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Carole Fisher oral history interview: transcript

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2016-12-14

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Oral history interview with Carole Fisher conducted by Barbara Tabach on December 14, 2016 for the Southern Nevada Jewish Heritage Project. In this interview, Fisher discusses her family background and moving to Las Vegas, Nevada in 1979. Fisher talks about Nathan Adelson Hospice, programs that they provide for the Las Vegas senior community, and the increase of hospices in Las Vegas. She describes how Nathan Adelson Hospice is able to provide care for uninsured people, fundraising events they organize, and how their hospice differs from traditional hospital care. Lastly, Fisher discusses the significance of death in the Jewish religion.

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OH_02923_transcript

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OH-02923
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    Carole Fisher oral history interview, 2016 December 14. OH-02923. [Transcript.] Oral History Research Center, Special Collections and Archives, University Libraries, University of Nevada, Las Vegas. Las Vegas, Nevada. http://n2t.net/ark:/62930/d17h1j41g

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    Today is December 14th, 2016. This is Barbara Tabach and I am sitting with Carole Fisher in her office at Nathan Adelson Hospice.

    Carole, thank you so much for participating in the Southern Nevada Jewish Heritage project.

    Yes. Thank you. Thank you.

    This is a real honor to be here. This is a very special place.

    Yes. Thank you.

    And you really are a busy woman. I like to start usually with a story with whatever you know about your family heritage. Where did the ancestors come from and how did they get to the United States and where did they land?

    It's so interesting that you would ask me that because my daughter, who is now thirty-one—her name is Brooke—is on this quest to figure this all out. So she's really on a journey. I know that some of my family came from Russia, and then some of the details are kind of sketchy, a couple of generations ago. They came to back east. So everyone landed in the Pennsylvania area in Pottstown, Norristown.

    Did you grow up in a religious family?

    So my family was active in the synagogue. I would say that I was not a great student. And so, yes, so I was busy doing a lot of extracurricular activities, mainly horseback riding; that was always my thing. So I would get a lot of passes out of Sunday school and Hebrew school and all that. Yes, we were pretty active in the temple that I remember in Norristown, Pennsylvania. I wish I could remember the name of it, but I can see it in my mind.

    So was that spiritual journey conservative, reform, orthodox?

    So it was very reform. My grandfather, whose name was Leonard Tose, he was a prominent

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    figure back in the Philadelphia area. He owned the Philadelphia Eagle football team.

    Oh, wow.

    And my grandfather owned a Tose's Trucking Company. So he was a pretty prominent man back in the day and when I was a little girl, and as such he was very involved in the synagogue and supporting them financially and the community. So I have great memories of going to the High Holy Days and being with him and being with my family back then, yes, great memories.

    That's very cool. Are you a football fan?

    Well, not as much today. No, not as much today. But I was raised on football. So we were there every Sunday, rooting for the Philadelphia Eagles, of course.

    Of course.

    Of course, yes, yes, yes.

    So what did your parents do in Philadelphia?

    So we are a family that gets divorced a couple of times. Let me see. My biological father, I didn't really have a relationship, so it's hard to speak about him. My second dad—so my mom got remarried—and my mom was a housewife. She also was an interior designer. She did interior decorating. She's an artist.

    My second dad had worked for my grandfather for a while. And then they went into the preschool business, my mom and my second father, my stepfather, and did that back in the Bryn Mawr area, back in Villanova area. Then we left that part of the country and we went to Florida for a while. So my latter years before I came here, I was in Florida.

    My mother then got remarried. She met a man that was from Vegas and his name was Stanley Schwartz. So that would be my third father. He adopted me. He's no longer alive, unfortunately. So we moved out here to Las Vegas. He had Schwartz Brothers Big and Tall

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    clothing store. I don't know if you remember that or not.

    I've heard of that store, yes.

    Then his brother, Seymour Schwartz, had Call It Macaroni. So those were old staples in our community. When my dad had Schwartz Brothers, he was on Fremont Street. He was next to Wonder World. I remember the old Wonder World right down the street from here.

    So you experienced the retail background, too.

    I did. I did.

    Oh, wow. Did you ever work in the store?

    I did. I worked in his and then I worked in Call It Macaroni, mainly Call It Macaroni. But I actually met my first husband who worked for my dad in Schwartz Brothers Big and Tall. That's the father of my daughter.

    That would be a good place to meet men I would think.

    Yes, right. It was all men. It was great. It was a dating pool definitely, yes, yes.

    So the other business I'm not familiar with. Macaroni?

    Call It Macaroni. It was a women's clothing store. It was a long time ago. So it was probably before you were here.

    And they sold what?

    It was all high-end, fun, funky women's clothing. I'm trying to think what I would compare it to today. It was a boutique. It was fun. It was in the same shopping center where Wonder World was and the Schwartz Brothers; that location. That shopping center is gone now.

    One by one we can kind of fill in the stores there as we hear the stories like this. This is great.

