The Evangelical Lutheran Good Samaritan Society kicked off the New Year with a familiar face as Nathan Schema took the helm as the company’s top executive.

Schema assumed the role on Jan. 1 following CEO Randy Bury’s retirement announcement effective Dec. 31.

His career in long-term care began 15 years ago when he joined Good Samaritan’s administrator-in-training program in Mountain Lake, Minn. He went on to work as a nursing home administrator and associate director of operations. Prior to taking on the role as president and CEO, Schema served as Good Samaritan’s vice president of operations.

Schema’s plans in the new role – as the non-profit giant enters its 100th year as an organization – includes bringing on more than 250 international nurses in 2023 through a partnership with placement company Connectics USA, further developing its partnership with Sanford Health and finding creative ways to make the work of long-term care staff “more sexy.”

He spoke with Skilled Nursing News last week on his goals and where the long-term care industry might be headed, in a conversation that has been edited for length and clarity.

What are some of your goals for this year? In light of the upcoming 100th anniversary, what are you guys thinking about 2022?

We’ve got a lot of exciting things on the horizon. I think it always comes back to three things for us. I think that it’s making sure that we continue forward with our safe culture and really … developing a highly reliable culture.

I think the second one is pretty obvious in what our priorities are around staffing and really investing in our people. Our people are the core and the heartbeat of our organization, and it’s just absolutely critical that we find others that share those same values and have the same passion for serving and the same passion for our mission. You know obviously we’ve been around for nearly 100 years and we’re gonna be here for 100 more … We need more folks that are dedicated to service and lead with their hearts, and find that calling just like I do within this industry.

Then thirdly it all comes back to how do we continue to grow? How do we bring and instill confidence back within the general public? Confidence has been really, it’s been really shaken here over the last couple years through COVID. While we believe we’re one of the safest places you can possibly be – and we’ve got all the measures in place, we’ve got all the tools to be successful and care for people safely – we want to get that message out. So one of our goals here moving into 2022 is to continue to build upon that message and make sure that we bring more people back to the Good Samaritan Society.

You talked about bringing workers in, what specifically is Good Samaritan planning to do and what are some of the plans to curb some of these shortages and bring [in] some more staffing?

Well it’s not a silver bullet but one of the things I’m excited about is we’ve been working really closely with an organization to bring over 250 international nurses into the Good Samaritan Society beginning in 2023. While we’ve done and we’ve dabbled in this over the last couple of years, we believe it’s a huge opportunity for us to really bolster many of our communities that are just struggling to find people. So we think that that is one area that we’re going to focus on.

I think the other piece is we have to think about our work differently. I think back 25 years ago when I first started in the workforce and was flipping burgers at the A&W, I was hungry for every single hour that came my way. Well this new workforce is, quite frankly, not motivated by money, maybe the same way that I was when I started. They’re looking for, ‘how do I get a little bit more time with my family? How can I get a little bit more time to go take that trip and travel?’

So we’re really focused on scaling up programs that allow our leaders and allow our frontline team members to have a little bit more flexibility in the work – maybe creating some unique shifts, unique positions. Maybe it’s even allowing our director of nursing or our administrators to work four days a week, maybe it’s creating some other positions just to augment that work life balance a little bit differently than we have in the past. We know our people, again, continue to be the core and the cornerstone of everything that we do to provide care so we have to be able to think about this differently than we have in the past.

I think it’s important that we make this work fun too. I think, as a leader in a building, or certainly now as a leader in a different place in the organization, I think it’s always so important to have fun.

I think we have to continue to seek out the little idiosyncrasies that might happen in your day, and truly figure out how to make this work a little bit more sexy. I say that not to be funny, and not just to be provocative, but the long-term care industry isn’t maybe something that we all grew up and thought, ‘you know what, hey, I want to go be a nurse in a nursing home. Or I want to be a nursing home administrator.’ But what I think people sometimes forget is, you know, one the work is just so incredibly important and valuable .… I think it is such a rewarding profession, but I think you can also have a lot of fun.

I think you’re going to see a lot of innovation come into space in the next few years as well – some of it driven by the lack of staffing, some of it driven by the need to integrate technology much more seamlessly than has been done in the past.

