Industry Veteran McGuinness Launches New Skilled Nursing Operator Journey

Bernie McGuinness has spent three decades in the nursing home industry, rising from a certified nurse aide (CNA) to reach the pinnacle as former CEO of Majestic Care. But the road for McGuinness has hardly ended there. Now, he is venturing into ownership with Journey Skilled Nursing.

McGuinness, president and CEO of Journey, sat down with Skilled Nursing News to discuss the mission and growth strategy for his new company, which is based in Noblesville, Indiana, saying that he is looking to expand in the Midwest and Southeast in “cluster markets” to optimize on efficiencies of scale.

He also talked about his outlook for the sector, his passion for skilled nursing and how SNF providers can tackle staffing challenges by investing in their workers’ long-term careers and by highlighting the role of the nursing home as a lifeline to local economies – not just as a quality care provider but also as a quality employer – and appealing to a sense of community and commitment.


“We are looking at building out that regional presence and being a provider of choice in our local markets,” McGuinness said. “A lot of people seem pretty excited about the launch of Journey and our ability to achieve our mission and vision and grow the organization over the next two to five years.”

Over the next 18 to 24 months, Journey hopes to add anywhere from between 10 to 16 locations, McGuinness said.

Relationships that McGuinness has garnered over the years will play an important role in funding the acquisition efforts of the new company as well. “We are going out to traditional lenders through the relationships of the ownership group in the market, or raise some private equity, some capital through different sources and relationships that we have formed over the last few decades in the profession,” McGuinness said.


One of the partners listed as co-founders of Journey is Sam Akabas, CEO at Akabas Properties, which specializes in real estate development and acquisitions in several sectors including self storage, hospitality, office, luxury condos and townhomes, seniors housing and skilled nursing.

Other executives helping McGuinness run Journey include its chief strategy officer, Austin Steele, who is tasked – among other initiatives – with creating a company culture that emphasizes employee wellbeing through an employment program called Journey AdvantEdge.

“Culture is really important to today’s workforce … I believe in it wholeheartedly,” said McGuinness. “And with Journey AdvantEdge, we’ll be able to recruit in local markets, the best executive director, the best director of nursing. And they’re going to have ties to the best staff in that market. They’re going to know who’s truly here to answer the call, to be a caregiver. So, we’ll be able to find those leaders that will help us find the staff in each market.”

The following interview has been edited for length and clarity.

SNN: What is your strategy and vision for growth?

McGuinness: I’m proud to work in skilled nursing and standalone skilled nursing facilities because I believe that the work we do in each local health care community is vitally important to the well being of the residents that we serve and to the whole health care ecosystem. And in many of our markets, it’s also important to that local town or county’s employment. Skilled nursing rises up and meets those challenges every day. So as we grow, we will look at an ability to grow regionally.

We believe that healthcare is about understanding those local markets, those referral sources. Having some regional density allows some efficiencies from an operational standpoint, from referral source management and from managed care contracting as well as from shared staffing focus.

As Journey Skilled Nursing grows, we’ll have CCRC components, we’ll have journey senior living, assisted living components, independent living … but I want to go on record to say I am a proud skilled nursing operator.

SNN: How many properties are you beginning with and how quickly do you anticipate being able to add to the portfolio?

McGuinness: We are the proud owner of one skilled nursing facility, Morgantown Woods, in Indiana, which closed on March 1. So that will be our first facility [and] over the next several months we’re under contract for some other facilities throughout the Midwest and the Southeast. And I anticipate over the next 18 to 24 months that you’ll see us strategically grow anywhere from between 10 to 16 locations, and maybe more – it just depends on the right opportunity, and the ability to live out our mission and vision with each acquisition.

SNN: As you approach this growth strategy, are you looking to mostly acquire or build facilities as well in the future?

McGuinness: The expansion will be mostly through acquisition. It would have to be the right development deal. But right now, mostly it’ll just be through acquisitions.

SNN: Are you looking at a particular profile of a facility to target for acquisitions?