    Right, right.

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    What was it like? You told me you were eighteen when you moved here.

    I was eighteen when I moved here.

    What was it like as an eighteen-year-old to move to Las Vegas?

    Well, it was a little bit of a cultural shock because I had never lived in the west side of the country and Las Vegas with all the glitz and glamour. But what I was attracted to in Las Vegas is that it was a very small town and the Jewish community was very small and tight and still is. So my dad, who had lived here forever, it wasn't as if I was totally coming in new because he was able to introduce and facilitate so many introductions and friendships. But it was a smaller town although I find today that Las Vegas still is a very small town even though it's so much larger. There's still that small town feel to me.

    So in terms of the physical geography, I think Decatur and Charleston was as if you were going to another side of the country. I remember feeling that way. It certainly was not as developed back then.

    So you were already graduated from high school?

    So I actually dropped out of high school. I dropped out of high school. Came out here. So when my mother got remarried to Stanley, I was not real enthralled about moving to Vegas. So I just kind of went and did my own thing for a little while and then came out here shortly thereafter and got my GED.

    At that point then it became important that I reengage with education and go off to college. So I did that in a couple of different places. I went to Santa Barbara for a while and went to school. I went to ASU. I kind of hopped around. Actually I started back East. I went to Bryn Mawr, an all-girls' school for a little while. So I did all that and then came back to Vegas.

    There was something about Las Vegas that always wanted me back here. I was very

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    attached at that point to the community and had made friends. So I came back to Las Vegas and ended up finalizing my degree here at UNLV and I got a bachelor's in social work.

    Now, while I was doing that, which was a journey because I didn't do anything—I have never done anything traditional in my life. So I didn't go to school traditionally, went four years and you got the education and was done. I haven't worked traditionally. I haven't had family traditionally. I just don't do conventional real well.

    While I was going to school here, I was fortunate to not have to work, and so I knew that I wanted to volunteer because volunteering was a way for me to be of service. It was also a way for me to understand what I wanted to be when I grew up. So I volunteered at different places. The final volunteer stop for me was at Bridge Counseling, which was Operation Bridge at the time, and it was a drug and alcohol counseling organization that helped people that were struggling with drug and alcohol issues. I ended up volunteering there for a while, while I was getting my degree and that morphed into a career for me.

    I ended up getting my certification in drug and alcohol counseling, became a counselor for them, and eventually became their executive director over a span of time. So when I was about twenty-seven, I believe, I became their executive director.

    Wow, you were young.

    Yes, I was young. I had no idea anything about leadership and they gave me that fancy title and put me in charge. At the same time, I had just had my daughter, too. So it was a wonderful time in my life and I did that for a while, learned a lot.

    So that would have been about what year?

    So that would have been 1987. Yes, so that was fun. I don't know how I just went off on that tangent. I was just kind of tracing my career. So I still hadn't graduated from UNLV. I think I

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    graduated around that same time.

    You had a lot going on during that time.

    Yes. I always am pretty ambitious, as evidenced by the fact it was hard for us to coordinate our calendars.

    For sure.

    So did the Bridge Counseling for a long time. I was probably with them for a good eighteen to twenty years.

    What was it like to work there?

    Oh, it was fabulous. It was a small organization with really good people that wanted to make a difference in the world. I'm a social worker. I love to help people and my whole quest in life is to make people's lives better. So it was a fabulous time. It was a grassroots organization that was just helping families and children—and I say children—a lot of adolescents. We did a lot of programs for adolescents.

    What was really fun about that, also, is that we grew that organization. So I had fun people around me. I'm a pretty competitive person. And we wanted to be bigger and better. And not necessarily that bigger is better, but you want to make sure that you really can help people where they're at. So with drug and alcohol issues, it often seeps into mental health issues. So we started to morph into that arena and grow the organization. So it was a lot of fun. We developed a whole mental side, a whole component where people could come in for marriage counseling, depression, anxiety, the whole host of issues that we all go through at different times in our lives.

    We then started to go and compete with for-profit companies that were doing what's called employee assistance programs. I don't know if you're familiar with those.

    No.

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    Where you go into a company—gosh, I haven't talked about this for so long; it's fun to talk about—you go into a company, Barbara, and you offer them counseling for their employees because we all bring ourselves to work every day and sometimes we bring the baggage that we're all experiencing. So an employee assistance program is designed to get you some counseling for whatever is going on in your life, and usually an employer will pay for that. They'll pay for three sessions, five sessions, six sessions. Here at Nathan Adelson Hospice we have a program in place, an employee assistance program, and we pay for six sessions. No questions asked. If someone's having some problems, they go, they get some help from a therapist and it's all confidential. So it's very nice.

    That's wonderful.

    Yes. So back to Bridge Counseling, we decided that we needed to bring in some revenue. So we went out into the hotels and worked to get some of that business and we became very successful. Mirage, Artie Nathan—do you know the name Artie Nathan?

