Skilled Nursing News

Leslie Campbell, COO of Touchstone Communities by Skilled Nursing News

Tom Coble, President & CEO, Elmbrook Management Company by Skilled Nursing News

Stuart Lindeman, President and CEO, Mission Health Communities by Skilled Nursing News

Joel VanEaton, EVP, Compliance and Regulatory Affairs, Broad River Rehab by Skilled Nursing News

The 52nd episode of our podcast, Rethink, is now available. Operating 152 facilities across seven states, the Providence Group strongly believes the best decisions are made at the local level. Each of Providence Group's facilities have their own unique needs, along with the other health care providers across the care continuum in each respective market. That means being deeply integrated into each individual community is crucial, according to CEO Jason Murray. It's a model that has been replicated by operators across the country, and one that he sees as the best model for success in the skilled nursing industry. Skilled Nursing News spoke with Murray more on Providence's decentralized, market model type of structure, what factors he considers when looking to grow and more. In this episode of Rethink, learn: • What Murray sees as the biggest regulatory challenge or threat to the nursing home industry • Providence Group's staffing wins and ongoing challenges • What Murray sees as the skilled nursing facility of the future

The 51st episode of our podcast, Rethink, is now available. The skilled nursing industry won't likely see material, system-wide change until the sector's stakeholders including CMS, operators, payors, as well as residents and their respective advocacy groups, can get on the same page. That's according to Focused Post Acute Care Partners CEO Mark McKenzie. The industry is ever evolving, he said, and while subtle improvements and strides will likely occur — like the move to private rooms — big changes will take big conversations. McKenzie has tried to make his voice, and the voices of his Texas-based team, heard at both the state and federal levels — especially as the state legislature will convene next year and discuss, among other things, potentially increasing nursing home Medicaid rates. He remains hopeful and believes state officials are more aware and have a much deeper knowledge of the challenges the nursing home industry faces than they did before. Operators in the state receive 154.98 per patient day even though the methodology says they should be making about $275 per patient day. I spoke with McKenzie on what adequate reimbursement looks like in the Lone Star state, the place in skilled nursing for heavily rural operators like Focused Post Acute Care partners, the need to staff up for higher acuity residents and more. In this episode of Rethink, learn: • The importance McKenzie places, and thinks others should also, on heavily rural operators in the skilled nursing sector • Whether CMS's changes to the special focus facility (SFF) program will make operators like Focused Post Acute Care Partners think twice about taking on such buildings in the future • The wins and ongoing challenges McKenzie's executive team faces with staffing

The 50th episode of our podcast, Rethink, is now available. In an industry fraught with headline risk – and still in the national spotlight – the future of skilled nursing will be wrapped up in words. Namely, the term “nursing home.” Deke Cateau, CEO of Georgia nonprofit operator A.G. Rhodes, says the term will become obsolete, but populations will still need to have communities where individuals can no longer be taken care of at home, or in an assisted living setting. It's all part of redefining the sector at a crucial point in time, as leaders also take a hard look at the future business model of skilled nursing facilities. Some operators have already started specializing in higher acuity, short-term care while others wonder what parts of the care continuum will pick up long-term nursing home residents. Skilled Nursing News spoke with Deke more on this separation, catalysts for change and how nonprofits like A.G. Rhodes will fit into the skilled nursing sector in the years ahead. In this episode of Rethink, learn: • Why Cateau is hopeful for the future • How A.G. Rhodes is creating private rooms for its mostly Medicaid population • What the evolution of the sector will look like, from terminology to acuity

