Transcript Generated by AI 00:00 Mark Parkinson back with Park Place and very happy to be actually in our studio 00:05 today with Marc Zimmet. 00:07 Mark, we're here in Manalapan and you can tell 00:09 that I'm, you know, we've got this going. 00:11 I can actually pronounce the name of the city that we have our studio in. 00:15 You're an adopted child of Manalapan, NJ Central New Jersey. 00:19 So today's segments on Florida. 00:20 We've been taking a deep dive and looking at Florida, 00:24 and one of the things I love that you've done in the last year is that you created 00:28 an objective way to grade every state's Medicaid reimbursement system. 00:33 And before we talk about Florida's grade, tell us a little bit about the criteria 00:38 that you used to grade a state, right. 00:40 So we want that to simplify it as much as possible. 00:43 There are a lot of moving parts to that influence the state's performance. 00:49 So we wanted to still it down, start with how a state did, 00:53 how they performed and then breakdown why they performed that way and how evenly 00:59 they performed throughout the state. 01:02 So it's an A,B,C,D grade. A being the best meaning the that the 01:08 highest share of providers generated positive income from patient services and 01:16 a D grade means most facilities lost dollars. 01:21 OK, so it's a lot like school A to D And when 01:24 you analyze Florida, where does Florida end up? 01:27 Florida is interesting. 01:28 Florida is a B. A strong state on its way to a status and 01:32 is the only state that we have looked at that we expect to go from B to an A. 01:39 But more importantly for big state especially is the second factor which is 01:44 what we call dispersion. 01:46 Dispersion is how evenly the factors that drove performance are throughout the 01:52 state. 01:53 So you have a B2 soon to probably be an A2. 01:58 You take a look at Florida, what the differences are. 02:02 Occupancy is strong throughout. 02:05 There are, there are really there are there are 02:07 three factors that impact how a state does or how a facility does. 02:11 Any way you slice it, you can just distill it down to occupancy, 02:16 Medicare share and the percentage of their net patient revenue that was used 02:21 for direct care. 02:23 Those three. 02:24 Now what's left over the state has to cover if those 3 structural variables, 02:30 however they land, Medicaid is the residual payer. 02:35 They have to make up the difference. 02:36 So Florida, you've got a situation where you've got 02:39 strong fundamentals, you have strong occupancy. 02:43 We, if you looked at if, if I asked somebody to look up Florida 02:47 occupancy right now versus 2019 pre pandemic, they would say, oh, 02:51 it's about the same. 02:53 But like every state they've contracted, they've lost some beds. 02:57 Florida's occupancy was about 87% in 2019. 03:02 It's about 87%-88% now. 03:05 But when we look at relative occupancy adjusted for the number of beds that were 03:09 lost, they're like 91%. 03:11 So demand is higher. 03:12 That's driven up performance and it is the textbook state for intentionally or 03:20 not, but for policy for, for, for the structural framework of a state 03:27 to put the correct amount of pressure on the Medicaid program, if that makes sense. 03:36 Yeah. 03:36 So I mean, obviously an A is a great grade and it's 03:39 an A2, which means that it's not just a good 03:41 grade, it's pretty consistent throughout the 03:44 state. 03:45 And I guess I wish every state was an A2. 03:48 Well, it's the difference is that that, yeah, every state A2 would be nice. 03:53 But you know, the difference here is, is you look at different parts of the 03:57 state, the lower cost parts of the state. 04:00 And this is where we get into Medicare wage index. 04:04 And there's a lot of Medicare in Florida. 04:07 The cost, the loaded cost for CNA in Miami-Dade is 04:11 just about the same as it is in the Panhandle. 04:15 It's, it's, you don't have that distinction. 04:18 That's what the dispersion means. 04:20 They that it, it should cost, a CNA should cost more in Miami in a high 04:25 cost area than in a low cost area. 04:28 So they've got those some of those little inconsistencies that every state has, 04:32 which makes them a 2, but and it's getting stronger. 04:36 It's a good state and it's and it's getting stronger. 04:38 Yeah, it's a well, it's a well managed state. 04:40 That's great. 04:41 Well, Marc, thanks for the great news on Florida and 04:43 it's good to, again, it's good to be here with you today. 04:47 Pleasure and congrats to all the operators in Florida. 04:49 And I know there's a lot of people that are looking to operate in Florida. 04:52 And as Marc indicates, there are a lot of good reasons for that. 04:55 And thank you for your continued support of Park Place.
