A relentless focus on process improvement and culture change has catapulted Clarkston Health and Rehabilitation Center into elite territory, making it one of only two nursing homes nationwide to earn the American Health Care Association’s prestigious Gold Quality Award this year. In this episode of the McKnight’s Newsmakers podcast, leaders from the Washington facility and parent company Cascadia Healthcare shared how a five-year transformation turned a struggling building into a regional powerhouse. "Making the informal formal and then responding to the criteria ... becomes a cycle of evaluation and improvement," said Maryruth Butler, director of quality and integrity for Cascadia. The awards program’s years-long process builds knowledge and confidence that Butler describes as “unconscious competence” among operations and care teams. When Cascadia acquired Clarkston in 2021, the building faced severe operational headwinds, including low census and a history of high administrative turnover. According to Chief Nursing Officer Jami Johnson, establishing reliable, standardized processes and fostering staff buy-in were pivotal to turning the tide. That structural shift allowed the sole skilled nursing facility in its county to double its resident census, expand specialized clinical offerings like parenteral nutrition, and navigate state regulatory surveys with zero clinical deficiencies. Beyond facility gains, guests tell moderator and McKnight’s editor Kimberly Marselas how Cascadia leverages its growing network of quality award recipients to elevate performance across all its properties. New discoveries and strategies from the chain’s silver and gold winners are supporting the quest for quality at newly acquired and turn-around facilities. “The sharing of best practices really has helped our organization as a whole,” adds Kate Hawkins, regional clinical resource for Cascadia Healthcare in Washington. “Reaching out to sister [facilities] and again just sharing that best practice has really moved a lot of mountains very quickly." Check out the full episode — and our previous conversation with fellow Gold Winner Todd-Dickey Nursing and Rehabilitation — to learn more about how these leaders are driving clinical excellence, building organizational consistency and sustaining long-term quality momentum.