Eitan Zeffren, Founder and CEO, Pearl Healthcare by Skilled Nursing News

The 48th episode of our podcast, Rethink, is now available. When the Centers for Disease Control and Prevention (CDC) eased Covid-19 guidelines earlier in August, many let out a sigh of relief. But as the nursing home industry toils its way through operational recovery amidst a staffing shortage, leaders in the space can't help but wonder when their turn will come to lessen some of the restrictions put in place more than two and a half years ago. That must be step one, according to Carespring CEO Chris Chirumbolo. And Chirumbolo isn't the only one with such concerns. Providers across the country have struggled to recruit and retain staff in nursing homes when in many other workplaces testing and masking requirements are no longer in place. Covid continues to be an issue both in nursing homes and across the world, but both the number of hospitalizations and deaths have declined dramatically. In this episode of Rethink, learn: • Why Carespring has stuck to primarily building new facilities in its regional footprint • What factors Carespring considers when considering expansion • What the Centers for Medicare & Medicaid Services (CMS) needs to hear from skilled nursing operators right now

The 47th episode of our podcast, Rethink, is now available. With an eye to the future, SanStone Health & Rehabilitation is embarking down two different but parallel paths toward bolstering its workforce. The first is a focus on internal growth and the creation of succession plans for SanStone employees. That planning led Jennifer Robinson to the role she is in today as company president. The second is a focus on getting young people introduced to the skilled nursing sector as soon as possible — such as opening up summer internships for teenagers. It's fundamental, according to Robinson, to get the state's youth comfortable in a skilled nursing setting, and opening the facility doors for that type of exposure is a good start. Not unlike many other states across the country, North Carolina is expected to see a 116% increase in its population of individuals 85 and older. What can be done today can shape the workforce for the next 10 to 20 years, Robinson said. In this episode of Rethink, learn: • How SanStone is managing the industry-wide staffing crisis • What the operator has done to become a quality referral partner for hospitals • How SanStone has implemented a "ground up" operating mentality

The 46th episode of our podcast, Rethink, is now available. There are a lot of things that keep Michelle Delker up at night. Ongoing workforce challenges are the obvious one, but the CFO of Mission Health Communities also thinks about state-level reimbursement and the ever changing regulatory requirement landscape. Despite the host of challenges facing skilled nursing providers, Mission Health is not sitting idly by, according to Delker. The Florida-based operator has invested more than $1 million in its own workforce to recruit and retain workers, including an in-house certified nursing assistant program that has resulted in a significant reduction in CNA agency use since its launch. In addition, Delker told SNN that feverishly engaging in conversations with leaders from the nine states that they operate in has been paramount to the company's success. Mission Health operates 47 skilled nursing, senior living, assisted living and short-stay rehabilitation facilities across nine states. In this episode of Rethink, learn: • How Mission Health's investments in training and retention have paid off • What Delker sees as the biggest challenges facing skilled nursing providers today • How inflation and rising prices have impacted Mission Health

Dave Sedgwick, CEO, CareTrust REIT by Skilled Nursing News

Nate Schema, President and CEO at The Evangelical Lutheran Good Samaritan Society by Skilled Nursing News

The 43rd episode of our podcast, Rethink, is now available. Since Ignite Medical Resorts came on to the post-acute care scene in 2017, the central focus has been to do one thing really well. CEO Tim Fields' goal is to be the best short-term rehab provider in the market. But that doesn't mean Ignite has rested on its laurels. Park Ridge, Illinois-based Ignite has experienced notable growth — most recently with its entrance into the state of Texas as the operator of four skilled nursing facilities acquired by real estate investment trust LTC Properties in a $52 million deal. In this episode of Rethink, learn: • How SNFs can provide value through quality and outcomes, become closer with managed care organizations and better partners with the acute care world • What specific ways Ignite has worked to recruit and retain staff, including starting its own staffing agency • How Ignite has executed sustained growth over a relatively short period of time Subscribe to Rethink to be notified when new episodes are released.

The 42nd episode of our podcast, Rethink, is now available. This episode of Rethink is sponsored by TeamHealth. Nursing homes with the right training and educational processes may be uniquely positioned to facilitate behavioral health services at a time when the patient population has become increasingly complex. Dr. Wayne Tasker and Dr. Richard Thompson Jr. joined Rethink to share the evolving definition of behavioral health as it applies to pos-acute care and what's changed relative to behavioral health needs during the pandemic. In this episode of Rethink, learn: - The biggest challenges providers are facing in regards to behavioral health - What SNFs can expect from behavioral health services being provided in their facilities - Key considerations around telehealth and behavioral health Subscribe to Rethink to be notified when new episodes are released. Listen today!

