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 Industry Luminaries Tackle Tough Issues

If there was one thing that nine long term and post-acute care company executives could agree upon, as they sat around a conference table in a hotel on a sweltering July day in the nation’s capital, it was that there is a lot of work to be done. The occasion was a roundtable discussion for leaders of some of the largest multi-facility companies in the country, who took a break from the American Health Care Association/National Center for Assisted Living Congressional Briefing to meet with Provider and address some of the most vexing issues facing the industry today.
Among the topics tackled were: measuring outcomes, reducing undesired hospitalizations, improving data gathering and utilization, and sprucing up the image of the profession.
Titled "Changing the Conversation: How to Validate and Measure Care During Healthcare Reform," the July 11 event was hosted by Provider and sponsored by PointRight, Lexington, Mass.
As the discussion opened, first out of the gate to address one of the most pressing issues of the day—outcomes measurement—was Neil Pruitt, president and chief executive officer (CEO) of Pruitt Health Care, Norcross, Ga.: "Our problem as a profession is that we all [measure outcomes] differently," he said. "We need a common outcome measurement system."
Vince Mor, PhD, researcher and professor at Brown University, agreed. "Common sets of outcomes make it possible to observe, for example, how many days it takes to get certain outcomes," he said.
Responding with a unique perspective was Gail Clarkson, CEO of the Medilodge Group, Washington, Mich., who suggested that outcomes may be different for each resident. "Perhaps residents should set their own outcomes, such as to drive or to cook, for example, and we can help them meet those goals," she said. "Personally, I believe that if we use the residents’ voices, we can get [CMS and others]" to recognize how well we are doing to meet their goals.
A point on which the participants agreed unanimously was that the residents they care for are the most important factor in determining their companies’ success.
Clarkson noted that focusing on her customer is part of what sets her company apart from the competition. To begin, Medilodge has renovated or rebuilt most of its buildings and added amenities and services to meet the needs of a more discerning population of baby boomers.
"We have doctors or nurse extenders in each building seven days a week, chefs in all of our buildings, as well as massage therapist, and permanent assignment nursing care for residents," she said. "Most of our buildings look like bed and breakfasts; they look very different physically. In some rural areas we are a one-stop shop, and for some, we are a rehab facility."
Moderator Joanne Erickson, editor in chief of Provider, asked other members of the panel to describe how they differentiated their companies from the competition.
Steve Chies, senior vice president of operations at Benedictine Health System, Duluth, Minn., noted that his organization views the baby boomer onslaught as an opportunity to improve its rehab services, among other things. "We’re looking at it as hips, knees, and shoulders," he said.
"The baby boomers are much more discriminating," said Tim Lukenda, president and CEO of Extendicare, Markham, Ontario. "They want more hospitality-oriented services, and we’re trying to modify our physical plants and align our goods and services to meet the needs of our referring providers and customers."
Lukenda pointed to Marriott as a business model for providers to consider in structuring their own businesses because the well-known hotel chain has several different service lines, similar to how many providers offer post-acute, long-term, assisted, and independent living. "They have many levels of hotel offerings for a reason," he said.
Similar to the view offered by Lukenda, Jim Avery, MD, senior vice president and chief medical officer of Golden Living, Plano, Texas, noted that his company’s services could be viewed almost as two separate businesses, and having the right data analysis helps him better examine to two groups.
Recognizing this view as universal among them, the panel discussed how such a dichotomy of patient type could be best served under one roof. "We need to create two or more paths of regulation," Michael Torgan, chief operating officer of Country Villa Health Services, Los Angeles, said.
"The politicians still have the mindset that we are the same old nursing home model, but we’re not just in the long term care business anymore," he said, adding that the survey process still views it that way.
Go to for video clips of the roundtable, including more details from participants.
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