    I've heard it.

    Artie Nathan's been in town forever. He worked for Steve Wynn. He ran all of his human resources. He's Jewish and he'd be a really good person for you to meet with, by the way. And I can give you his contact information. He took a chance on me and I still thank him to this very day and he let us come in and do the employee assistance program work for the Mirage and then that just put us on the map. So it was a fabulous time. I was young and the people around me were doing great things and we were committed to making the world a better place. So it was just a great, fun time.

    How many employees were there at that time?

    Oh, boy, I don't even remember. I would say our budget was maybe like three to five million. So

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    it wasn't a huge organization. We had a lot of contracted counselors, too. So maybe I had twenty employees and the rest were contractual.

    Does it still exist?

    It does. Bridge Counseling is still here, but I don't know anyone over there and I don't know what they do today. They don't do employee assistance work. They really went back to the grassroots from what I hear. That was a really relationship driven model.

    So I then left there and went to work for Harmony Healthcare for a year where they hired me to be their CEO. So that was my first step into for-profit. Then from there—I wasn't really happy; that's a whole other story—I went over to Sierra, which is now United. So when I went to Sierra Behavioral Healthcare Options, they brought me on and a lot of that business came with me, the for-profit side of that business. So Bridge Counseling really had to change their business model.

    So how did you end up finally at Nathan Adelson Hospice?

    That was a journey. Well, let me tell you a fun story. So I am at Bridge Counseling and we did a lot of work with...if there was a critical incident. So let's say there was a bank robbery. We would go in and do the counseling because the employees were very shaken. That's part of the employee assistance program.

    There was a gentleman over there at a bank whose wife was the CEO here at Nathan Adelson Hospice. I remember thinking—her name was Betsy Grannette—I remember thinking, gosh, what a great job to work at Nathan Adelson Hospice, to help people die well, to have the type of board of trustees that this organization has, to have the community support. Mind you, I had been at Bridge for a long time. In behavioral health and in drug and alcohol counseling, in that environment people either want help or they don't want help. So I was getting a little burned

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    out with that. So I remember sitting at my desk one day and thinking, boy, I wish I was the CEO of Nathan Adelson Hospice. That was many, many, many years ago.

    Wow.

    From Bridge Counseling I went over to Harmony and then I went to Sierra. So I'm over at Sierra Healthcare Services running their behavioral healthcare company and, again, staying in behavioral health, realizing that I was getting a little tired of that.

    Southwest Medical Associates—I don't know if you're familiar—their clinics that belonged to Sierra, now United, they were changing their model and they needed an executive director of a division and I applied for it. I knew nothing about running medical clinics and they took a chance on me. When they did that there was other people, too. I don't know how much of that story you want.

    No. This is good.

    It was a time when I was reinventing myself; they were reinventing themselves, but they weren't sold that I was the right person for them totally in the bigger picture. But I proved myself to them and I ended up in a much larger role. When they kept giving me more and more and more and my daughter is graduating from high school and I'm exhausted and I'm missing out on some key events, I'm realizing that my need in life if I'm going to get up every day and suit up and show up, I want to help people; it is the core of who I am.

    Someone said, a dear friend of mine, my best friend actually said to me, "You know, Susan Drozdowski"—who at that time was the CEO here at Nathan Adelson Hospice—"is looking for someone to come in and be her number two and I really think you should go meet her." So it was Nathan Adelson Hospice. How could I say no?

    But I was very seduced into that corporate life. I had the nice corner office. I was making

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    a lot of money. I was getting nice bonuses and I was getting stock. So I had to really step back and go, what's important for me as a person? At the time I was married and my husband was very supportive of me taking a step back financially and learning something new.

    So Susan hired me. She was on like a five-year plan, I thought, to be a CEO here five more years and then I'll take it easy and I'll learn everything and then I'll be the CEO one day. That was kind of the unspoken agreement.

    I came over here and I had to detox myself almost because I had been working so quickly and at such a fast pace. I had so much responsibility and now I could kind of breathe and learn something new and I'm in this not-for-profit organization where we work hard and we take things very seriously, but it's not a corporate bureaucratic environment. It's just different.

    There were some issues that happened with the government, not bad. We hadn't done anything wrong, per se, but it was complicated and I think Susan was very much done. She wanted to retire and she wanted to get out. So within a year I became CEO. I hadn't planned on that. I was just trying to lay low.

    One year as opposed to five years.

    Right. So within the first six months she knew she was leaving. So the board is kind of cuing me up to be the CEO.

    So what I love about this story is that I put that out to the universe twenty years prior that I wanted to be here and it's a gift each and every day that I'm here. I love this organization. We do amazing work with people. We are truly committed to our cause and we're passionate about that. What I'm always in awe of are the people that work here, the team we have. They are just incredible. Everyone thanks me, but I'm not doing anything. Look at me, I'm sitting here in my office. These people are just angels. To work at the bedside with someone dying is a gift for that

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    person, but it also takes a special person to do that. You can't have a bad day and bring it into that patient's room. So you have a fight with your spouse or your kids are irritating you, you have to leave that at the door. So I'm always in just great respect and admiration for my staff that show up and they're present for our patients and their families.

