In the skilled nursing world, it was a truth universally acknowledged that the Patient-Driven Payment Model was a lifeline for operators trying to navigate the COVID-19 pandemic and the resulting “business nightmare.” But the federal government has proposed a recalibration of the new system, and it’s not clear yet what that could mean for providers. 

Mark Parkinson, the president and CEO of the American Health Care Association, joined Rethink to talk about why SNFs can be more optimistic than in years past about the proposed changes from the Centers for Medicare & Medicaid Services – and why the Biden administration’s push to invest $400 in home- and community-based care isn’t as antagonistic to SNFs as it might first appear.

Listen to this episode to hear about:
-The unanswered questions around occupancy and what needs to happen for recovery
-Why the proposed PDPM recalibration isn’t likely to be a repeat of drastic Medicare cuts in 2011
-Elevating and investing in frontline caregivers, and what it will take to do that properly

Mark Parkinson,  President and CEO of the American Health Care Association (AHCA)

The 40th episode of our podcast, Rethink, is now available. This episode of Rethink is sponsored by Reliant Rehabilitation. 

Shelley Horst has always been passionate about helping skilled nursing facilities better collaborate with their post-acute partners, and her role as director of strategic partnerships at Reliant Rehabilitation allows her to do just that. 

With an abundance of experience in skilled nursing business development and working in managed care, Horst is able to provide insights through analytics and her own background to help SNFs develop a strategic marketing plan that better aligns with their hospital partner’s needs and to set them apart in the market. 

She joined Rethink to talk about her role, and why now especially is an important time to make a good first impression. 

Listen to this episode to learn: 
-- How marketing has taken on a whole new dimension in the last 18 months
-- A few best practices for skilled nursing operators when it comes to connecting with and maintaining relationships with case managers
-- How providers in today’s operating environment need to approach customer service compared to the pre-pandemic era

Shelley Horst, Director of Strategic Partnerships, Reliant Rehabilitation

The 43rd episode of our podcast, Rethink, is now available.

Since Ignite Medical Resorts came on to the post-acute care scene in 2017, the central focus has been to do one thing really well. CEO Tim Fields’ goal is to be the best short-term rehab provider in the market.

But that doesn’t mean Ignite has rested on its laurels. Park Ridge, Illinois-based Ignite has experienced notable growth — most recently with its entrance into the state of Texas as the operator of four skilled nursing facilities acquired by real estate investment trust LTC Properties in a $52 million deal.

In this episode of Rethink, learn:

• How SNFs can provide value through quality and outcomes, become closer with managed care organizations and better partners with the acute care world

• What specific ways Ignite has worked to recruit and retain staff, including starting its own staffing agency 

•  How Ignite has executed sustained growth over a relatively short period of time

Subscribe to Rethink to be notified when new episodes are released.

Tim Fields, CEO, Ignite Medical Resorts

The 46th episode of our podcast, Rethink, is now available.

There are a lot of things that keep Michelle Delker up at night.

Ongoing workforce challenges are the obvious one, but the CFO of Mission Health Communities also thinks about state-level reimbursement and the ever changing regulatory requirement landscape.  

Despite the host of challenges facing skilled nursing providers, Mission Health is not sitting idly by, according to Delker.

The Florida-based operator has invested more than $1 million in its own workforce to recruit and retain workers, including an in-house certified nursing assistant program that has resulted in a significant reduction in CNA agency use since its launch.

In addition, Delker told SNN that feverishly engaging in conversations with leaders from the nine states that they operate in has been paramount to the company’s success.

Mission Health operates 47 skilled nursing, senior living, assisted living and short-stay rehabilitation facilities across nine states.

In this episode of Rethink, learn:

•  How Mission Health's investments in training and retention have paid off

•  What Delker sees as the biggest challenges facing skilled nursing providers today

• How inflation and rising prices have impacted Mission Health

Michelle Delker, CFO, Mission Health Communities

The 47th episode of our podcast, Rethink, is now available.

