Transcript Generated by AI 00:00 Hey, 00:00 Mark Parkinson back with Park Place and another segment of Let's Talk. 00:04 Let's Talk is our monthly segment where we 00:07 feature a superstar from the sector who has 00:10 contributed to the sector in multiple ways. 00:14 Today, 00:14 we have none other than Chris Wright, 00:16 who 00:17 actually qualifies for a Let's Talk segment for two different reasons. 00:20 First, 00:21 he's been a successful founder and owner of nursing facilities, 00:24 principally in Connecticut. 00:25 We're gonna talk with him 00:27 about his success as an owner. 00:29 And second, 00:30 and maybe most important because she's the current 00:32 national chair of the American Health Care Association, 00:35 which represents 11,000 of the 15,000 nursing homes in the, 00:39 in the United States and has become a really powerful voice for us. 00:43 In Washington DC, 00:44 I want to start out by thanking First Quality, 00:47 the great leadership team there, 00:49 the great products that they provide to so many providers across the country. 00:53 First Quality and the other sponsors that we have allow us to keep this site as, 00:58 as a not a non-annoying site. 01:00 There's no pop-ups, 01:01 you don't have to sign up. 01:02 You can just get on for free and, 01:04 and listen to the content. 01:05 So thanks very much to First Quality for doing that. 01:08 Chris, 01:08 we're thrilled that you've agreed to be here on Let's Talk. 01:10 Welcome to Park Place. 01:12 Well, 01:12 thank you very much. 01:13 Thank you for inviting me. 01:15 Well, 01:15 it's great, 01:15 it's great that you're here. 01:16 Now, 01:16 a lot of the people that we've had that we 01:19 featured on Let's Talk started out in long-term care as a 01:22 CNA and sometimes as an administrator. 01:25 Chris has had a different path. 01:26 He grew up in North Carolina. 01:29 He married his high school sweetheart, 01:31 Robin. 01:32 He decided he wanted to be an accountant, 01:33 not necessarily going to healthcare, 01:35 but as an accountant instead. 01:37 And then at the age of about 25, 01:39 when he was working as an accountant, 01:41 a very 01:43 interesting thing occurred that really changed his career path, 01:45 and that is that a building got built next to the building that he was working in. 01:49 And that doesn't sound like a very significant event, 01:51 Chris, 01:52 but tell us how that sort of changed your life. 01:55 Yes, 01:55 it's a very interesting story, 01:57 but I think it definitely was not by mistake. 02:00 Uh, 02:01 you know, 02:01 as a CPA, 02:02 I wanted, 02:02 went to school to be a CPA, 02:03 so working for a CPA firm and not just working for my apprenticeship, 02:07 you know, 02:07 I had to take the exam to be certified, 02:09 so you have to have 2 years. 02:10 So, 02:11 I sit there, 02:11 as you said, 02:12 I saw this building come up and then it ended up being a regional nursing home, 02:16 multi-regional nursing home, 02:17 central office or corporate office, 02:20 uh, 02:20 that had about, 02:21 end up having about 50 nursing homes across the, 02:23 uh, 02:23 the Southeast, 02:24 Virginia, 02:25 North Carolina, 02:25 South Carolina, 02:26 and Florida. 02:27 And so, 02:28 after I became a CPA and got did my apprentice, 02:31 I knew I did not want to stay in just accounting or auditing. 02:34 I, 02:34 I really did want to get into the healthcare field. 02:37 I was thinking more of the, 02:38 of the acute care side, 02:39 but 02:40 long story short, 02:41 the, 02:41 uh, 02:42 I was recruited uh to be in the finance department 02:45 at the accounting department of this nursing home chain, 02:47 regional nursing home chain. 02:49 And, 02:49 um, 02:51 and, 02:51 and then I was eventually, 02:52 you know, 02:53 promoted to be VP of budget. 02:55 I was there for 8 years. 02:57 That job entailed really drilling down and working closely 03:01 with the operations team. 03:03 Actually, 03:03 they promoted me up to the operations as the numbers guy 03:06 and that allowed me to work very closely with regional administrators, 03:10 directors, 03:10 and, 03:10 and just going through their budgets. 03:12 I was responsible for all the budgets, 03:14 even everything, 03:14 tying everything together. 03:16 But what that really did for me, 03:18 I fell in love with the long-term care. 03:21 And why? 03:21 It's because even though I was a numbers guy, 03:24 seeing 03:25 what administrators, 03:26 regional people do 24/7 and knowing that 03:30 they're, 03:31 you know, 03:31 they're doing everything possible to take, 03:33 to, 03:34 to, 03:34 to provide quality care 03:36 and that my job as the numbers was how can 03:38 we allocate resources better that is more patient quality focused. 