    It's a gift to be here. We do great work. Hospice is hard. I didn't realize that. When I got here the whole business model had some great challenges. I mentioned to you before you started taping, we have over forty hospices here in Southern Nevada.

    I had no idea.

    Yes. When I became CEO maybe there was five. There's nothing wrong with competition. It keeps you on your toes. But it has wreaked havoc in our business model. Medicare is the primary source of funding for us because most people are older and they have Medicare coverage. So we get about 80 percent of our revenues from Medicare. Medicare is really looking at the money that they're investing for people at the end of their lives and how that's a lot. Most of their expenditures go there, most of their budget. So they have tightened up some of what they'll pay for and what they won't pay for. So that's changed the business model.

    From a compliant standpoint there's been a lot of growth in hospice, actually way too much growth just here in Southern Nevada, but across the country. A lot of people see this as a way to make money. As a result of that the government has really been looking as to make sure organizations are compliant and that has caused us to have to tighten up in a good way, but invest in resources that you don't get paid back for. It's not bedside care and that's where most of our resources have always been invested.

    So we've had this perfect storm in hospice—I think in healthcare overall—of reimbursements declining. Medicare is paying less. They're not covering for what they used to.

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    The competition, the regulatory environment. So it's been a very interesting past three years at this organization and I feel like we're just coming into a new chapter that is very bright and our future is going to be great.

    But we've had a really rough time and you can't really go out and talk to the community about that. So they see us as this pillar and it's really not their concern if we're having problems. We just want to make sure we're there for them.

    So we have this amazing board of trustees. If we didn't get you a list, I will. But some of the pillars in our community are on our board and they have been here through the good times and they have been here through the rocky times. I must say they are happy right now that we're seeing some light in terms of how we're organizing this to be a sustainable business model for many years to come. Our board makes themselves available to me at all times no matter what the issue is. They're just always available whether it's Irwin Molasky when we're in a real estate deal or I'm in a complex issue or problem or his CEO, Rich Worthington, or Don Snyder, who I'm sure you know, who is just a mentor to me bar none with his decision-making acumen and his financial ability to look at things. He's just such a wonderful resource for me. I could go on and on about the depth and breadth of our board and what they give and make themselves available.

    We give away—and even during our hard times—over a million dollars a year in free care. Never turn anyone away because of inability to pay and that really sets us apart. That puts a lot of pressure on us. When the economy went south, we had to act quickly and make sure that we were a nimble organization where we could honor that commitment and make sure we could still take care of our employees and that they could take care of themselves. So it's been some challenging times here, but it's been great.

    Wow. So the financial part, you do fundraisers.

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    Yes, yes.

    I've gone to a luncheon or something, I think you've done.

    We do a lot of different things. I should just circle back to your original question, which is how I got here. So I just want to touch on that for one more minute because what I wanted to say to you is that I feel like my journey, my career journey that I put this out there that I wanted to be here and then it took me twenty years to get here, everything I did was to learn to prepare to perform this role. So it's just been and incredible gift that I had some really tough job assignments in my career that could prepare me to be a CEO. I stepped into this role as CEO and they give you a fancy title and that's really a privilege, but that doesn't mean I can perform the role. So I had to practice, I continue to practice each and every day to be at my best. So there was a lot of preparation I had and I wanted to make sure I said that to you.

    We should go back to that in even the history of Nathan Adelson Hospice. What did you know or feel about the history of how the organization came to be?

    One of the reasons I wanted to work here, Barbara, was because this organization is so well respected and it does such wonderful things for people in helping people that that attracted that social work background in me. As I said, I just want to make a difference in people's lives. This organization, I've never seen anything like it. The community owns it. This is not the board's organization. It's not my organization. It's not my team's organization. This is a community owned organization. What I mean by that is that you can—we have over three hundred employees. We have over three hundred volunteers. They have a sense of pride and ownership that I've never seen in any other venue that I've been associated with. A volunteer takes as much pride about this organization and what we do as Mr. Molasky does or as I do or my senior leadership team does. There's just a sense of family, community, ownership that we're all in this

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    together that I've never experienced and I wanted to be a part of that. I wanted to be a part of that journey and I wanted to learn from such smart people as my board members. They have an education that I could never repay except to repay to people that work for me and help them be the best leader they can be. So being part of this has just been an amazing journey for me.

    Matter of fact, I was getting a little antsy to leave because I've been CEO now it's been ten years and I feel strongly that you should have change and not stay too long whether it's change for the organization, change for me. I've been teaching leadership courses through what's called the Thayer Institute. So in my mind I'm going to reinvent myself one more time and I'm going to do executive coaching and I'm going to do leadership training. And I still will do that, but I'm not done here yet. So I just recently renegotiated my contract with the board. So I just signed on for two more years and it's a privilege that they'll have me and want me. So I have three more years in total because I had one year left come January.

