Transcript Generated by AI 00:01 Mark Parkinson back with Park Place and we're continuing our deep dive on Florida 00:05 and what it's like to operate in Florida. 00:08 Today we're joined by one of the leading operators in the state, 00:12 Josh Wagoner and we're delighted to have Josh here with us. 00:15 We really couldn't have a better person to talk with. 00:18 You know, there's a lot of people in the long term 00:21 care sector that are generational providers, 00:23 and Josh definitely fits that category. 00:25 Believe it or not, decades ago, his grandfather was the president of a 00:29 long term care association. 00:31 And now he's come completely full circle because the Florida Healthcare 00:35 Association meeting recently, Josh was elected president of the Florida 00:39 Healthcare Association, which de facto makes him one of the 00:43 leaders in the country in long term care. 00:45 He's also the division director at Aviata Health Group, 00:49 which is a nursing home company that has 44 SNFs and three assisted living 00:53 facilities in Florida. 00:54 So Josh definitely can tell us what it's all about in Florida. 00:59 Josh, welcome to Park Place. 01:02 I'm excited to be here. 01:03 Mark, thanks for having me. 01:05 And it looks nice and bright and sunny where you're at, 01:08 which makes complete sense for Florida. 01:10 So we're again, we're really, really glad that you're here with us. 01:13 When I just asked you, you know, like a high level question, 01:16 what it's like to operate in the state of Florida. 01:18 What, what are the some of the things that come 01:20 to your mind? So the first word that comes to my mind 01:23 is fun. 01:24 And I know it's not an answer most people expect, but it's, 01:27 I genuinely believe it's one of the most exciting times to be working in our 01:31 profession, especially here in Florida. 01:33 You know, we definitely have challenges, but we also have incredible opportunities 01:36 here. 01:37 We can shape policy, improve quality and make lasting 01:40 differences on the people you serve. 01:42 And that's what makes it so much fun. 01:45 Well, I appreciate that because I would be 01:46 honest with you. 01:47 I don't want to ask people what it's like to be in long term care. 01:49 Fun is not the word that usually, you know, comes out of their mouth. 01:52 So that's, that's refreshing to hear. 01:55 Tell us about reimbursement in the state. 01:57 And I know it's a it's a battle everywhere. 01:58 How, how, how have you done in Florida with 02:00 reimbursement? 02:02 So it's probably the best answer is it's good, but not perfect and you know it. 02:06 And no operators asking for perfect, but it it's good. 02:11 We've done a lot of great things. 02:12 We've had made tremendous progress. 02:14 Legislators recognize our challenges that we have, you know, between workforce, 02:19 you know, quality improvements, helping us, you know, 02:23 looking at what Medicaid and just making sure we can keep pace with what's 02:28 happening with our centers. 02:29 And it's tough, but at the same time, they get on board, which is great. 02:34 Now, I mean, one of the things that's interesting 02:36 about that is that Florida obviously is a red state. 02:39 You, you got a, a fiscally conservative governor, 02:43 a Republican legislature. 02:46 You know, you look across the country in a lot of 02:49 red states, providers really struggle with Medicaid. 02:52 But somehow you've overcome that. 02:54 How how have you done that? 02:58 I think we've shown that investing in the population we care for isn't a partisan 03:03 issue. 03:05 You know, we have a great association that we work 03:08 with, Florida Healthcare Association, which has really brought us together. 03:12 I guess the biggest thing really helped us getting all rowing the boat the same 03:16 way. 03:16 It wasn't always that way in Florida. 03:18 And so being able to get all the providers on the same page was the first 03:22 step. 03:22 And then after that kind of really developing a great strategy. 03:25 Lobby Wednesdays is something that we've been doing for years of, 03:29 of down here in Florida and it's really been a effective strategy. 03:33 We bring up every Wednesday of the session, not just one, 03:36 not at the beginning, not at the end. 03:38 Every Wednesday during session, we bring up groups of providers, 03:42 all companies, and we're bringing up from CNA's, 03:44 staffing coordinators, nurses, dietary aids, therapists, and even, 03:48 you know, of course the CEO's and of course you 03:51 know, the leadership of the teams and stuff 03:53 that as well. 03:54 But what we do is we get our frontline caregivers to tell their stories and that 03:58 has just made a huge, huge difference. 