03:43 And, 03:44 it kind of occurred to me that even though I'm a numbers guy, 03:48 uh, 03:48 I used to call myself a digit head, 03:50 but, 03:50 uh, 03:50 a number guy, 03:52 um, 03:52 I realized that there are people 03:54 behind the numbers and that was a calling, 03:56 and so I just fell in love with it and 03:58 so that was for 8 years and I ended up in consulting. 04:01 So, 04:02 I mean, 04:02 really, 04:03 I, 04:03 I wonder if, 04:04 if this building hadn't been built, 04:06 been built next to you, 04:07 if you would have gotten into long-term care. 04:09 But 04:09 for the next 8 years, 04:10 then, 04:10 the 8 years that you worked for this company, 04:13 you were drilling down, 04:14 you were learning a lot about the operations of these buildings, 04:17 you were helping administrators put their budgets together, 04:19 and you probably ended up with an incredible amount of knowledge on how to actually, 04:23 how the business side. 04:25 Correct. 04:25 Correct, 04:26 I did. 04:27 And um it's, 04:28 um, 04:29 it, 04:29 it was just amazing. 04:30 It's, 04:30 we would sit in a room and go through, 04:32 I, 04:32 I mean, 04:32 line by line item of their budget and so it was really a good perspective and, 04:37 and I saw the struggles that the DNS would be there and everyone had. 04:40 So 04:41 I really just wanted to support them any way that I could. 04:44 So after that 8 years, 04:45 then you ended up 04:46 consulting nursing homes, 04:48 I think for another 5 years. 04:49 Tell us about that. 04:50 Yeah, 04:51 obviously moved away from North Carolina. 04:53 I was in Denver, 04:53 Colorado for about 5 years 04:56 specializing. 04:56 It was a CPA sort of consulting firm, 04:59 but it was more of a boutique 05:01 that our specialty was really focused only on skilled nursing homes 05:05 and so we would do, 05:06 you know, 05:06 Medicare and Medicaid made cost reports, 05:09 but not only that, 05:10 We did the consulting side on operational strategies. 05:12 We had, 05:13 you know, 05:13 nurses, 05:14 clinical nurses, 05:15 we had therapists and billing people 05:16 that would go out and help clients all across 05:20 SNFs all across the country 05:22 on, 05:22 you know, 05:22 assisting them 05:24 and what's the best way and why it matters 05:27 where you spend your costs and where you, 05:29 it's optimal to where, 05:31 you know, 05:31 you're going to get the appropriate reimbursement to take care and to really 05:35 get the right reimbursement based on what you're doing. 05:37 So, 05:37 we did a lot of that and then, 05:40 That led to, 05:41 you know, 05:42 the, 05:42 obviously getting into studio ownership. 05:45 Well, 05:45 I mean, 05:45 I think to have 13 years where you're not an owner, 05:48 but you're learning everything that you could possibly learn 05:51 about the business side is really an incredible background. 05:55 So that gets us to the year 2000. 05:57 You've been at this now for 13 years, 05:59 and then you decide that you want to be an owner, 06:01 or you, 06:02 or you get into a situation where you have an opportunity for ownership. 06:05 Tell us about how that opportunity 06:07 developed. 06:08 Well, 06:09 being on the consulting side, 06:10 I traveled the country from west to west coast to east coast. 06:14 And my partners and I, 06:15 you know, 06:16 we saw a lot of, 06:17 you know, 06:17 different buildings and struggles, 06:19 and 06:20 we decided that, 06:21 yes, 06:21 consulting was great and they had the same kind of desire. 06:24 Why don't we get into ownership? 06:25 Because we know a lot about the business. 06:27 So, 06:28 um, 06:28 in Connecticut, 06:29 there were 5 facilities that went into receivership and 06:31 we bid on it and we won the bid, 06:34 uh, 06:34 took them out of receivership, 06:35 that was in 1997, 06:37 it went into receivership and we purchased them. 06:40 Out of receivership in '99 and that's, 06:42 that's how we started iCare. 06:43 So, 06:44 I literally moved back to the East Coast to be the, 06:48 I was the president, 06:48 CEO 06:49 and the, 06:50 um, 06:51 obviously the statutory manager or managing partner, 06:54 and we set up the company. 06:57 Now, 06:57 and it's now grown to 12 buildings in Connecticut, 07:00 Massachusetts, 07:01 and Vermont. 07:02 Very successful, 07:03 and I'll talk about that in just a second. 07:05 But I, 07:06 I think that it's, 07:06 there's an interesting story about the name, 07:08 the, 07:09 the name iCare. 07:10 How, 07:10 how did you come up with the name of your company? 