American Senior Communities’ incoming CEO, Steve Van Camp, plans to focus on the road to recovery from Covid in restoring occupancy levels while advancing workforce initiatives.
In an exclusive interview with Skilled Nursing News, Van Camp also shared his worries about resolving the staffing crisis amid sector-wide concerns related to the forthcoming proposal on minimum staffing standards. And although ASC has made improvements on new hires, retention and reducing turnover, he said workforce challenges are “a battle” with no short term solutions.
As for other challenges facing the sector, such as financial pressures from rising interest rates, Van Camp said ASC is on better footing and not “overly” impacted because the company carries very little debt based on variable interest rates.
Areas of innovation and growth for ASC that Van Camp has his sights set on include population health management – of short-term versus long-term residents – through greater involvement of Institutional Special Needs Plans (I-SNPs) and other businesses.
Family-owned ASC has a portfolio of more than 100 Indiana-based senior care properties.
Through his previous role as CFO of ASC, Van Camp also brings a wealth of financial knowledge on deal making.
“I came in as CFO, and over the last five years I’ve gotten well acquainted with the owners,” he said. “ASC is owned by the Jackson family, all based in Indiana. They were working with the second generation of the founders. I have found them to be deeply committed and compassionate towards health care in the state of Indiana.”
He also spoke to SNN about changes in leadership at other levels of the C-suite within ASC.
Van Camp, who takes over the helm from long time CEO Donna Kelsey, told SNN that he is looking forward to honoring the legacy of his former boss by continuing on the path of delivering quality care to the residents of ASC’s facilities.
Kelsey, who will be moving into a senior advisor role at the company, was known for improving staffing amid the crisis left by Covid, with a strong focus on improving facilities.
Van Camp will become CEO effective June 1, the company shared in a press release Thursday.
The transcript below has been edited for length and clarity.
How did you get your start in the senior care industry?
Back in 1995 when I was named chief investment officer at Health Care REIT under the late George Chapman. That’s how I got my start into senior housing … That taught me the finance side of the business because we were providing financing for a variety of operators, both on the skilled nursing and assisted living platforms. And so that’s how I got my start in terms of really understanding the financial metrics that make up senior housing, both on the acquisition and on the development side.
What are your first priorities as CEO?
The priority is, first and foremost, to continue on our road to recovery from COVID. Pre-pandemic we were operating at an overall occupancy level of around 82%. During the heart of the pandemic, we reached a low of around 67%. Over the last 14 to 15 months, we’ve been slowly increasing that, and so we find ourselves just under 75%.
The number one priority continues to be recovery from all of the impact of COVID.
Besides occupancy, what are some of your other priorities?
The secondary focal point for us is to continue our workforce initiatives. It’s well documented in the industry that skilled nursing lost 245,000 jobs during the heart of the pandemic, and the last numbers that I saw, we’re still down over 200,000. You can just see the astronomical impact of the Covid and what it did specifically on skilled nursing. When you break it down between skilled nursing and the other segments of healthcare, the other segments have recovered to pre-pandemic levels. Skilled nursing is still lagging. So a priority for us is to continue our workforce initiatives and focusing on our employee engagement and retention, along with continuing our quality initiatives that we work on each and every day.
How concerned are you about the proposed minimum staffing mandate?
I think the data speaks for itself by virtue of the fact that skilled nursing has not yet recovered from the pandemic. There are a lot of questions on not only what the staffing mandate will be, but whether it will be funded. What is the actual calculation of what is included – which workers count in the calculation? Will there be any waivers? Will it be phased in? And lastly, what would the penalties of not being able to meet the standard be?
Those are all questions that we really won’t be able to address until we actually see the language as it gets published … I did see recently an analysis done by the accounting firm Clifton Larson Allen that just based upon PBJ data, that if the 4.1 [ratio] is implemented, that would require [new hires] of just under 200,000 positions nationwide, or an average of about 12 more per facility. I just think about that in the context of the existing shortfall in staffing, and I have questions about how we would ever be able to meet that.
Are there any metrics you can share related to labor?
We are seeing some progress as it relates to improvement in the net hires, but it’s just not at a pace that, you know, that we would like it to be. Secondarily we have improved our overall turnover by about 10% in the last six months so we are getting better. There’s always room for improvement as it relates to continuing to focus on our employee base. We’ve done a lot of initiatives towards career ladders, trying to encourage working with nursing schools to build programs to be able to add to our nursing platform as we go forward. But it’s a battle. It’s a continuous focal point that will be long term in nature, because you know, there are no short fixes to the solution.
Have inflation and rising interest rates posed any specific challenges for ASC?
For our 2023 budgets, we obviously had increased labor costs that were impacted [by high inflation and interest rates]. Medical supplies, food, those things have gone up. But we’ve been able to manage through most of that impact thus far. On the interest rate side, most of our debt is long term in nature, so we carry very little variable rate debt. So that has not been overly burdensome to us.
Are you more focused now on restabilization, or growth and innovation?
One area that we are looking at and studying is population health management. We’ve seen the CMS guidance that by 2030, they’ll be no more fee-for-service. Knowing that, we’re going to look at population health initiatives, whether that be an I-SNP or another structure. There are a variety of different structures to participate in to help us be in control of our future. Skilled nursing is continuously getting more complex, and so population health management is an area that we will focus some efforts on in terms of learning.
Can you speak to the changes in the C-suite at ASC and what these new appointments mean for the organization?
Andy Shane came on as chief operating officer in February of 2023. We’ve also promoted Alicia Sims as our chief nursing officer. We’re particularly proud of Alicia. She started in long term-care as CNA back in ‘95. She has worked and grown, and is a tremendous leader within our organization with a tremendous focus on all of our quality initiatives and delivery of health care.
We’ve announced the promotion of Mark Dice to become my successor as chief financial officer. Mark has been Senior VP of finance and accounting for ASC for the last seven years. And he has over 20 years of long-term care experience in the finance chair and has a long standing relationship with our owners. And so he’ll be a tremendous leader for us as an internal promotion.
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