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 Mission Health Sets New Path for Once Struggling Kansas SNFs

​Stuart Lindeman, president and chief executive officer, Mission Health, says his company’s efforts to turn around 15 skilled nursing facilities (SNFs) in Kansas is going well as he offers insights into what it takes for an organization to assume the weighty task of charting a new path for care communities that enter receivership.

Receiverships have become a necessity when companies find themselves no longer able to successfully provide care and consistently pay their employees. Over the past year, Mission has brought receivership businesses in line with its existing business model and core values.

Based in Tampa, Fla., Mission has 28 SNFs in Georgia, Kansas, Minnesota, Tennessee, and Wisconsin and had prior experience in managing communities put into receivership. This most recent turn came last year and involved the Kansas Department of Aging and Disability Services (KDADS) reaching out to the provider to seek assistance in saving 15 properties in Kansas, operated by New Jersey-based Skyline Healthcare.

“KDADS Secretary Tim Keck and Mike Flanagan, the head of the receivership program in Kansas, said, ‘We know Mission has turned around buildings before, and we have a problem now, and can you help us out?’”

Very quickly, Mission agreed to step in with no long discussion needed since Lindeman says the company knew it could rely on the state for support and that there was a silver lining in coming in to operate the financially hampered facilities. “There are good, hard-working people in each of those communities,” he says.

After the decision to manage the SNFs was made, Mission immediately embraced the receivership properties and identified a talented team both inside Mission and within the Skyline properties to grow them in ways that best position the communities for care and sustainable operations.

Lindeman says the first task was to make payroll, which was achieved in quick order when the state funded the $2 million required. “The employees also got their benefits because we were able to get them quickly onto our health insurance plan. The previous owner did not pay premiums for health insurance,” he says.

The next assignment for Mission was to partner with the vendors to ensure supplies were there for care and nutrition needs were met.

“We knew what we needed to do, and that was No. 1: Make sure the residents are taken care of,” Lindeman says. “I know that sounds like a normal answer, but in reality we were taking over the care of some 800 or more new residents [new to Mission].  We also focused on consistency of care by integrating key software platforms.”

The way in which Mission stepped in and oversaw the once-distressed Kansas properties shows the organization is adept at so-called turnarounds, Lindeman says, but not all of Skyline’s properties were in that shape, and being receivership experts is not first and foremost on his mind. 

“We have our own portfolio, a good group of communities, some needed to be turned around and some did not. We have really built out a second business of assisting struggling communities, and people seem to know us by that, as we continue to get additional inquiries from other states.  However, it was not my strategic plan to begin with,” he says.

Lindeman says the fair number of SNFs either shutting down or looking for new owners because of financial problems is primarily because operators assume too much debt and cannot afford to be in the business.

The warning signs are readily apparent, he says. They include bills in arears and an inability to maintain benefits like health insurance for employees, as well as not paying bed taxes to the state and the deterioration of clinical outcomes.

Some states, such as Kansas, have decided to keep properties like the Skyline buildings open, while other states, such as Nebraska and South Dakota, have shuttered buildings.

As for the care of residents and how it is affected in situations like this, Lindeman says the same survey process is in place as for all SNF communities. But, in the case of Mission and Kansas, “we moved all 15 SNFs in receivership to the Mission way of doing things,” Lindeman says.

“This was helped, of course, because we saw right away these communities had great nurses, CNAs, and administrators, and we immediately told them they should be looking to participate in the National Quality Awards Program” by the American Health Care Association/National Center for Assisted Living, he says. And, in fact, four of the 15 buildings are receiving the bronze level award for 2019, Lindeman says.

The impact of all this positive change for residents means not many have decided to move out of the communities, he notes. “I will tell you the number of seniors we are caring for in these communities has grown. We are having some of the highest census in a couple of years. It is wonderful.”

Other operators have had trouble in Kansas with financial and rural state issues such as population shifts and staffing barriers, he says, “but we feel really good. We are very optimistic about our role in senior care in the state of Kansas.”

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