07:12 Yeah, 07:13 that, 07:13 that's kind of dear to my heart because, 07:15 um, 07:16 you know, 07:16 as the CEO and I was, 07:18 you know, 07:18 having to move to Connecticut, 07:20 one of my jobs was to come up with a name. 07:22 Well, 07:22 we're starting a brand new company and organization, 07:24 so, 07:25 you know, 07:25 I, 07:26 I really spent a lot of time, 07:27 weeks trying to figure out what's a good name for this company and 07:31 one weekend I was sitting, 07:32 you know, 07:32 in the living room and just an iPad and just trying to 07:35 figure out names and my 11 year old daughter at the time, 07:37 she was 11 then. 07:39 Came up to him and said, 07:39 Dad, 07:40 what are you doing? 07:40 And I said, 07:41 well, 07:41 I'm just sitting here trying to come up with a name for 07:44 the new company I'm going to start. 07:46 And she says, 07:47 well, 07:47 you're spending a lot of time on it. 07:49 She says, 07:49 why are you spending a lot of time on it? 07:51 And I said, 07:51 well, 07:51 honey, 07:52 sweetheart, 07:52 I, 07:53 it's like I care. 07:53 I care about the name. 07:55 And she looked at me and she just said, 07:57 why don't you just call it I Care? 07:59 And it hit me and I was like, 08:01 oh my gosh, 08:02 out of the mouth of babes, 08:03 as they say. 08:04 So, 08:04 I was just like, 08:05 so, 08:06 I took eye care, 08:07 did the little Y and a capital C to focus on care cause that was the main thing, 08:11 and we started Eye Care Management at that time and now 08:14 we call it Eye Care Health Network. 08:17 Well, 08:18 and, 08:18 and even greater, 08:19 and that's, 08:19 it is a great story, 08:21 even greater is that you've been able to live up to your name of eye care. 08:24 You have fantastic quality results. 08:26 Your quality measures for all your buildings are in the 4 and 5 range. 08:30 You've also been successful on the business side with your occupancy is, 08:34 I think, 08:34 over 95%, 08:36 97%. 08:37 You were able to keep that occupancy even during the pandemic. 08:41 So what I wanna talk about now is how you've been able to succeed. 08:45 You, 08:45 you've had great success and frankly, 08:46 some of these states, 08:47 particularly Connecticut, 08:48 are pretty challenging states 08:50 to operate in. 08:51 So to, 08:51 to succeed in the states that you've been in is remarkable. 08:54 I know a lot about you and your background and your success, 08:57 and I, 08:58 as I look at it, 08:58 I think there's 4 reasons that, 09:00 that at least I attribute your success to. 09:02 Let me, 09:03 let me mention those so you can comment on each one. 09:05 The first is that you knew a lot about what you were doing before you ever owned. 09:09 You've been at it for a long time. 09:11 Tell, 09:11 tell us your thoughts on that. 09:13 Absolutely. 09:14 I'll tell you, 09:14 13 years, 09:16 um, 09:16 being on, 09:18 actually working in an organization, 09:20 a regional 09:22 organization and working with the operations team, 09:24 I gained a lot of knowledge and obviously I can understand reimbursement. 09:28 I knew every state's Medicaid system was different. 09:31 It was easy for me to pick up and try to know where is the best way we should be 09:36 spending the money to be sure that we're 09:37 getting paid adequately for the care we're providing. 09:40 So it just gave me a different perspective in 09:42 the consulting and seeing all across the country. 09:45 So I thought it, 09:45 you know, 09:46 it wasn't, 09:47 it wasn't a stranger to me, 09:48 you know, 09:49 it was really just like the next step 09:51 that, 09:51 hey, 09:52 not only can I consult or 09:55 just be, 09:56 you know, 09:56 in a finance department of one, 09:58 I would like to be an owner. 09:59 I would like to be an owner because of the calling I felt that I had. 10:02 That's great. 10:03 And I, 10:03 I, 10:04 the reason I wanted to highlight that is there's so many 10:06 people that think they can just come into the sector, 10:08 buy buildings and run them with no background. 10:10 You were not an overnight wonder. 10:12 You were 13 years into the making before there was any ownership at all. 10:16 The second thing that I think is interesting that 10:18 you've done is that you've taken over challenged buildings. 10:21 Uh, 10:22 you're not going out there buying Taj Mahals for large amounts of money. 10:25 You've, 10:25 you've taken over buildings that have, 10:27 that, 10:27 that need help. 10:28 Tell us about that strategy. 10:30 Yeah, 10:30 I mean, 10:31 my partners and I, 10:32 you know, 10:32 me being the CEO, 10:35 we, 10:36 we 10:37 felt, 10:38 well, 10:38 let's put it this way, 10:39 we were never afraid of taking on a challenge. 10:42 I mean, 10:43 and obviously, 10:44 when we saw these buildings that was distressed, 10:46 the occupancy was very low, 10:48 and so we knew we had to do something to bring them up 10:51 and the quality of care and the census was like 70s and 80s, 10:54 and that was just, 10:56 you know, 10:56 so we had to find, 10:57 you know, 10:58 a niche and so, 11:00 You know, 11:00 me being a numbers guy too, 11:02 I had a, 11:03 you know, 11:03 I had many conversations with the rate 11:04 reimbursement people at the state of Connecticut 11:07 on how we could better these buildings 11:10 and obviously they were underpaying and that, 11:13 you know, 11:13 told them the vision of what we wanted to do and, 11:16 um, 11:16 and that led us into a niche of uh behavioral health and so I don't know. 11:22 Well, 11:22 I'm gonna get into that niche in a second. 