Transcript Generated by AI 00:00 Mark Parkinson here with Park Place, and we have Marc Zimmet with us. 00:04 And Marc, I'm really glad you joined us today. 00:08 Just want to run a couple things by you. 00:09 I'm still running around the country a lot, 00:12 and a lot of people are telling me they're doing really well. 00:16 But I still get into some parts of the country where people tell me that they 00:19 are on the verge of bankruptcy and if one single little thing goes wrong that, 00:23 you know, they're going to have to end the whole 00:25 thing. 00:26 So who's who's telling me the truth? 00:28 What's going on? 00:28 Well, I bet you got some people saying that 00:31 I've got facilities in five states, four states. 00:33 I'm doing really well this once. 00:34 They just can't make money in, you know, what's going on. 00:37 And and I'll tell you something, it's got it's got nothing to do with 00:41 necessarily the local conditions in terms of operations. 00:45 You know, we call, we call a little sector of, 00:48 of our study here, SNFonomics and SNFonomics dictate that a 00:51 skilled nursing facility can only do as well as market will allow and that there 00:56 are differences in rates. 00:58 There are differences across states that you can take the the the best operator on 01:03 the planet and put them in a market that that simply cannot support their their 01:08 facility either for occupancy or, or the reimbursement and you know, 01:12 they're not going to do well. 01:14 That's it. 01:14 So you know, skilled nursing is not a national 01:17 industry. 01:17 It's that simple. 01:19 The Medicaid rates vary. 01:20 I mean, the difference is unbelievable because 01:22 there are 50 different programs, 51 different programs. 01:25 I can show you that, you know, facilities across the street from each 01:28 other in one state or across state lines that are exactly alike in every single 01:32 way, yet their Medicaid rate is $30 a day 01:34 different. 01:36 And why is that? 01:36 They're exactly the same in every single way. 01:39 And that's because of the way the state is positioned. 01:41 The state has set their regulations the way, you know, 01:44 things happened in a state like New Jersey, 01:46 we're getting paid based on activity that happened 12 years ago, 14 years ago. 01:51 So when you don't update, when you treat the the sniff rate 01:55 structure in the revenue structure differently across states, 01:59 you get different responses. 02:02 So generally, the sector is doing pretty well right now, 02:04 but there are certainly pockets that aren't. 02:06 Yeah. 02:07 So overall, when people ask me what I think about the 02:09 skilled nursing facility industry, I say be more specific. 02:12 There's no such thing. 02:13 So you know, skilled, I'm optimistic about the future, 02:16 but the way we are positioned right now, you're going to have pockets of the 02:20 country, you're going to have Swiss cheese that 02:22 that simply cannot, cannot operate a skilled nursing 02:25 facilities. 02:26 I've got providers in certain states, I get to model it out at 100% occupancy. 02:31 At 100% occupancy, they cannot, they cannot make it. 02:34 They can't make money. 02:35 And I know there are some people in states that have 60% occupancy and 02:38 they're making money. 02:39 Well, you know, people ask me, tell, tell me about the skilled nursing, the, 02:42 the sniff economy as we call or sniff anomics. 02:44 You know what skilled nursing facilities are most like? 02:47 You know, people call it a skilled nursing 02:49 hospitals, home care. 02:50 No, skilled nursing facilities are most like 02:52 cruise ships. 02:53 That's the, that's the, that's a sector that we're most aligned 02:56 with. 02:56 Why? 02:57 It's, it's simple. 02:58 It's basically occupancy. 03:00 So if you don't care, if you like to cruise, 03:01 I got sick as a dog. 03:02 Now let's cruise, that's a different story. 03:04 But, but if you want to take a cruise and you 03:05 want to go next week and you don't care where you're going, 03:08 you're going to get a really good price. 03:10 You're going to get, you know, you could wind up in Nova Scotia, 03:12 you could wind up in the Caribbean, but you're going to get a good price. 03:15 So why is that? 03:16 Because they're going to put you on a ship that's filled with Medicare and 03:21 Medicaid patients where that's already filled because taking another, you know, 03:26 cruiser on is not going to cost them X number of dollars a day. 03:30 It's not going to cost them. 03:31 It's basically the marginal cost of somebody else getting on that ship is $0. 03:35 00. 03:35 So, So is there a solution to this? 03:38 The fact that we have such a massive difference between the states, what, 03:42 what is the solution? 03:44 The truth is you got to RIP it down and rebuild it. 03:46 But that's not going to happen. 03:47 So we go state to state. 03:49 We work with the a number of States and number of associations on rationalizing 03:53 the payment system. 03:54 So we're not going to, it's not going to be torn down and 03:56 rebuilt. 03:57 But I mean, it would have to be done at the federal 03:59 level, right? 04:00 There'd have to be some federal plan. 04:02 The federal, please, please, please, I would love a federal plan. 04:05 We used to have one was called born amendment, but that one bye bye. 04:09 No, it's got to, it's got to be a facility has got to be 04:11 adjusted. 04:11 The rate has got to be adjusted on a facility specific basis, 04:15 taking into consideration the limitations of each facility and where they are 04:20 positionally. 04:21 Position sets potential. 04:24 That sets performance. 04:25 You can't measure performance without measuring the 1st 2:00. 04:28 So it sounds like both sets of people are telling me the truth. 04:31 The folks that say they're doing well or doing well, 04:32 the folks that aren't doing well probably aren't. 04:34 And we're all in the same business. 04:35 They're all in the same business. 04:36 Crazy system, but a different industry, you know, That's it. 04:39 Hey, hey Marc, thanks for your input today and thanks to 04:42 all of you for continuing to support Park Place. 04:45 Oh my God. 04:46 If you're still watching this, this means that you watch the end of a 04:50 very long video on Park Place. 04:52 I'm not sure what that means. 04:53 It says something about you or maybe there was just nothing else to watch 04:57 today, or maybe your priorities are a little bit 04:59 off. 05:00 But whatever it is, we really appreciate your support. 05:02 And if you want to continue to follow us, follow us on LinkedIn and our various 05:07 social media sites and, you know, try to find something else to do.
