From hospice nurse to Chief Nursing Officer, Erin Shadbolt, CEO of Ascension Living, discusses the importance of helping families understand the benefits of moving into senior living prior to a health need. Erin shares her unique journey from nurse and hospice caregiver to senior living executive, and the surprising lessons she’s learned along the way. From bridging gaps in the healthcare continuum to reshaping the perception of senior living, Erin offers candid insights on why community living is a life-giving alternative to isolation.

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This episode was recorded at the NIC Fall Conference 2025.

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Produced by Solinity Marketing.

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Intro 

Welcome to season eight of Bridge the Gap, a podcast dedicated to informing, educating, and influencing the future of housing and services for seniors. The BTG network is powered by sponsors, Aline, NIC MAP, Procare HR, Sage, Hamilton CapTel, ServiceMaster, The Bridge Group Construction, and Solinty and produced by Solinity Marketing. Bridge the Gap in three, two.

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00:48 - 00:54

Lucas McCurdy

Welcome to the Bridge the Gap podcast, the senior living podcast with Josh and Lucas. Here in Austin, Texas at the Fall NIC Conference. I want to welcome a great guest today, Erin Shadbolt of Ascension. Welcome to the show.

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00:54 - 00:56

Erin Shadbolt

Hey, so nice to be here with you. Thanks for having me.

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00:56 - 01:16

Lucas McCurdy

You wear a lot of hats. Currently, one of them is CEO, and we have been having a really fun, healthy conversation. Off mic. And we are really interested for you to tell our audience about your journey through the healthcare continuum that has led you to this point, and some of the surprises that you've seen along the way.

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01:16 - 05:04

Erin Shadbolt

Yeah. So I have a unique background. I think, in senior living. I am the CEO of Ascension Living, which is the senior living part of Ascension Health Care. So very large, national health system across 11 states and DC. And I have communities basically in the same. Areas, I would say. Our total community count is a little bit over 20, and we're in the middle. Of some divestments. So that sort of changes day to day sometimes, even, and we see sort of all levels of care. So lots of skilled nursing. But we are pivoting more strategically, focusing on housing. So I am a nurse by background. And when I started as a nurse.

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I was going to be in the ICU. For sure. I knew for sure that's what I was going to do. I ended up working as a travel nurse and came back to Utah. Where I was from, there were no jobs. I got a job. As a hospice nurse, just until I could get into the ICU. And those are two really different things. And it turns out I would not have been a good ICU nurse. I loved hospice, and I. I sat down next to somebody today and said, Well, you know, like this is a dream job too, but when this dream job is done, I would love to go back and be a hospice nurse again. So anyways.

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Did home health and hospice and in my most recent role I was at Mayo Clinic. I was actually over a lot of hospital operations. So our ObGyn regional practice, which was two critical access birth centers and an inpatient. And then I also was over some of our post-acute stuff, as well as I helped Mayo Clinic launch their home hospital program in northwest Wisconsin.

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So I had all this really kind of interesting and varied background, and I got an opportunity to come to Ascension. And when I came, I was the senior director of post-acute care, and I was told you won't have to worry about senior living. They have a leadership team. You just do post-acute. And I did for about three months before there was no longer a leadership team of senior living, and I was appointed as interim CEO and CNO.

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So you made a comment that my LinkedIn is not up to date. It's because. I've been intermittently CEO and CNO in the past few years with Ascension Living. But what I was so surprised, and it has been such a steep learning curve. There's so much stuff in senior living that is just not known to anybody else in the health care ecosystem. And I mean, I worked as a hospice nurse, I worked in senior living. Like, If any nurse is going to know it, other than someone who works in senior living, it should have been me.

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And my Aha was that we were seeing residents come into our communities and essentially living. As I started to hear the stories I realized that our communities were a solution for all of the problems that I was trying to manage in home health and hospice. I tell people now that. The thing I love about senior living is that it's a lot. Like home health and hospice.

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Except like the water's clean. And there's not cats in my sterile field. It's amazing. It's everything that's great about providing care to people’s homes, except you provide the home. And so it's safe and it's clean and there's enrichment and there's the socialization. And it's just been really incredible to see the improvement. And the opportunities that seniors that move into senior living really have when they're coming from that very isolated single-family home. You know, often by that time, they've lost sort of everyone that was their support system: friends, family, spouse. The kids aren't living there anymore. And they're just isolated, alone. And we know how bad that is for mental health.

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05:04 - 05:18

Josh Crisp

Well, it seems like a huge opportunity for senior housing. I mean, is that shaping some of your leadership strategy for ascension, living on the things that you've learned as you come into senior living?