With an eye to the future, SanStone Health & Rehabilitation is embarking down two different but parallel paths toward bolstering its workforce.

The first is a focus on internal growth and the creation of succession plans for SanStone employees. That planning led Jennifer Robinson to the role she is in today as company president.

The second is a focus on getting young people introduced to the skilled nursing sector as soon as possible — such as opening up summer internships for teenagers.

It’s fundamental, according to Robinson, to get the state’s youth comfortable in a skilled nursing setting, and opening the facility doors for that type of exposure is a good start.

Not unlike many other states across the country, North Carolina is expected to see a 116% increase in its population of individuals 85 and older. What can be done today can shape the workforce for the next 10 to 20 years, Robinson said.

In this episode of Rethink, learn:

• How SanStone is managing the industry-wide staffing crisis

• What the operator has done to become a quality referral partner for hospitals

• How SanStone has implemented a "ground up" operating mentality

Jennifer Robinson, President, SanStone Health & Rehabilitation

The 48th episode of our podcast, Rethink, is now available.

When the Centers for Disease Control and Prevention (CDC) eased Covid-19 guidelines earlier in August, many let out a sigh of relief.

But as the nursing home industry toils its way through operational recovery amidst a staffing shortage, leaders in the space can’t help but wonder when their turn will come to lessen some of the restrictions put in place more than two and a half years ago.

That must be step one, according to Carespring CEO Chris Chirumbolo.

And Chirumbolo isn’t the only one with such concerns. Providers across the country have struggled to recruit and retain staff in nursing homes when in many other workplaces testing and masking requirements are no longer in place.

Covid continues to be an issue both in nursing homes and across the world, but both the number of hospitalizations and deaths have declined dramatically.

In this episode of Rethink, learn:

•  Why Carespring has stuck to primarily building new facilities in its regional footprint 

• What factors Carespring considers when considering expansion

• What the Centers for Medicare & Medicaid Services (CMS) needs to hear from skilled nursing operators right now

Chris Chirumbolo, CEO, Carespring

The 52nd episode of our podcast, Rethink, is now available.

Operating 152 facilities across seven states, the Providence Group strongly believes the best decisions are made at the local level.

Each of Providence Group’s facilities have their own unique needs, along with the other health care providers across the care continuum in each respective market.

That means being deeply integrated into each individual community is crucial, according to CEO Jason Murray.

It’s a model that has been replicated by operators across the country, and one that he sees as the best model for success in the skilled nursing industry.

Skilled Nursing News spoke with Murray more on Providence’s decentralized, market model type of structure, what factors he considers when looking to grow and more.

In this episode of Rethink, learn:

• What Murray sees as the biggest regulatory challenge or threat to the nursing home industry

• Providence Group's staffing wins and ongoing challenges

• What Murray sees as the skilled nursing facility of the future

Jason Murray, CEO, Providence Group

In this episode, Skilled Nursing News speaks with Kent Rodgers, president and CEO of CarDon & Associates. Kent discusses CarDon’s 90% occupancy on average across its 19 buildings, all while acquiring a pharmacy and diving into the I-SNP world with Optum, and reaching an “equilibrium” between its labor retention and agency use.

Kent Rodgers, president and CEO of CarDon & Associates

In this episode, Skilled Nursing News speaks with Jerald Cosey, senior health care expert and owner of J. Cosey Speaks, who served as operational leadership development director for American Senior Communities until September 2023. Jerald, a senior care veteran, says nursing home operators must "rehydrate and motivate" their staff through leadership development, reigniting purpose while investing in skill set growth fro management. All the while, the nursing home space should work hard to rebuild trust among its workforce and with the public.

