Transcript Generated by AI 00:01 Hey, Mark Parkinson back with Park Place. 00:03 And we're continuing to look at Massachusetts and what it's like to 00:07 operate there. 00:08 And we're here today to talk with another operator. 00:11 And it's not just any operator, it's an operator that can give us a 00:14 fantastic perspective. 00:15 We're here with Tom Lavallee. 00:17 And the recent Tom can give us such a great perspective is he's not only an 00:21 operator of facilities in Mass, he's also the head of the association, 00:25 the outside chair of Mass Senior Care. 00:27 So Tom, welcome to Park Place. 00:29 Thank you, Mark. 00:30 Good to be here. 00:31 Now, Tom, let's start out with with your company, 00:33 Alliance. 00:34 You're the Chief Operating Officer. 00:35 You guys do a fantastic job clinically, financially all across the board. 00:40 I think you've got 8 facilities that you operate, 00:42 own and operate and a couple more that you manage. 00:44 Tell us a little bit about Alliance. 00:46 Sure. 00:46 Alliance is a not-for-profit organization exclusively right now in Massachusetts, 00:51 though there are opportunities outside of of Mass that we we continue to look at. 00:57 We've been around for 20 plus years and yeah, do a good job. 01:01 Quality is at the center of what we try to do. 01:05 And it's been a, it's been a good run of Alliance. 01:08 I've been with them for almost 13 years now. 01:10 Yeah. 01:10 And you guys are such a great example of what operators need to be. 01:14 And so it's not surprising that you've been identified for leadership and you've 01:18 come in to run Mass Senior Care as the outside chair. 01:21 What is really interesting is I think you're probably the longest tenured chair 01:25 of a state association. 01:27 You've been at it now for seven years. 01:30 Tell us how that happened. 01:31 Well, I was voted in as board chair in November 01:35 of 19 with a term that started in a January of 20. 01:39 And typically they go consecutive, 2 consecutive one year terms. 01:44 Of course, as, as we know, as we got into 2020, 01:47 a COVID hit and I and I, I remember saying to Tara Gregorio, 01:51 our president, that I don't want to be remembered as the 01:55 COVID chair. 01:56 So 2 years became three years became four years, etcetera. 02:00 And wrapping up this year as, as board chair. 02:04 But it's been a, it's been a terrific run and fun and, 02:07 and really one of the highlights of my career. 02:10 Yeah, I mean, and I've heard from the members what a 02:12 great job you did leading folks through COVID and you've just done a terrific job. 02:16 And if you're going to end on a high note, yes, because the big high note, 02:22 we're going to be in Boston. 02:24 American Health Care Association, this year's annual convention is in 02:28 Boston. 02:28 And I'm looking forward to welcome, welcoming all my colleagues from across 02:32 the country. 02:32 It'll be an exciting event for us. 02:35 Yeah, we're all looking forward to that. 02:37 OK. 02:37 So when I look at Mass, Mass, I mean, one of the things that jumps out is just 02:41 the unity. 02:43 You don't have all these different groups fighting with each other. 02:45 Tell us about that. 02:46 So when I became board chair, Tara, Tara and I said to each other, listen, 02:50 we want to have an association where everybody feels like they have a voice. 02:55 And so let's do that. 02:56 Let's create subcommittees, let's create opportunities for people to 03:00 be involved. 03:01 And and we did that really from from day one. 03:04 And it's resulted in the vast majority, I mean, 03:07 very few providers and not members of Mass of the Mass Senior Care Association, 03:12 the state affiliate of of AHCA. 03:14 And, and we're very proud of that. 03:16 Yeah. 03:17 I mean, when you look across the country at the 03:19 dysfunctional states, you just don't see that. 03:21 You know, it looks like bringing folks together is 03:23 a real key element to success. 03:25 Let's talk a little bit about operating there. 03:27 Tell us about how you viewed the reimbursement system. 03:30 So we've done tremendous work in the area of of Medicaid reimbursement. 03:36 Early on, you know, we talked about how can we advance our 03:41 Medicaid rates in a way that's meaningful for members. 03:46 And, and we got our members to buy into the 03:48 notion that, hey, quality matters. 03:50 Let's approach the state with we're going to improve our quality and you're going 03:54 to pay us for that. 03:56 And, and that's what we've done. 03:57 And so we get add-ons for quality rating improvement. 04:02 We get add-ons for taking care of challenging folks, Sud behavioral issues. 04:10 We get an add on for taking folks direct Medicaid right from the hospital. 04:15 And all this is couched in a way that hey, if we provide good care to these folks, 04:21 the state will pay us for it and we will take that money and reimburse, 04:26 reinvest that in our workforce. 04:28 Excuse me. 04:29 And that's what we've done. 04:30 And I think it's been a it's been a real home run. 04:33 Yeah. 04:33 It's such a great strategy. 04:34 I mean, you ask a policy maker, do you want to increase funding for 04:37 nursing homes? 04:38 It's like, I don't know. 04:39 But if you say do you want to increase funding for nursing homes that are 04:42 showing outstanding quality or they're taking care of behavioral patients or 04:46 that are solving some particular need of the state? 