11:24 Before I do, 11:25 let's stick on this challenge building concept because the other, 11:27 the other advantage of challenge buildings is you don't have 11:29 to pay a ton of money to get into them. 11:31 That's right. 11:32 I say, 11:32 you know, 11:32 it's been now 27 years 11:35 and 11:36 obviously in the state of Connecticut at the time 11:38 they did not want to close these buildings. 11:39 They wanted a quality provider, 11:41 someone who can take it up, 11:42 and obviously, 11:43 you know, 11:43 they were in bankruptcy and the prior owners, 11:46 so they really had no control. 11:47 So yes, 11:48 it was 11:49 very low pricing we could get these per bed compared 11:52 to what you would say the market is today. 11:55 But we knew that 11:56 that was the value. 11:57 We knew we had to build a value and we owned all the assets, 12:00 so. 12:01 And it's, 12:02 it's not, 12:03 there aren't as many opportunities as there were 20 years ago, 12:06 but there are still challenge buildings out there that people can look at and, 12:09 and, 12:09 you know, 12:09 maybe take over leases. 12:11 There, 12:11 it's, 12:11 it's still, 12:11 I think, 12:12 a very viable strategy if, 12:13 if folks are patient. 12:15 The third thing gets into what you were talking about with the behavioral, 12:17 which is that you've developed some niches. 12:20 You have some real niches of care that 12:22 you provide that most people aren't providing. 12:24 Tell us about that. 12:25 Well, 12:26 when we took over those 1st 5 buildings in the census low, 12:29 we obviously needed to go to our referral 12:31 sources and build referral sources and relationships. 12:34 But not only that, 12:35 we've always looked at ourselves to be a problem 12:37 solver for the state and our referral sources, 12:39 and that during that time, 12:41 the state of Connecticut had closed some 12:43 mental health and um 12:45 State funded behavioral 12:48 hospitals 12:49 and um they were backed up in the hospital and that's all we heard from the hospital. 12:53 So we thought, 12:54 why don't we develop something, 12:55 go out on a limb 12:56 and try to help our referral sources and even the state. 12:59 We're getting calls from the state that, 13:01 you know, 13:01 would you take these patients because nobody wants to take them. 13:04 They're behavioral, 13:05 they've got issues and they were underserved. 13:09 Long story short, 13:10 we developed a behavioral program. 13:12 We opened up our 30 bed unit in 2002, 13:16 and it was full within 90 days. 13:18 And so now over half of our buildings have behavioral health. 13:22 We've evolved that from behavioral health to substance use disorder. 13:25 We've got different programs within that. 13:27 Um, 13:28 and then, 13:28 you know, 13:29 obviously that led us 13:31 to the state knew that we were doing a good job with that. 13:34 We sort of had a niche. 13:35 Even only about 1/3, 13:36 I'd say, 13:37 of our population was in the behavioral health program. 13:40 We still did short term, 13:41 long term care, 13:42 everything else. 13:43 But the, 13:44 the state of Connecticut was very progressive in that 13:47 they had what we call justice involved patients. 13:50 You had, 13:51 uh, 13:51 uh, 13:51 uh, 13:52 in the Department of Corrections infirmaries, 13:54 they had a state-run mental hospital 13:57 that they couldn't find that needed skilled care, 13:59 but nobody would take them because they maybe had some justice involved. 14:03 And, 14:03 and, 14:04 or they were at the end of sentence, 14:05 but they needed skilled cares. 14:07 Um, 14:08 there was a bid for Connecticut to do that back in 2011 or 2012 14:13 and we bid on it and 14:15 it was kind of like 14:16 we were the, 14:17 you know, 14:17 even the state kind of said after we won the bid, 14:19 and you guys were the obvious people 14:21 to try to do this project. 14:23 So we actually bought a facility 14:25 to then, 14:25 uh, 14:26 to specialize, 14:27 to have this specialty program. 14:29 For what they call difficult to place residents, 14:31 and our referral sources came from Department of Corrections, 14:34 Department of Mental Health and Addiction Services, 14:36 from, 14:37 from the hospital, 14:38 and um it was very successful, 14:41 uh, 14:41 and, 14:41 and we've expanded that now in two other states. 14:44 That's terrific. 