Coming off of his first year as CEO of American Senior Communities Steve Van Camp is busy planning an Institutional Special Needs Plan (I-SNP) joint venture with five other providers in Indiana, while also devoting time and resources to meeting quality measures and outcomes among ASC facilities.
Important considerations to forge ahead with these efforts for Van Camp are the benefits and drawbacks of concentrated scale in the state. Of course, scale allows a certain level of influence with state legislators and the perks of a robust back office team to keep survey tags below the state and national average. However, with the workforce shortage continuing, ASC is sometimes competing against itself for needed staff in the state.
And yet, ASC has managed to achieve quality outcomes and quality care as evidenced by the organization receiving 26 bronze and 14 silver awards from the American Health Care Association (AHCA). “These 40 winners have been quite the accomplishment,” Van Camp said.
Indiana-based ASC was founded in 2000, and Van Camp served as CFO prior to taking the helm. ASC is one of the largest nursing home providers in the country with 110 communities, despite operating entirely within the state of Indiana.
Skilled Nursing News sat down with Van Camp in a fireside chat-style conversation at our ReThink conference in Chicago. This conversation has been edited for length and clarity.
What are ASC’s plans for growth?
We’re in the process of forming an I-SNP in a joint venture with five other Indiana operators because we really believe value-based care will be the path to take moving forward.
In 2022, a group of us were together, and we were wondering about where value-based care was headed. We were looking at the directives from CMS, and they said by 2030 most participants will be enrolled in Medicare Advantage plans. Having a fee-for-service environment won’t be the future.
It took a lot of time to evaluate figuring out how we can all work together because we’re usually competitors. We need to be moving our mindset from an operator to an insurance company. We needed a transition period to help us see what that might look like. What does that care model look like relative to what we’re doing now?
Once the six of us got together, it took us a year to make sure that we were all aligned with the same initiative and strategy, and we made sure that we were all binding into the same thesis.
This is a collaborative effort, and we’re going to redefine what collaboration means. This year has been the time period where we’re going through processes from the department of insurance approval to CMS approval. We won’t go live until Jan. 1, 2025. We’re anticipating all those final approvals to arrive pretty quickly, and so we’ll go live in 18 counties, and 25 added to that collection.
Let’s talk about ASC’s highly concentrated scale in Indiana. What are the benefits, and drawbacks?
Indianapolis is centrally located, so the benefit for us is that we can reach any of our facilities. That’s a big benefit having outreach ready to be hands-on.
On the marketing side, being able to coordinate county-specific, or region-specific is easier with some scale. You can utilize that to your benefit.
We also have back office support. We have a large regional team that does a lot of survey preparation to make sure we’re ready to go, because it doesn’t take long for things to get sideways. Our chief nursing officer, she does a wonderful job keeping us prepared, our survey experiences. We average about 3.8 tags per facility per year, and the state average is more like six. And then I think nationwide, it’s eight.
On the downside, we’re still managing labor like everybody else. We’re sometimes competing against ourselves in certain regions.
Any plans for expansion beyond Indiana?
Never say never, right? If the opportunity presented itself, we would look at it, but it’s not in our top five things we want to get done. There’s a comfort level within Indiana. Our ownership base lives in Indianapolis, and they participate in the business, and they’re active in it.
What accomplishments are you most proud of from your first year?
Our organization has really put a focus on quality outcomes and quality care. I just want to keep elevating that component of the business. Secondarily, our occupancy is not quite back to pre-Covid numbers, it’s within a couple 100 basis points.
What are ASC goals for the near future?
Number one is our employee base. If we go back to the misery of the pandemic, our turnover was 90%. A couple of years post-pandemic it’s more like 65%. We’re continuing to focus on what we learned from the pandemic regarding the hiring process. We really needed to speed up and create some efficiencies in our recruiting, including timeliness of returning phone calls. The whole hiring process needed to be organized better and we eliminated some of the inefficiencies that were there.
If we can get our employees to the 12-month mark, we have a very good success rate. Data tells a story, and so we spend a lot of time looking at metrics of what’s going well, what’s not going well with the hiring process. The retention rates at various intervals tell a story. We found some holes – that we needed to shore up with our employee experience, to get them past the year mark, to keep them engaged, and provide opportunities. That’s been a focal point for us.
For the last 18 months, our net hires have been positive. Our ability to bring people in has increased, but now, how do we keep them? It gets back to creating that employee experience, giving them leadership programs, giving them scholarships, giving them opportunities to expand. Our industry needs to do a better job of creating a career path for employees. These are some of the ways that we can reach our employees and give them something to grow into.
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