Jerald Cosey, Founder and CEO, J. Cosey Speaks

In this episode, Skilled Nursing News speaks with Derek Prince, president and CEO of HMG Healthcare. HMG oversees 37 post-acute care facilities across Texas and Kansas. Derek is one of the Texas operators leading the American Health Care Association’s lawsuit against federal agencies, seeking to rescind the staffing rule. Derek has also served as a board member for the Texas Health Care Association since 2005.

Subscribe to the Rethink Podcast to be notified when new episodes are released. Listen today!

Derek Prince, president and CEO, HMG Healthcare

The next episode of our podcast, Rethink, is now available!

In this episode, Skilled Nursing News speaks with Clifton J. Porter II. Clif very recently was tapped by the American Health Care Association and National Center for Assisted Living to be its next president and CEO starting this fall; he currently serves as the association’s senior vice president of government relations. He expressed excitement to put unique solutions in front of policymakers as part of his new position, while also reflecting on how lobbying for the sector has changed since the pandemic.

Subscribe to the Rethink Podcast to be notified when new episodes are released. Listen today!

Clifton J. Porter II, Senior Vice President of Government Relations, AHCA/NCAL

In this episode, Skilled Nursing News speaks with Neil Pruitt, chairman and CEO of PruittHealth, which has been expanding and diversifying at a steady pace with more facilities and new services lines, and no plans to downsize. “We always say we don't sell. We buy and we build,” he told Skilled Nursing News.


Neil Pruitt, Chairman and CEO, PruittHealth

In this episode, Skilled Nursing News speaks with Rick Matros, CEO of Sabra Healthcare REIT. Matros, who has served as CEO for Sabra since May 2010, discussed the challenges in skilled nursing financing, why Medicaid rates are expected to remain high through 2025, and the REIT’s focus on innovative providers along with tech pilots to enhance operations.

Rick Matros, CEO, Sabra Healthcare REIT

In this episode, Skilled Nursing News speaks with Barb Clapp, CEO of Dwyer Workforce Development, which has been training and placing workers in partner nursing homes – a footprint that is fast growing. Since the program’s inception in 2021, Dwyer Workforce Development has trained around 6,000 CNAs, according to Clapp.

Barb Clapp, CEO, Dwyer Workforce Development

Bob Lane, Director, Long-term Care & Senior Living, Forvis Mazars

In this episode, Skilled Nursing News speaks with Aimee Middleton, chief operating officer at the Evangelical Lutheran Good Samaritan Society, one of the largest non-profit providers of senior care and services, including skilled nursing. The Sioux Falls, S.D.-based Good Samaritan Society has 200 locations in 17 states currently. Middleton spoke about ongoing staffing challenges and how her organization is countering these through technology-based efficiencies and creative workforce solutions that include an exciting Administrator-in-Training program as well as a CNA-retention program.

Rethink

Aimee Middleton, Chief Operating Officer, Evangelical Lutheran Good Samaritan Society

Bernie McGuinness, CEO, Journey Skilled Nursing

In this episode of Rethink, Skilled Nursing News speaks with Keith Persinger, CEO of Provider Partners Connect Care, about how providers can navigate the evolving skilled nursing payment landscape and capitalize on value-based care. Persinger also explains how Provider Partners Connect Care’s High-Needs ACO REACH program helps long-term care operators and physicians enhance care, reduce hospitalizations, and share in financial rewards—without added risk or complexity.

Keith Persinger, CEO, Provider Partners Connect Care

Joining us on today's episode of RETHINK is Jessie McGill, Senior Curriculum Development Specialist of the American Association of Post-Acute Care Nursing, or AAPACN, which represents more than 20,000 post-acute care nurses and professionals. In this interview, Jessie discusses the Skilled Nursing Facility Value-Based Purchasing program, provides the ins and outs of how this program is progressing, and lays out the strategies and tools that SNF leaders can use to be successful.

