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Prosper by recruiting workers using culture

During the pandemic, Nexus Health increased agency staff costs by a factor of 12 from $ 1 million a year in 2019 to about $ 12 million in 2020 and 2021, respectively.

Fran Curly

Today, the company has reduced or reduced its expensive code. Texas and Louisiana have no agency staff, and their reliance on Mississippi has dropped significantly.

Like the rest of the business, CEO Fran Kirley recognizes the culture by allowing the company to adopt, retain and improve its offerings to make nursing care work attractive.

“I don’t think people are putting enough effort into culture,” Curly said in an interview. McNight Long Term Care News last week. “We believe that the culture of our organization rewards action and promotes growth, education and support. We need to be a company where people want to work, be together and grow together. ..

“Our tenure reflects that,” he added. “Let my colleague tell me. I can’t steal from Nexion. I can’t recruit from you. That’s the biggest compliment to me.”

Nexion operates 48 skilled and two long-term care facilities in four states, some of whom are wholly owned and most of whom operate through leasehold agreements with Omega Healthcare Investors.

These figures include an early pandemic expansion to 13 Texas facilities formerly operated by Daybreak Venture. Despite two significant postponements, Daybreak was released by Omega after a significant delay in rent payments.

However, Maryland-based Nexion has boosted the census by 22% since its acquisition. Efforts to motivate staff and increase salaries, profits and promotion opportunities are crucial factors, Curly said.

“What we are doing is working,” he explained. “It’s reflected in the 13 buildings in Texas. We have stabilized and made them better. Our work makes people better, more successful, rewards and grows their actions, and Hopefully it’s a tough business, so it’s about reducing their stress. “

Commit to 5 Cs

Kirley founded Nexion in 2000. COOMeeraRiner has been with him from the beginning and has an average tenure of 16 years on the company’s senior leadership team. Among the local staff, the number is over 10 years.

COVID addressed Nexion many of the same challenges regarding frontline staffing, but the company was able to retain many of its managers and nursing managers. Their average tenure is 6 years.

Nationwide, providers stir an average of 1.2 managers annually, according to new data posted by the Medicare & Medicaid Service Center.

Curly said much of the success comes from a quality improvement process that involves developing leaders, surface issues and assessing them as part of their day-to-day operations.

Nexion uses the BaldrigeExcellence Framework, the same method used by the American HealthCare Association in its Quality Awards program, to identify weaknesses and build strengths. They operated the approach by creating working groups to overcome the problem by type when it occurred.

“When we started Nexion, we called it Five C: clinical outcomes, census, customer service, culture, and cash collection,” Curly explained. “These are five that have introduced the Boldridge process to maximize results in each of the five areas. This eliminates cash and customer service issues.

“If we receive a negative customer service response, everyone will find out what is the root cause of the problem. What’s wrong? What can we do to fix it? Did you lack communication? Inadequate training? We look in the mirror. “

Much of the data the company uses to inform its focus comes from powerful research programs. Nexion has partnered with Pinnacle Quality Insight to regularly survey the experience and satisfaction of its employees and residents.

This includes focusing on new employees invited to the survey at 15, 30, 45, 60, and 90 days. Approximately 40% of our employees participate, which is a much higher share than Pinnacle’s average in nursing homes.

Nexion uses personal-level information to provide further training and to intervene in dissatisfied employees. We also collect and analyze data by building across the brand to consider new strategies for increased engagement.

The response reaffirmed the company’s decision to strengthen its payroll and benefits package and its decision to launch a next-day payroll program of recent choice by more than 1,000 employees.

When Nexion took over 13 Texas facilities, it immediately offered upgraded benefits, including more competitive health insurance and 401K matches. Also, according to Curly, it was about getting employees into the culture early on, seeking what everyone needed, from maintenance to developing leaders, and meeting those needs.

“The culture of supporting our people was communicated prior to the acquisition and continues today,” said Curly, who has been involved in more than 500 acquisitions in his health care career. “As I always say, there are three most important things. No. 1: Always pay employees. No. 2 pays employees, No. 3 is No. 1 and No. 2. Make sure that is done correctly. “

Awareness boosts reputation

In addition to empowering its employees, Nexion has frequently pursued building certification.

As a result of that effort, AHCA awarded three Silver Quality Awards in 2022, two of which were awarded to nursing homes. Overall, Nexion has 57 bronze winners, 30 silver winners, and gold candidates.

The company selects candidates based on performance quality indicators and the ability to demonstrate how well Boldridge’s approach works in skilled nursing.

This year, Nexion is also pursuing recognition as a worthwhile company in the US News & World Report. This is a ranking that is considered another great way to recognize longevity and drive recruitment activities.

But the most important impetus for Curly’s perception is between the key to long-term financial sustainability and the legislators he sees.

Despite spending millions of dollars on agencies over the last two years, Texas operators haven’t seen a rise in Medicaid rates for seven years, not to mention the increased costs of regular staffing, PPE and inflation.

Louisiana and Mississippi offer at least annual adjustments, Curly said. Nexion operates in Texas, primarily thanks to additional payments earned through the state’s Quality Incentive Payment Program and a $ 19 COVID subsidy per day that expires in the event of a public health emergency. I was able to maintain.

Parliament will not be reconvened until January, but the former chairman of the AHCA Political Action Committee is inviting lawmakers for a visit to disseminate information about the complex care offered in today’s nursing homes. He is also part of a group of 13 large operators working in collaboration with advocacy.

“We predict that about $ 40 a day will be what we need to get as a rate adjustment in Texas to keep us overall,” Curly said. “If you have problems with the workforce, inflation, etc. and you don’t refund us, you can’t expect quality. We’re based on that and gaining momentum.”

Meanwhile, Nexion is trying to maintain its own momentum. Curly said he plans to sell Colorado’s only real estate in the short term and use the proceeds to complete a multi-site pickup with the company’s current footprint by the end of the third quarter.

“It’s all a strategic approach to making Nexion more economically viable. Adding things in the right places will enable us to be stronger and more capable economically. “He explained.