The 41st episode of our podcast, Rethink, is now available. At a time when the industry is facing staffing shortages coupled with looming federal regulations and possible Medicare cuts — all the while recovering from Covid — it can be a scary time to be running a skilled nursing operator. That's according to Bernie McGuinness, CEO of Indiana-based Majestic Care. McGuinness joined Rethink to talk about how proposed Medicare cuts could further stymie the skilled nursing industry's recovery, and how Majestic Care's efforts on staffing have resulted in the reduction of — and in some cases — eliminated agency use. In this episode of Rethink, learn: • How the Centers for Medicare and Medicaid Services recently proposed Medicare cuts may hurt operators like Majestic Care • How they eliminated agency at one facility through its innovative recruiting and retaining efforts • Why now is not the right time to implement federal staffing minimums Subscribe to Rethink to be notified when new episodes are released.

The 40th episode of our podcast, Rethink, is now available. This episode of Rethink is sponsored by Reliant Rehabilitation. Shelley Horst has always been passionate about helping skilled nursing facilities better collaborate with their post-acute partners, and her role as director of strategic partnerships at Reliant Rehabilitation allows her to do just that. With an abundance of experience in skilled nursing business development and working in managed care, Horst is able to provide insights through analytics and her own background to help SNFs develop a strategic marketing plan that better aligns with their hospital partner's needs and to set them apart in the market. She joined Rethink to talk about her role, and why now especially is an important time to make a good first impression. Listen to this episode to learn: -- How marketing has taken on a whole new dimension in the last 18 months -- A few best practices for skilled nursing operators when it comes to connecting with and maintaining relationships with case managers -- How providers in today's operating environment need to approach customer service compared to the pre-pandemic era

Dr. Buffy Lloyd-Krejci made it her life's work to improve infection control practices, founding the consulting firm IPCWell to further that mission in long-term care facilities. As a result, she sees nursing home practices first-hand, and she wasn't surprised by how hard COVID-19 hit these facilities when it started spreading last year. Dr. Lloyd-Krejci worked with Doctors Without Borders in their missions in nursing homes in Detroit and Houston, and continues to work with nursing homes on various infection control challenges. She joined Rethink to talk about that work, and why she's optimistic about improvement for infection prevention practices in nursing homes. Listen to this episode to learn: -How the current regulatory landscape for skilled nursing facilities hinders good infection control -Why frontline staff are becoming increasingly demoralized about the survey process -How hospital regulations around infection prevention provide lessons for nursing home oversight

In the skilled nursing world, it was a truth universally acknowledged that the Patient-Driven Payment Model was a lifeline for operators trying to navigate the COVID-19 pandemic and the resulting “business nightmare.” But the federal government has proposed a recalibration of the new system, and it’s not clear yet what that could mean for providers. Mark Parkinson, the president and CEO of the American Health Care Association, joined Rethink to talk about why SNFs can be more optimistic than in years past about the proposed changes from the Centers for Medicare & Medicaid Services – and why the Biden administration’s push to invest $400 in home- and community-based care isn’t as antagonistic to SNFs as it might first appear. Listen to this episode to hear about: -The unanswered questions around occupancy and what needs to happen for recovery -Why the proposed PDPM recalibration isn’t likely to be a repeat of drastic Medicare cuts in 2011 -Elevating and investing in frontline caregivers, and what it will take to do that properly

