Ignite Medical Resorts is entering the second half of 2025 eager for regulatory reform, but it has been able to overcome burdens stemming from managed care so far by envisioning it as a “core competency” alongside a strong focus on tech innovation. The company is also forging ahead with plans to grow its physical footprint and clinical service lines.

According to Tim Fields, CEO of Ignite, his company continues to differentiate itself in the skilled nursing and short-term rehab sector by embracing technology, investing in internal talent pipelines, and advocating for regulatory reform.

In a wide ranging interview with Skilled Nursing News at the LTC 100 conference, Fields reflected on key wins and persistent headwinds shaping the sector.

“[In 2025] we’ve continued to live on the bleeding edge of technology,” Field said. “We’re really, really heavy into data analytics … we’ve really had to use data to tell the story. And so we’ve built a kind of custom dashboard where we are looking at all the KPIs every day.”

Ignite is using technology to boost staff efficiency and make worker lives easier, improve clinical and customer service metrics, and enhance reimbursement outcomes.

Ignite operates in 26 locations across six states and employs over 3,500 people.

Federal regulation: ‘Punitive and vindictive’

Despite internal progress, Fields called out the regulatory climate as the company’s – and indeed the sector’s – “biggest challenge.”

“We just operate in a very punitive and vindictive environment,” he said, criticizing the current CMS Star rating system and inconsistent surveyor expectations.

“We’ve gotten cited for not having a resident council president [when] we don’t have residents in a lot of our buildings. We have guests for two to three weeks.”

Survey practices disrupt care and fail to reflect the short-term rehab model, he said.

“It’s just not a collaborative process,” Fields said, citing burdensome oversight, misunderstanding of acuity levels, and excessive regulation by surveyors, sometimes due to incompetent surveyors, who’ve issued immediate jeopardy citations for minor issues.

Ignite has often successfully contested the Informal Dispute Resolution (IDR), a process that gives nursing facilities the opportunity to contest deficiencies or correction orders issued during inspections or complaint investigations, but ultimately the outcome was rejected by the State Department of Health.

“The state contracts with an agency to be their appeal, and then they don’t take the recommendations. I mean, it kind of feels like you have a judge, jury and an executioner,” he said. “We’re more overregulated than nuclear power … we have state surveyors in our building, like every other week. It’s just a burden for our staff and makes a very challenging business harder.”

Still, there’s optimism about regulatory reform. “Things that are coming out of the Trump administration, RFK, and CMS Director Oz are at least encouraging,” he said, pointing to the consolidation of CMS regional offices – from 13 to five – as a sign of reduced bureaucratic oversight.

“There are great winds of change, and we’d love to start to see the fruits of those efforts and have a lot of confidence that the next year’s gonna be better than the past year,” he said. “[The survey process is] the number one thing we’d love to see change on.”

One of the fronts where Ignite plans to continue to fight for reform also includes Medicare Advantage and fairness.

As the debate around Medicare Advantage (MA) reimbursement intensifies, Ignite wants parity.

“What we need to do as an industry is continue to advocate for being paid some percentage of Medicare PDPM,” he said. “If Ignite has a very good facility, provides great care and great outcomes, we should get paid more than the facility down the street that doesn’t.”

Medicare Advantage continues to place administrative burdens on providers.

“We have an entire department of case managers that… get authorizations, do updates, and issue discharge, cut letters.” And yet the sector has no choice but to adapt, he explained.

“We’re spending more resources and energy and we get paid less. But this is the way the world, and it’s not getting better. [And] so we have to learn the system and learn how to do good at it,” he said.

In the absence of regulatory reform and with 60% of its revenue coming from managed care, Ignite is pushing for more meaningful partnerships with payers and learning how to better juggle the operational burden of managed care – even calling it a “core competency.”

In this regard, Fields is all for value-based contracts that reflect his company’s ability to reduce rehospitalizations and manage high-acuity patients more effectively than traditional SNFs.

Growth plans

For the remainder of 2025, Ignite is preparing to open two new state-of-the-art facilities in St. Louis and Chicago – its first new developments in several years. With a third facility on the way in Houston, the company is targeting smart growth near major hospitals and in regions where its upscale, high-acuity care model fits best.

Describing its care model as “a blend of boutique hotel and inpatient rehab hospital with the culture of Disney,” Fields said Ignite’s buildings are equipped with Starbucks in the lobby, chef-prepared meals, and concierge services all while managing high-acuity cases ranging from patients needing dialysis to a variety of heart conditions as well as advanced wound care.

Ignite continues to expand its in-house dialysis programs and is exploring renal centers of excellence. It also aims to enhance its capabilities in treating complex wound care and high-acuity respiratory patients through advanced technology, bolstering its ability to admit and retain patients with significant care needs.

“There’s a lot of optimism… and we’re just excited at Ignite to keep growing, keep fostering our culture, and keep providing great patient experiences.”