Future Leader: Justin DiRezze, CEO, Theoria Medical x 5-Star Telemed

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 senior housing, skilled nursing, home health, and hospice care. To see this year’s future leaders, visit Future Leaders online.

Justin DiRezze, CEO at Theoria Medical x 5-Star Telemed, has been named a 2020 Future Leader by Aging Media Network, SNN’s parent company.

To become a Future Leader, an individual is nominated by their peers. The candidate must be a high-performing employee who is 40-years-old or younger, a passionate worker who knows how to put vision into action, and an advocate for seniors, and the committed professionals who ensure their well-being.

DiRezze sat down with Skilled Nursing News to talk about how he came to skilled nursing, and why focusing on patient needs to be the center of post-acute care’s future.

What drew you to this industry?

I accepted a job at an Ascension hospital — I was trained at Ascension — and then I accepted a job at Ascension Genesis, in hospitalist medicine. I became chief hospitalist and was able to improve a lot of the metrics; I decreased length of stay and decreased readmission inpatient.

But really to dive down and get into the return to hospitalization from post-acute, I didn’t have a solution at that time for it. There was a facility that was opening up near the hospital, and the group that was opening it approached the hospital and was looking for a medical director.

Even as a resident, I always had the notion that the second I discharge this patient to post-acute, the physician’s there immediately and they’re seeing the patient and they’re doing an evaluation. I had this false sense of sense of security when I was sending patients to post-acute care facilities. I never fully understood why they would come back, because how does the patient come back if there’s a physician there all the time?

Well, we both know that’s not how it is in post-acute. Sometimes these patients, in great facilities, they may be seen in 24 hours, but in facilities where you have lack of physician presence, sometimes those patients aren’t seen for days. So I took that opportunity when it was offered to me to become a medical director. Within three months of me taking the first facility, I was asked to take another facility, I took on that facility. Then maybe eight months later, seven months later, I took another three facilities. Fast forward 14 months later, and we’re the largest post-acute care group in Michigan.

If there’s one thing that you could change as you look to the future of skilled nursing, what would it be and why?

There was a misconception in the past that SNFs are just a place that people go for rehab. And that’s not true. SNFs take care of seriously ill patients. So one thing I want the medical community to understand is that SNFs are beyond just a rehab facility. It’s where acutely ill patients go.

For example, the amount of CHF [congestive heart failure] patients and COPD [chronic obstructive pulmonary disease] patients that we get in the facilities is significant, and the reason being is because along with multiple chronic comorbidities comes the fact that you’re more likely to become debilitated during your acute stay in the hospital. So these patients are high-risk for rehospitalization. And it’s absolutely necessary that these patients are taken care of to ensure that they don’t decompensate and end up back in the hospital.

Our goal as a group is to A) make that transition as safe as possible so that we don’t prolong their stay within the facility, B) make sure that they stay out of the hospital in a safe environment after being discharged from an acute hospital, and then C) make sure that they transition home with the appropriate care and also supervision to ensure that they don’t end up back in the hospital.

What do you foresee as being different about skilled nursing and post-acute care as you look ahead to next year?

During the COVID pandemic, a lot of SNFs were used almost as a transition for COVID patients, so I think hospitals always realized the importance of SNFs. Hospitals are very compartmentalized, so they operate almost as pods. I think that it’s really come to light that SNFs are more than just a rehab facility. They are a place that can provide a healing environment for patients to get better when they are acutely decompensated and when they have acute issues that may further exacerbate or make it worse during the course of time.

So I have great faith that as 2021 rolls around, that SNFs will continue to be seen as a great next site of care not only for patients that “need rehab,” but for a next set of care for acutely ill patients, and basically be seen as an extension as an extension of the hospital, rather than as a place where completely stable patients need to go for rehab. I think through 2021, there’s going to be more of an emphasis on transition of care of sick patients. And I think the patients are not going to become more stable. I think we’re going to continue to see sicker patients simply because our population is getting older.

To learn more about the Future Leaders program, visit the Future Leaders homepage.

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