James M. Berklan, McKnight's Editor

Read any history book that traces a country or people through the centuries and you’ll find its strategic leaders hedged. If they wanted to preserve the capital city or a certain place, they almost inevitably tried to grab the spaces stretching out from it.

I believe it’s called covering one’s flank. Some of the most interesting developments lately in long-term care involve a classic case of this.

While providers have dipped into the occasional ancillary business, such as therapy, transportation services, or hospice, one company seems to have seized on one of the newest strategies stronger than others: covering everything almost all by themselves. In cuisine circles, this is called presenting a dinner that goes from soup to nuts.

Only these healthcare execs aren’t nuts. Far from it.

I’m referring to Kindred Healthcare’s announcement earlier this month that it was moving closer to opening replacement transitional-care hospitals in Charleston, SC, and Dayton, OH. This is on top of newly announced plans for transitional-care centers in Las Vegas and Indianapolis.

Kindred, of course, is the behemoth that we already thought was pretty smoothly covered with a huge holding of long-term care facilities and just about as much in acute-care hospitals. That’s not to mention one of the single biggest holdings of long-term acute care hospitals.

These latest announcements, though, take things further. The new Las Vegas and Indianapolis facilities both will offer short-term rehab and will open next to existing acute-care hospitals.

This is getting to be a little like the late Dave Thomas’ philosophy of trying to build a Wendy’s hamburger restaurant as close to any McDonald’s one he could find. The difference is that Kindred is poised to corner the market on all beef products: We’re talking about strategic growth, but we’re also talking about equipping a company better for upcoming demands of better coordination of care throughout the post-acute spectrum, and before.

Something says CEO Paul Diaz and his cabinet won’t be as fearful of calls for bundled payments or accountable care organizations as others might. Not with the pathways they’re building. Along with some hospice acquisitions, this provider is doing more than just dabbling in various modes of care.

Could it be they know something about the future of necessary care models that the rest of us don’t? Or is that they’re the only ones, so far, to put the resources into building a better experience?