    Well, that's great.

    Yes. So I'm excited to stay here.

    That's good for everybody.

    I think so. There's a feeling of satisfaction to help people die well, but it's bigger than that because we not only want to be the hospice of choice in our community, we're very committed to being an employer of preference and a training center of excellence and the community's trusted partner. So in the spirit of getting that done, it's important that we build a foundation operationally that is sustainable that anyone can come through or any situation can come through and it doesn't rock it.

    Because here is the trick about Nathan Adelson Hospice; we are a business, but we're this business with heart and soul. So people don't recognize all the time including our employees that

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    we're a business. If we don't have X amount of revenue coming in, we can't pay the bills. It's just this business with this amazing spirit because of what we do. So for me right now it's really getting that business model very secure so that if the economy was to tank again or we have forty more competitors or Medicare doesn't pay as much money that we will be here forever, and that is a commitment and that's why I needed a couple more years. I didn't feel done yet.

    So all those leadership principles I teach, I am looking to bring in here and train people under me and do a better job with that, mentor.

    To create a better exit strategy so that you're happy with what you're leaving behind.

    Yes, I want to leave this organization in really good shape. I didn't receive it in good shape and I built it up with a great team and the direction of the board and then we took a hit with everything, the economy and everything I said about Medicare, competition, and now we're rebuilding. So it didn't feel right for me to leave in a year because we're not done.

    So as I mentioned to you, we just bought a hospice; we bought a major competitor. We did that because we need to build a model where we have access to patients and that hospice was part of a delivery system, Healthcare Partners, and they are owned by DaVita and they have a contract with Humana Insurance. So you have to have access to patients today and make sure that you're aligned well. So that was the goal working with them. So we have a couple of more of those to do. I don't know if we're buying more hospices, but more aligning opportunities. Alignment is kind of what I'm working on right now.

    So the increase in competition comes with the aging of the population?

    Well, the increase in competition comes with people recognizing that they can make money off of death and dying. While I think anyone who works at a bedside is an angel—I don't care if you work for me or my biggest competitor, I have great respect—I think that to make money off

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    death and dying is a little bothersome to me. I don't mind competition at all, but to come into the market because you can make money on this doesn't seem authentic at this journey in someone's life. Now, I'm all more for making money and I'd love for us to make some money. But what we do differently than the for-profits is we invest back into programs and services and our employees. So that's really the goal.

    That's a distinction that a lot of times people don't understand with not-for-profits is that you still need to make money.

    Yes. We have to make money.

    And be able to sustain yourself and to improve.

    Yes. And we have to pay our staff compatible wages. We have to take care of people so that they come here. You can't just bring in people at low level incomes that are in, let's say, leadership positions where you can't get the best of the best. But at the same time, it's what you do to further that cause and purpose.

    So you started to ask about the foundation. We do a lot of things to raise money and then very targeted to support different programs and services. So our fashion show, which is our signature event founded by Susie Molasky and several of her friends, Jane Schorr and Beth Weinberger and then this whole committee of wonderful women, they do this Flare for Care Fashion Show every year. It has turned into an amazing event over the years. It's a luncheon and they always have a great designer. Boy, it's the who's who in that room and the women look forward to that event. They mark their calendars out six months; the "save the date" goes out.

    That money we use to support uncompensated care. So when we have people that don't have insurance, that are underinsured, in our commitment to never turn anyone away, that's what that money is used for. We raise anywhere from a half a million to a million dollars a year on

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    that event. So it's fabulous.

    Then we have other events. So in no particular order, we have a wine tasting event. It's a wine tasting and food extravaganza. We do that once a year. Laura Coleman—do you know Laura?

    No.

    Another Jewish person you might want to interview. That's her baby and we raise about fifty thousand a year on that event. It's held at Gaudin Porsche in their showroom. They just let us come in. And we have food vendors that come in; they donate the food and their time. We have great wine and people come just to experience the company, the food, the prizes you can win. What I love about that event is it's grown over the years and now we're running out of room in the showroom. It's so fun. It's one of my favorite events, probably because I get to drink wine, too. It's because I'm not sitting at a table and I can mingle and have fun. Usually by the end of the night we have our shoes off because the floors are hard and we've ruined our feet. But it's just a fabulous event.

    We use those funds to support pediatric programs and families in need. So we do a lot for families that people probably don't realize. For instance, someone's light bill; they need help with Nevada Energy because their power bill is going to get turned off. Or they can't pay rent. Or they want to fly in a family member that they'll never see again and no one has any money to do that. Or they need groceries. Here you and I are talking and we're really close to Christmas and Hanukkah. It's holiday time. We're just coming off of Thanksgiving. We use some of those funds to support people's needs at that time. So we're always looking to how we can be of service. It's not just to help someone die at that point in time of them dying. It's how we can serve that patient and their family overall—emotional, physical, spiritual, whatever they need. So that event, the

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    wine tasting helps support those efforts.