04:49 Fantastic strategy. 04:50 OK, so let's talk about the regulatory 04:52 environment. 04:52 I know everybody is constantly complaining about that, 04:55 but it's kind of a unique situation in in mass. 04:58 Tell us about it. 04:59 So again, we decided let's get to the table with 05:03 our regulators and and let's have open conversations about the process. 05:08 Let's invite them into our meeting. 05:10 So we've had folks from the state agency that deal with our annual surveys. 05:15 We've had the director, the assistant director, 05:18 the director of the complaint unit all come to our annual meetings, 05:23 our other conferences. 05:24 They've been involved with webinars and really have been involved and, and, 05:29 and gotten to know some of our providers in a, and I think a different way in a, 05:34 in a more personal way. 05:35 Now that doesn't mean that they're not going to cite us if things go wrong or if 05:38 they see deficient practice, they're going to cite us. 05:40 But what it has done is create an environment where it's not a hostile 05:45 situation when they come into our facilities. 05:48 I mean, it's a pressurized environment when we 05:51 have an annual survey, but because of that relationship building, 05:55 it's made it, it's made it manageable. 05:57 And, and, and that work continues. 06:00 We've got a questionnaire that we provide every one of our nursing facilities in 06:04 Massachusetts, they can fill this thing out. 06:06 It's anonymous and it, and it's a questionnaire about, you know, 06:09 how did the survey process go? 06:12 And it includes things like where the surveyors cordial, 06:17 did they introduce themselves? 06:20 And then we take those results, we meet with the state agency leadership 06:24 and and share them. 06:25 Now again, I think it's created a better environment, 06:28 not perfect, but but much improved over over the 06:31 course of time. 06:33 Yeah. 06:33 And I mean, I just not surprised, you know, 06:35 Steven Littlehale from the Zimmet organizations put together this ranking 06:39 of regulatory across the country and masses in the in the group that's at the 06:42 very top. 06:43 So, so again, the strategy, the strategy is clearly working census 06:47 work since it's it's a pretty high census state. 06:50 Yeah, I mean, we're back over 90% feels like pre COVID 06:55 days and your census is very strong. 06:58 And going back to my my comment on on Medicaid add on for taking folks out of 07:03 the hospital system directly that that don't qualify for Medicare direct 07:08 Medicaid patients from the hospital that's really benefited the hospital 07:13 system. 07:14 So, so our partners in in the acute, in the acute care setting appreciate that 07:20 outreach and that that ability to take folks that that are challenging the place. 07:26 And I do think that in time we're not going to have enough beds here in 07:29 Massachusetts. 07:30 I suppose that's a good thing for providers, 07:32 not necessarily a good thing for consumers. 07:36 Staffing is that I assume that's gotten a little better. 07:39 We're getting close to pre COVID in terms of both open hours and our reliance on 07:46 agency usage in within my organization, we're lower than we were prior to prior 07:52 to COVID in terms of agency utilization. 07:56 So that's come a long way. 07:58 And I think that's directly related to taking our Medicaid increases and putting 08:01 them to workforce. 08:02 We're finally paying people, Mark, in many cases what they deserve to be 08:07 paid. 08:07 I mean, do you remember before COVID, the mortal threat to the sector was, 08:11 Oh my God, they're going to mandate a $15. 00 an hour minimum wage in, 08:15 in nursing homes. 08:16 Well, we've blown that away. 08:18 Yeah, we, we're way, way beyond that. 08:22 Well, great report. 08:23 What do you, what do you attribute this good report to 08:26 what you have a summary of, of kind of how, how does all this happen? 08:30 Well, I think I'll give the, the, the bulk of the credit to Tara Gregorio. 08:35 She is a fantastic leader of our organization. 08:39 She is always available. 08:42 She is, I, I don't know how she, she's got more energy than anybody that I 08:47 know. 08:48 She's tremendous at, at team building, bringing people together, 08:52 coalescing over important issues. 08:55 And really I think having the bulk of operators, providers in Massachusetts, 08:59 being a part of the state association I think is a is really why we're successful 09:05 as we are. 09:05 We're together on most issues. 09:08 You know, one other comment that I'll make, 09:10 because none of you would brag about yourselves this way. 09:12 But when you're in Mass and you talk to the owners and the operators, 09:16 you're talking to some of the smartest people in the space. 09:19 I mean, people that have gone to these fancy 09:21 schools that know what they, they read the Wall Street Journal, 09:24 they know, they know a lot about what's going on. 09:27 And you combine that kind of knowledge and intelligence and humility with 09:30 leadership that you all have and a great association in Tara, 09:33 and it's not surprising that you have great results. 09:37 Tom, thanks a bunch for joining us today. 09:39 Thanks, Mark. 09:40 It's been my pleasure. 09:41 And thanks all of you for your continued support of Park Place.