Where do you think some of that innovation will come from?

Specifically one of the things that I’m excited about for 2022 is a platform that we often talk about as being this interoperability platform. Essentially what that allows us to do is to share information seamlessly from the hospital to a nursing home, a hospital to assisted living, home health, etc. We know it’s critically important that the right information gets to the right place at the right time.

I think what it also allows us to do, and again I keep coming back to what maybe it does for our staff members, but it saves them a bunch of time. If they don’t have to go rewrite all those orders and pull it off the fax machine and call back the physician it definitely propels us forward. So we piloted a couple interoperability sites here in late 2021, and we’re looking forward to expanding that into 2022.

I think the other things that I’m excited about, again being a part of an integrated health system, is our virtual care strategy and our virtual hospital. Our biggest benefactor, Denny Sanford, gave $350 million to our organization in 2021 for a virtual hospital and a virtual care strategy. I’m excited about what that’s going to mean for rural health and specifically what that’s going to mean for our ability to connect to specialties across our footprint. I think the ability to connect into our virtual care command center is really going to be a game changer for our ability to get people the right care without having to travel miles and miles. I think it’s a game changer for us.

What are your plans for the next year in terms of retaining and recruiting staff as you await the group that is coming in 2023?

One of the things that we’ve been really intentional about is how do we beef up our advocacy presence to drive funding to then be able to compete in any market, any space, any state. Right now we’ve been fortunate enough to see some increases by 6% from some of our states. But you and I both know, if you go to a Jimmy John’s or any restaurant right now, that sandwich has gone up a heck of a lot more than 6%. They’re just passing it right on to their workers and without that same type of investment into long-term care, it’s really difficult for us to do that same thing and be viable.

So we’ve certainly gotten creative with national hiring days and in trying to get people hired quicker; we tried to take a non-traditional approach and invite people back into the workforce that maybe are doing some other different things. But I’ll be the first to say that I don’t know that there’s a silver bullet on this front and we’re going to continue to work with universities and colleges all over the nation to try to build that pipeline but it’s going to take time, and I think 2022 is going to be kind of a tough year.

I know this was in the news last month and we actually spoke with the Nebraska Health Care Association president [about some of the closures taking place in the state, including two Good Samaritan facilities]. Are there any future closures planned right now, and what are the future plans for growth? How might that be affected by the latest staffing issues that you, and frankly the entire industry, are seeing?

I would love to be able to tell you that we’re going to be in all these communities for another 100 years, but I think the reality is things continue to move and change and we see some of these communities where we have plenty of residents to serve but we don’t have enough people, we don’t have enough staff – and that is the harsh reality of it.

So without some fundamental systemic changes within the industry that would help us compete at a much different level for staff, I’m afraid that we’re going to see more of these types of things on the horizon within our industry.

Where is Good Samaritan positioning itself, especially with its partnership with Sanford Health, to stand out and to survive and thrive in 2022 and beyond?

I think fundamentally we’re here to serve our communities and our people wherever they need the care, and I think you’re seeing that and feeling that; you’re hearing that in the strategies that we’re deploying with our virtual hospital and our virtual command center. We’re hopeful that our people are going to be able to stay right in their communities, whether they’re in a town of 400 people in North Dakota, or in a large community like Fargo or Sioux Falls. So definitely that remains core to our strategy moving forward.

I think the other piece that I see on the horizon is while so many people would love to stay in their home indefinitely, I believe there’s always going to be a place for long-term care. That might look different than it does today. Certainly I think as an industry we need to continue to move toward, again with the right appropriate reimbursement strategies in place, how do we move even quicker to all private rooms and how do we upgrade our infrastructure so we can meet the needs and wants of those seniors of tomorrow. I think that’s going to be challenging but I think we’re up to it.

I think third year we’re going to continue to see innovation like our dialysis den, where we’re not traipsing people all over our communities getting them to and from dialysis. So I do feel that the future is very bright, the care will continue to change, our buildings are going to continue to change, but it’s not going to be done in a silo. Certainly I feel like we’re well positioned as a large integrated health system but we’re going to certainly need to partner with our states and the federal government to transform what care looks like in the future.