    We have a doctors in concert, Serenades of Life event. Dr. Ed Kingsley—he's an oncologist; he's on our board—an amazing man who is actually in a rock and roll band. To see Dr. Kingsley and know Dr. Kingsley, you wouldn't picture that. But he's been doing this event for—and we can get you the exact years—I think it's been twenty years, maybe longer. That event started over at Flamingo Library and now we were at Smith Center the last several years. So it's just amazing. We just had that event. I think he raised fifty thousand dollars. We use that event to support Bonnie Schreck Complimentary Therapies Program. Bonnie Schreck was a pillar in our community. Her husband, Frank, is a well-known gaming attorney who is also on our board. Bonnie and family were very appreciative of the complimentary therapies that we did, the nontraditional approach of taking care of people, massages and Reiki and Healing Touch and pet therapy and all those types of extras that you do that really help a person emotionally and physically. So we're committed to that program by providing those services for our patients and families. So that event supports that.

    What else do we do? We have a butterfly release here in Las Vegas and in Pahrump every year. We don't raise a lot of money at that event, but it's an opportunity for families to come together and we all have this one thing in common and that is we're honoring, celebrating, remembering a loved one. They purchase butterflies and we have a special program for children at that event. So they all release the butterflies at the same time. We have done it over at UNLV now for several years. I think we're going to Smith Center maybe next year. I don't remember because I have this wonderful team, by the way, and the foundation that just tells me where I need to be. So I don't have to do much on these events.

    Isn't that great?

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    Yes, it's wonderful. They don't really need me to make decisions. So it's fabulous.

    So the butterfly releases, it makes a little money for us, but more importantly is that it is just an opportunity for people to come together and share and take part together.

    Symbolic of what your mission is.

    Very symbolic, yes, very symbolic. What else do we do? I know I'm forgetting stuff.

    Brad Garrett is a spokesperson.

    Well, yes. You want to hear my Brad story?

    Yes, please tell the Brad story.

    He's an amazing man. Okay, so let's see. Brad Garrett...I'm minding my own business and I'm sitting at my desk. It's a Friday afternoon and I get a call from a colleague in Washington, D.C. I should mention that we don't just stay local. I am back in D.C. quite a bit doing public policy work. So part of our commitment is to make sure that Medicare and the folks in Congress, they understand the importance of end-of-life care. We're a part of solutions in terms of making sure we preserve the benefit. So I over the years have been very active in D.C. through our trade association and through the contacts we have, like Senator Reid, a major champion of hospice and Nathan Adelson Hospice.

    So someone from D.C. calls me from the trade association that Brad Garrett has a dear friend who has an insurance that we don't take and he wants to go into an in-patient facility and they don't have one and he needs that because he's maybe fifty years old and he has five or six children and he doesn't want to die at home. So I talk to Brad. I kind of knew who Brad is, but not really. Then, of course, recognize that Brad is from "Everyone Loves Raymond" and he was just the hilarious, tall, fun, police officer character, Ray Romano's brother.

    We help Brad right away. We bring his friend into our in-patient unit. It was his best

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    friend and it was a friend from college and he's the godfather to his children. It was through that that Brad and I became very close, a lot of text messages, a lot of laughter. Brad's Jewish; I'm Jewish. Brad has a horrible mouth; I have a horrible mouth. So we're not shy to say bad words. So we became really, really close. Brad and I are pretty much the same age and today he's like a brother to me.

    We helped his friend die well and Brad wanted to do something for us. He wanted to do a fundraiser. "Carole, what can I give the organization? You guys are unbelievable." At the time the competition was at an all-time high and we had just hired a public relations firm and we recognized that we can't take ourselves for granted. We're Nathan Adelson Hospice, but if we don't tell that story well, no one's going to really realize why we're better and different.

    So I say to Brad, "Brad, how about doing a commercial? I want to run a commercial." I had talked to Irwin Molasky first and said, "Brad wants to do something for us and I think this would be a great idea." So Irwin said, "Yes, let's do it." So we film a commercial.

    During that journey and ever since—and it's probably been, I don't know, five, six, seven years; I'm bad with my time—Brad knows a lot of people and we've helped a lot of his friends and family, mainly friends. I would always say to Brad, "You know too many people that are dying."

    Well, the story gets worse. So his friend that we took care of, Ed, the wife several years later gets cancer.

    Oh my.

