J. Thomas Briody

Edna Briody opened a home for the aged in Buffalo in 1946. Eighty years later her grandson runs one of San Francisco's largest aging-services nonprofits. The family never really left the business.

Tom Briody took the corner office at Institute on Aging in 2012. He had spent the prior 25 years inside elder care: skilled nursing, home health, seniors housing, community care management. By the time he flew west, he had already integrated a continuum of services at the Catholic Health System of Buffalo and hung his own consulting shingle in Western New York. San Francisco was the next chapter, not the first one.

IOA was already a 30-year-old institution when he arrived. It had a $38 million budget, 450 employees, and roughly 8,000 older adults on its rolls. Today it has nearly twice the staff, more than twice the budget, and operations stretching into Southern California. The Geary Boulevard headquarters now serves more than 20,000 people a year.

The way he tells it, none of this was a pivot. Tom's grandmother started a home for the aged the year after World War II ended. His parents took over in 1960 and ran it for three decades. His sister assumed control in 1990. His son Patrick earned a graduate degree in health administration and works for a Chicago health system. Four generations, one preoccupation: what happens to people as they get older, and who shows up.

What he actually does

The title is President and CEO. The job is integration. Tom's first big move at the Catholic Health System of Buffalo was taking independently operated skilled nursing facilities and welding them into one continuum. That continuum reached across skilled nursing, home health, seniors housing, and community care management. It is the same logic he brought west.

IOA in 2012 was a respected San Francisco nonprofit with a Bay Area footprint. IOA in the mid-2020s is a multi-region operator with a staff list nine hundred strong and a revenue base nearing nine figures. The Geary Boulevard address has not moved. Almost everything around it has.

The thesis is unfashionable. The aging-services sector is full of point solutions: a tech startup for medication reminders, a hospital service line for falls, a hotline for crisis calls. Tom's organization runs the hotline (the 24-hour Friendship Line for older adults), staffs the home care, coordinates the medical, runs the adult day programs, advocates for the population, and trains the family caregivers. All of it, in one place, under one roof, with one phone number.

The argument is that the older adult doesn't actually want a stack of best-of-breed vendors. The older adult wants someone to pick up. The institution he runs is built around that observation.

Why San Francisco

Tom did not get into the field for the city. He got into the field because his grandmother did. But San Francisco was a logical landing. Few American cities have a denser concentration of older adults living alone, a more aggressive housing crunch, and a more politically engaged senior population. The civic challenge matches the family vocation.

He joined Rotary the month he started the job. It mirrored his father, who had been a Rotarian back home. He has stayed active in the San Francisco club since.

The cyclist

Off-duty he rides. Thirty miles, forty miles, weekends mostly. He hits the gym several days a week. He and his wife Greta - who works for Sutter Health - have traveled to Austria, Amsterdam, and Tanzania. They are San Francisco restaurant people. The biography is not exotic. The longevity in one calling is.