Ahzam Afzal, Co-Founder & CEO at Puzzle Healthcare, has been named a 2025 Future Leader by Skilled Nursing News.

To become a Future Leader, an individual is nominated by their peers. The candidate must be a high-performing employee who is 40 years of age or younger, a passionate worker who knows how to put vision into action, and an advocate for seniors, and the committed professionals who ensure their well-being.

Afzal sat down with Skilled Nursing News to share what drew him to the skilled nursing industry, the biggest leadership lessons he has learned, his thoughts on the future of skilled nursing, and much more. To learn more about the Future Leaders Awards program, visit https://futureleaders.wtwhmedia.com/.

SNN: What drew you to the skilled nursing industry?

Afzal: I’ve always been drawn to solving complex problems as a healthcare provider. Early in my clinical career, I saw how broken systems, inefficiencies and care gaps were failing both patients and providers. Through my work in value-based care, collaborating with ACOs, health systems, payers and CMS Innovation, I kept seeing the same problem surface: the post-acute setting, especially SNFs, was where the sickest and highest-acuity patients were falling through the cracks.

I noticed the lack of structured follow-up and meaningful coordination, which led to worsening health and unnecessary hospital readmissions. That’s when I realized there was a big opportunity to improve the patient experience, reduce total cost of care and reshape outcomes. Over time, that mission turned into Puzzle, where we now collaborate nationally with health systems, SNFs and everyone in the post-acute continuum. The goal is simple: make sure patients not only recover but continue to improve.

My path to this industry wasn’t conventional. It was purpose-driven with a focus on identifying what’s broken and building something better.

SNN: What’s your biggest leadership lesson learned since starting to serve this industry?

Afzal: The biggest lesson is that purposeful innovation beats shiny innovation every time. It’s easy to chase trends like AI, wearables or automation, but unless you’re solving real problems, it doesn’t matter. In healthcare, especially in SNFs, the stakes are too high for surface-level solutions. You have to deeply understand the problem, respect the complexity and build with empathy.

I’ve also learned the importance of aligning the mission with the people. Whether it’s our team members who dedicate themselves every day or the patients who trust us with their care, you’re not just building a company — you’re building relationships. And leadership in this space means staying resilient through the setbacks, evolving when things don’t go as planned and never losing sight of why you started.

SNN: If you could change one thing with an eye toward the future of skilled nursing, what would it be?

Afzal: We need to evolve from reactive care to proactive care. For too long, SNFs have been forced into a model where they’re reacting to complications after they’ve happened, whether it’s a fall, an infection or a readmission. That’s costly, dangerous and unsustainable.

Instead, we should leverage technology like remote monitoring, predictive analytics and early warning alerts to identify risk before it escalates. At Puzzle, we’ve built a system where our multidisciplinary team continues monitoring patients for 90 days post-discharge, flagging issues like functional decline, wound exacerbation or respiratory symptoms before they lead to a crisis. It’s no longer enough to discharge patients and hope for the best. The future of SNF care must center on anticipation, prevention and continuity.

SNN: In one word, how would you describe the future of skilled nursing?

Afzal: Adaptive.

SNN: If you had a crystal ball, what do you think will impact the skilled nursing industry now and into 2026?

Afzal: I believe that the skilled nursing industry will be impacted by a few different variables in the near future, including: 

• Hospital alignment: SNFs will increasingly be evaluated not just by CMS, but by health systems looking for reliable partners to reduce readmissions. Facilities with strong data, care coordination, and escalation pathways will see the greatest success in referrals. 
• Value-based care expansion: As reimbursement continues to shift toward outcomes, SNFs that can prove high quality results will gain a competitive edge. Partnerships with ACOs and health systems will become critical in gaining this edge and advancing outcomes. 
• Functional recovery and physiatry: With CMS survey changes emphasizing functional outcomes and discharge planning, the role of physiatrists will expand and be crucial in facilities. At Puzzle, we’ve seen how embedding physical medicine and rehabilitation specialists helps SNFs stand out in a value-based world. The demand for physiatrists will continue to grow in the coming years as facilities look to improve outcomes and establish themselves in the field. 
• Technology that actually works: The SNFs that will see the greatest results won’t be the ones with the flashiest tools. They will be the ones using tech that integrates into workflows and improves decision-making. Remote monitoring, real-time data and predictive alerts will become standard in all facilities. 

SNN: In your opinion, what qualities must all Future Leaders possess?

Afzal: Future leaders need three things: resilience, adaptability and humility. Resilience to handle setbacks without losing direction. Adaptability to evolve in a constantly shifting landscape. Humility to recognize that no one person has all the answers. You need to build a team that challenges you, customers that guide you and a mission that grounds you.

SNN: If you could give advice to yourself looking back to your first day in the skilled nursing industry, what would it be and why?

Afzal: Control what you can and embrace what you can’t. This industry is filled with variables — regulations evolve, patient needs are complex, and the care environment is constantly shifting. You won’t have it all figured out on day one, and that’s not the goal. This work is iterative. You’ll listen, adapt, and refine the model again and again based on what patients need, what SNFs are experiencing, and how the broader industry shifts. That ongoing evolution isn’t a weakness — it’s what drives real progress.