saturday, I go to arms class with them. And again, you don’t get the opportunity to even think you are moving and you are working and you are focusing on your health and they are driving you. And I have to tell you, those these last two years of doing this has been, I wish I would have started this young. I wish I would have invested in my health before I turned 50. I mean, I started it at 49. So I guess I did.

I wish I, you know, when I was growing in my career, I spent a lot of hours at a computer sitting. And I didn’t take care of my mental health as much as I should have. And working out, I will wholeheartedly tell you is important for your mental health, not just your physical health. You, it’s great. You decompress, you take out your stresses.

It’s critical. I tried a sauna and then my gym coach, Andre, got me doing ice baths. And so those are something. And I actually did a team building with a couple of my leaders and Nick went as well, and we did a ice bath challenge. So when I first started at my teams, I was telling my teams, they were like, no way, you’re not going to do it.

I’m like, yeah, yeah, I am. And they said, I said, well, how long do you think I can do it for? So they started this in-house bet.

And the highest amount of time they said was three minutes. So I did it. I had to beat that. I did. And I recorded it. And I did it for six minutes. Wow. And then I started doing it for 10 and 11 and 12 minutes. And yeah, it’s a great thing.

It shocks your body. It is tough. But it proves to you what you’re able to do when you set your mind to something. And the studies tell you it’s really good for you. So how do you feel when you come out? Cold.

Anthony Codispoti: Relaxed, energized, just cold. Cold. Just cold.

Manda Ayoub: It takes you a couple of minutes after you get out to, you know, get your, your body will take care of itself, right? Your, your body is amazing. And what you’re doing is you’re shocking it. And it’ll help with getting rid of those stubborn fats. They call them the brown fats. And it, you know, your body will work harder and it’ll metabolize faster and it’ll heal inflammations. And they believe it helps your cardiovascular health.

And so I think I started it as a challenge, but now I do it because I know it’s good for me. I don’t do the plunges as much as at the end of my showers. I turn on the ice cold water and I sit there as long as I can. Because the place I used to go to for my ice plunges is closed and I haven’t found a local place. It was right next door to my gym, which was convenient. And then they sold and went to Rochester Hills and that not so convenient, right? So I can’t do my workout and then do a nice plunge. I have to. So yeah.

Anthony Codispoti: You can always acquire one for in home. You can.

Manda Ayoub: I know my trainer has one in his yard and it turns into a block of ice every day. And he has to go out there with a weighted kettlebell and break it up and then he gets in it. God bless him. I have this thing about dirty water. So yeah, that’s not going to work for me.

Anthony Codispoti: Okay. Well, you said, so you got a physical coach. You’re also working with a life coach who’s encouraged you to work on this book. Yeah.

Manda Ayoub: I invest in bettering myself. I think we’re so imperfect, right? We should always be striving to be better. We should always be striving to learn. We don’t know everything. There are people who are afraid to say, Hey, I don’t know what that means.

Can you define it? I, I, in the middle of this interview, if you ask me something, I’m not aware of. I’ll ask you to explain it to me. I, I don’t have any issues showing my weaknesses. I don’t have any issues saying, I don’t know that answer.

Let me get back to you. I know I’m imperfect and I just try to be better every day. My, I got rid of my therapist about three years ago. I’ve been working with my life coach Matt now for three years.

I’m honored because he got rid of all of his other clients because of his current job. But has kept me because we have made such great strides together. And he, he pushes me. And some days I’m so mad at him, but in the same breath, I have the most love and respect for what he’s done with me. He’s been amazing for me.

Anthony Codispoti: And do you feel like he’s helped in the personal side of your life, the professional side of your life? Absolutely. Absolutely. Both. Absolutely.

Manda Ayoub: He has, he has made me a better wife to my husband, a better sibling to my, my siblings, a better daughter to my parents, a better coworker to my teams. Wow.

Anthony Codispoti: You’re a better version of Manda today.

Manda Ayoub: Every day. Every time I meet with him, it’s a better version of me. Yeah.

Anthony Codispoti: Manda, I’ve just got one more question for you. But before I ask it, I want to do two things. Everyone listening today, I invite you to hit the follow or subscribe button on your favorite podcast app so you can continue to get more great episodes like this.

And I also want to let people know the best way either to get in touch with you personally, to continue following your story, or that of Pomeroy Living. What would that be?

Manda Ayoub: Probably the most I share as it relates to my growth is LinkedIn. And I think it’s Manda, you LinkedIn. And you can follow me there. I put my struggles. I think last Sunday, I did something about pushing through the tough times because I was in a tough time and I was frustrated and I put my thoughts together and then I posted it on LinkedIn. It’s like my small little stories instead of going to the book. So I love LinkedIn.

I love sharing my growth on LinkedIn and sharing my struggles. And I do this thing where I’m like just another venting session or I just have to rant and I have people come up to me going, I need to hear a new rant. And I’m like, well, I don’t have one. I don’t create them. It’s like, when they happen, I put that right.

Anthony Codispoti: When they happen, you talk about them. That’s great. Well, we’ll include a link to your LinkedIn profile on the show notes. But for those folks listening, Manda, M-A-N-D-A-I-U-A-Y-O-U-B. So we’ll include that link there. But last question for you, Manda. As you look to the future, what is the single thing that you’re most excited about at Pomeroy kind of unfolding? Oh, one.

Manda Ayoub: Most excited, I think. There’s a lot. So I’m excited because the team I have currently is the best we’ve ever been. So I’m excited to see where the growth happens next.

Right? So we’ve gotten here. And if you would have asked me two years ago, if I had the same confidence in my team, I would have definitely said no. We weren’t where we needed to be for growth. We are definitely there now. I’m excited because I trusted Nick and Keith to grow us. And I’m excited in whatever the next adventure is until it’s there.

I can’t even fathom. But I love that we embrace technology. We believe in doing it better. We believe in graceful senior living. I mean, I’ve told them, I know where I want to live when I retire and it’s one of our communities. And I already have my room picked out. And I expect a discounted rate.

And yeah, I listen. I think no healthcare community is perfect. And you’re never going to always have a perfect experience.

Right? Dropping off your loved one and hoping that everything goes okay is not okay. You have to be an active participant in their care.

And you have to help. Just dropping them off is not like, oh, it’s done. No, it’s not how it works. That’s not how good a care happens.

Not in any hospital setting, not in any private pay setting, nowhere. You have to be an active participant in your own life and in the lives of your family. And I think, you know, yes, we’re imperfect, but I think we’re better than most. And I love that. I love that we are pushing the envelope and always trying to raise the bar.

Anthony Codispoti: Amanda, I want to be the first one to thank you for sharing both your time and your story with us today. Thank you very much.

Manda Ayoub: Thank you for being interested enough to ask.

Anthony Codispoti: Folks, that’s a wrap on another episode of the Inspired Stories podcast. Thanks for learning with us today.