We want to give residents as much control over their own lives as we possibly can
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executive leadership within a healthcare system that expanded across the US and into the UK.“ That experience not only brought operational discipline and scale, but showed me exactly where traditional care models were failing families. We were building a massive footprint, yet the industry as a whole were missing the mark on true relational care.”
Breaking the model
As Loren began researching the sector in the mid-1990s, he found an assisted living industry built on a well-established, realestate-first formula. Operators competed on location, pricing, and high-end amenities.“ The whole foundation of the sector was real estate. Occupancy drove the business, and actual clinical care was often treated as an afterthought.” Some providers introduced designated memory care wings, but these frequently lacked meaningful integration with medical and psychosocial support.“ The result was a system that looked supportive on paper but couldn’ t meet complex medical needs.”
Rather than separating residential living from healthcare, Loren combined them. He integrated skilled nursing, social work, and daily cognitive engagement into a single, cohesive hospitality model.“ You can’ t just walk into a residential setting with a pretty living room and expect it to work if you don’ t have the back-end clinical support. At the time, that approach ran completely counter to industry wisdom.”
The sector viewed deep clinical investment as an unnecessary expense and a commercial risk.“ They all told me,‘ Don’ t do it,’” he recalls.“‘ Don’ t hire full-time nurses. Don’ t bring in social workers. Don’ t build a medically complex model; it’ ll only increase your liability.’ I rejected the advice.” The gap between what people needed and what they were getting was simply too wide to ignore.
The first community Silverado built challenged every prevailing assumption, operating at a scale that outsiders questioned.
“ From the start, we served residents across every stage of disease progression, from early diagnosis through end-of-life care.” Traditional assisted living settings faced strict legal limits on the acuity of residents they could support,” Loren says.“ We were going to change those laws- and we did.”
The same willingness to push boundaries extended to the company’ s approach to neurology.“ We’ ve had neurologists tell us that once a part of the brain is gone, it’ s gone forever. That’ s an interesting clinical take, but we don’ t let it become a barrier to care. We succeed by never giving up on people and by designing programs around the cognitive abilities they still have.”
We want to give residents as much control over their own lives as we possibly can
Daily practice
As Silverado expanded, Loren’ s focus shifted from proving the model to sustaining it across dozens of communities. He points to culture as the anchor.“ Culture is everything. We want to create freedom to move around, freedom to enjoy life. We want to give residents as much control over their own lives as we possibly can.”
At Silverado, residents enter warm, open living spaces rather than formal, clinical reception areas, allowing their daily routines to remain recognizable.“ We let residents move in with their own pets. Why should someone have to give up their last best friend just because they need care?”
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