Transcript Generated by AI 00:00 Hey, 00:00 Mark Parkinson back with Park Place, 00:02 and we are continuing our series on Illinois 00:05 and analyzing what it's like to own and operate 00:09 in Illinois. 00:10 Last week, 00:11 we talked with Matt Pickering, 00:12 who, 00:12 of course, 00:12 is the executive director of the council. 00:15 This week, 00:15 we're talking to an actual operator, 00:17 somebody that does the work that all of you do, 00:20 and it's not just any operator, 00:21 we have none other than Jonathan Aaron, 00:23 who's the founder of Omnia, 00:25 very successful company. 00:26 Jonathan's a great operator. 00:28 And this actually has 45 facilities in 3 different states, 00:32 principally in Illinois, 00:33 and on top of all of that, 00:35 he's the co-chair of the council, 00:37 and I can tell you from being involved in this, 00:40 Jonathan was instrumental in bringing the providers together 00:43 in Illinois. 00:45 Jonathan, 00:45 we are doing an analysis of Illinois and, 00:48 you know, 00:48 it's a, 00:49 it's traditionally been considered a really, 00:51 really tough state. 00:52 First of all, 00:53 let me welcome you to Park Place. 00:55 Well, 00:55 thank you and I appreciate all the kind words. 00:57 Great. 00:58 Um, 00:59 Illinois has always had a bad reputation. 01:01 I've had people telling me for the last 20 years that it's 01:03 one of the worst states in the country to operate in. 01:07 Let me, 01:07 let's just, 01:08 let's really do an analysis of that. 01:10 So, 01:10 you know, 01:11 keeping in mind that this is a PG website, 01:14 um, 01:14 when somebody asks you what it's like to operate in Illinois, 01:17 what, 01:18 what are the first things that come to your mind? 01:21 I would say it's historically been challenging on all fronts, 01:24 you know, 01:25 regulatory reimbursement, 01:27 and the overall relationship between the state and the 01:30 operators has been a little bit punitive in nature. 01:33 But that being said, 01:34 we're, 01:34 we're putting in a lot of hours, 01:36 um, 01:37 to, 01:37 to improve all those relationships and, 01:39 and frankly, 01:39 I'm pretty bullish about the future. 01:42 OK, 01:42 let's talk about some specific things. 01:45 We'll just run through and you just, 01:47 you know, 01:47 kind of give me your, 01:48 your thoughts on each. 01:50 Workforce has been tough everywhere. 01:51 What's it like in terms of Illinois and a great 01:54 thing is that you've got other states to compare to. 01:56 What, 01:56 what, 01:56 what's the workforce availability? 01:59 I think we've seen a lot of improvement over the, 02:01 over the year or so. 02:02 I'd say 12 to 18 months, 02:03 it's improved a lot. 02:04 Our agency numbers are down, 02:06 um, 02:07 but more importantly, 02:07 the wages of the agency workers are down. 02:10 Um, 02:10 but I, 02:11 but I think what's most important is we can't let our guard down. 02:14 I think we need to take what happened during COVID as a, 02:16 as a lesson 02:17 and realize that all it takes is one thing to 02:20 really decimate the workforce, 02:22 so we need to 02:23 stay vigilant and, 02:24 and keep hiring. 02:26 One objective data point that I think worries 02:28 people when they look at Illinois is census. 02:30 The, 02:30 the nationwide census for sniffs is a little bit over 80%. 02:34 The data indicate in Illinois, 02:35 it's about 70%. 02:37 What's the deal with census in Illinois? 02:40 You know, 02:41 I, 02:41 I think it's more than just one thing. 02:42 I think that the evolution of the 02:46 managed care organizations becoming so prevalent every day is, 02:49 is really changed it, 02:50 you know. 02:51 It's, 02:51 it's difficult to get those pre-authorizations to get them in, 02:53 the residents, 02:54 and then when they're in, 02:55 the MCOs want them out. 02:56 So you got that to balance that. 02:58 There's 02:59 a, 02:59 a great demand for private rooms, 03:01 more so than there is supply, 03:03 which, 03:03 you know, 03:04 can also skew the numbers if you take beds offline. 03:06 But 03:07 yeah, 03:07 the census numbers are not exactly where they need to be, 03:09 but we're going in the right direction and 03:11 we're evolving with the changes and, 03:13 and I think we're gonna be in a pretty good spot over the next year or two. 03:17 OK, 03:17 every 03:18 operator that I know, 03:20 well, 03:20 that's not exactly right. 03:21 Most operators that I know think that their state is 03:23 the worst state in terms of survey and regulation. 03:27 Uh, 03:28 what's, 03:28 where, 03:29 where would you rate Illinois? 03:30 What, 03:30 what's your relationship with the regulators? 03:33 I'd say let's call it a work in progress. 