14:45 I, 14:45 I, 14:45 and, 14:46 and I think these niche 14:47 areas of care, 14:48 whether it's behavioral or working with the judicial system or other, 14:52 they're out there for people to find if they're creative like you've been. 14:55 And then the final thing that I attribute 14:56 your success to is your hands-on positive approach. 14:59 Just, 14:59 just talk about how often are you in your buildings and what, 15:02 when you're in your buildings, 15:03 what are you doing? 15:04 Well, 15:04 I, 15:05 I was in my buildings a lot 15:06 more frequent, 15:07 obviously, 15:08 in the first few years beginning and building because 15:10 we went from 5 to 12 and obviously involved, 15:13 but 15:13 When I am in the buildings, 15:15 I already know in my mind the numbers. 15:17 I already know what they're struggling with, 15:19 you know, 15:19 as far as maybe financial performance. 15:22 I go in those buildings with an attitude that listen, 15:25 these are the boots on the ground. 15:26 This is, 15:27 this is where the rubber 15:28 hits the road, 15:29 and 15:30 I 15:30 want to be sure 15:32 that our administrators, 15:33 our department heads, 15:34 our DNSs and nurses are supported and as an owner support them. 15:38 And one other thing that I would like to say, 15:40 I've made it very clear to the, 15:42 to the management company that we have, 15:44 you know, 15:44 we have management. 15:45 People sometimes say corporate office. 15:48 I have never liked 15:49 us to be called the corporate office. 15:51 I said we're the central office, 15:53 main office, 15:53 and I make it clear to my staff that's on the management payroll, 15:58 that the facilities are not here for us. 16:00 We are here for the facilities, 16:02 and that's the culture 16:03 that I want to make clear. 16:05 They pay us a management fee. 16:07 The, 16:07 the facilities are our customer 16:09 and it's not the other way around. 16:11 So, 16:12 That's been a culture that I think we continue 16:14 and I got a great team and good longevity, 16:17 and 16:17 I'm just thankful and blessed for that. 16:20 That's terrific. 16:21 Now, 16:21 Chris, 16:22 after you were already deeply into your ownership, 16:24 you then had a personal experience that I know has impacted you quite a bit and, 16:28 and has impacted your perspective on the whole 16:31 long-term care service area. 16:33 Tell, 16:33 tell us about that. 16:35 Yeah, 16:35 I mean, 16:36 obviously, 16:37 you know, 16:37 being in the business, 16:38 but in 20, 16:39 you know, 16:40 since, 16:40 since, 16:40 uh, 16:41 you know, 16:41 1999, 16:42 2000, 16:43 uh, 16:43 my mother, 16:44 uh, 16:44 at 75 had a very severe stroke. 16:47 She lived in North Carolina where I'm originally from, 16:49 and, 16:49 um, 16:51 she was ended up being 16:52 very severe. 16:53 We thought we was going to lose her, 16:54 but she was paralyzed from, 16:55 her whole body on the left side was paralyzed and 16:58 unfortunately, 16:58 short-term care didn't work. 17:00 We had a great facility we put her into. 17:03 Um, 17:03 they tried, 17:04 but she ended up being a long term patient 17:07 for 8.5 years in a nursing home, 17:09 and she was even there during COVID. 17:11 So, 17:12 I got the perspective and, 17:14 you know, 17:14 and you can imagine 17:16 being a provider, 17:17 I had buildings of my own and then seeing also 17:19 the same struggles of staffing and everything else in COVID. 17:23 I, 17:23 I was just amazed at the heroes of what they, 17:27 how they took care of my mother. 17:29 She never got COVID 17:31 and they had COVID running through the building. 17:33 And, 17:33 you know, 17:33 it was hard for all of us having to look through the window to talk to her, 17:37 but I had confidence that, 17:39 um, 17:39 The, 17:40 the staff was taking care of her. 17:41 So it just 17:42 made me even more want to advocate. 17:45 Not, 17:45 I mean, 17:45 this is true. 17:46 Now I've got both perspective as an owner, 17:48 I can see it and it came full circle. 17:51 And yeah, 17:51 I would get frustrated sometimes with I could see they could improve on things, 17:55 but, 17:55 you know, 17:56 overall it was great care, 17:58 but 17:59 like everything else, 17:59 they had their limited resources that that's even more reason for me. 18:04 To advocate more to legislators and to say, 18:07 be sure they're hearing the right message from, 18:09 from what we do as nursing home operators 18:12 and, 18:12 you know, 18:13 and what we're all about and it's about the residents. 18:15 That's the center of it all. 18:17 And I think that's giving an interesting 18:19 perspective because you're not only an advocate for 18:21 facilities, 18:22 you're an advocate for, 18:23 for residents. 18:24 Absolutely, 18:25 absolutely. 