Mikko Cook and Carrie Leljedal by Skilled Nursing News

When the first vaccines against COVID-19 received emergency use authorization, long-term care residents and workers at those facilities were at the front of the line to receive them. And as the shots have rolled out, residents have participated at high rates, and new COVID-19 cases among residents have plummeted. Frontline workers have been more hesitant – but with time, that could change. Angela Perry, the administrator at Vernon Manor Nursing Home in Connecticut, joined Rethink to talk about the facility's ongoing efforts to boost staff uptake of the vaccines – and how her facility is thinking about the future of keeping COVID-19 out as the federal partnership to distribute vaccines comes to a close. Listen to this episode to learn about: -- The ongoing process of talking with staff members and listening to their concerns about the vaccine – and the importance of knowing which voices they trust -- The questions about immunization for new admissions to a facility and in terms of staff turnover -- One of the options for facilities to sign up for immunization, even after the federal Pharmacy Partnership for Long-Term Care Program ends

Simply maintaining day-to-day operations at a nursing facility in 2020 was a herculean task, but several providers were able to also execute on the roll-out of an I-SNP, a special kind of Medicare Advantage plan for long-term care residents that proponents say provide both clinical and financial benefits to individual facilities. Hank Watson, chief development officer at American Health Plans, sat down with SNN to talk about the experience of launching new I-SNP ventures in 2020 and beyond, and why he — and his company's nursing home partners — still see promise in serving as both provider and payer. Listen to this episode to learn: 1. How COVID-19 changed the I-SNP calculus for providers 2. Why investing in clinical care is vital for I-SNP success 3. How operators can bridge the gap between value-based payments and fee-for-service 4. And more!

Tim Peck and Rob MacNaughton of Curve Health by Skilled Nursing News

Third-party rehabilitation providers are a crucial part of clinical care in the skilled nursing setting, and neither the pandemic this year nor an overhaul of Medicare reimbursement last year has changed that fact. But it has changed how rehab providers are working with their SNF partners. Tammy Tuminaro, the recently named CEO of Century Rehabilitation, joined Skilled Nursing News' Rethink podcast to talk about how third-party rehabilitation providers are navigating the pandemic and how Century sees the relationship between SNFs and third-party rehabilitation evolving. Listen to this episode to learn more about: -- The promises and pitfalls of telehealth for providing rehabilitation -- How SNFs and third-party rehab can collaborate more closely – and why they need to -- The importance of clinical pathways in getting residents to the best outcomes.

The institutional special needs plan model was one of the hottest topics of conversation in the skilled nursing world – of course, prior to the COVID-19 pandemic. But for PruittHealth, its role as a Medicare Advantage provider gave it a unique position in its role as a skilled nursing provider, according to the operator's new corporate medical officer, Dr. Rayvelle Stallings. She believes that offering the I-SNP allows PruittHealth to ensure continuity of care in a way that helps navigate the new reality of the pandemic – while keeping residents and employees safe. Listen to this episode to learn: -Why the institutional needs plan model positions PruittHealth to provide the fullest continuity of care for its patients. -The promises and pitfalls of greater telehealth use, and why it's here to stay. -How infection control is shaping the new normal for PruittHealth's SNFs.

After a disheartening experience working in nursing homes, former director of nursing Susan Ryan spent years spearheading initiatives designed to keep the elderly out of institutional care settings at all costs. But over time, she came to believe that there would always be a need for skilled nursing facilities to serve a specific portion of the aging population — just not the kind that have existed for decades. As the senior director of the non-profit Green House Project, Ryan has traveled the country spreading the gospel of nursing campuses centered around small homes, with resident independence and autonomy at the heart of the care model. It's an initiative that could gain steam as regulators, operators, and investors look to a post-COVID future. Listen to this podcast to learn: -- How operators can work with regulators to implement unique, resident-centered designs -- Why Green House can give operators a competitive advantage in their marketplaces -- And more!

