As the skilled nursing market continues to heat up with larger corporations adding smaller operations to their portfolio, Symphony Care Network launched a new division Monday designed to give small- to mid-sized skilled nursing facilities (SNFs) the tools and insight they need to not only survive but thrive post-COVID.

The launch is paired with a few changes at the top as its chief operating officer Michael Munter will be moving up to CEO. Symphony’s former CEO, David Hartman, will transition to executive chairman.

“I’m in a position right now where there’s so much coming my way that I need to free up my time to start to look for other opportunities to bring to the Symphony network,” Hartman told Skilled Nursing News. “With Michael’s incredible knowledge on the operations end of the business and his understanding of where the industry is going as a whole, I thought it was important for him to move to CEO to put his strategic mind to use on a broader level.”

Munter described his relationship with Hartman as a kind of yin and yang and said that the new roles will play to each other’s strengths.

Munter served as Symphony’s COO for nearly a decade, overseeing the company’s three state network of SNFs while Hartman served as CEO since 2014. During his time with Symphony he’s seen the company expand into Indiana and Michigan, growing it from 15 facilities to its current 30 locations.

Growing the Symphony Care Network

One goal for Symphony in 2021 and beyond will be to build out its new consulting division. Dubbed the Symphony Affiliated Network, the new consultative practice is designed to provide operational, financial, clinical and regulatory assistance services for operators that need it the most.

Hartman said as the sector looks to build back its census through hospital referrals, being part of a larger network will be essential for some of the smaller, mom-and-pop operations that seemingly are being pushed out in the modern post-acute care continuum.

“There are operators that don’t want to sell their businesses, they’ve been in business for 20, 30 years and they can’t walk away at this time,” Hartman explained. “However, they realize that there is value that can be created if they run more efficiently.”

Hartman indicated that could mean better marketing, improving clinical outcomes and creating more value in the building by bringing Symphony in as a management consultant.

“The ultimate goal here is to take these individual buildings and make them stronger and to give them tools and resources that they don’t have access to. It could be at various different levels,” he added.

Munter said that when an operator came to Symphony seeking help with declining census and market analysis, Symphony responded with recommendations backed with data.

One of those recommendations was to add inpatient dialysis, a growing trend in the industry.

Acquisition Growth

While Symphony is launching a consulting division for operators, Hartman said the organization remains committed to acquiring mom-and-pop operations and nonprofits, just as it’s done for the past 10 years, if the opportunity is there. 

“This is part of our growth strategy as well. We’re finding owner-operators who want to sell and have finally come to that point in their career where they are done but they don’t want to sell to a big corporation,” he said.

Hartman said Symphony will remain active in those deals while offering the affiliated network for those that aren’t interested in selling. He also indicated that some of the deals taking place in the SNF market have been higher than what Symphony would be willing to pay.

“We’re not going to chase crazy numbers,” he added.

Hartman said that Symphony wants to be aggressive but also smart with its growth.

“We’re not going to be the highest number, but we are going to come in and take over the property and make it better,” he said.

Munter predicted that by the end of next year heading into 2023 there will be quite a bit of distress in the industry.

“There are going to be transactions and so ahead of that one of our strategic plans is to raise a fund of equity in order to take advantage of that,” he added.

Munter said that he can’t say which states Symphony will move into but that the company will continue to be opportunistic and methodical with its investments.

While one third of nursing homes in the country are owned by regional operators like Genesis, Ensign and Sava, the other two thirds are family-owned and operated and that’s the “sweet spot” for Symphony, Munter added.

Still, recovery for Symphony has not been very easy across all its facilities.

“I would say the recovery has been spotty where some parts of our portfolio are hanging in there but we’re not seeing the growth that we would like to see and then there are others that are above pre-COVID levels,” Munter said.