Nursing home leader: Innovators needed

Merge mission with metrics, says Good Samaritan Society conference speaker

Mark Parkinson, a former governor of Kansas with extensive experience in the nursing home sector, addressed the crowd at the Good Samaritan Society's Annual Operations Conference at the Sioux Falls Convention Center.

Former Kansas governor Mark Parkinson, one of the nation’s most respected voices in nursing home care, delivered counsel, encouragement and good news about the future to the Good Samaritan Society’s 2019 Annual Operations Conference.

Now the president and CEO of the American Health Care Association/National Center for Assisted Living, Parkinson founded and developed facilities offering skilled nursing care, assisted living and dementia-related care in Missouri and Kansas prior to moving into politics full-time.

So when Parkinson addressed a crowd of 350 at the Sioux Falls Convention Center, he brought big-picture analysis. He accompanied it with a sensitivity to the challenges of providers on the front lines.

This was Parkinson’s first opportunity to speak to Good Samaritan Society members as a group since the Society’s affiliation with Sanford Health in January. He was also part of a panel discussion that included former Utah governor and Secretary of Health and Human Services Mike Leavitt at the conference, which attracted more than 400 attendees over its five days in Sioux Falls.

“With the new payment models and population health management, it makes a lot of sense to partner,” Parkinson said. “It may prove to be a way to keep rural buildings open and alive and vibrant. The whole health system is watching the Sanford-Good Samaritan Society alliance to see what happens.”

Changes coming

Parkinson’s address at the conference touched on obstacles the Good Samaritan Society and others in the nursing home sector have been up against the last decade. He also talked about how innovative operators are dealing with those challenges.

One of the most significant incoming changes involves a new payment system to be instituted nationwide. This would determine how providers are compensated for patient care. While it’s not a conversion process making national headlines, it’s a transformational change within the nursing home sector.

When asked to list a few of the top concerns facing the sector for the extended future, the Patient-Driven Payment Model (PDPM) was at the top of the list. To implement the new model Oct. 1 nationwide, providers need to be prepared.

“It’s not a minor alteration of the current system. It’s a completely brand new system,” Parkinson said. “And so we’re doing everything we can to make sure that CMS (Centers for Medicare and Medicaid Services) gets it right and that the rules and regulations are issued in a way that will help our members and help our residents. Members need to be doing a really good job of being ready.”

Confronting challenges

It’s not the only item on Parkinson’s AHCA/NCAL agenda for the extended future, however.

“The second thing that we consistently hear across the country is dealing with the labor shortage,” Parkinson said. “It’s just hard to find workers anywhere in the country. Buildings are really struggling with that.”

AHCA represents more than 13,500 members providing care for more than 1 million individuals. Parkinson said the group is devoting significant attention to achieving a more sensible regulatory system.

“The third thing that impacts people is the onerous regulations we are under,” Parkinson said. “We’re the most regulated sector in the country. In some states, the enforcement regulations are worse than some others. That’s a topic that is on a lot of our members’ minds.”

Rural obstacles

Of special concern is the future financial viability of long-term, skilled care in rural locations. In short, the system doesn’t work quite like it used to, or how it should.

“It is really hard to succeed as a small, rural building,” Parkinson said. “The reimbursement systems that existed in the ’70s, ’80s and ’90s worked well for small, rural facilities because we were able to get paid for our costs and a little bit above that. But since the costs-plus systems have all gone away, it’s really, really hard for a rural facility to succeed.”

Parkinson pointed toward public health management and creating in-house insurance products as ways to minimize the inherent obstacles involved.

“I think the Sanford-Good Samaritan alliance helps because you’re able to create some efficiencies with your buying and with your various systems,” Parkinson said. “Running a rural building is going to be hard anywhere with any company. But you’re probably in a little better position than the average operator.”

Mission and metrics

Parkinson was recently named a 2019 top CEO by The Washington Post as part of its annual Top Workplace survey.

In an interview with The Washington Post, Parkinson emphasized that as president and CEO of a nonprofit organization, he has tried to combine mission and metrics.

He sees a lot of the former in his work with the AHCA/NCAL membership but the metrics often fall short.

“Private business really understands the power of metrics — the power of creating objective, numeric-based goals and incentivizing people to achieve those goals,” Parkinson said. “But often private business doesn’t get the mission part. They get so focused on the numbers and all that that they lose track of why they’re doing what they’re doing.”

If you can combine the two, Parkinson said, “you have something very powerful.”

“It’s clear to me that if you analyze Sanford and Good Samaritan, you have very dynamic leadership,” he said. “They completely understand the power of mission and metrics. I’m sure I can learn a lot from them and what they’re doing.”

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