12:00 pm – 5:00 pm

Executive Golf Tournament

Tiburón Golf Club, designed by Greg Norman, is home to the LPGA CME Championship and the PGA QBE Shootout. Replicate shots executed by top pros surrounded by Norman’s appreciation for nature.

12:15 pm – 3:30 pm

Naples Sightseeing Yacht Cruise

Cruise beautiful Naples Bay, home to luxurious waterfront properties, on a recently renovated yacht. Dolphin sightings are possible — sunshine and relaxing sea breezes guaranteed.

12:30 pm – 4:30 pm

Beach Blast

The resort’s pristine beachfront offers an idyllic setting on a lounge chair, paddleboard or ride a wave runner.

Reinventing Skilled Nursing for the Next 20 Years

Skilled nursing facilities are encountering an imperative of reinvention. In the face of deteriorating occupancy and LOS, strategies must shift toward new business models that break the mold of the last 20 years. For organizations that can crack the code, tailwinds of more favorable demographics are on the horizon. But SNFs must first face existential questions about the future of institutional skilled nursing:

• Is PDPM the end of high-margin therapy, and if so how will this affect SNF strategies going forward?
• If high-acuity is the future, what does a SNF med-surge unit look like, and how do you get there from here?
• What risk opportunities (iSNPs, Bundles, ACOs) will best alleviate SNF dependence on declining reimbursement?
• If home is the setting of the future, what are SNFs’ optimal home health strategies?

SNF Outlook 2024: Buy, Sell or Hold?

The current SNF market is sending mixed signals. The average price per bed is down, consolidation is up, and many REITs are shedding SNF assets. Yet a wave of seniors will soon begin to age into SNFservice range. Will the market remain in wait-and-see mode? Or will activity pick up as investors seek deals? This session will explore several key factors affecting the mid-range outlook for SNF investment:

• Interest rates are likely to climb — should sellers act now before they do?
• With asset prices low, is now the right time to expand regionally?
• PE activity has started to pick up — will that continue into 2020?
• Are the ProMedica and Sanford models of health systems buying SNFs isolated cases or an emerging trend?
• When will SNFs begin to feel the Silver Tsunami?

These rapid-format meetings connect providers with innovative solution partners. You will gain some fresh insights, and perhaps find another great business partner.

The Nirvana Model: Integrated Post Acute Care

The ultimate endgame, perhaps: some leading SNF chains are now embarking on a strategy to own and integrate all the pieces in post acute. Why do it? When risk fully arrives, you will be able to run the whole post acute continuum (and chronic care management) better and cheaper than anyone else. Also, you diversify out of SNFs, you control more of your referrals, and you gain market clout with payers, hospitals and docs. We will discuss top operators’ visions, long term plans and execution challenges, and debate whether Nirvana can possibly be achieved through tight post acute partnerships.

Lincoln Report: SNF Case Studies in Extreme Cost Control

SNFs often exhaust every opportunity to grow revenue, but are they turning over every stone to control costs? LTC 100, in partnership with CliftonLarsonAllen, is conducting in-depth research on extreme cost control opportunities at different skilled nursing facilities. Using benchmarking data to compare each SNF to its competitors, its county, and top SNF performers in its state, we will uncover cost saving opportunities in areas from revenue mix and rehab services to nursing hours and administrative overhead. We’ll analyze specific examples, and weigh the implications that bold cuts could have on star ratings, payer relations and the bottom line.

Preparing for PDPM: Why Compliance is Critical to Reimbursement

CMS intends PDPM to be budget neutral, yet coding practices historically change along with payment rules. Operations executives will describe how to achieve accurate reimbursement excellence, while establishing an environment of compliance. Specific strategic and tactical success strategies will be debated, along with projections on how CMS will monitor program integrity.

Building a Sustainable Behavioral Health Strategy

Behavioral health programs are not easy to operate, but the reimbursement rates are undeniably attractive. Some operators are successfully tapping into supplemental state and hospital budgets allocated to behavioral health programs. SNF providers from Washington and Colorado, whose programs span mental illness, crisis intervention and psychotropic medication, will describe their behavioral health program journey, including financial results and regulatory and staffing requirements.

US Immigration Policy & the SNF Workforce

Lincoln has conducted a research project exploring the connection between US immigration policy and skilled nursing’s labor needs. To what degree does our labor force — from RNs to CNAs — depend on immigrants? How are current immigration policies affecting this labor pool? Will our labor force shortage deteriorate as baby boomers age? What immigration policies are in the best interest of SNFs, and should we advocate more for them?

