Don’t let this happen to you

by John O'Connor

My colleague Jim Berklan has been covering one of the year’s most compelling and troubling stories in long-term care: the unfolding saga of Forrest Preston, the 91-year-old founder of Life Care Centers of America.

New details emerging from Tennessee sound like something out of a soap opera. Since marrying his third wife, Kim, nearly 40 years his junior, Preston’s life and business have reportedly spiraled into chaos, according to a court complaint by his son, Aubrey.

Allegations range from restricted family contact to questionable financial transfers benefiting Kim and her siblings. Fears of a planned exit from the country and a recent passport renewal attempt have escalated the situation further.

The court has now ordered a legal guardian to assess Preston’s mental health, while Life Care’s leaders warn of operational disruptions, morale issues, and financial risks stemming from Wife Number Three’s influence over Preston.

The story will likely resonate with many nursing home operators, as countless facilities were founded and are still run by aging visionaries. The occupational risk here is founder syndrome — a condition often rooted in deep emotional investment. Symptoms can include excessive control, micromanagement, and a reluctance to plan for succession. Left unchecked, founder syndrome not only weakens operations but also exposes companies to serious risks if a founder’s health falters.

Here are five ways to help protect your organization from a similar fate:

Embrace succession planning early

Every organization needs a clear plan for leadership transitions. Founder syndrome often thrives in environments where succession planning is seen as a threat rather than a necessity. By actively working to groom potential successors and formalize a transition plan, founders can prevent their departure from becoming a crisis.

Establish a robust, independent board

Boards should be empowered to act in the organization’s best interests — and that means being able to provide oversight and checks on founder-driven decisions. By ensuring that no single individual holds outsized control, companies can safeguard against rash or irrational decisions that may emerge in later years.

Create boundaries and delegate authority

Founders should work to delegate authority and establish boundaries within the organization. Not only does this help the company prepare for a future without them, but it also encourages a healthy organizational culture where leaders can emerge, and the business can operate autonomously.

Seek legal and financial protections

This case also underscores the importance of legal and financial protections. Business and personal finances should remain distinct, and proper legal documentation can help protect assets in case of familial or personal disputes. Transparent accounting and clear policies around asset management are essential.

Be open to retirement and life transitions

Letting go is difficult, but aging is an inevitable part of life. When a founder refuses to step back, they risk not only harming their company but also their legacy. Preston’s story serves as a reminder that maintaining full control into one’s twilight years can lead to serious and possibly irreversible damage.

Whether or not the company can weather this storm remains to be seen, but it stands as a glaring example of the risks associated with founder syndrome.

For today’s nursing home operators, the message is clear: don’t wait until it’s too late to put safeguards in place.

John O’Connor is editorial director for McKnight’s.

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Don’t let this happen to you