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05:18 - 07:01

Erin Shadbolt

Yeah, one of the things that I have really tried to make sure that I'm elevating is as I'm in my communities. And talking to seniors, we're really capturing those stories. And then thinking about, like, how do we bring those to our future seniors? How do we make sure that the aspect I think a lot about the children of senior parents, they're trying to manage a really difficult situation. Maybe the resident is like my mom who's like, you know, just. Take me out back and shoot me before you put me in a place. That's my mom. And I'm like, I'm the. CEO of a place like, you've got to stop saying that to people.

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So how do we take the stories of our current residents who are thriving physically, emotionally, mentally, and share that with the prospective residents and their families so that this decision, right now, feels terrible and like you're giving up on someone?

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And I think it really does feel like that for a lot of families. It felt that way for me. I think it felt that way for my boss, who's going through something similar. And instead it's like, oh gosh, you finally got into senior living, right? Like, this is like college. This is like your senior living college years, like you're part of a fraternity or sorority, like you have a whole. Group of friends. Like, how often do you get to have dinner with friends?

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Like it's at conferences like this. And maybe once a week. As you get older and like your friends are dying or just not as mobile, you're just isolated in your home, and it’s just not good for us.

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Mid-Roll

07:01 - 07:48

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Josh Crisp 

7:48 - 8:18

it seems like you've kind of described off mic and then on mic, sort of a disconnect in the health care continuum where, you know, senior housing is, is a great place. So much opportunity to probably even do more or at least tell the story better of what we do. Where do you think that disconnect is between, like, true, like, healthcare system and senior living community? And how do you bridge that gap? I mean, it seems like that's something that we need to do a better job of. Right?

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8:18 - 10:34

Erin Shadbolt

That's a really good question. And I'll be honest I think for people in leadership and senior living, especially those that are associated with health systems, which, I mean, those are getting fewer and further between. We have a real opportunity in my senior living team, when I look at kind of that team, most of them do not have acute care leadership. And when you go.

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And work in the hospital, most of them do not have. Senior living leadership. And when you look around health care, there's really not a lot of other places where you find almost the total siloing of an entire component. Right? Like most people who work in the hospital, if you ask them, where else have you worked? They've worked in clinics, they've worked in outpatient surgery. Maybe they've worked in inpatient rehab, like they have some, there's a general understanding of other sides of care outside of the hospital, except not senior living. Senior living is sort of a black hole. The case managers know that they send referrals. They know that sometimes some of those communities, those patients are coming back to the E.R. over and over, and they see them a lot. But what really happens in the community?

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What I find is, at least in my organization, it's a really narrow group of people that truly can tell the story of the great things. I might have case managers who can tell me about the therapy and the wound care. And that's all great for the skilled nursing side, but for the housing side of like, we're going to solve so many social and physical and emotional issues.

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And like really manage the medical stuff as it gets to be more and more burdensome. It's just not known anywhere else. And I think in senior living. This is where, as you know, a lot of what we've been talking about at NIC is partnerships and how we really partner better and differently. I think partnerships have a real.

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Strong potential to drive. Understanding, knowledge, and even more importantly, real advocacy of senior living from our partners in the rest of healthcare. And we are critical to the success of the rest of the health care system, whether they think of us that way or not.

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10:34 - 10:52

Josh Crisp

Yeah. So strategy for you all in growth. Are you looking to develop communities in the senior sector? Are you looking to acquire communities? What are you delivering services to those communities and third party those services. Where is your growth coming from?

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10:52 - 14:24

Erin Shadbolt

I would say we've not been in the growth phase the past few years. We've mostly been divesting, and that's been really strategic to align our senior living portfolio to our acute portfolio, which matters were health system-based. We have. Some important gaps in aligning with our hospital system. So we are looking at acquisitions or potentially new developments to support the needs in those areas.

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I don't know that that's going to look like any skilled nursing beds unless we really found the right acquisition, because we really are looking at how to have really great housing for seniors, and then partner to bring in all of the other services?

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The one exception to that is that we are building out geriatric care coordination. That will be sort of an overplayed service on top of our senior living to help our residents and their families navigate the complexity of just accessing services around medical or health care for seniors.

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And that will be available both for our residents, but also. as something that anybody could sign up for. So we're really excited about that. That seems to be a real gap in housing still, where I think the right leverage of care coordination could tell that story of what's happening to the partners that our residents are dealing with in the health care system. So you think about a resident who goes to the doctor, the doctor brings them.

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You know, the doctor and resident are not thinking of telling the doctor all the great things that the resident is doing in the community. But if you have the right care coordinator, that person may provide a report like, hey, give your physician this we want them to know how, how your mom is doing, or they actually go with them.

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And really advocate for that resident and tell the physician, hey this is you know, we've been talking about goals. This is what's important to this resident. This is what she really wants to visit the grandkids. But getting in and out of the car is hard let's get therapy involved just for car training. Like that's her goal. She didn't need to run.