03:35 I think there are, 03:36 there's a lot of new relationships, 03:39 and 03:40 there's a lot of old relationships that have to be repaired, 03:43 current relationships to maintain, 03:45 um, 03:46 but I think that the focus is, 03:48 let's continue talking, 03:49 let's get each other at the table, 03:50 let's understand each side's position, 03:53 and let's work together to provide a, 03:55 a collaborative industry for the people that need it the most. 03:59 OK, 03:59 now, 03:59 I've saved the last data point 04:02 that's probably the most important one for last, 04:04 which is the Medicaid rate. 04:05 And I think one of the things that's had people 04:08 kind of 04:09 really wondering about Illinois is the blue state. 04:11 You almost always have Democratic governors, 04:14 members of the, 04:14 you know, 04:15 House and the Senate, 04:15 and yet somehow the Medicaid rate has not been very good. 04:18 So, 04:19 what's, 04:19 what's the deal with the Medicaid rate? 04:21 Where do you see it? 04:22 And 04:23 how do you see the relationship with officials evolving over time? 04:28 I think our biggest challenge has been that Illinois historically has been 04:33 really far behind in where we need to be on the Medicaid reimbursement system. 04:37 And 04:38 when we keep have to go, 04:39 when we keep continuing to have to go back 04:40 for more conversations about what needs to be improved, 04:43 uh, 04:43 it becomes, 04:44 we become pretty unwanted guests pretty quickly. 04:47 Uh, 04:47 that being said, 04:48 that 04:50 There are 04:51 significant improvements that we're discussing and 04:53 working on along with the state. 04:55 We want to start talking with them from the get-go 04:57 about pieces of our reimbursement system that don't work today, 05:00 what we think will work, 05:02 what changes need to be made, 05:04 um, 05:04 and give them a little bit more insight into why we need those as to just saying, 05:08 hey, 05:08 our, 05:09 our reimbursement system has fallen behind, 05:10 we need some help. 05:11 So, 05:11 it's a lot of education, 05:13 and I think we're, 05:14 I think we're doing a pretty good job. 05:16 One of the, 05:17 the realities of Illinois has been that there have 05:18 been so many different voices in the state capitol. 05:21 Um, 05:22 you seem to have, 05:23 have sort of solved that problem. 05:25 Just talk about the history of that, 05:26 what, 05:27 how challenging that's been and where you're at now. 05:31 It's, 05:31 it's been tough because there, 05:33 again, 05:33 there's a lot of veteran legislators, 05:36 there's a lot of, 05:38 you know, 05:38 a couple, 05:38 3 years legislators who have been there, 05:40 and then there's a lot of new ones. 05:41 So, 05:42 I think the focus is let's get back to grassroots and let's get back to 05:47 education 101, 05:48 doesn't always have to be fancy. 05:50 Let's have coffee, 05:51 let's get them out to the buildings. 05:52 Let's see what we do on a daily basis, 05:55 um, 05:55 because a lot of what our industry does is, 05:57 is misunderstood 05:58 and always viewed as the place where 06:01 You don't want to end up. 06:02 But the fact of the matter is it's not really true, 06:04 and I think the more 06:06 education we do and the more grassroots we do, 06:08 I, 06:08 I think we'll, 06:09 we'll get to where we need to be. 06:11 As I understand it, 06:11 the council now represents over 500 nursing homes of the 700 or so in Illinois, 06:17 and, 06:18 and that, 06:19 there's never been that kind of single voice before. 06:21 Is that right? 06:22 That is right. 06:23 It's something that we felt is very important and 06:26 took a lot of time to get there, 06:27 but 06:28 we got there. 06:29 So it sounds like your view is it's tough, 06:31 but things are getting better. 06:32 Is that your overall assessment of Illinois? 06:35 Yeah, 06:36 I mean, 06:36 look, 06:37 I, 06:37 I, 06:37 I don't think the reputation came out of nowhere. 06:40 Um, 06:40 there were certainly some things that warranted it, 06:42 but 06:43 You know, 06:43 I've been, 06:44 I've been doing this in Illinois for 20 years and everything is cyclical. 06:46 Everything goes up, 06:47 everything goes down, 06:48 but 06:49 I feel that the, 06:50 the future is more up than down, 06:52 and I, 06:52 I think over the next 20 we'll get a lot more good done than not. 06:56 Well, 06:56 Jonna, 06:56 thank you, 06:56 thank you so much for spending time with us here today and giving us that view. 07:01 And, 07:01 you know, 07:01 I think I'm pretty optimistic about Illinois after talking with Jonathan and Matt 07:05 and the other folks that we're gonna be talking to in this series. 07:08 Yeah, 07:08 it is pretty shocking that the Medicaid rate has not been good, 07:11 given that it's a blue state. 07:13 But it looks like the state is uh improving 07:15 and hopefully there are good things in the future. 07:17 Jonathan, 07:17 thanks for all your time. 07:19 Thank you for having me. 07:20 I appreciate it. 07:21 You bet. 07:21 And thanks to all of you for continuing to support Park Place.