Raising the Stakes in Physician-Led SNF Care

Physician-directed care coordination is taking on new importance, thanks in part to VBP bonuses, the arrival of PDPM, and an overall heightened expectation from payers that SNFs can sustain a higher acuity level of care. But what’s the best model — the SNFist approach, where hospital docs round in your facility? Or the newly emerging SNF-led model where you employ your own PCPs? Providers on both sides of the debate will explore the economics of employing vs. outsourcing and outline best practices for aligning the goals of SNFs and PCPs.

VBP Success Strategies: Keys to Mastering Low Re-Hospitalization Rates

Only one quarter of SNFs nationwide earned back their VBP Bonus in 2018. If you weren’t one of them, you should be! Three SNFs from within the CMS bonus-earning pool will describe how their organizations drove down — and maintained — a low short-stay re-hospitalization rate. This session will organize their strategies into a blueprint — for any SNF to replicate — of protocols essential to success in VBP, including coding, care plans, intervention, telehealth and physician training.

Shifting the SNF Mindset Toward the Future

What are the defining characteristics of the future of post acute care? What are the optimal business models to harness opportunities ahead? How have other industries coped with massive change and converted new ideas into actionable strategies that have endured over the long run? This session will set the stage for the discovery of new strategies and innovative ideas.

Roadmap to Risk

Are SNFs unusually averse to risk? We don’t think so. Rather, CMS has teed up few opportunities for post acute providers to benefit directly from Alternative Payment Models. Despite that, there are paths to risk for SNFs. Four providers with experience in iSNPs, Next-Gen ACOs, BPCI, and risk-based MCO contracting will walk through the elements of a successful risk strategy, including culture, contracting, care coordination and confidence.

ProMedica & HCR ManorCare:
A Vision for Acute/Post Acute Integration

Many providers have dreamt it. ProMedica has brought it to fruition: the integration of acute and post acute services in a risk-based payment structure. ProMedica CEO Randy Oostra, the architect of the most audacious health system/SNF merger in a generation, will share his rationale for a heightened focus on post acute services; the growing importance of “total cost of care” versus a siloed, site-based strategy; and his thinking on the prospect for future health system/SNF mergers.

Genesis Healthcare: Creating the Nation’s Only LTC ACO

Genesis Healthcare will describe its four-year-old physician-led CMS-approved MSSP ACO, the only such organization in the nation geared exclusively to long term care SNF residents. Genesis will show how benchmarking against one’s own population’s expenditure history makes the MSSP model viable for long term care providers, and will share performance data, including improvements in hospitalization rates, quality metrics and physician bonuses as a qualified Advanced APM under MACRA.

Signature HealthCARE: Seizing the iSNP Opportunity

Signature HealthCARE, an early adopter of the I-SNP program, will describe its experience with this new MA opportunity, including risk based capital requirements, marketing, credentialing, clinical models, and how it manages the post acute spend within the medical loss ratio.

OnPointe Health: Advancing Risk-Based Managed Care Contracting

Texas-based OnPointe, a SNF company whose breadth of services include transitional care, long term care, assisted living, home health, private duty and hospice, has built a very innovative care model on episodic risk through sub-capitation agreements with managed care organizations. OnPointe will share how it has succeeded in garnering deals with managed care using a TCU-based framework of high-need patients, care management tools, Resident Assessment Function scoring, and PMPM risk contracts.

OPTIMISTIC: Transforming Care Through Nurse-Led Quality Improvement

What clinical resources does it take to reduce hospital transfers of nursing home residents? That’s what CMS wondered in 2012 when it funded OPTIMISTIC, an eight-year demonstration project led by Indiana University Center for Aging Research. OPTIMISTIC leadership will share best practices that its team has amassed from years of field testing in 40 Indiana nursing facilities.

Culture & Strategic Change

What makes a great culture? Can you transform a culture from mediocre to great? As we engineer our business models, do we need to think about changing our cultures as well? Lincoln Healthcare Leadership is conducting a study of both exemplary organizations across the general economy, and an assessment of culture in the SNF sector.

Building a Culture of Innovation “The Amazon Way”

When a company like Amazon goes from Internet startup to trillion-dollar market cap in just two decades, it has everyone asking, what’s their secret, and how can I get some? John Rossman, who had a front-row seat during Amazon’s formative years, explains how a strict adherence to a culture of innovation is the root of their phenomenal success. Rossman will share several of Amazon’s “14 Leadership Principles” to show how they drive every action within the organization, from “obsess over the customer” to “deliver results.” It’s an invaluable for any skilled nursing provider intent on building a winning culture.