McGuinness: [A facility] has to match that regional presence. Obviously, it has to be a little bit larger – a 100 to 120 bed facility would be a good size facility because I think there’s built in efficiency at that range. But we’re really looking at cluster markets and the ability to have several beds within a geographic geographic area,

several 100 beds within a geographic area for shared staffing efficiencies, to find entry points and build those relationships at a local level.

As we grow, we are looking at facilities and opportunities where there may be some need for occupancy, there may be a clinical turnaround component or a focus on capturing the care they’re providing. And state-specific Medicaid plays a large part in our due diligence as we look at acquisitions.

SNN: How are you planning to fund the company, and who are some of the other investors or partners?

McGuinness: Our first acquisition is self funded between the ownership group, myself and a couple of investors. We’re looking to purchase facilities that may go under lease – if it makes sense in a certain market.

One of my partners is Sam Akabas. Sam has a long history on the mergers and acquisition side and putting together debt structures, debt stacking.

Each acquisition, each deal is different in its needs. Some may come with some assumable HUD debt. Other deals may be a lease to purchase with a landlord. And the size of the deal will also determine the capital needs.

SNN: Are you anticipating any challenges, especially in the area of staffing at these facilities? How do you plan to overcome those?

McGuinness: We are not going into this with our heads buried in the sand. We understand that these facilities that we take over, a lot of times staffing will be a major focus. With our company culture, there is a strong focus on the care team members. Simply put, we believe happy staff give better care. And we know this through being able to recruit really quality people onto the leadership team such as our chief strategy officer, Austin Steele.

The culture we’re creating from ownership on down can set us apart in our markets … From my days as a CNA or as a floor nurse in a facility I was making sure that my leaders and the people who mentored me followed through [on commitments]. Where was their heart at? Were they here for the resident? Were they here for quality care? Were they here for me? And with Journey AdvantEdge, we’ll be able to recruit [the best leaders and employees] in local markets.

SNN: Can you speak to the resident needs that Journey will be catering to? And what about the payor mix?

McGuinness: We’re focused on traditional skilled nursing. We’re going be really good as a Medicaid operator. We’re going to try and find facilities in different markets where you have opportunities to have higher skilled mix facilities with the Medicare and the Medicare Advantage.

[Reliance on] traditional insurance may be around 25% to 30% skilled mix in certain markets. And then there’s going to be other buildings that are 85% to 90% Medicaid in those markets.

We are very interested and very in tune to the Medicaid systems in each state that we would look for an acquisition opportunity.

SNN: How do you intend to approach some of the challenges related to Medicare Advantage?

McGuinness: So you really have to do your homework as you’re looking to grow into a market because Medicare Advantage does put a burden on us as skilled nursing operators versus traditional Medicare.

You have to understand who the players are in the market [and] the reality of the facility of which you’re assuming [ownership]. You have to understand the penetration of Medicare Advantage in a market [and] what it’s going to be over the next two to three years. You have to know what type of star rating you are walking into. How soon could that improve so that you can become contracted in these markets and have some sort of plan in place whether it’s with contracting, managing length of stay within those markets, avoiding rehospitalizations.

A proven record and some market density [allows you] to be able to have some negotiating power when you’re looking at ongoing contracts.

SNN: So tell us the story behind your new venture, Journey Skilled Nursing?

McGuinness: Journey Skilled Nursing came about through the continued passion I’ve had for long-term care and post-acute care and the desire to venture out into ownership through a partnership with a couple of investors, who were like minded in our vision and our mission to really be a quality operator.

My journey hasn’t concluded nor has the circle around the heart for the letter O in Journey. It is intentionally open. There’s still room for me to grow as a leader in post-acute care, but it also signifies our care team and all the opportunities in their careers. This isn’t just a job but it’s really a career for those who answer that call. We’re here to rise up wherever they’re at on their professional journey, whether they’re a brand new CNA or a dishwasher or laundry aide or maybe the experienced operator or registered nurse.

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