Trilogy Health Services, one of the largest providers of skilled nursing and senior residences in the United States, aims to recoup 90% of pre-pandemic occupancy by the end of the year.
The Louisville-based company also pursues selective new developments and seeks to grow through its ancillary services business, while meeting workforce challenges through its continued investment in education and other programs. professional development and support, President and CEO Leigh Ann Barney said recently.
Trilogy operates a portfolio of over 110 retirement homes. The company was one of the largest SNF leaders in market share growth in Indiana, Kentucky, Michigan, and Ohio between Q2 2020 and Q3 2020.
This interview has been edited for length and clarity.
How will Trilogy Health seek to develop after COVID?
One way we seek to grow is through our ancillary company lines. We have a therapy business and a pharmacy, called Synchrony Health Services, and we’re starting a lab business.
Earlier this year, we brought our employees’ pharmacy in-house so they could get their medications by mail order from us.
We launched all of these lines of business to provide excellent service to our campuses and to be able to control the service. If a unique type of service arose or there were technological advancements, then we could control that through our ownership of these companies.
All of our entities that we currently have serve as third parties and have been able to build a business base outside of Trilogy. Our pharmacy only represents about 30% of Trilogy’s business, the rest of their business is outside of Trilogy. It’s a great way for us to increase our revenue, it’s cheaper than the development model of building new facilities, which we will continue to do, but it’s really more of a business approach to building new facilities. business and get contracts
What other trends are you seeing in the industry right now?
We will all be challenged to offer more private rooms than semi-private rooms. I think those with older facilities with mostly semi-private rooms will have a little more trouble.
Over the past few years we have spent time changing our design to have more private rooms.
I think post-COVID will see a lot more desire for private rooms.
Higher clinical acuity [is another trend we’ll see from SNFs].
We have the capacity, as an industry, to take care of the highest acuity patients; this is something that has been really proven during COVID.
The patient-centered payment model (PDPM) really focuses on paying for acuity under the SNF, so I think you will be challenged to adapt and change and be a resource for hospitals and other providers.
Home care now supports this lesser severity client, so we will have to adapt to take the higher severity patients from hospitals.
The American Health Care Association (AHCA) is currently push for legislation to help the industry, as a decline of 19,500 nursing and residential care jobs was reported in the May employment report. How does Trilogy Health deal with staff shortages?
I think everyone is struggling with staff shortages right now. I would say I think our revenue, even during the toughest time – which was our fourth quarter of last year – is probably lower than a lot of the rest of the industry. I saw 100% turnover figures, and we went from 40 to 40 in our turnover.
We have seen an increase, but not to the significance of more than 100 percent.
What are you doing to attract new employees and keep the staff in place?
Our biggest focus, and it was before the pandemic and it certainly is now, is our employee education programs. We run one of the largest apprenticeship programs in the country and it is a way for our employees to improve professionally and financially.
We have a very strong scholarship base, we offer student loan repayments, and we have our program with Purdue Global for college education. We’re using that as a tool versus something like a login bonus or something that would be a short-term attraction. We try to look at the longer term that we invest in these people.
Do you have any other programs to mention?
We have a lot of other great programs, we have a homeownership plan, and employees can save money and have it when they buy their first home.
I think that stuff shows that we care about them and care about them for the long haul. We hope this attracts employees and that they stay with us longer because they see these benefits.
Will you seek to build a universal direct care workforce that can work in multiple settings?
I wouldn’t say that we are necessarily looking for a universal worker, but we have opportunities through our employee learning program to take different courses.
Customer service is one of our programs, so anyone can participate. Regarding hospitality, our housekeeping staff can take the dementia learning course so that they are familiar with it as they are in the rooms treating residents.
And so this is a way for them, again, to educate themselves, but they get paid better for every course they take.
What does the success of the post-pandemic occupation look like to you?
We expect a return to pre-pandemic levels by the end of the year. We are seeing month-to-month growth.
We opened some campuses last year during COVID and I would say it was a mixed bag. Some have still seen very good occupancy rates and growth as you would expect from a startup, while others have been a bit slower.
Now that we have no more COVID in our buildings and are recovering, we are seeing those who were lagging behind, picking up. If you look at our same store, our goal would be to get back to 90% occupancy [by the end of the year].
Right now, we continue to see growth, but we’ll be careful in our reflections on what summer will be like.
How will you seek to attract more high acuity patients?
I think a greater reliance on technology and telehealth [is key].
We have a few partnerships in place now, but we’re looking at others and what they offer in terms of nurse practitioners on the staff.
Many of our physicians already provide us, in our more urban markets, with 24/7 access to nurse practitioners. But in our more rural markets where we don’t have this, we look more to the telehealth model for that.
And again, as I mentioned, educating our staff [is essential].
We’re trying to get more of our LPNs to become registered nurses, maybe more of our nursing assistants go into an LPN program.
We have a certified nurse in all of our locations and require infection control certifications, from COVID. Again, this investment in education helps us improve the level of clinical competence of our staff.
Do you expect regional consolidation of SNFs once federal aid dries up?
I think it’s probably safe to say that there will be consolidation. We have never been a very buying company. If you look at our history, our acquisitions have been small and very planned to fit our model.
We are primarily a development company and still have development plans for the next two years, but it’s not our history to make a big acquisition.
We like to enter into management contracts, so you might see us doing more as long as it strategically matches what we do.