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Joe Murabito

Owner of Elemental Management Group in Oswego owns, co-owns  or operates eight nursing homes in Upstate New York with over 600 residents; says connection to the senior population and ardor for healthcare started at a young age

By Stefan Yablonski

Q: How did you come to be interested in this type of work?

A: I have always had a pretty strong connection with the senior community, whether it be extended family or through church growing up. I feel like I had a perspective that maybe some people didn’t.

Q: Is there any special training involved?

A: As far as the training, I went through my undergrad in health administration at Ithaca College and then graduated from Cornell with my master’s in the same program. I had done multiple internships in the VA hospital in Syracuse, St. John’s Hospital in Los Angeles. There were some projects that were very specific to the senior population. I found myself playing the piano up at the VA for two summers. I have a really great video of that. I have that news clip still from 30 years ago, and I watch it. There has always been some connection there with seniors. I listened to ‘20s, ‘30s, ‘40s music growing up, probably more than most people. I feel like I’m doing what I’m supposed to be doing.

Q: How long have you been in business?

A: That video of me on Channel 5 News was from 1996. I really haven’t done anything else since 1996. I finished up school, did internships through school and have been doing this call it 30 years.

Q: What did you do before this?

A: I really didn’t do anything before this (laughs).

Q: Why do you still do this?

A: There is a passion word and then there is a consistency and commitment word. It’s a challenging profession. It’s a fairly thankless profession — you don’t read a lot of great news articles about nursing homes. It seems like we are always doing something wrong or something not quite right. People are not working in health care by accident. You’re doing it for a reason.  You’re getting something out of it more so than if you were doing something a little less service-oriented.

Q: What did you want to be when you were growing up?

A: My grandfather [the late Joe Castaldo] was a contractor. I worked outside a lot, working on a farm; my brother and I did growing up. We had 15 head of beef cattle. Fished and hunted, mostly with my grandfather. He was retired by that time; he took several smaller jobs. At one point, I had the idea of architecture; but to be honest with you, I watched my grandfather who had every tool known to man — I spent a lot of time being frustrated with all those tools. I don’t get a lot of satisfaction with hands-on fixing stuff. I was always interested in mechanical things. I remember taking my BB gun apart; I couldn’t put it back together. That really didn’t bother me much. I never got a lot of satisfaction out of fixing things.

I did find myself though through school and in college — I was always in these leadership positions that I didn’t ask for. I was first trumpet in the wind ensemble, captain of the football team, treasurer of my college class. I was the older of two brothers. My dad was handicapped growing up — so there was something about health care —he had MS. He was either with a cane or eventually with a wheelchair. He just passed away in 2021. So, there was something about that that maybe clicked in my brain.

Q: How did it all start for you?

A: I came back to Oswego at the request of my grandfather to a facility that he built here — formerly Harr-Wood Nursing Home and then Sunrise. It was never his plan to own a nursing home; he was just supposed to build it. And then he ended up owning it because the developers had walked and in 1995 he ended up being the receiver. He found himself in all this stuff he didn’t want to do, either.

I had left the area when I got married. The work atmosphere wasn’t great, healthy. I ended up working for a company in Boston for a decade. Then, right around 2007 or 2008, I got a phone call … was I interested in trying to work out a deal with a place in Oswego because it was going to close? So I really took a big risk. I had two kids. It took me about two years to strike a deal on the operations with my grandfather. By 2012 we had a deal. My grandfather was a good businessman, he wasn’t gifting anything.

In 2014 I was able to refinance the building with HUD — roughly a $9 – $10 million loan — the biggest thing I ever did. And we started from there. Started the Gardens then there was the Waterville facility which was another financing with Pathfinder [Bank]. If it wasn’t for Pathfinder I really wouldn’t be as far along as I am. They’re very supportive. I think they’re very supportive of most businesses that they have confidence in. They have been a great partner.

As far as ongoing investment — we’re working on a deal with a large facility down in Horseheads and that’s a $35 million deal.  Over time you start feeling comfortable with those numbers. It feels normal after a while.

Q: Are you going to expand further?

A: I feel like I’ve gotten to the point where if I expand any further or much further, I feel like I would lose the context of what I think health care is about. There are larger health care providers out there with two or three times more property than me or more. But I don’t think healthcare is a commodity — it’s a personal business it’s a people business.

You can’t survive as a single stand-alone facility anymore. You need some scale. I felt the tug-of-war of that scale because as you scale up you get further and further from the individual people. I don’t want to contribute to the same sorts of problems that I feel like our profession is known for.

Q: So, you’re saying enough is enough?

A: When is enough is enough? There is a point when enough is enough — especially in health care. You have to maintain a certain amount of contact with the right people. How do you balance the business end of it with the people end of it? I’ve had this conversation with some friends that own more property than me and I’ve never really got a great answer.

There probably won’t be more facilities in an expansion. Probably everybody who reads this will laugh — but the goal is to find when it’s enough. I’m in the process of making some decisions with partners — what is the three-year plan, the five-year plan, where do you want to be ultimately and who is going to be behind me to pick up the baton and do what I do.

Q: Who helped you get going?

A: My grandfather was a huge motivator for me across the board. I watched him work my whole life. So he gets certainly the lion’s share of that credit. The perspective that I learned from my dad, who was much less functional and active because he was so dependant on everybody, I think my passion for healthcare was defined there for sure.

There are all sort of people I’ve have had the support of. The VA — so many guys that I worked with through my internships who were very supportive of me. I’ve had great bosses, I have had some that aren’t so great. The great bosses were very supportive, paid attention to me and listened and coached me. I take a lot of that with me. There’s a whole village of people that I feel like that contributed, that’s just on the professional side of things.

My wife, Ana Maria, she moved here from Colombia and has been bouncing around with me for 30 years or so. That’s a huge part of the picture, too.

Q: Was it tough for your business during the pandemic?

A: It was probably the two most difficult years out of the 30 I’ve been in healthcare. A lot of the leadership suffered general fatigue. I feel like the staff did a really great job handling things — this sort of unknown — all the way around the table.

Q: What is your business philosophy?

A: Life balance and promoting the success of other people.

An old-school term a common ending to correspondence between people in the 14, 15 1600s 1700s even the Revolutionary times, it’s basically ‘the reservation clause.’  It’s an acknowledgement that you can have the best plans in the world but sometimes things don’t work out. It’s not like you live to work — it’s the other way. You need to have some balance.

Q: If you weren’t doing this, what would you be doing?

A: During COVID, we opened a vineyard [Strigo] in Baldwinsville. Growing up we were always cooking. Somebody was always fermenting something. I just want to be on the land making wine, having a place for people to come. At Strigo, people walk into your place of work and they are really happy to be there. Strigo gives me a lot of things — I grew up on a farm — I was outside all the time, hunting and fishing. We make our own wine with our grapes. We have a nice little restaurant.

Q: Do you have any hobbies?

A: Have a lot of interests — that’s why I have the winery. Over the course of COVID, I got a black belt. I fish a lot all over the world. Balance is important — don’t get caught up in your own brain, which is a struggle sometimes. I’m mindful of physical and mental health, which at 50 I’m really spending a lot more time focusing on how do I get more active? I work out five or six times a week, still go to karate twice a week, do mixed martial arts. I do some fairly intense stuff because if you don’t move it you lose it.