Jessie McGill, Senior Curriculum Development Specialist, AAPACN

In this episode, Skilled Nursing News speaks with Dr. Robert Russell, Chief Medical Officer for Majestic Care. Russell touched on survey changes set to take effect, shared his thoughts on the legal decision concerning the federal staffing mandate, and shared why he thinks embracing technology is key to meeting an evolving clinical landscape.

Tune in now!

Dr. Robert Russell, Chief Medical Officer, Majestic Care

In this episode of Rethink, Skilled Nursing News speaks with Zach Cattell, newly appointed President and CEO of Cardon & Associates, a second-generation, family-owned company operating 20 senior living communities and affiliated health care services throughout Indiana. With a background in health care law and public policy, Zach brings more than two decades of leadership experience in long-term care, regulatory strategy, and value-based health care innovation.

Cattell discusses Cardon’s achievements thus far in 2025, including strong census numbers and success in value-based purchasing as well as the company's biggest challenges, such as Indiana’s shift to full Medicaid managed care. He also outlines key performance targets as well as investments in new service lines, pharmacy integration and workforce initiatives.

Zach Cattell, President and CEO, Cardon & Associates

Joining us on this episode of Rethink, the Skilled Nursing News podcast, is Eric Palm, Chief Growth Officer at Provider Partners Connect Care.

At 35, Eric is part of a new generation of health care executives shaping the future of long-term care with a blend of innovation, empathy, and real-world experience. Provider Partners Connect Care is a value-based care organization focused exclusively on long-term care. Its High-Needs ACO REACH program is a purpose-built value-based care solution created specifically for Medicare beneficiaries with complex health conditions. Eric leads the program's growth.

In today’s conversation, Eric shares how his team helps long-term care operators and clinicians make value-based care work in the real world, and addresses some of the common misconceptions that still surround the model.

Tune in now!

Eric Palm, Chief Growth Officer, Provider Partners Connect Care

In this episode of RETHINK, CEO Kimberly Green shares her journey that led to her founding Sage Integrated Health this year. Green has been in the skilled nursing industry for decades, formerly as Chief Operating Officer at the Diakonos Group. Sage Integrated Health serves the Greater Tulsa and Oklahoma City markets.

Green spoke with SNN about her new venture, and what it has been like to start a new nursing home business amid ongoing staffing shortages, shifting policy trends and an industry evolving in real time. Our full interview also offers wide-ranging insights on Medicaid cuts, value-based care and the future of reimbursement programs, among other hot-button topics. 

Subscribe to the Rethink Podcast to be notified when new episodes are released. Listen today!

Kimberly Green, CEO, Sage Integrated Health

In the latest episode of RETHINK, Trilogy Health Services Chief Medical Officer Dr. Andrew McNamara shares his perspective on the company's value-based care strategy, common misunderstandings around Medicare Advantage, ideas for simplifying MA processes, and how to address rising resident acuity. Trilogy operates over 134 senior living communities across five states, with many offering the full continuum of care, including skilled nursing.

Dr. Andrew McNamara, Chief Medical Officer, Trilogy Health Services

It's never been a more important time for skilled nursing facilities to get to know their hospital partners, especially as SNFs face penalties for patient readmissions and a constant battle to maintain census and provide the best quality of care. That makes open lines of communication and strong relationships essential for acute and post-acute care —and Sue Craft, the vice president of inpatient case management and post-acute care services at Henry Ford Health System is at the forefront of that work.

She oversees the Detroit-based hospital system's preferred SNF network, as well as the team that makes decisions about patient discharges. Skilled Nursing News sat down with her to discuss the financial pressure that hospitals are facing, and how Henry Ford has changed its approach to post-acute partnerships over the years.

Listen to this episode to learn:
-Why Henry Ford focused on developing a preferred network to combat readmission struggles
-The metrics SNFs should bring to hospitals in partnership discussions
-What hospitals want from their post-acute partners

VP at Henry Ford Health System Sue Craft

Over the last few years, there's probably been no hotter topic in the skilled nursing space than I-SNPs — special Medicare Advantage plans that cover long-term residents of nursing homes and other institutional sites of care.