About John Rossman

Author, advisor and entrepreneur, John Rossman gained his inside knowledge of the Amazon culture by working side-by-side with Jeff Bezos. He has written two books, The Amazon Way: 14 Leadership Principles of the World’s Most Disruptive Company and The Amazon Way on IoT: 10 Principles for Every Leader from the World’s Leading Internet-of-Things Strategies.

2:30 pm – 5:15 pm

Parasaiing

Olde Naples’ quaint neighborhoods are known for their unique architecture, beautiful gardens and stunning views of the gulf. You’ll take a quick break to stroll famous Naples Pier and Lowdermilk Park.

2:30 – 5:30 pm

Ritz-Carlton Spa

Indulge in a 50-minute relaxation massage or 50-minute custom facial. Take advantage of the steam rooms, aqua lounges and outdoor mineral pool for a holistic experience.

2:45 – 5:30 pm

Revs Museum Private Collier Collection Tour

This one-of-a-kind collection, noted by The NY Times as one of the finest in the world, celebrates profound and rare automotive innovations. A docent will take you through three galleries, featuring over 100 automobiles.

2:45 pm – 5:30 pm

Olde Naples Cycling Tour

Olde Naples’ quaint neighborhoods are known for their unique architecture, beautiful gardens and stunning views of the gulf. You’ll take a quick break to stroll famous Naples Pier and Lowdermilk Park.

Reception, Dinner & Dessert Social

7:45 am – 8:05 am

HighPointe on Michigan: Using Tech to Track Patient Frailty

Buffalo, NY-based HighPointe on Michigan will describe how its pioneering use of a Frailty Index has helped it address care management of clinically complex populations, which has led to the improvement of its Nursing Home Compare Quality Ratings from 2-stars to 4-stars in a single year.

8:05 am – 8:25 am

Norterre: Senior Care Reimagined

Norterre (Kansas City) represents a new model of skilled nursing that combines a healthcare household model, a JV with an adjacent hospital, and a multi-generational setting co-located in a multi-use development that includes AL, IL, fitness, arts, childcare and restaurants.

8:25 am – 8:45 am

Evernest: Envisioning Skilled Care in a Granny Pod Setting

Dallas startup Evernest is launching a granny pod concept that brings hospital quality design to this fast-growing sector of Accessory Dwelling Units. Positioned as a senior housing alternative, Evernest’s units offer skilled care by way of a personal care aide, telehealth and remote monitoring technology.

8:45 am – 9:05 am

Titanium Extra Clinics: A New Twist on Chronic Care Management

LA-based startup Titanium Extra clinics has developed a new model: post acute primary care designed to manage chronic seniors in a clinic or at home. Titanium partners with risk-based payers and SNFs to manage patients nearing the end of a post acute episode or at risk of a readmission.

9:05 am – 9:25 am

Ignite Medical Resort: Next Gen SNFs Creates LTAC/IRF Diversion

A Midwest SNF called Ignite is betting big on high-acuity care. Its facilities are positioned adjacent to hospitals and offer chronic care capabilities as an alternative to LTACs or IRFs. This session will describe the Ignite business model, including how it creates value for upstream payers.

Discovering ROI in SNF-Based Telehealth

Is telehealth ready to take off in skilled nursing? After years of half-hearted commitment and general trepidation, the prospects now look good. This session will highlight three case studies, with an emphasis on state-of-the-art technology and pro-forma financials. Then we’ll conduct a detailed discussion on ROI, including how telehealth is helping resolve core SNF priorities, including expanding clinical services (ie, behavioral health), engaging physicians and solving staffing shortfalls.

Case Study: Commonwealth Care of Roanoke

Roanoke-based CCR is building a suite of virtual physiciansupported services, through a partnership with TripleCare/ Curavi Health, that it recently rolled out to three of its 12 SNFs.

Case Study: Central Island Healthcare

Long Island-based Central Island is four years into an NP/ telehealth hybrid emergency care model from Call 9 that has dramatically driven down unwarranted ER visits.

Case Study: Saber Healthcare Group

Cleveland-based Saber Healthcare is bringing physicians to the bedside with a cart-based remote monitoring system from TPG that it recently rolled out to all 88 of its SNFs.

For LTC 100 board members only.