When it comes to recruiting and retaining nursing home staff, Chelsey Gray has taken a cue or two from her time in the tech world.

Prior to joining Revive Health Senior Care Management as an owner and chief transformation officer, Gray worked for a large government contracting firm and spent time as a data scientist.

From that time, and the realities of competing with the likes of large scale hotels and companies like Tesla, she’s realized the need for nursing home operators to innovate and offer less traditional benefits and perks as another way to fill commonly open positions.

“So we’re trying to think outside the box and a lot of that is bringing in kind of what the Bay Area tech companies have to offer just because I had a lot of exposure working with them,” Gray told Skilled Nursing News.

Gray now owns and manages three nursing homes in Nevada alongside Zachary Gray, her husband and Revive’s CEO.

The two purchased their first facility, Reno-based Alta Skilled Nursing and Rehabilitation Center, back in 2019, before taking on two more facilities this past February — Alpine Skilled Nursing and Rehabilitation Center in Reno and Wingfield Skilled Nursing and Rehabilitation Center in Sparks.

One of the ways Gray has tried to take their buildings to the next level, which has also served as a recruiting tool, is a move toward being as paperless as possible.

Not only was the move toward technology a no-brainer, Gray also recognized moving everything online would allow for continuation of operations which would, in turn, allow staff to take time off without worry.

Revive Health Senior Care Management also provides free vouchers for scrubs, housing subsidies, holiday gifts, a loan program for struggling staff members, enhanced health care benefits and sign-on bonuses, among other things.

Revive has also sponsored nurses from the Philippines, bringing on the first two during Covid, and hopes to do the same for certified nursing assistants.

As part of the company’s goal to build and keep strong ties to the community, Revive has an endowment at the University of Reno Nevada for local nursing students and one at Truckee Meadows Community College for certified nursing assistants. 

“We think that successful skilled nursing facilities need to recognize the role they play in the community and have super strong relationships with the hospitals and then also just with families in the community and the schools,” she told SNN. “We live in the community that we serve which we think is very, very important for nursing homes.”

Incentivizing turnarounds

Each of the three nursing homes Chelsey and Zachary have acquired were either one or two-star facilities. Alta now has a five-star rating, according to Gray, and the goal is to do the same for Alpine and Wingfield.

Revive purposely acquires low performing nursing homes to turn them around, however, Gray is concerned about the federal government’s tendency to only reward the top performers instead of providing incentives to operators who want turnarounds.

Now with the Center for Medicare & Medicaid Services’ latest move to toughen requirements to its Special Focus Facilities (SFF) program, that could make it even harder.

“I think there’s a lot of conversation too about rewarding five-star nursing homes … I bought poor performing nursing homes on purpose and how are they ever going to be incentivized to get better if we just give them less money,” Gray said prior to the CMS announcement. ““There should be incentives to invest, loan programs where I’m going to invest in this nursing home and make it better.”

Criteria for successful completion of the SFF program will now have a threshold that prevents a facility from exiting based on total number of deficiencies, according to CMS.

The program’s monitoring period is being extended, what CMS calls “incentivizing sustainable improvements.” Surveyors maintain a readiness to impose increasingly harsh enforcement actions if a facility’s performance declines after graduation.

“Don’t get me wrong. I mean, it’s awesome to be rewarded for being a good performer, but typically good performers their margins are also better,” Gray said.