Transcript Generated by AI 00:00 Hey, Mark Parkinson back with Park Place. 00:02 And we're continuing to do a deep dive on the state of Massachusetts and looking at 00:06 whether or not it's a good state to operate in or not. 00:09 We've had a great interview with Tara Gregorio and I hope you get a chance to 00:12 look at that interview. 00:13 She was fantastic. 00:15 And now we're talking to some providers who tell us, you know, 00:18 what it's really like. 00:19 And today, we have so long with us today. 00:21 And she's not just any provider. 00:22 She's with one of the very best companies in the space, 00:25 Life Care Centers of America. 00:27 And so it's a bit of an anomaly because she's been with them except for one year 00:32 since 1989. 00:33 And, you know, in a profession where people hop around, 00:35 the fact that she's done that is pretty remarkable. 00:38 And maybe a separate conversation we'll have. 00:40 We wanted to interview Zo because she has such a great perspective. 00:44 She's a division vice president and operates buildings in Michigan, Ohio, 00:48 Massachusetts, Pennsylvania and Rhode Island. 00:51 So we thought she would be the perfect person to tell us about what it's like. 00:55 So Zo, welcome to Park Place. 00:58 Thank you. 00:59 So you've got this broad experience when when you think about the question, 01:02 what's it like to operate in the Commonwealth of Massachusetts? 01:06 What what, what comes to your mind? 01:08 Well, Massachusetts is a state with a great 01:12 heritage for healthcare, is based in its longevity. 01:17 However, with that comes a lot of complexity, 01:20 both from a regulatory, federal regulatory and from a a state 01:24 regulatory perspective. 01:25 So I, I can honestly say that Mass Senior Care 01:29 and their ability to help us filter through the regulations, 01:34 the reimbursement and just being overall updated on what's happening in 01:39 Massachusetts has been probably the most helpful thing to any provider in 01:45 Massachusetts. 01:47 Because again, it is complex, but it's also a lot of the availability 01:52 of different entities to help us along the way. 01:56 But really the efforts of Mass Senior Care through their lobbying, 02:01 through their regulatory advice and through their reimbursement advocacy has 02:07 been really tremendous. 02:08 So I, I give a lot of credit to being able to 02:11 be part of Mass Senior Care. 02:13 Yeah. 02:13 One thing that's really jumped out in these early interviews is that obviously 02:16 it's a strong association and that, and that that gives you a leg up. 02:19 OK, let's talk about reimbursement. 02:21 You've got exposure to at least, you know, 5 or 6 states. 02:24 What's, how do you view the reimbursement 02:26 situation? 02:27 Well, Massachusetts I believe finally converted 02:32 to PDPM case mix reimbursement in 2019 just before COVID. 02:37 So I've been able to really learn a lot from that process of the conversion. 02:44 At the same time, we had different reimbursement systems in 02:47 some of the other states. 02:49 Several now have converted also to PDPM, which I think is an even even playing 02:54 field. 02:54 Basically it's case mix. 02:56 So if you're documenting properly and capturing all the diagnosis, 03:00 it allows you to take care of the patient and you get paid for it. 03:05 Certainly it's never enough in, in, in the real world of Medicaid, 03:10 but at least it even the playing field as far as acuity and our ability to take 03:15 care of our residents better clinically. 03:19 And one thing I've heard a lot about in, in Mass are these at these Medicaid 03:23 add-ons. 03:23 Have you been able to utilize those? 03:26 Yeah. 03:26 Massachusetts, unlike the other states that I operate in 03:31 that have PDPM case mix, was working collaboratively with Mass 03:36 Senior Care and created a series of add-ons post COVID to help us admit 03:42 patients from the hospital quicker, but also to get better reimbursement for 03:48 patients that might have behavior issues. 03:52 So there's several different add-ons that are very helpful to providers. 03:56 The most, probably the most utilize one is the 03:59 behavior add on because it really does apply to proper documentation and care 04:05 provided to Alzheimer's patients and those with related dementias. 04:10 But there's also a bariatric add on. 04:15 There's add on for homelessness that the state pays extra money if you take 04:20 somebody that's homeless directly from a hospital, but they're relying on Medicaid. 04:25 So they've made a big tracheostomies are also included. 04:29 So very Yeah, the bariatrics are also very helpful if 04:33 you need to purchase special equipment. 04:35 So I, I must say that Massachusetts has been 04:39 very gracious and working with Mass Senior Care to get us those additional 04:44 add-ons, which frankly help nursing homes survive 04:48 because you know that we do get audited and luckily we've withstood those audits. 04:55 So just making sure your documentation is good and appropriate that you should be 05:01 OK with that. 05:02 Tell, tell, tell us how the census situation is there. 05:06 The census, I believe has recovered pretty well post 05:08 COVID. 05:08 It took a while. 05:11 Right now we're running about 91% occupied in Massachusetts with many 05:17 patients on Medicare, Medicaid and of course Medicare Advantage 05:22 plans and some senior care organizations. 05:26 I, I believe our census is pretty strong. 05:29 It it does ebb and flow. 05:31 There are months that there's a lot more volume. 05:35 And also Massachusetts is a 37 hospitals are teams state, 05:40 so that's a mandatory requirement for hospitals here, the 37. 05:45 So they're approaching care patterns a little bit differently. 05:49 So we're looking at census and how that's kind of shaking out with the first 05:54 quarter being done this year. 05:56 So we're seeing a little dip in census, but I think it's going to recover fairly 06:00 quickly. 06:01 Yeah, over 90%, certainly compared to the rest of the 06:04 country. 06:04 That's terrific. 06:05 Now finally, let me just ask you about workforce. 06:07 How how hard is it to staff and find people to work in the buildings? 06:12 We've been fortunate. 06:13 I and I think my colleagues also feel that we've really had a lot of growth in 06:21 our ability to hire CNASLPNSI think the challenge is most mostly RN still. 06:29 I don't think we are where we want to be with RN coverage, 06:33 but I think we could probably do a better job as an industry really kind of 06:38 promoting the the real purpose of working in a skilled nursing facility and 06:43 promoting how meaningful the job can actually be. 06:47 And I'm not sure that we do a good job of letting nurses know that, hey, 06:51 this is a great place to work and we'll make you make great relationships with 06:55 your patients. 06:56 You make a difference in their lives. 06:58 So, I mean, we still can work on that because we do 07:01 need to get more RNS. 07:02 Yeah. 07:03 Well, so thank you so much for this update. 07:05 I mean, first of all, let me thank you for your long career 07:08 with one of the best companies in the space. 07:10 And I know you've done incredible things that we, again, 07:12 we need to have another conversation about that. 07:15 But it's great to get this information about the state. 07:17 It confirms what we've heard from other folks, 07:19 which is that sort of at the center of the state is mass senior care. 07:23 That's really done a nice proactive job at making this a pretty darn good state 07:27 to operate in. 07:27 So thanks for spending time with us today. 07:30 Thank you for inviting me. 07:30 It's a pleasure and thanks to all of you for your continued support of Park Place.
