Some skilled nursing providers have been wary of accountable care organizations (ACOs), payment and care delivery models that some fear will push more and more potential residents into home health care to save money.
But one East Coast operator has found success under the ACO model, and entered into a partnership with a third-party rehabilitation provider in part to bolster its existing relationships in the space.
The Brick, N.J.-based Marquis Health Services last week announced an alliance with Reliant Rehabilitation to provide services at Marquis’ 18 skilled nursing facilities across New Jersey, Massachusetts, Rhode Island, and Pennsylvania. The goal, according to Marquis CEO Norman Rokeach, is to provide consistent outcomes amid strict expectations from their ACOs.
“They want to see outcomes,” Rokeach told Skilled Nursing News. “They want to see length of stay shortened. They want to see rehospitalizations at the numbers they expect.”
Acting on discussions with other Reliant partners, Rokeach and Marquis decided to ink a deal with the Plano, Texas-based therapy provider to streamline its existing therapy programs, which Marquis designed in part to fit ACOs’ needs. For instance, Rokeach said his company developed therapy initiatives that focus on securing stroke certifications for therapists through training with neurologists, as well as a specific pulmonary rehabilitation program.
“We have great outcomes with ACOs,” he said. “We’re very privileged to be able to be involved with them. We aligned most of our plans to have the same shared outcomes as the ACOs.”
Under the ACO model, providers from across the care continuum work together to improve a single patient’s outcomes, splitting the Medicare reimbursements with an added goal of reducing total government coverage outlays. Some in the industry have worried that due to the inherently lower costs associated with in-home health care, ACOs would naturally work to push more residents from SNFs and into the home.
Indeed, ACOs led to a decline in SNF costs between 2013 and 2015, according to a recent report from the Centers for Medicare & Medicaid Services (CMS). But care quality also increased, and participation in an ACO could provide SNFs with a significant amount of free government data about competitors — which they can then use to improve their own business standing.
Expansion ahead at Marquis
The rehab partnership marks the start of an expansion plan at Marquis over the next year, though the company remained mum on the exact details.
“We’re looking to grow a healthy portfolio, and we think those opportunities will be there in 2018,” said Uri Kahanow, director of acquisitions for Marquis’ parent company, Tryko Partners.
Tryko owns and manages buildings in a variety of other spaces — including multi-family and affordable housing — but Kahanow said he and the other partners were drawn to the the hands-on care aspect of the SNF business.
“For those groups that do go into it just for the investment, it shows and it catches up to you,” he said. “This is not a world that you can just be in just to make a few dollars and move on. If your heart’s there, you’’ll be around for the long term, and if it’s not, you definitely won’t be.”
Since Marquis launched in 2011, Kahanow has been focused on more modern properties that still require some investments to upgrade — but that also don’t typically feature old-school layouts such as three- and four-person rooms. Tryko puts anywhere from $2.5 million to $7.5 million into each of the properties it purchases, Kahanow said, with the aim of developing a property that will remain fresh for a decade and beyond.
“We’ve been extremely picky and choosy to go into facilities that we feel we can be proud of, but yet bring it into the new age and adopt what residents are looking for — both in terms of resident care and aesthetics,” he said.
Written by Alex Spanko