As CEO of Longevity Health Plan, René Lerer has had a front-row seat to the expansion of these plans, which the company currently offers in Illinois and New York. 

Lerer joined "Rethink" to discuss trends in this specialized space, as well as how providers can launch their own plans — either on their own, or with strategic partners.

Listen to this episode to learn:
- How Longevity built its network, and how it plans to expand
- The different ways providers can create or join an I-SNP
- Why I-SNPs can open other opportunities beyond reimbursement control

René Lerer, CEO of Longevity Health Plan

For the first time in 34 years, an annual report on nursing home finances found that the median operating margin for operators fell below zero. For CLA managing principal Cory Rutledge, a co-author of the report, the result wasn't exactly surprising, given the headwinds battering the skilled nursing space over the past decade.

But while he acknowledges that the number doesn't look great, Rutledge sees sunnier times ahead for operators in the space — specifically those that take bold action to adapt to a changing world.

Listen to this episode of "Rethink" to learn:
- Why the median margin fell below zero
- How operators with positive margins pulled off their success
- What operators should do to turn their fortunes around
- ...and more!

CLA Managing Principal Cory Rutledge

As COVID-19 initially swept through nursing homes across the country in March and April, operators and staffers had a key advantage: Just about every state implemented stay-at-home orders that kept public spaces clear for the essential health care workers, reducing the risk of infection.

But as spring turns to summer, states around the country have implemented varying degrees of “reopening” plans, setting off increases in case counts — and underscoring the reality that the coronavirus will plague long-term care for an indefinite period of time.

Dr. Paula Lester, a an associate professor of medicine at the NYU Long Island School of Medicine and a geriatrician at NYU Winthrop Hospital, joins "Rethink" to discuss the top lessons learned from the peak of COVID-19 cases in New York, one of the nation's worst geographic hotspots.

Listen to this episode to learn:
-- Why operators can't assume they're in the clear, even after performing baseline tests
-- Top considerations for reopening safely
-- What providers should seek from reform efforts
-- And more!

Dr. Paula Lester, NYU Winthrop Hospital

Until scientists develop a vaccine or effective treatment for COVID-19, infection control — already so vital to resident safety — must be at the top of every nursing home operator's list of priorities.

For Karen Hoffman, that topic has been the subject of her career over the course of four decades. As a former CMS consultant, current clinical instructor at the University of North Carolina, and 2019 president of APIC, Hoffman has dedicated her professional life to improving infection control and preventing the spread of disease in nursing homes and other settings.

She joined "Rethink" to discuss why COVID-19 can be so difficult to contain, how operators should reframe their mindsets to fight it as a chronic menace, and what CMS should do when evaluating its enforcement strategies.

Listen to this episode to learn:
-- Simple investments with major preventative payoffs
-- Ways CMS can improve and enhance enforcement efforts moving forward
-- Key areas for operators to focus on 
-- And more!

Karen Hoffman, Clinical instructor, University of North Carolina School of Medicine

As nursing homes navigate COVID-19, the actions they take now could present legal minefields in the months and years to come. Those could stem from lawsuits brought by individuals – or by investigations from the state or federal government. 

Jon Ferry, a partner at the law firm Bradley Arant Boult Cummings and a former assistant U.S. attorney, joins Rethink to talk about some of the considerations for skilled nursing providers.

Listen to this episode to learn:
-The nuances of liability regulations in different states, especially those established for health care settings during COVID-19
-The ways the pandemic-induced changes might shape legal definitions and future lawsuits
-What the Department of Justice’s National Nursing Home Initiative – announced just before COVID-19 hit in full force – will be investigating with the backdrop of the pandemic
-And more!

Jon Ferry of Bradley Arant Boult Cummings

Skilled Nursing News covers the business and operations for Skilled Nursing owners, operators and developers.

Skilled Nursing News

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