Jon Ferry of Bradley Arant Boult Cummings by Skilled Nursing News

Until scientists develop a vaccine or effective treatment for COVID-19, infection control — already so vital to resident safety — must be at the top of every nursing home operator's list of priorities. For Karen Hoffman, that topic has been the subject of her career over the course of four decades. As a former CMS consultant, current clinical instructor at the University of North Carolina, and 2019 president of APIC, Hoffman has dedicated her professional life to improving infection control and preventing the spread of disease in nursing homes and other settings. She joined "Rethink" to discuss why COVID-19 can be so difficult to contain, how operators should reframe their mindsets to fight it as a chronic menace, and what CMS should do when evaluating its enforcement strategies. Listen to this episode to learn: -- Simple investments with major preventative payoffs -- Ways CMS can improve and enhance enforcement efforts moving forward -- Key areas for operators to focus on -- And more!

Dr. Paula Lester, NYU Winthrop Hospital by Skilled Nursing News

LeadingAge CEO Katie Smith Sloan has been outspoken in her calls for increased government support for nursing homes and other senior care providers amid the COVID-19 crisis. As the case count continues to rise and operators face down a new normal with coronavirus at the center of every decision they make, Sloan has loudly and forcefully argued that the industry needs more funding and assistance. Sloan joined SNN's "Rethink" podcast to discuss the feasibility of a federal plan to reopen nursing homes to visitors, as well as the top changes she thinks providers should fight for as lawmakers and advocates start to consider new rules and regulations around nursing homes in a post-COVID world. Listen to this episode to learn: -- Why reopening nursing homes is "virtually impossible" right now -- Why Medicaid-focused relief has been so slow to arrive -- What steps leaders and lawmakers should take to prevent future crises -- And much more

Randy Oostra, the president and CEO of ProMedica Health System, is well situated to see every angle of the unfolding COVID-19 pandemic in both the acute and pos-acute fields. The Toledo, Ohio-based ProMedica acquired the operations of HCR ManorCare in 2018 – which puts ProMedica in a unique position during a pandemic that is attacking every part of the health care continuum and hitting skilled nursing facilities particularly hard. Listen to this episode to learn: -Why more hospital beds are not the solution to the current strain on the health care system -Some of the ways the COVID-19 pandemic could change health care for the better -How ProMedica has worked to give the SNFs the clinical resources they need

The Royal Health Group in Massachusetts had long-standing plans to change the location of its skilled nursing facility in the town of Falmuth; what they weren't expecting was that a global pandemic would hit as they planned the transition. Instead of freezing in place, the operator accelerated the move to give the Cape Cod Healthcare system a location for recovering COVID-19 patients. Royal Health CEO James Mamary and vice president of operations Robyn Sloniecki joined Rethink to talk about how they made the change and worked with the state and the health system – and about what other operators can learn from their experience. This episode was recorded on April 17th and reflects the COVID-19 situation at the time. Listen to this episode to learn: -How Royal Health kept its staff and residents updated during the move -How it worked with Massachusetts on fast-tracking its former facility to become a COVID-19 building. -What operators should think about as they find COVID-19 cases in their own SNFs

As the chief medical officer for skilled nursing giant Genesis HealthCare, Dr. Richard Feifer has a direct view into hundreds of individual nursing homes as they deal with the ongoing coronavirus pandemic. Dr. Feifer joined "Rethink" to make a direct appeal to leaders about the dire need for personal protective equipment (PPE) and access to COVID-19 testing, two vital weapons against the disease that have been far too hard to come by across the country. He also shared tips gleaned from his work on the front lines, while praising the tireless efforts of staffers on the ground. Listen to this episode to learn: 1. The top lessons Genesis and Feifer have learned throughout the crisis so far 2. How nursing homes can safely separate COVID-19 cases from those without the disease 3. Why operators shouldn't fear overreacting when it comes to infection-control protocols 4. And more!

