Mark Parkinson, CEO of Park Place Live, moderated a recent panel discussion at the THRIVE Midwest event outside of Chicago featuring three top leaders of the uber successful Journey skilled nursing provider, a company that has grown swiftly and in the right way.

“By the end of 2026, they will have 43 facilities. In the facilities that they have taken over, there is remarkable progress. The Quality Measure (QM) star in the Five-Star score for their mature buildings is up over one full point. Their occupancy, systemwide, in their mature buildings, is over 90 percent. They take their buildings down to zero agency usage, and they created in a short period of time a culture that is working well for employees,” he said in his opening remarks.

Three of Journey’s major principles, including Matt Trammell, chief operating officer, Jody O'Mara, chief nursing officer, and Austin Steele, chief strategy officer, shared their insights on just how the company has gone from zero to 60 so fast.

For Trammell, who has been an administrator before reaching the C-suite, the Journey Vision statement is foundational: “Change the World, One Heart at a Time.”

An example of this mantra in action is that for every single acquisition, on day one, the facility gets a new bus. “When we share that information with the department head, they're so excited,” Steele said. One resident who hadn’t left the building in four years was one of the very first to be on board with the new ride, he adds.

When assuming control of a facility, the Journey team said it spends a lot of time getting to know the staff, learning not only who the key leaders are in the buildings, but who the drivers are on staff and what they need to point the facility in the right direction.

Follow the Playbook

Journey has a playbook, or a checklist that is used to get things turned around at a facility. For example, it introduces nine clinical systems that involve the nursing administration.

“One is the clinical meeting, or an A&I, the follow up, the notification, the care plan, the card decks, doing rounds to make sure those interventions are in place,” O’Mara said.

“So, for instance on labs, we ask questions like are they normal, abnormal? Do we get new medications? Is the medication here? Do we notify the family of the lab?”

Journey, she said, has afforded nursing leaders a lot of clinical applications that help nursing teams go faster, smarter, and more efficiently.

“It’s a new process that the staff needs to learn, and regional nurses, overseeing three or four buildings, are actually in the buildings, making sure that these nine clinical systems are intact, while providing quality care,” O’Mara said.

Measuring Progress

The Journey team is consistently measuring goals, keeping on top of the metrics is a big part of what they do, like driving agency use in newly acquired buildings down to zero. Steele said of the first 22 buildings Journey bought, 17 were at zero agency use within 90 days of purchase.

“During the pandemic, a lot of norms became abnormal. The first thing that Journey did was to reintroduce the basics. Like, viewing applications, calling them, doing interviews when they show up on time, touring those folks, you know, having a 30-day schedule, real basic ABCs of long-term care,” Steele said.

“We focus first on ensuring all of that's in place, and we can't get it wrong. It's repetitious, it's built into behaviors. That's one piece, and that goes a long way.”

Employees First

Another plank of the Journey experience is to have something to sell to employees and potential employees. This is called the Journey AdvantEdge, and it has benefits. It’s weekly pay for perfect attendance. All employees get a free cell phone if they're full time. It’s all the different items that make up a compensation package and in turn shows who you are as a company, the group said.

“It’s a huge resource to the DNS, or director of nursing, to be able to bring in a good group of nurses and aides and to not have to use agency. People want those benefits. People also get free behavioral health services,” O’Mara said.

Perfect attendance and weekly pay are a significant perk. “We have weekly pay, and they can get paid every single day if they would like. But we also have weekly pay. You know, one of the finishing touches on our agency elimination plans is that you're breaking down the pillars of a poor culture, and you're rebuilding the new. And you can't do something that hard without a full commitment,” Steele said.

QMs

The clinical accomplishments, to take the QMs up one full star, are very important to Journey. O’Mara said “it's unacceptable for any of our buildings to be a one star. So, it's a race to be three and above quickly. Week one, we write a PIP review of anything that's below national average. I think 90 percent or more came to us as a one-star QM. Most of those are now three-star and above, and some are five-star already.”

It's important, she said, to educate your DNS, your MDS, your regional nurses, on what are the QMs that impact a five-star rating? What are the thresholds, the national averages? And then consistently, every week, putting action items in to improve. ‘Oh, we grew a wound, then that wound issue was resolved. Let’s do an MDS and get that off of our QMs,’” O’Mara said.

Incentives in Line

The Journey team said one of the most important pieces of the puzzle are that directors of nursing and the building executive directors have the same incentive plan, uniting the leadership in a common incentive structure.

“Whenever I ran a building as an administrator, if I was on the same page with my director of nursing, whether we're trying to accomplish quality, a good survey outcome, census, no agency, expense control, any of those things, if we were united, nothing could stop us. When the director of nursing is bonusing off of quality measure improvement, so is the administrator,” Trammell said.

Being There

The trio credits the Journey success story to all of the factors above and more, but it boils down to leadership, common goals, and being there in-person, from CEO Bernie McGuinness on down the line.

There is very little remote anything at Journey, with the CEO in the office every single day, to O’Mara driving long distances to commute, and so on among all the leadership.

“We are an in-person company, which means our regionals, they go into the buildings, every day. And so that creates connectivity to the residents and the community above just the facility level. And over time that changes things. You're not just saying, ‘Oh, corporate's coming, and it's once a month.’ I think being in-person really matters. Body language matters, how we engage each other, and that helps change trust in a community,” Trammell said.

Comments or questions? Contact Patrick Connole at pconnole@parkplacelive.com.