04:01 And then also we build relationships with our legislators and we start, 04:05 we start when they start, you know, we're starting when they're starting as a 04:09 new state Rep or state senator. 04:11 We're starting when they're the city council's. 04:13 Oftentimes we're getting them into our centers to tour from a local level up to 04:17 a state level, which has made a huge, huge difference. 04:20 And it's not something, you know, advocates is just something you do during 04:24 the session. 04:24 It's something you build all year long. 04:26 And we've really taken that to heart. 04:28 And, you know, it helped us because what I believe is 04:31 people support people they know. 04:34 And so if they know us, they'll support us. 04:36 Yeah, I'm, there's so many things that you're doing 04:39 that are, are smart And, and frankly, many of them could be copied by other 04:42 states. 04:43 I mean, basically, I think every state has like a, 04:46 a day during the legislative session where they bring operators and, 04:51 and frontline folks up. 04:53 But the fact that you do it every single Wednesday, 04:57 it that's incredibly impact it makes. 05:00 Hopefully other people will learn from what you're doing. 05:03 So when you, when you look at the success that you've 05:05 had, what you know, you've talked about a lot of different 05:07 strategies, what, what's your take away? 05:08 What's, what's the lesson of the success of 05:10 Florida? 05:12 So I think you can really say there's three things that we really focus on in 05:17 Florida, quality workforce and relationships. 05:22 Quality is is number one for us. 05:24 We really recently had a great Senate President, 05:27 Senator Ben Albritton and helped us drive through the quality incentive program and 05:32 it's really incentivizing and helping us with with our Medicaid rates. 05:36 But what we helped the legislature realize is when the investing caregivers 05:41 quality follows. 05:42 So when quality improves, residents win. 05:44 So everything starts with investing in the people providing the care. 05:48 And that's, I really think we kind of focused around 05:50 that and it helped a lot, you know, making residents first, 05:53 making sure they're rewarding those that are continually improving, 05:57 making sure that, you know, we're doing everything, you know, 06:00 taking the data, taking, taking all the information we get and 06:03 improving and innovating and doing new things to better improve the lives of the 06:07 people we care for. 06:08 And then, like I said as well, relationships, 06:11 as I talked about with legislators, you know, 06:13 it's not just relationships with them, it's also relationships from, you know, 06:17 company to company, you know, the association is engaged, they're, 06:20 they're in it together. 06:21 You know, we're yes, we're competitors and competition makes 06:24 everything better. 06:25 But at the same time, we all go, we're all working towards the same thing. 06:28 You know, they stay in, we get people involved, they stay engaged, 06:31 we know the legislators and we can have wins. 06:34 And that's what we're looking for. 06:36 And then the last thing is workforce. 06:37 That's the biggest part. 06:38 And I know it's the hot topic all around the country is making sure we have the 06:44 number of people we need, but also finding those people that want 06:48 to do this, you know, invest in those caregivers, 06:51 invest in training, creating career pathways. 06:54 And one of the things we're doing down in Florida is we're actually recently 06:58 created a huge scholarship fund that we made and we just raised over $1,000, 07:02 000 for the endowment to go back. 07:03 We gave away $300, 000 at conference last week to careovers. 07:07 88 people got opportunities to just continue their career in long term care. 07:12 Yeah. 07:12 Well, Josh, it's it's fun to talk with you because I 07:15 can feel the excitement. 07:16 You actually do think this is fun. 07:18 And more than that, though, you all have developed a strategy and 07:22 you've executed on the strategy and the results speak for themselves. 07:26 So congratulations on your recent election as President and continued 07:29 success in the future. 07:31 And thank all of you for your continued support of Park Place. 07:35 Thank you, Mark. 07:35 Appreciate being on.