As both the chief medical officer for Signature HealthCARE and president of AMDA, the Society for Post-Acute and Long-Term Care Medicine, Dr. Arif Nazir has a micro- and macro-level view on how skilled nursing facilities are fighting the novel coronavirus. Dr. Nazir sat down with SNN to talk about what he's seeing on the front lines, as well as the viability of some of the sweeping proposals that governments have floated to help beat back the COVID-19 tide. Listen to this episode of "Rethink" to learn: -- Why the COVID-19 pandemic will permanently change the post-acute and long-term care landscape — potentially for the better -- The roles geriatricians, nursing home operators, and other elder care experts need to play in the coronavirus response -- How frontline caregivers are weathering the storm -- And more!

The novel coronavirus outbreak has put skilled nursing facilities on lockdown and disrupted daily life around the world. But health care needs continue apace, and the junction between SNF and hospital is crucial. Angie Roberson, the president of the American Case Management Association and the director of case management at the Spartanburg Regional Healthcare System, joins Rethink to talk about the importance of communication in the face of COVID-19 and the steps hospitals are taking as they work with SNFs. Listen to this episode to learn: -More about how hospitals are looking at the outbreak and what they're hearing from SNFs -Why the flu season has lessons for dealing with the new virus -What hospitals are assessing as they get patients ready for discharge

In the senior housing and care spectrum, nursing homes typically have the worst reputation among the general public and the press — a negative image that can only worsen in cases of abuse, neglect, or high-profile accidents. As the managing partner and co-founder of Trifecta Public Strategies, Kelli Luneborg-Stern has guided skilled nursing operators through a variety of difficult times, and despite the challenges, she has nothing but praise for the industry. "They simply do not get the credit that they deserve for what they deal with on a day-to-day basis," Luneborg-Stern says. Listen to this episode to learn: -- How operators can more effectively communicate with the public and press -- The ways misconceptions about the industry have changed over time — and what remains the same -- Top challenges for operators in the year ahead -- ...and more!

As the CEO of JMD Healthcare Solutions, John Delossantos has had a front-row seat to the Medicare payment model change still roiling the skilled nursing space. So far, Delossantos is upbeat about PDPM's potential to improve the health of both residents and the industry as a whole, but he's also identified some key areas where operators are still making mistakes that could lead to costly reimbursement losses — or, worse, scrutiny from the federal government. Listen to this episode of Rethink to learn: 1. The most common PDPM errors operators are making — and how to fix them 2. The top regulatory red flags that could lead to payment clawbacks 3. The biggest PDPM surprises so far 4. ...and more

The Patient-Driven Payment Model – and all the changes that came with it – arrived officially for skilled nursing providers in October 2019. The new Medicare reimbursement system for SNFs was top of mind throughout the year, but 2020 will bring a variety of new challenges, ranging from the entrenchment of accountable care organizations (ACOs) to the rise of managed care in the Medicaid program. Fred Bentley, managing director at the consulting firm Avalere Health, joined Rethink to talk about what SNFs should think about going into 2020 and how they can position themselves for viability and success. Listen to this episode to learn about: -The need to examine therapy and documentation as PDPM takes hold -Why some larger SNF chains are considering joining the ranks of ACOs -Why managed long-term supports and services in Medicaid is 'an existential challenge' for SNFs

The opioid crisis has hit every part of the U.S. health care system – skilled nursing facilities included. But the state and federal regulations haven’t moved as fast as the crisis, even though more and more providers are seeing these patients come through their doors. For the Communicare Family of Companies, which is based in Ohio and has 87 SNFs in some of the most opioid-affected states, there are ways that providers can help address the needs of patients struggling with addiction and other disorders. Fred Stratmann, Communicare’s general counsel, joined Rethink to talk about how SNFs could help and why the problem of caring for these patients goes back even further than the opioid epidemic. Listen to this episode to learn about: - Why nursing homes are filling the gaps in community resources - The regulatory hurdles to changing paradigms of care - The ways empty SNF beds could be repurposed for behavioral and substance use disorder treatment

For the first time in 34 years, an annual report on nursing home finances found that the median operating margin for operators fell below zero. For CLA managing principal Cory Rutledge, a co-author of the report, the result wasn't exactly surprising, given the headwinds battering the skilled nursing space over the past decade. But while he acknowledges that the number doesn't look great, Rutledge sees sunnier times ahead for operators in the space — specifically those that take bold action to adapt to a changing world. Listen to this episode of "Rethink" to learn: - Why the median margin fell below zero - How operators with positive margins pulled off their success - What operators should do to turn their fortunes around - ...and more!

