Transcript Generated by AI 00:03 Hey Mark Parkinson back with Park Place, and we're continuing to 00:06 do our analysis of Florida and trying to figure out is 00:10 Florida a good state to operate in or not. 00:12 And we're joined by an operator who I think can give 00:16 us some tremendous insights because Kim Biegasiewicz has been involved in 00:19 every part of the long-term care profession. She started out on 00:22 the clinical side as a registered nurse, she became a DON, 00:26 she then became a licensed nursing home administrator, 00:28 and she is now the CEO of Avante. 00:31 Which is a company that has 11 SNFs throughout Florida. 00:34 On top of that, she's also the chair of the Florida 00:37 Nursing Home Administrators Board, a gubernatorial appointment. And on top of 00:40 that, last week she received an award for the top lobbying 00:44 effort for a Florida provider, the Arthur Harris Government Services Award. 00:47 In short, Kim has done it all, and we're delighted to 00:50 have her with us here today. Kim, welcome to Park Place. 00:54 Thank you so much for having me, Mark. 00:56 It's really great to have somebody with your broad view of 00:58 the whole sector. So when you think about operating in Florida, 01:01 and I know you've come at it from the clinical angle, 01:04 from the leadership angle, from the government affairs angle, 01:06 what are some of the first things that come into your 01:09 mind about operating in Florida? 01:10 Really, I think Florida is such a unique state and really 01:14 a special state to operate in. I think we are a 01:17 very forward-thinking state, leading the way in innovation and technology and 01:20 looking at enhancements for efficiency for the care that we're providing 01:23 to our most vulnerable population here in the state of Florida. 01:26 So I'd like to think that we are ahead of the 01:30 curve, always willing to push the envelope in terms of new 01:33 ideas and new processes to make us bigger and better and 01:36 enhance our quality. and I think that's really what makes us 01:39 stand out as an operator across the United States. 01:42 Right. Yeah. You know, one of the things we always talk 01:45 about when we look at a state is reimbursement, 01:47 and reimbursement is tough, you know, in every state. 01:50 How would you assess it in Florida? 01:51 You know, I really think that Florida does it right. 01:55 Florida really has a big focus on quality tied into especially 01:59 Medicaid reimbursement and reimbursement rates. and if we look at our 02:02 Florida quality improvement program here in the state, 02:05 there is massive opportunities for increased revenue. the average state points 02:09 across the state of Florida is 25, which really equates to 02:13 about $37.50 per add-on for those particular patients. 02:15 And that equates to almost a million dollars in additional revenue 02:19 if a provider is performing to that average threshold. 02:22 So you can see that they're really incentivizing us to put 02:26 efforts and initiatives into enhancing our quality, really rewarding the good 02:30 actors and making sure that those good actors are financially reimbursed 02:33 for the care that they're providing so they can continue to 02:37 enhance their quality. I think it makes sense. 02:40 I think it's what the state should be known about, 02:43 known for and known about is about a state that is 02:47 focused on quality improvements for our elderly. and I think that's 02:51 what really sets us apart and that gives us a huge 02:54 opportunity from a financial aspect to really drive those reimbursement rates, 02:58 you know, based on how we're performing. 03:01 Yeah, and when you link reimbursement to quality like you've done 03:02 in Florida, it makes it such an easier sell to the 03:03 legislature because you're basically saying, Well you give us the funds 03:05 if we do a great job. If we don't do a 03:06 great job, don't give us the funding. 03:07 Correct. 03:13 Yeah, I mean any any representative that's representing, you know, 03:15 a state representative, whether that's on the legislative side or the 03:19 House side or the Senate side, they all want the same 03:22 thing when they're talking about nursing homes. They want good quality 03:25 care to the residents of Florida. and so when we're proposing 03:28 additional increases to our reimbursement, it's easy to have that conversation 03:31 and say, hey, the money that you're giving us is going 03:34 directly to providers that are already investing in quality. 03:37 And we'll continue to invest in quality with those additional funds. 03:40 So I think that's a huge easy sell. 03:42 And it's our commitment too to the state. 03:45 It's our commitment as providers to continue to always raise the 03:48 bar and increase our quality initiatives to really enhance that care 03:51 that's being provided. 03:52 Okay, I can see why you won the government service award. 03:53 You've convinced me with your arguments already. But let let's talk 03:53 about the regulatory side. I it again, very, 03:54 very challenging across the country. How would you describe the environment 03:54 as well? 03:54 Yeah. 04:03 Sure. I mean, I think we all have our challenges. 04:06 like every state would probably have their own unique challenges. 04:09 But I think what is beneficial for us as a state 04:12 is that we really have good communication and good transparency with 04:16 our state regulatory body. we have good open communication and transparent 04:19 communication with the heads of our regulatory bodies, 04:22 which really allows for us to have those tough conversations and 04:25 look at ways that we can maybe come together and partner. 04:29 At the end of the day, they want the same thing. 04:32 They want good outcomes. We want good outcomes as providers. 