The Future Leaders Awards program is brought to you in partnership with PointClickCare. The program is designed to recognize up-and-coming industry members who are shaping the next decade of care delivery across the senior housing, skilled nursing, home health and hospice industries. To see this year’s future leaders, visit Future Leaders online.
Gina Bruno, vice president of value-based care at naviHealth, is a member of the 2020 Future Leaders class named by Skilled Nursing News’s parent company, Aging Media Network.
SNN’s Future Leaders represent some of the most dedicated and innovative young professionals shaping the next generation of post-acute and long-term care. Nominated by their peers, each of our honorees demonstrates a commitment to improving the lives of elders — and making the changes that skilled nursing will need to serve the seniors of tomorrow.
SNN sat down with Bruno to learn about her path into the industry, and where she wants to shape senior care in the years to come.
What drew you to work in post-acute and long-term care?
It’s funny, it wasn’t really until my early 30s that I put my own pieces together. Growing up, my grandfather, my mother’s father, was diagnosed with Pick’s [disease, a type of dementia] at age 50 and was admitted to a nursing home at 58. He spent six years in that nursing home before he passed away. When he went in, I was five, almost six, and my mother was really his primary caregiver. So I grew up in a nursing home.
I didn’t realize that that wasn’t a normal thing for a child to do until I hit my 30s and realized that there weren’t a lot of folks who shared that experience. As I reflected back — I had worked about a decade or so into my career — I thought about where I really wanted to make my impact. I thought a lot about that experience growing up — that experience at the bedside, washing someone, feeding someone, holding their hand, and speaking to someone who for years could never speak back.
I realized that I felt there was a place that I could give back with respect to senior care, long-term care. At the time, there was all of this innovation beginning to emerge out of the Affordable Care Act and health care in general, and it felt like the right time to make a choice that was sure as heck going to be be challenging, but was also going to give me a chance to honor my grandfather and honor that experience to help support other patients and other families.
What had you done prior to joining the industry?
I spent several years as a consultant in Washington, D.C. I worked on the public sector side, but worked primarily in homeland security and emergency management. So it’s a bit of a departure coming into health care. But what was interesting, as I looked back, is the common thread throughout was really work that focused on vulnerable individuals and vulnerable communities. My work in emergency preparedness was often around communities that perhaps lacked access to resources to truly prepare; very similarly, my work in this aspect of health care often deals with individuals and their loved ones who are in an incredibly vulnerable time, trying to find their way, find information, and support one another.
But it was quite a departure from what I had been doing before. I spent seven years or so in consulting, had a few other experiences along the way, and made the choice to go back to graduate school. That was really the pivot point from my previous career into the last five years now in health care.
What about it has made you want to stay and continue to build a career?
There are so few jobs that really let you get up every day and make a real meaningful impact on individuals and families and communities. It sounds really lofty, but I tell folks: This is an incredibly complicated industry. It is unforgiving in many ways. It is wonky and complex and things don’t make sense and incentives aren’t aligned — and yet we get up and we do it anyway.
To me, I do it because there is a patient like my grandfather. There is a caregiver like my mother. There’s a little kid like me who’s out there trying to navigate a system that is complicated and scary, and somehow sleep at night feeling like they’ve done the best for their loved one. And for me, if I’m in a position where I can help those families or help the caregivers that we employ, for example, that are serving those patients — that’s the greatest motivator, and I don’t know where else I could find that level of fulfillment.
What changes do you want to see — and perhaps help shape — in the wake of the COVID-19 crisis in post-acute and long-term care?
You’re absolutely right: Change is coming. What it looks like, how we shape it, remains to be seen in some ways.
COVID has elucidated a real concern around how we care for our loved ones. The headlines have talked about patients and residents at nursing homes, and the inability for their families to come and visit them — and the challenges that are then really exacerbated by social isolation and loneliness.
I think that you’re going to see some significant shift — both from the industry in how they more effectively engage the family caregiver, but also from the family caregiver as a consumer of health care, or a decision-maker in health care. I believe that we will see a much more active role for the family caregiver than we’ve seen before. We’ve always talked about it, and they’re always part of the care team. But I think we’re going to see that manifest in a very different way, in a much more active way, in the future.
I think that’s going to come hand-in-hand with one of the things that we’ve also seen through COVID, and that has been around patient goals of care. We have seen patients that have been vulnerable and higher-risk with respect to COVID come into the hospital, and there have been life-saving measures, ventilators, et cetera. You have to wonder whether the work has been done to determine what’s important to those patients, what decisions they would have made had they been able to make them prior to an emerging event like that.
That’s going to be another place where I believe we may be more ready for a conversation around advanced care planning, end-of-life care, palliative and hospice care, than we have before.
Perhaps it doesn’t have to be such a scary topic. We all will die one day — death and taxes, right? But I think really focusing in on what is important to patients when they come into a long-term care facility for the first time, and making sure that we honor and respect and update those patient goals — for me, it’s the part that’s probably the farthest reach in the work that I do, working with hospitals and health systems and post-acute providers and alternative payment models. But I think there’s room there, and room within these models in particular, to innovate and try new ways of engaging the family in that care plan, supporting the family at home, supporting the patients who may leave the facility and return to the community.
There’s just so much that can make that fabric richer, and I’m really excited that we may see something over the next five or so years that really strengthens the community around the patient and brings the care team together in a real sincere way, maybe more than we’ve seen in the past.
To learn more about the Future Leaders program, visit the Future Leaders homepage.