With 140 facilities, Consulate Health Care is something of an outlier in the skilled nursing world, and has seen its share of ups and downs related to its size. But after a strategic shrinking – and an overhaul to improve quality and care at the bedside – the operator is ready to grow again. CEO Chris Bryson has led the work in turning the company around. He joined Rethink to talk about how Consulate “doubled in size overnight” in 2012 and had to streamline in subsequent years, the work of improving care and retention, and why the operator is looking to the future. Listen to this episode to learn more about: -Why scale can still benefit skilled nursing facilities -The importance of maintaining local autonomy -Why regulators and providers need to collaborate for better care

Over the last few years, there's probably been no hotter topic in the skilled nursing space than I-SNPs — special Medicare Advantage plans that cover long-term residents of nursing homes and other institutional sites of care. As CEO of Longevity Health Plan, René Lerer has had a front-row seat to the expansion of these plans, which the company currently offers in Illinois and New York. Lerer joined "Rethink" to discuss trends in this specialized space, as well as how providers can launch their own plans — either on their own, or with strategic partners. Listen to this episode to learn: - How Longevity built its network, and how it plans to expand - The different ways providers can create or join an I-SNP - Why I-SNPs can open other opportunities beyond reimbursement control

It's never been a more important time for skilled nursing facilities to get to know their hospital partners, especially as SNFs face penalties for patient readmissions and a constant battle to maintain census and provide the best quality of care. That makes open lines of communication and strong relationships essential for acute and post-acute care —and Sue Craft, the vice president of inpatient case management and post-acute care services at Henry Ford Health System is at the forefront of that work. She oversees the Detroit-based hospital system's preferred SNF network, as well as the team that makes decisions about patient discharges. Skilled Nursing News sat down with her to discuss the financial pressure that hospitals are facing, and how Henry Ford has changed its approach to post-acute partnerships over the years. Listen to this episode to learn: -Why Henry Ford focused on developing a preferred network to combat readmission struggles -The metrics SNFs should bring to hospitals in partnership discussions -What hospitals want from their post-acute partners

As the Medicare program's top clinical official, Dr. Kate Goodrich has played a major role in the wave of nursing home regulatory scrutiny coming from Washington and Baltimore over the last few years. Goodrich and CMS administrator Seema Verma have placed skilled nursing facility compliance and oversight at the top of their to-do lists, with a litany of accomplishments already under their belts — from an overhaul of the five-star rating system to the public identification of properties under consideration for the Special Focus Facility program. SNN sat down with Goodrich to learn more about what's been driving this enforcement push, as well as what additional moves the federal government may have in store for the future. Listen to this episode to learn: -The inner workings of CMS's enforcement strategies for nursing homes -Why the agency is focusing on beefing up state-level survey efforts -Goodrich's vision for the long-term future of value-based care

Skilled nursing providers can get chills at the thought of alternative payment models, which include Medicare arrangements such as bundled payments — one reimbursement shared by a range of providers for a single episode of care. After all, many bundled payment programs achieve their savings by cutting down on post-acute spending, adding pressure to already-squeezed skilled nursing facilities. But Brian Fuller, the CEO of Integrated Care Solutions, thinks SNFs shouldn't despair. ICS is a care coordination company and bundled payments convener under the Bundled Payments for Care Improvement — Advanced program, and Fuller sees both sides of the acute and post-acute world. He joined Rethink to talk about how SNFs need to change their mindset and get creative to thrive in a value-based world. Listen to this episode to learn: - The disconnects between acute and post-acute care, and what they need to learn to come together - Why post-acute is a savings target in alternative payment models, and how SNFs can take control of their own destiny within their market - The tenets SNFs need to adopt as their "true north" for success in the evolving world of value-focused health care