18:26 When I, 18:26 when I, 18:27 um. 18:28 You know, 18:29 to get it, 18:29 even at the position I'm at, 18:31 I've always in the back of my mind, 18:32 I said, 18:32 I'm gonna fight for Mom and I'm gonna fight for 18:34 other moms and dads and grandparents out there because I, 18:37 I felt that it was real and maybe we should give a shout out to the, 18:40 what, 18:40 what was the nursing home in North Carolina that was 18:43 it was Trinity Ridge 18:44 and It was under Ted Goins, 18:46 uh, 18:47 I think they called him L 18:48 L 18:49 LCS 18:50 or, 18:50 or, 18:51 yeah, 18:51 I always get the acronym wrong, 18:52 but the Lutheran, 18:53 it's the Lutheran group, 18:54 yeah, 18:55 Ted Gos and his team doing it. 18:56 They do a great job and yes, 18:58 the administrators, 18:59 they're DNS, 19:00 they were, 19:00 you know, 19:01 they were solid, 19:02 and any concerns we had, 19:03 they were just, 19:05 they were just wonderful to my mom. 19:06 My mom loved it. 19:07 And I think you told me that when you would visit your mom, 19:10 you never told the staff or the teams that you were in 19:13 the business or you were a leader at the national level. 19:17 I did not. 19:17 I did not, 19:18 especially the first six months, 19:20 because, 19:20 you know, 19:20 I, 19:20 obviously I knew the struggles they had, 19:22 but 19:23 they end up finding out, 19:24 you know, 19:24 they do their research and they found out 19:28 some of the CNAs, 19:29 it's funny. 19:29 Some of the CNAs thought, 19:30 well, 19:30 what's your rate you're paying per hour in Connecticut versus where they are? 19:33 And I said, 19:34 oh yeah, 19:35 they, 19:35 I said, 19:36 you knew you were outed. 19:39 All right. 19:39 So, 19:40 let, 19:41 let's talk about ACA now. 19:42 So on top of doing all this other stuff that you were doing and operating, 19:45 which obviously you had your hands full, 19:47 you got involved in the state association in, 19:48 in Connecticut. 19:49 So tell us, 19:50 why did you get involved? 19:51 How did that happen? 19:52 Well, 19:53 I got involved from the very beginning because, 19:55 you know, 19:56 wanting to just advocate again for the calling that I had and I felt, 20:00 so, 20:01 you know, 20:02 advocating. 20:03 Again, 20:04 with other providers, 20:05 whether they're competitors or not, 20:06 I, 20:06 I ended up being on the board of the Connecticut Healthcare Association 20:10 and ended up being the board chair from 2010 to 2016. 20:14 And one of the things that when I came on board, 20:17 I, 20:17 I, 20:18 I realized we had great board members, 20:20 but I needed more decision makers. 20:21 I, 20:21 my, 20:22 my goal was to get more CEOs and owners that had a stake. 20:25 And so I did that over that time. 20:26 And so we end up, 20:27 and it was very successful. 20:29 So when you go to the Hill, 20:30 we got, 20:30 you know, 20:30 they can hear from us and the advocacy, 20:33 really know what was going on and um it, 20:35 it was really successful. 20:37 And um so that's why I got involved and I loved it. 20:41 And then 20:42 before we know it, 20:43 all of a sudden you're involved at the national level. 20:45 How did that happen? 20:46 Well, 20:46 as you, 20:47 as you know, 20:47 I mean, 20:48 or most people know, 20:49 I was board chair 20:51 and then I was a representative on the council of 20:53 states at all of the ACCA Council of state meetings. 20:56 And so I, 20:57 I got involved in, 20:59 you know, 20:59 obviously I would be able to vote on, 21:01 on policy agendas, 21:03 obviously elections and all the initiatives 21:05 or the strategic or policy agenda that, 21:07 that ACCA had to support it. 21:10 But not only that, 21:10 I got involved in a lot of, 21:12 you know, 21:12 uh, 21:13 cities or councils. 21:14 I was on the IO for a while, 21:15 now I'm a multi-facility, 21:17 and I was elected, 21:18 as you know, 21:18 I think I was, 21:20 uh, 21:21 elected in 2018 as, 21:22 as an at-large. 21:24 And then all the way up until you did 21:26 that until 2025 where you're elected national chair last, 21:29 last fall, 21:30 and it's, 21:31 and you, 21:31 things have gone really well under your leadership. 21:34 You've had a lot of success early on. 21:35 Let's talk about some of those in your priorities. 21:38 You've had a huge win at the federal level 21:39 on Medicaid with nursing homes being carved out, 21:42 the big beautiful bill. 21:43 I now know, 21:44 I know that now you really want to focus on the states. 21:47 Tell us, 21:47 tell us what your uh goals are with the states on Medicaid. 