04:35 And it's understanding how do we get there and what can 04:39 we put into place that obviously makes our jobs as providers 04:42 easier, but still holds us to that same level of accountability 04:46 with the regulatory body. So I think that's what's really important 04:49 for us here is we really have those open lines of 04:53 communication with Kim Smoke and and our secretary of the Agency 04:56 for Healthcare Administration, Secretary Harris. Just that opportunity to have transparent, 04:59 honest conversations, but also come solution oriented so that we can 05:03 bring solutions to the table that work for the regulatory body, 05:06 but also work for the provider as well. 05:09 Yeah. Now, like every state, Florida got crushed in census shortly 05:12 after the pandemic started. But as I look at the data, 05:15 it looks like things have basically recovered. Is that right? 05:18 Yeah, I would say across the state, we as an industry, 05:22 we have leveled back out with occupancy and census, 05:25 which is refreshing and reassuring as we continue to navigate post-COVID. 05:28 you know, I think Florida is unique in the sense that 05:32 our population is obviously of more of the elderly population. 05:35 We're retirement communities all over the place. So we have a 05:39 lot of elderly population here in the state of Florida. 05:42 So that's great for our census and our census development. 05:45 But yeah, really happy to say that as a state, 05:49 we have levelized from a census perspective and continue to see 05:52 improvements in the overall skill mix and the overall occupancy for 05:56 the centers. 05:57 Well, this is a great report. And you know, 05:59 one of the things I'll I'll comment on towards the end 06:02 of our conversation here is that obviously Florida's a red state. 06:05 You've got a Republican governor, Republican legislature, and we hear from 06:08 a lot of red states across the country that they just 06:11 can't get the Medicaid reimbursement that they want. You know, 06:13 just there aren't good states to operate in. 06:15 What do you attribute the success of Florida to? 06:18 How have you overcome that? 06:19 Yeah, so we are actively involved with our legislature and talking 06:22 to our House and Senate and Governor to have those communications 06:25 about our industry. And that starts with a couple of different 06:29 things. One, we have an organization called Our Florida Promise, 06:31 which is essentially our political advocacy group at the CEO owner 06:35 level, where we as CEOs and owners are getting together to 06:38 talk about key issues and strategizing how to communicate exactly what 06:41 we are doing as providers out here in the field. 06:44 And how do we articulate that to the government so that 06:47 they understand the importance of funding and the importance of the 06:50 support of different programs to enhance our operations? 06:53 And then we do something at more of the line level 06:56 where owners and CEOs still participate, but we invite all of 06:59 our leadership from the facilities up to Tallahassee to participate in 07:02 what we call Lobby Wednesday, where we are telling our story. 07:05 We're meeting with the House and the Senate and we're telling 07:09 the stories of long-term care and all of the wonderful things 07:12 that our caregivers are doing on a daily basis to really 07:15 paint the picture of the good that's occurring in the industry. 07:18 And then we have of course our ask, you know, 07:21 our reimbursement ask and maybe some of our policy ask that 07:24 we are asking to enhance our industry and our profession. 07:27 But I think that presence, that presence at the Capitol, 07:30 the presence in front of our key leadership in the state 07:33 is instrumental because they know us. They trust us. 07:36 They know that we're going to come with good information. 07:39 We also invite them into our centers to tour our centers 07:42 on our routine patterns so that they are seeing it live 07:45 and in real color, exactly what happens in a nursing home. 07:49 You know, we have a lot of unfortunately negative connotations that 07:52 are associated with nursing homes. And so it's really important for 07:55 them to see that care being delivered on the front line 07:58 to really understand we're trying, we're doing the right thing. 08:01 That's always our intention is to do the right thing. 08:04 and come see it and come live it because once you 08:07 do. you join in that passion and you join in that 08:10 love for long-term care. And that's really where our success has 08:14 been in that collaboration with our key leaders across the state. 08:17 And and I and I think all of this is pulled 08:17 together by a great association led by a really good leader 08:18 in Emmett Reed, who I'm just going to give a shout-out. 08:19 He's done a great job of pulling all this together. Well, 08:19 Kim, thank you so much for giving us all of these 08:20 insights. And it's encouraging to know that things are going, 08:21 you know, as well as they are. It's certainly not perfect 08:21 anywhere, but Florida is such a critical state to the country 08:22 and to the profession that it's great to great to get 08:23 this report. And Kim, thanks for all that you've done. 08:23 Really great. 08:23 Sure, absolutely. Absolutely. 08:45 Absolutely. It's my honor and it's my honor to serve here 08:48 in Florida. I I really appreciate what we do here. 08:51 we have a great association, great providers and great leaders across 08:54 the state. And I think we're gonna continue to raise the 08:58 bar and continue to surprise people with the wonderful things that 09:01 we're achieving here in Florida. 09:02 Terrific. Well, thank you very much. And thank all of you 09:05 for watching and for your continued support of Park Place.