Publicly traded health care REITs have been blamed for some of the skilled nursing industry's woes in recent years — after all, how can a provider keep up with annual escalators as it navigates an uncertain reimbursement landscape and ever-rising staffing costs? But Wendy Simpson, president and CEO of LTC Properties, Inc., says REITs aren't the ones to blame — and that operators should instead make sure that any lease arrangement leaves enough money to put back into their operations before signing on the dotted line. Listen to this episode of Rethink to learn: - Why Simpson remains frustrated with the ongoing bankruptcy of tenant Senior Care Centers - How a dearth of younger, newer operating teams could cause trouble for the industry down the road - Why REITs still make sense for operators looking to unlock the equity in their assets - ...and more!

Between the release of a "secret" list of underperforming nursing homes and multiple hearings on Capitol Hill, the skilled nursing industry has found itself under the regulatory and media microscope for most of 2019. And for the most part, Mark Parkinson thinks that's a good thing. The president and CEO of the American Health Care Association sat down with Skilled Nursing News to discuss why transparency could ultimately help operators by raising awareness of other issues in the space — along with his vision of what the industry will look like a decade from now. Listen to this episode to learn: - Why operators should see opportunity in recent media attention on the industry - What he thinks is the bigger challenge for the space: PDPM or Medicaid - How SNFs can avoid becoming a mere commodity in the overall care landscape - ...and more!

Care Providers Oklahoma President & CEO Nico Gomez by Skilled Nursing News

The challenges of government reimbursement and shifting consumer demand have hit non-profits in the skilled nursing space particularly hard. Many of them have exited the business entirely, with independent non-profits and local governments moving to cut their losses and sell. Non-profit continuing care retirement communities (CCRCs) have also shied away from the sector, with some companies exploring CCRC-like models without any skilled nursing at all. But Altenheim Senior Living, a CCRC in Strongsville, Ohio, has no plans to eliminate its skilled nursing presence. The non-profit has 170 skilled nursing beds, and got its start more than 100 years ago as a nursing home. That said, it has moved to diversify its offerings in the face of increasing reimbursement pressures. In this episode of Rethink, Altenheim CEO Paul Psota discussed the company’s evolution in the changing skilled nursing world, as well as the role of skilled nursing in senior living. Listen to this episode to hear: -How Altenheim began evolve beyond skilled nursing, starting with assisted living -Why it decided to purchase an outpatient therapy provider -How SNFs can benefit from short-term rehab amid the push to lower-cost settings

Stephen Rosenberg founded Greystone 30 years ago with the modest goal of forming his own consulting shop after an executive stint at Dean Witter Reynolds. But over time, Rosenberg and Greystone built a name for themselves in the health care and multifamily housing lending space, growing to encompass a portfolio of $34 billion — with a major stake in the government-backed financing of skilled nursing facilities. Listen to this episode of Rethink to hear Rosenberg discuss: - Why investors are increasingly coming around to the idea of skilled nursing facilities as long-term winners - How the Greystone team evaluates deals - What types of skilled nursing properties are increasingly hitting the market - And more!

Amid the revolution sweeping Medicare reimbursements for skilled nursing facilities — from PDPM to value-based purchasing — Medicaid has quietly emerged as a prime threat to operators across the country. Reimbursement rates in multiple states don't cover the daily cost of caring for Medicaid residents, forcing buildings to close or endure disruptive receiverships across the country. As the CEO and founder of law firm sb2 Inc., Chad Bogar has dedicated his career to helping residents and operators solve their Medicaid problems through the courts and other mechanisms designed to protect them. Listen to this episode of Rethink to learn: 1. How providers can apply Medicaid victories won in other states to their operators 2. Why federal law trumps state regulations on Medicaid rates 3. How Bogar and operators in fought the government over long-delayed Medicaid claims 4. And more strategies for Medicaid success