21:51 All right, 21:51 well, 21:52 first of all, 21:53 Yes, 21:53 we, 21:54 it was a nice win, 21:55 and we really do think the congressional legislation of carving 21:59 out nursing homes in ICL from the provider tax cut. 22:02 That was a tremendous win and unprecedented to have one sector 22:07 turned out, 22:07 I mean, 22:08 uh, 22:08 carved out of the cut. 22:10 But I don't think we can, 22:12 I think we're very short-sighted if we would say 22:14 that that's a victory overall and we won the war 22:17 because now, 22:18 as we know, 22:18 I was talking to the state affiliates and states, 22:21 we know that the 22:22 one big beautiful bill, 22:24 which I'm going to call the OB3. 22:26 Um, 22:27 with those other provider Medicaid cuts, 22:30 the state budgets could have a lot of pressure and 22:33 a lot of federal funding is going to be shorted 22:36 or less than what they got, 22:37 and they could be facing, 22:39 you know, 22:39 millions of dollars of, 22:41 of the state budget just because of these federal cuts. 22:44 So 22:45 we at ACCA are wanting to be sure we're listening to our state 22:49 execs, 22:50 our state affiliates, 22:51 and their members and their struggles. 22:53 We know every Medicaid system is different. 22:56 But now we want to help them to advocate, 23:00 which they are doing. 23:01 I've been speaking to some state execs. 23:02 They're already up there 23:04 advocating for the fact, 23:05 listen, 23:06 it was Congress's intent not to cut us, 23:08 so, 23:09 You know, 23:10 it makes sense. 23:11 Why would you cut us, 23:12 you know, 23:12 when we're still the highest percentage of Medicare. 23:14 But not only that, 23:16 look at the growth in need 23:18 of what's going to happen with long term care over the next 1520 years, 23:22 and we know they're already underfunding. 23:25 Many states are already underfunding the cost of care. 23:27 So 23:27 we want to be kind of part of that because it, 23:29 it's important to our members because 23:31 Medicaid, 23:32 Medicare is great, 23:32 but Medicaid is, 23:34 is the biggest payer. 23:35 Yeah, 23:36 and it's very smart that you've turned your attention to the states. 23:39 I, 23:39 I also know that you're looking for some regulatory reform. 23:42 How, 23:42 how is that going? 23:43 Yeah, 23:44 a big one, 23:44 you know, 23:45 one of the things we do is a strategic plan, 23:46 and I was kind of part of that as vice chair. 23:48 We wanted to hear from our members, 23:50 so we have a multi-year strategic plan, 23:52 but, 23:52 you know, 23:53 so 23:54 one of the biggest things that 23:56 we're hearing from our members and we're trying 23:58 to advocate for is the Medicare Advantage plans, 24:01 uh, 24:01 or MA plans now. 24:03 Medicare Advantage plans are not a bad thing. 24:05 We know that they drive innovation. 24:07 We know it gave citizens choices, 24:09 and there's nothing wrong with that. 24:11 But it's just gotten to the point where 24:14 they, 24:14 they, 24:15 they've gotten so large, 24:16 and, 24:17 you know, 24:17 I, 24:18 I think it's, 24:19 um, 24:19 it's almost about, 24:20 I think 5 of the largest, 24:22 you know, 24:23 MA plans kind of dominate 70% of the market. 24:26 So, 24:27 what that means is there, 24:28 there's limited choices for beneficiary and also not only that, 24:32 just, 24:32 you know, 24:33 negotiating rates. 24:34 And so, 24:35 one of the things that's very frustrating is, 24:38 you know, 24:38 we want to hold managed care 24:41 accountable or reaffirm the promise to the beneficiaries that, 24:45 listen, 24:45 don't deny access of care. 24:47 Be sure you're giving not only the care they need, 24:49 but enough care and don't cut them short. 24:52 And at the same time, 24:53 we need a fair payment system. 24:55 You know, 24:55 to, 24:56 to adequately cover, 24:58 uh, 24:58 the care that we give them. 24:59 So that's a, 25:00 that's a big thing. 25:00 It's a big thing for our members too, 25:02 um, 25:03 and that's one thing that we would like to 25:05 continue advocating for and advocating to, 25:07 to our legislators. 25:09 Yeah, 25:09 too often the payments just aren't enough from the MA plans, 25:11 and I appreciate your efforts to fix that, 25:13 but you're also working on some regulatory stuff over 25:15 at CMS on survey that's had some good results. 25:18 Yes, 25:19 we have, 25:19 and I'll tell you, 25:20 this kind of started even before I became chair, 25:22 the Better Way Plan. 25:23 You know, 25:23 we know, 25:24 we all know 25:25 the regulatory system has been broken for decades. 25:28 We know it's punitive. 25:29 We know it really, 25:31 you know, 25:31 the regulatory surveys does nothing to really incentivize quality care. 25:35 And so 25:37 we, 25:37 we obviously sent 25:39 our proposals on how we can streamline 25:43 the regulatory system. 25:45 That makes sense. 25:45 We call it rationalizing the, 25:47 the, 25:47 the, 25:48 the regulatory system, 25:49 but 25:50 what I mean by that is, 25:52 you know, 25:52 we, 25:52 we still 25:54 believe. 25:55 Accountability, 25:56 transparency, 25:58 everything, 25:58 and, 25:59 you know, 25:59 that we need to be doing to these 26:01 residents. 