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She doesn't even want to walk. She just wants to sit in a wheelchair, but she wants to get in and out of the car. So being really thoughtful about having a voice that can bridge The siloing of senior living and speak to the medical and the health implications, but also the whole person approach, because, I mean, that's the magic for us is I'm not just taking care of your toileting needs, right?

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Like, we're going to do fun stuff, we're going to go on trips, you're going to have friends, we're going to have great food. You know, I'm going to serve you crazy food you've never had before. We just had a kimchi hot dog. That. Doesn't sound like something that I would love. And it sold out and we have residents begging for kimchi hot dogs, like, I just those residents were not going to eat kimchi hot dogs at home by themselves, in their single-family home.

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And really telling that story, like, this is a whole different living experience. We have to tell the story, and we have to tell it in a way that we really overcome this unfortunate stigma. This is just where, unfortunately, is really thought of as this is where old people go just until the end. And that is not what we're doing and it really isn't fair that that's how it's thought as well.

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14:24 - 14:56

Josh Crisp

It seems to me that, sort of, that gap that you're talking about, the knowledge base of that talent pool that you're going to need to be able to scale that to make that impact. That seems like a real challenge, a real opportunity. Do you have any thoughts around is that going to be literally there's talent out there that knows and understands the health care delivery system and understands that seizing senior housing and coordination of those services? Or is this something internally you're going to have to build out these training programs to educate people in the way that you need?

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14:56 - 16:14

Erin Shadbolt

That's a good question. I think it's both. There are people who truly know the health care continuum and the navigation it. Complexity of payers and services and how to advocate for medications. I mean, we see residents with lots and lots of medications. We know that’s dangerous. So we have some resources. We actually have a program that is somewhat similar to this. That is, we call it Live at home. It's an assisted living community.

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And we already have a group of care coordinators that basically are doing this. So they already have this skill set. My guess is, you know, we'll get. A small core team that kind of knows. And then from there we will need. To train all of our future coordinators. And I also think that there, you know, as we build this out there, sort of the clinician. Which really does need to be a nurse or somebody that really understands the medication implications of aging process.

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But then there are people who just need to coordinate all the stuff that's hard to coordinate. You know, you're on the phone, you're waiting for callbacks, and so we are thinking about how to have the right level of individual who is supporting these residents in this journey of care navigation.

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16:14 - 16:19

Josh Crisp

Lucas, I don't know about you, but I'm really glad that you and I don't want to solve that problem.

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16:19 - 17:03

Lucas McCurdy

I know, I know it, yes, this is very smart. People like Erin and so many other people here that help drive these conversations. And that's what's fun about coming together at a big conference like this, where there are so many thought leaders and such great, actually, sessions that are hard to get to through the meetings. Right?

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There's a lot of great content here. And it's fun for Bridge the Gap to capture these conversations, to put it out on the podcast, ecosystem for free, so people can learn from it. It's been a fun time. Fun conversation. Any final thoughts? You know, oftentimes we'll kind of end with, do you have any encouragement for, maybe that younger generation that's looking for a career in senior housing? You were there once, and I'm sure recruiting for people like that all the time.

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17:03 - 17:07

Erin Shadbolt

Oh my gosh, I am oh, when I'm out, I must, I must drive my waitstaff crazy. I mean, if I get like a good barista or waiter I am on them. Like, have you thought about being a nursing home administrator? Have you thought about being a senior living administrator? Let me tell you, this is the pay range. This is the career. Like, I actually need a handout to give people. And I think in a lot of ways it is us going person to person as we meet great talent, people that are energetic and that are engaged and that are giving us great service, like those are our people. And these one-on-one conversations are really important. I think we can get into schools and we're doing all the sort of traditional stuff, but I have this sense of in senior living, like we are very much missionaries of our work, and it is on us to carry sort of the faith and senior living forward and convert other people into the same belief that senior living is amazing.

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18:03 - 18:11

Lucas McCurdy

Love that can set it any better myself. All right. That's wonderful. Well, thank you, Erin, for your time today and for telling your story. Really appreciate it.

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18:11 - 18:12

Erin Shadbolt

Thanks for having me.

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18:12 - 18:44

Lucas McCurdy

And for our listeners who love this conversation and love this content, you can go to BTG voice.com and you can download it. This and so much more. And one other final note from producer Sara, we were introduced to Erin through Christy Towey. She's one of our Bridge the Gap ambassadors. And, if you are interested in being a Bridge the Gap ambassador, you can go to btgvoice.com, fill out that application and see if you can get in for the 2026 class. Thanks for listening to another great episode of Bridge the Gap.

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Outro

Thanks for listening to Bridge the Gap podcast with Josh and Lucas. Connect with the BTG network team and use your voice to influence the industry by connecting with us at btgvoice.com.

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