When Ivy Healthcare Group looks to expands its geographic footprint — as it is now coming out of COVID — that conversation always starts with reimbursement.
After acquiring its first assisted living facility in 2018, Ivy Healthcare Group added its first skilled nursing facility in 2019 where it developed an affinity for the sector. It has since grown to nine facilities total, eight SNF and one assisted living, in Iowa, Montana, North Carolina, Florida and South Carolina.
“Some SNFs have still maintained really good margins,” President Ryan Coane told Skilled Nursing News. “We’re looking to put our name more out there. Right now we’re at that nine mark and we really want to get to ten.”
Coane said that decisions are made to expand by first understanding the state’s Medicaid reimbursement since most of Ivy’s residents are Medicaid payers.
“Some of the sites we are not as much of a fan of but we’re definitely open to new opportunities,” he said. “We want to expand our footprint probably in Montana and the Carolinas.”
Coane determines if a facility fits into Ivy’s long-term plan first by looking at its upside. With some buyers paying record-setting prices for SNFs, culminating in prices that are $17,000 more per bed compared to 2020, Coane is looking to the future more than the past as he approaches the SNF market.
“If I’m paying X amount per bed I want to know where I can go with it,” he added.
Coane said he acquired a facility in May after seeing the upside the deal had if he was able to cut agency staff out.
He, like many operators, often find himself competing with agencies for a shrinking staffing pool as he’s been forced to pay up to $100 an hour for registered nurses, though he’s been more successful keeping agency staff out lately.
“We have a really good team that provides stable staffing to our facility. With more guidance, consulting and management we are able to take on agency facilities and provide more stable staffing,” he added.
One way he’s looked to make life easier at his facilities for staff is through technology.
All of his facilities now offer “restore skills” therapy, which uses interactive therapeutic video games to help patients work on their balance, range of motion and more.
“With CMP funds we’ve been able to provide different iPads and tablets for video conferencing,” he added.
Still Ivy has had to put admission holds at some of its facilities due to staffing shortages.
“That’s been an issue in some places,” Coane said. “We’re offering a lot of different benefits to people like reimbursement for tuition and we started talking about gas cards to get people to work because that’s been part of the issue too. We’re talking about getting some food staples or household staples to help as well.”
As it looks for further expansion, finding ways to bring in more short-term stay residents has become a point of emphasis for Ivy coming out of COVID.
“For nursing homes to be sustainable you have to have both long-term and short-term stay,” Coane said. “So we’re trying to get a number of short stay residents who want to have a nice rehab area. A number of facilities have low Medicare reimbursement rates and our question is why is it like that and how can we help better provide services to the community.”
Companies featured in this article:
