With greater than 1,700 areas in 46 states, Kindred Healthcare has a singular perspective on caring for sufferers throughout the COVID-19 pandemic. Its community spans long-term care, rehabilitation and behavioral well being. And regardless of the monetary pinch the pandemic has placed on the trade, Kindred President and CEO Ben Breier says the group is well-positioned to stay with an formidable progress technique. He just lately talked with Fashionable Healthcare Managing Editor Matthew Weinstock. The next is an edited transcript.
MH: Are you able to discuss your method to spreading greatest practices throughout a big community throughout a pandemic?
Breier: It’s been a problem as you would possibly count on. Like a lot of the trade, we virtually in a single day needed to arrange digital help facilities. And all of us take as a right, six months later, the know-how and the folks that we’ve deployed to do this. We had deliberate for it slightly bit again in February and early March, however when the day really got here the place we stated, “Let’s flip the sunshine on, and stand this factor up,” it was fairly a activity.
We’ve the distinctive problem of offering healthcare in 46 states. And, it’s been fascinating, not simply the infrastructure facet of how we set issues up, however really to look at because the COVID-19 pandemic performed out throughout the nation. We noticed the Northeast hall go first, notably in New Jersey and New York. We’ve seen it unfold to the Midwest and out West. After which, most just lately over the summer time, the large rise in Florida and Texas, that are two of our largest states. We’ve needed to construct on the progress we’ve made across the improvement of our infrastructure every time, to verify we had been finishing up that constant operational mission throughout the nation.
One of many issues we did early on that has been so profitable by way of managing that platform throughout the nation is the creation of a really formal incident command construction. We knew instantly that we must always create command and management so we might be sure we had been gathering the essential movement of knowledge and make choices in real-time, notably scientific choices. And like so many others, we needed to early on ensure that we had been managing the availability chain.
MH: Are there some issues that you simply’ll do in another way in a second surge?
Breier: One factor that we foundationally realized was that our long-term acute-care hospitals, our inpatient rehab services and our acute behavioral well being hospitals … in some ways turned out to be splendid settings to deal with these actually sick, actually medically complicated sufferers.
How do you isolate a affected person? How do you deal with a affected person who has a number of system issues? How do you take care of a affected person who’s on a ventilator, or who is perhaps affected by stroke, or neuro rehab wants, or who is perhaps paralyzed from the illness? These are issues at our core that our services are actually good at and capable of present.
Within the early phases … inpatient hospital programs had been so involved about ICU mattress capability, med-surg mattress capability, as they had been increasing into tent hospitals. We instantly grew to become an outlet for lots of these sufferers to be moved out of ICUs, into our longer-term care services.
For those who ask our physicians and different clinicians, there’s a lot that we realized about how one can look after the illness, about how one can check for the illness, about how one can isolate and ensure that we had been additionally caring for all the different sufferers in our services. If we will construct upon each of these, we’ll be well-prepared, each for what we’re at present seeing and what we’ll see sooner or later.
MH: On the behavioral well being entrance, are there two or three issues that appear to be essentially the most urgent points?
Breier: If you get right into a pandemic of this type, and also you’ve received people who find themselves already affected by these sorts of issues, that now turns into much more acute in the way in which that melancholy would possibly set in, and the way in which that social isolation would possibly set in. The largest factor that I’ve seen … is that so lots of our sufferers and our potential sufferers which have been socially remoted from others are actually affected by it.
If we aren’t proactive … the pandemic goes to show right into a pandemic round psychological well being.
MH: COVID doesn’t appear to have stopped your progress technique. You had some bulletins over the previous couple months to increase your footprint. What do you see for Kindred over the rest of 2020 and into 2021?
Breier: During the last decade, Kindred has developed in plenty of totally different kinds and sides. If you return a few years in the past to our board’s choice to take the corporate personal, and basically promote our house well being and hospice firm to Humana, as they’ll personal it outright, we determined that we wished to be centered on being actually the biggest specialty hospital firm in America.
We’ve large infrastructure on the enterprise degree to handle and preserve operating heaps and plenty of these 60- to 80-bed specialty hospitals throughout the nation. At the moment, we have now virtually 200 of these services within the states the place we function.
One of many issues that we’ve realized within the operation of specialty hospitals is that having shut and direct relationships with the short-term acute-care well being programs in these native markets is de facto the important thing ingredient, not solely towards our success, but additionally towards native well being system success within the context of how do they place and transfer sufferers from one setting to a different as seamlessly as attainable.
We go in as 50/50 companions usually. We maintain the native well being programs model on the wall. We helped to deliver the enterprise-level sophistication for how one can run these. We get them up and operating rapidly. We get them up and worthwhile rapidly. We’ve extra progress than we virtually generally know what to do with. We’re going to construct and open eight new rehab hospitals subsequent yr. We’re in all probability going to do this once more the yr after, and possibly the yr after that.
We’re additionally rationalizing and managing our present portfolio. This yr, in 5 of our long-term acute-care hospitals, we opened acute rehab models—an inpatient rehab hospital inside an LTAC. We’ve 5 as we speak and count on to triple that over the following couple of years. In partnership with hospitals, and principally round natural progress, we expect our path to progress is de facto thrilling.
MH: So there’s no actual slowdown in sight.
Breier: We had been definitely involved within the early phases of the pandemic about the place folks’s consideration span would go—regulatory companies, issues that we’d like for approvals. However knock on wooden, we’ve been lucky. It hasn’t slowed issues down in any respect. In actual fact, if something, I feel it’s been extra of an instigator towards we have to do that quicker and we’d like extra.
MH: There are considerations about personal fairness reaching additional into healthcare. How do you deal with these given Kindred’s possession mannequin?
Breier: We rigorously selected our personal fairness companions in TPG and Welsh Carson, as a result of we knew that these two companions particularly had arguably the deepest nicely of expertise and information, in having run and owned healthcare service firms. And what they perceive is identical factor I perceive, which is that high quality is what drives monetary outcomes.
Within the two years that we’ve been companions with them, we have now changed all of our ventilator models at a a number of million-dollar value.
We’ve added greater than 25 CT scanners to our hospitals at a a number of million-dollar value.
We’ve purchased ourselves out of leases for hospitals that weren’t performing nicely at a a number of million-dollar value. And our companions, in each expertise, put their cash the place their mouth is, to verify we had been delivering a high quality product. If finished the correct means, that’s the place personal fairness can serve all of us in healthcare nicely.