    Yes. And she's maybe forty-nine. We end up taking care of her. Her name was Lori. You can't come out of those types of situations and not then be really, really close with somebody. Because Brad became our spokesperson, because I had great respect for him, because he now has become

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    a dear friend, when Lori was in and out of hospitals and he's trying to help her fight for her life, here she has these young children, beautiful children, he's calling me a lot for help. So I remember the day very well when I went over to Summerlin Hospital, one of the final times she was in a medical/surgical hospital and brought her over here and said, "Lori, you can't stay in this hospital. Let me help you. We'll do some curative treatment. We'll do whatever we can from a palliative perspective. But you're going to die in that hospital." Not that that hospital was a bad hospital, but she was just so weak and compromised.

    So brought her over here. I would say at that point Brad and I will never ever not be brother and sister, dear friends. It was a horrible time for him. One of those children was just having a birthday. So we brought the whole birthday party into our unit.

    So Brad and I, we talk all the time. We text all the time. His son just moved to Las Vegas and Brad is asking me, "Where do I get a doctor? Where do I get a dentist?" So we talk all the time, mainly by text and email. He loves this organization. He is a man of great integrity. I think that what I know about Brad today is that if you help him he wants to help you, and it's not even just about that because that's probably not even the right way to put it. He wants the world to be a better place. He and I share that. And he recognizes that what he does for a living is nothing compared to what we do for a living, and he'll always say that. "What you do over at Nathan Adelson Hospice is like real stuff, Carole, and what I do, I'm making people laugh, but it's not the same impact on the world." So he wants to be a person who helps others.

    He has a foundation that he named after his children. It's a wonderful foundation that helps children, families financially, and mainly it's in California. It's called Maximum Hope after Max and Hope, his two children. So he'll give money to like a family...kind of like our families in need program. They don't have the money for medication or they don't have the money for

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    rent or whatever. So because we're such good friends and we have such great respect for him, we help him now with that foundation. So he has a yearly event. We'll go support that. We've helped him with advice on how to raise money. So we work with his team. Yes, it's just a wonderful friendship.

    That's great.

    Yes, yes, it's fun.

    I always wondered how that relationship came about. The commercial says that you helped him, but you still always want to know the rest of the story.

    And Brad now comes to our events if we need him. So he now does, the last several years, our fashion show. He just did Serenades; he was the emcee for that. It's always fun to go on stage with Brad. I never know what I'm going to get. He picks on me mercilessly. So it's fun. He's just a wonderful, wonderful man. I appreciate him letting us borrow his celebrity status. It means the world to me for this organization because he really has helped us get the word out and normalize the message. To have a comedian talk about death and dying, it really changes things. I think people can relate. They know he's funny, but they see him talking serious and they're like, wow, I want some of that. So we'll get calls like that. "Whatever Brad's doing, we want some of that." It's very, very nice, yes.

    It seems like comedians oftentimes are able to help see the seriousness of issues.

    Yes, yes, definitely.

    That's what he does so well.

    Yes, yes.

    And the story of the Molaskys and them being so...Without them—

    Well, we wouldn't be here.

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    —Nathan Adelson would not exist.

    We wouldn't be here. Irwin and Susie don't like us to say that. Irwin is very humble; Susie is very humble about their contributions. I tell Irwin all the time Nathan Adelson Hospice is his greatest legacy. We've helped over sixty-six thousand people. Look at all the people he's employed over the years. It's his greatest, greatest gift to our community, I think. But you can't take away Sunrise Hospital and you can't take away the malls and the apartments and all the good he's done in that arena. I just think that helping people die well and have what they need at the end of life is just something that you can't even measure the impact of that.

    Irwin is very active in this organization, as is Susie. Irwin is aging now. So I don't hear from him like I used to. But in my early tenure and still recent—I mean, he was just at a board meeting a couple of weeks ago—he would call me once a week, "What's going on? How's it going? What do you need from me or what can I do to help you?" He still cares very much about that. His interest in this organization is just phenomenal. Irwin is someone who when we are faced with a problem, whatever that may be, he takes time with me to walk through it, to talk about different options, to explore good strategic intervention. He's just such a wise, wise man. I have learned so much from Irwin Molasky as a leader, as a CEO. He is a mentor to me. He's a friend to me. He's a father figure to me. He's just all that for me. I just love him to pieces. He's just a great man.

    He's not the easiest man. He has opinions about how things should be and he's not wrong usually and he'll challenge me or I'll challenge him. I think one of the things that Irwin loves about me is that I respect him, but I also stand up to him. So if I don't agree, we're going to have a healthy debate. He always wins, but we're going to have a healthy debate. I think he understands that I really am as committed to carrying this forward for him as he was committed

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    putting it in place. So it's just a privilege to work for him. Yes, he's just a wonderful man.

    Susie, equally committed. Susie has sat at bedsides with patients. That's a well-kept secret. We had a patient over the last several years. She was friends, I think, with the daughter and the daughter couldn't handle being at the bedside. Susie didn't want that gentleman to die alone and she'd sit at that bedside. She was here every day. She would say to me, "Don't tell anybody. I don't want people to know." Who does that? She doesn't have to spend her time that way. Her contributions are genuine. They're from the heart. She loves this organization like Irwin does. Again, it's her legacy of what she's done here.

