Joe Kiernan discussed consumer confidence
Ocean Healthcare’s Joe Kiernan addresses the NIC audience. (Credit: Teri Soper)

DALLAS — Consumer confidence has taken center stage as a top discussion topic  — and as an indicator with opposite meanings — more than a few times this week at the spring meeting of the National Investment Center for Seniors Housing and Care.

Despite a U.S. economy that is in “phenomenally good shape” in many ways, overall consumer confidence is down because of gas prices above $4 per gallon, said Kenneth D. Simonson, chief economist for the Associated General Contractors of America.

“They want to see $2.50 gas,” he explained at a session addressing construction trends and macroeconomic influences.

Just a day earlier, however, the leader of a large regional skilled nursing chain heralded improving consumer attitudes for an optimistic rise in business.

“There is less fear and less concern, a stronger level of consumer confidence and engagement,” Joe Kiernan, chief strategy officer and senior vice president at Lakewood, NJ-based Ocean Healthcare, told McKnight’s after his session focused on improving occupancy levels. “The public’s perception of COVID is not what it was. The media is more manageable and it’s not always about death and dying.”

As a result, this has helped vastly strengthen a pipeline of hospital referrals over the last four to six weeks, he explained. For post-acute providers such as Ocean, which ramped up clinical capabilities just before the pandemic hit in March 2020, this is an especially good sign.

“There’s been a return of patients OK with engaging in the health system, so their utilization of health services goes way up,” Kiernan said. “We’re the new ‘hospital.’ I’ve said hospitals [of the future] will have an OR, ER and ICU. We’ll be next.”

Partner confidence key

Hospitals will welcome this development, Kiernan maintains.

“We’re helping our healthcare partners,” he emphasized. “They want to minimize exposure and costs. Our goal for this year is to re-engage our clinical program, and that will add to our market share.”

This is particularly helpful with value-based care arrangements, such as accountable care organizations (ACOs) and bundled pay arrangements, he pointed out. And while he said he’s also seeing continuing robust growth in home health, he is notably encouraged that some of the home services are also seen migrating back to skilled centers.

Ocean has 12 skilled nursing facilities, a home health and staffing agency, and four hospices throughout New Jersey, Pennsylvania, Ohio and Michigan. It also has a pair of acute-care psychiatric hospitals, three outpatient behavioral care centers, and assisted living and skilled home care home businesses in New Jersey. All told, it employs about 4,000 workers who serve 2,400 patients a day.

Ramping up clinical capabilities doesn’t mean a provider has to have post-surgery suites or ventilator patients in every room, Kiernan said. Ocean does a lot with distributing IV medications for cardiopulmonary care and conditions like sepsis and stroke treatments.

“With stronger assessments, (clinicians) are catching what they think might happen before we have to send somebody back out to the hospital. I don’t even look for orthopedic patients any more. They should be going home. But home is not always the right spot. You need high-acuity, post-acute care. To reduce avoidable hospitalizations, you need a higher level of care capabilities in place.”

Heartening signs

Kiernan said although occupancy is still 5% to 7% below pre-pandemic levels, he is encouraged about the recent rise of demand for skilled services. While he expects the entire post-acute sector to need 18 months to two years to get back to “normal” occupancy, some providers will do it quicker and some later, depending upon local conditions.

“The last four to six weeks, we’ve seen the stress  ease up. Recently, we were able to stabilize our staff,” he added, crediting the stability for further occupancy growth. 

As of this week, just one of 2,200 Ocean employees in its 12 skilled care buildings was diagnosed with COVID, he said.

“Nurses are coming back to work — RNs, LPNs, CNAs — because they don’t have COVID or don’t have to be isolated due to exposure or being around someone symptomatic. Safety has been put back in play,” he said, echoing similar comments made by Sabra REIT CEO Rick Matros on a recent earnings call.

One of the keys to success has been Ocean’s own staffing agency, Kiernan explained.

“If we need to cover 10 shifts over a certain period, it has to come from someplace, so even though we’re shifting money within the company, we’re getting it done,” he said. “Some people don’t want to work in the same building all the time or like to travel or have personal commitments that prevent a full-time job with us. They might have a different lifestyle. Some want more stability and want to see the same people all the time. We treat them all with dignity and respect.”