For at least the last decade Consulate Health Care was considered a skilled nursing giant. The long-term care provider at one point had 208 buildings across 21 different states, and was the largest nursing home provider in Florida.
Consulate has been through its fair share of ups and downs, including a bankruptcy filing and a financial settlement with the Department of Justice. In December of last year, the skilled nursing provider underwent a significant downsizing – now only managing about 60 centers across five states.
Consulate currently operates in Pennsylvania, Virginia, North Carolina, Mississippi and Louisiana. All Consulate-managed facilities in the state of Florida were either sold or moved to a different provider.
At the same time, several former executives at Consulate – including former CEO Chris Bryson, COO Tim Lehner, CFO Greg Hayes and CNO Andi Clark – made the move to join newly formed Atlanta-based Synergy Health Care Services.
With restructuring comes new leadership – and Consulate’s new CEO Jeron Walker took the helm in December 2021. Walker began his career in long-term care 23 years ago as an administrator-in-training after graduating college.
Walker, a licensed nursing home administrator, served as Consulate’s mid-Atlantic division president before stepping into the new role. He’s also served in leadership positions at Windsor Healthcare and Life Care Centers of America.
Walker told Skilled Nursing News that his understanding of the importance of building relationships at the local level has allowed him to create a set of goals that he hopes will reshape what people think about Consulate, and what residents and families experience under their care.
“Our smaller footprint has allowed us to adjust our structure so the local market is the focus. I go around when I’m visiting our centers and I tell our executive directors all the time: I work for you. I am a shovel, put me to work,” he told SNN.
“This is the approach that I take and it’s allowing our centers within each market to share what they need to be successful, and then let me and my team work on those areas so they can focus on quality and connection within the center,” he added.
Leadership is key
One of the first positions Walker added to the newly formed team was Chief Leadership Officer Robin Baschnagel. The position tasks Baschnagel with cultivating and enhancing Consulate’s leadership at every level.
Consulate developed a “really robust” preceptor and administrator-in-training program, as well as a new initiative set to start this fall called the Consulate Leadership University. A select number of executive director and chief nursing officer applicants are chosen to participate in the yearlong program, he said.
“Leadership is key to our company, it’s key to me. To me it’s always, where we have excellent leaders in our buildings, we tend to have excellent outcomes,” Walker told SNN.
Walker said these programs are part of Consulate’s new core set of values, which includes creating connection and teamwork, helping leaders enhance their skills, accountability and trust at the local levels and working with an attention to detail that promotes excellence in every building.
Given the challenging state of hiring and retaining all levels of nursing home facility staff, Walker recognizes the importance in finding more personalized ways to connect with employees.
Consulate’s Transitional Health Services of Kannapolis facility in North Carolina was able to eliminate agency usage in just a few months through its executive director’s strategy to personalize the hiring experience of every new employee.
Executive Director Shawnna Fairman conducts every interview at the Kannapolis skilled nursing facility to get to know future employees on a personal level, Walker said. On their first day of employment, the goal is to connect them to the building and show them their value from the very beginning.
A mentor is also assigned who has a vested interest in their team member being successful.
“When a leader commits to hiring their own staff, creating their own positive experiences that connect them to the center, we see some great things happening as far as reducing dependence on agency,” he said.
And while it’s a program Walker said he’d love to see every center implement, he understands that taking a market-first approach means the ideas need to come from the centers themselves.
For example, one unique aspect of Kannapolis is the local connection to NASCAR.
“They’re taking pieces of that NASCAR component and racing … that becomes part of their culture and part of their onboarding and part of the personality of those centers,” he said.
In conjunction with onboarding staff, Consulate has also instituted a “care plan” for new staff members, not entirely different from the approach with new residents.
These care plans, according to Walker, allow the building’s leaders to know how to best approach and help a staff member be successful.
“When we have a vested interest in them, when they know that we value them, retention skyrockets, morale improves and ultimately quality of care improves as well,” Walker said.
And while nearly every long-term care position is hard to fill, health care certified nurses and certified nursing assistants (CNAs) are in particularly short supply, according to Walker.
Since the start of the pandemic, the skilled nursing industry has lost 241,000 workers, or 15.2% of its total workforce. Most recently, according to a Seniorly analysis, 25% of facilities in the US report staff shortages in 2022, up from 16% in 2021.
Staffing shortages have played a role in occupancy recovery, Walker said. While declining to give specific percentages, Walker noted that Consulate’s occupancy continues to grow but “probably not at the pace that we would like.”
“We have centers that are fully occupied and those that have a ways to go with that … everybody’s at varying phases of emerging from the latest variants of Covid as well and that’s dictated some of that growth,” he added.
‘Somewhat outraged’ by Biden’s message on nursing home reform
Like many skilled nursing leaders, Walker feels the Biden administration’s reform proposals around more severe penalties and fines, and the mandating of minimum staffing, are “way off base and out of touch.”
Walker pointed to the ways in which the nursing home profession has improved resident quality, including reducing hospitalization rates, lowering the use of unnecessary antipsychotic medication and more individualized care.
“We would love to hire more nurses and nurse aides, and as I discussed earlier, we’re working hard to do so,” Walker said. “However, we can’t meet additional staffing requirements when we continue to struggle to find people to fill open positions that we have now.”
The White House rolled out a comprehensive set of intended nursing home reforms at the end of February, aiming to “crack down on bad actors.”
The reforms surrounding a federal staffing minimum remain a high priority for the Centers for Medicare & Medicaid Services (CMS) – the government agency tasked with conducting a study and releasing a proposed standard within one year.
“When we think about quality, what we’ve heard over and over is staffing, and we’ve heard that from residents – speaking directly to them – we’ve heard that from staff,” CMS Administrator Chiquita Brooks-LaSure told SNN.
While Walker does not believe the ability to provide quality care should be dictated by a staffing minimum, if such standards were in place and funded appropriately, he could understand how that could be successful.
The bigger issue surrounds the need for policymakers to invest in “chronically underfunded health care sector,” he said.
Consulate remains an active participant in each of the state associations across its markets, including by giving facility tours to state and local government officials.
“I feel like this is an area, Medicaid reimbursement or any reimbursement for that matter, that impact is made at the local level. When we connect and we build relationships with our policymakers at the local level, and they’re able to understand our story, I feel like we will make some traction in improving Medicaid reimbursements in the future,” he said.
Companies featured in this article:
Centers for Medicare & Medicaid Services, CMS, Consulate Health Care