    I think their love comes through. I did Susie's oral history and I thought that was really special to hear her talk about how it came to be.

    Yes, it's a rich history.

    Yes. And why it's named that and the clarification even down to that it's not a Sheldon Adelson relative; it's a distinctively different family and all of that. And people know. You just say Nathan Adelson; you don't even use the word hospice.

    Yes, with the name recognition.

    They know what you're talking about.

    Yes. It's part of that community ownership that I mentioned to you. It's a well-recognized organization. Yes, I have not experienced that before. It's not like Southwest Airlines, for lack of a better example, where everyone knows that because they've advertised and they did all this strategy on it, or some of our hotels here. It earned its reputation through good work and it is community owned because of that, because of our commitment to excellence and quality and just the mission and the vision is just authentic, I guess, for lack of a better word.

    I don't know if you can answer this. I still struggle with this. There seems to be a

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    special...Death and dying is important to all of us. We're all going to be dealing with it multiple times or for ourselves or whatever. But there seems to be some regard in the Jewish tradition for taking on that responsibility. Have you ever felt that?

    Yes.

    Thought about that? I can remember my husband had an uncle who would take care of the Jewish cemetery. I thought there was a word for it, but I struggle now to find what that word was. Then there was a time I went and did a tour of Temple Beth Sholom here and Rabbi Goodman went through the cemetery and he's telling the story. It just seems that that's a subtle foundation that this organization maybe was built on and has thrived from.

    Yes. So we don't recognize ourselves as a Jewish organization.

    Right.

    But I will say there is a Jewish-rich history here and it makes me think of Alvin Benedict. Do you remember Alvin Benedict?

    I know the name, sure.

    So Alvin was one of our founding members, members of the board. He died several years ago. He was the President/CEO of MGM. He was the one who helped Susie make sure that they could do that big event, the jubilee event, Butterfly Ball. Up until the time he died, he would show up here about once a week, every other week just to say hi, drop off a little money. He had been a friend of my family's for years. So he'd love to come say hi to me and tell me what a good job I'm doing or not doing.

    What made me think of him is he went to the cemetery every week to visit his wife, Jane. He would go say hi to my dad. He would tell me about that experience when he would go every week and who was out there and who was not taking care of the tombstones and which ones

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    were. There was just this real rich connection for him of completion and honoring people that came before and that were special in his life.

    I think in the Jewish tradition we see that often, not just including Judaism. But if we're just going to talk about the Jewish faith, there's a commitment to family, there is a commitment to community, there is a commitment to honoring what came before, and to make sure that that history doesn't lose its place, which is certainly what you're working on. We see that. We just see that. We recognize it.

    There's a lot of pride in those families, in the Jewish families we take care of. There is a lot of...How do I say that? Asking for help is hard; and, yet, when they do, when there are families that do ask for help, and they do, realize that it's okay to ask for help and get our help, they're just so appreciative of what we can do for them and make sure that they let us know that and that they honor that through a gift, a donation or a kind letter, depending on their financial status. So, yes, we see that in the Jewish tradition quite often.

    And death knows no religion.

    No, it knows no religion, no boundaries.

    No boundaries, right. So you're full all the time, I'm sure.

    Yes. So we have two in-patient units. That's our flagship one. This in-patient unit has twenty beds and it was the second in the country. It actually was looking like the second one in the country. So we put about two million dollars into, a little over, several years ago. It's looking much better now. Then we have a unit on the northwest side of town. It's on the campus of Mountain View Hospital in their medical office building and that has eighteen beds.

    Most of our patients are at home, though, or wherever home is. It could be an assisted living, nursing home, group home, wherever home is. We've taken care of people in prison

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    before and in hospitals, wherever they are. So from a home care capacity, since we can go to them, that's easy to do. So there's no capacity. Sometimes our two units are filled and we have a waiting list. That's always unfortunate. But people usually aren't here that long. So we're able to accommodate community.

    I can just say that having been a family that took advantage of—that's the wrong word.

    I know what you mean.

    Were here. It was an amazing experience to have.

    Thank you.

    Because I knew the tradition and the respect and all of that. But to experience it firsthand just was everything we expected.

    Yes. Thank you. It was a privilege to be of service. I had that experience. So when I became CEO my mother-in-law became very ill and ended up dying on our hospice. She was living in California, but my husband and I—my husband at the time—we brought her here and took care of her. So I remember that feeling of, oh, I'm going to be a user of this service. It's a whole different deal and that ability to ask for help and that ability to then just show up as a daughter and just show up as a daughter-in-law and just show up as a wife and not have to worry about all the logistics. That's what's so great about hospice because that's what we do. We go and help so you can just have the best quality time you possibly can while your loved one remains.

    Yes. And it brings such dignity to the inevitable.

    Yes, it does.

    So I thank you very much, Carole.

    [End of recorded interview]