26:02 But 26:02 we have proposed a lot of different things to try to focus on that, 26:07 and we have seen some movement. 26:09 We, 26:09 it's very positive movements we've been seeing. 26:11 I've met personally with some CMS officials and 26:14 And I know our staff has, 26:16 and you know, 26:16 for instance, 26:17 you know, 26:18 the revalidation 26:19 delay is one victory and also the CMP reinvestment program, 26:24 you know, 26:24 is another one. 26:25 So we're, 26:25 we're, 26:26 we're inching away, 26:27 we're making strides, 26:28 and we want to continue that, 26:30 continue that journey, 26:32 and you're also pushing on the quality side, 26:34 I know 26:34 with the quality, 26:35 absolutely, 26:36 you know, 26:37 it's interesting, 26:38 you know, 26:39 I, 26:40 um. 26:41 You know, 26:41 I, 26:42 we know that we've had the Quality Awards program for AHCA now. 26:45 I think it's our 30th year, 26:46 we're celebrating the anniversary. 26:48 And 26:49 we want to encourage our members, 26:51 if, 26:51 you know, 26:52 we're all about quality, 26:53 so show it by 26:55 You know, 26:56 pushing yourself towards that 26:58 end goal to always strive to increase quality and 27:01 our awards program application hit a record year. 27:04 We're like 30% higher than what we were in 25. 27:07 And the data proves, 27:09 we have the data that it proves 27:11 that if you're, 27:11 whether you're bronze, 27:12 silver, 27:13 mainly more in the silver area and 27:15 Old, 27:15 if you achieve it, 27:16 or even it doesn't really matter what award, 27:19 all of their outcomes 27:21 and metrics are much higher than the rest of the industry in our sector. 27:25 And so that's what we're all about, 27:27 you know, 27:27 our, 27:28 our mission statement is delivering solutions by developing, 27:30 I mean, 27:30 excuse me, 27:31 improving lives by developing solutions for for quality care. 27:35 That is one avenue and 27:37 You know, 27:37 it's interesting, 27:38 we have a lot of constituencies and, 27:41 you know, 27:41 we're, 27:41 we're, 27:42 we want to be sure that everybody's on the same page and that, 27:45 that's the good thing about it is that we're all know that we want quality 27:48 and 27:49 honestly, 27:50 we need to 27:51 see how we can push some of our members 27:53 the bar higher on quality. 27:55 Some do better than others. 27:56 So how do we get those others 27:58 that are struggling 27:59 up to the quality level that I think CMS and we all would like to see. 28:04 Right. 28:04 And then the final thing. 28:06 Under Phil Scalo's leadership and now you continue in it, 28:09 you guys have done a great job at unifying the sector. 28:11 You, 28:12 you wanna talk about that and why it's important? 28:14 Yeah, 28:15 I mean, 28:15 I give credit a lot to, 28:16 uh, 28:17 my, 28:17 my, 28:17 uh, 28:18 uh, 28:18 predecessor because he was involved with Phil Scalo, 28:21 but, 28:21 you know, 28:22 now we have a representation of all 50 states. 28:25 50 states have a state affiliation of ACCA, 28:27 obviously including 28:29 The District of Columbia. 28:31 That's very, 28:32 very important. 28:33 I think, 28:33 I think that's one of the reasons because 28:36 we have such a presence, 28:37 uh, 28:37 uh, 28:38 have such a presence 28:39 that we're united 28:41 within our sector with one large organization on the Hill versus two or 28:45 three or whatever who may not be going after the same agenda. 28:48 And I think that's one of the reasons we had to win on the provider tax. 28:51 So that has got to continue. 28:54 Yeah. 28:54 Well, 28:55 Chris, 28:55 you've had a remarkable career and it sounds like there's still a lot left. 28:58 Thank you very much for joining us here today on Park Place. 29:02 Well, 29:02 listen, 29:02 Mark, 29:02 I really appreciate it and uh I'm, 29:04 I'm having a, 29:05 a great time. 29:06 It's, 29:07 it's, 29:07 it's hard work, 29:08 but 29:09 um it's very rewarding and I, 29:11 and I, 29:11 I just want to hear from our members and just stay together 29:13 and if we stay together and focus what's right for the residents, 29:17 if we always put, 29:18 put the residents at the heart of everything we do, 29:21 we have to win. 29:21 We will win. 29:22 So I appreciate it. 29:24 Absolutely. 29:24 And thanks to all of you for your continued support of Park Place. 29:28 Particularly thanks to First Quality, 29:31 who along with all the other sponsors, 29:32 allow us to do this segment without people having to sign up, 29:35 get pop-up ads, 29:36 all that other stuff, 29:37 and the First Quality folks are also just 29:39 fantastic and on so many different levels. 29:42 But again, 29:42 thanks for your support of Park Place and thanks for your, 29:45 for your support of Let's Talk.
