At age 66, Mark Parkinson still has plenty in the tank when it comes to championing long-term care causes.
But the nation’s top nursing home leader of the last 13 years said Tuesday that his carefully planned final lap as president and CEO of the American Health Care Association/National Center for Assisted Living is the right one to take.
The association announced Tuesday that Parkinson’s extended tenure as the industry’s most visible spokesman would end Jan. 15, 2025. He had originally planned to depart in 2022, but given the stresses of the pandemic and added regulatory pressures from the Biden administration, he and the AHCA board agreed it would be best if he stayed through the current US presidential term.
“I love this job and I’m going to miss it,” Parkinson told McKnight’s Long-Term Care News Tuesday. “But I do think it’s time. We’ve had a fantastic run, and I’m very appreciative of this position and work we’ve been able to do.”
Parkinson agrees with supporters that his unique background as a former governor (Kansas) and assisted living owner/operator helped him lift the association to new heights — in membership, innovation and, most importantly, credibility.
He said the keys for anyone taking the position are getting policy results — from Congress, the administration and state legislatures — and unifying the membership.
“You have to win on [Capitol] Hill, you have to win with [the Centers for Medicare & Medicaid Services], you have to win in the state – really all three,” he explained. “But in addition to that, you have to pull the members together. In many regards, the second part is the hardest because long-term care operators are a very diverse group. If you can succeed in doing that, you’re probably going to succeed on the policy side.”
In that vein, one of Parkinson’s biggest victories came early upon unifying a splintered membership. A breakaway group of disgruntled major nursing home chains started their own lobbying efforts in 1999 and had pulled support from ACHA eight years earlier, but Parkinson convinced them to return to the fold in 2013.
“What I told them was that, as a governor, what I had seen was when sectors were divided and there were multiple voices and multiple trade associations, the politicians would simply dismiss them,” he said. “There’s a limited amount of money available, at the state level and federal level, and there’s going to be winners and losers. And if you’re divided, you’re probably going to be a loser.
“The sector had had a pretty good run of being a loser,” he continued, “so it knew that what I was saying had credibility. And then it was a matter of people setting their egos aside, which they did beautifully. There was real leadership that people showed and that allowed us to bring the groups together.”
Quality appeal
One of Parkinson’s biggest thrusts actually began before he officially took the AHCA top post in January 2011. Hired in the fall of 2010, he immediately set about constructing a new Quality division.
“We’re not just an association of lobbyists and political people,” he noted Tuesday. “We’re also filled with clinical people, most notably [Chief Medical Officer] David Gifford and [Senior Vice President of Quality, Regulatory & Clinical Services] Holly Harmon and their teams. Because we developed that clinical capability along with the analytics capability, we have the CDC and, from time to time, CMS and various folks involved in public health who are contacting us to get our opinions on how things ought to be done.
“That proved incredibly valuable during the pandemic when no one knew what best practices were and people were often calling us, government agencies were calling us and saying, ‘How do we do this?’”
Parkinson recalled that while he was still governor, he contacted Gifford, a geriatrician who was then Rhode Island’s Director of Health and well known for his nursing home expertise. Gifford told him that he’d lead the new Quality division, if he could be convinced Parkinson and members’ motivations were sincere.
“‘If you prove that to me, I’ll commit to being here at least three years,’” Parkinson recalled Gifford telling him. “That was 13 years ago. We’ve been able to make a lot of progress.”
This is where Parkinson’s Midwestern candor took over in an interview Tuesday.
“I would not have taken this job if I was not convinced that providers really wanted to improve quality and that AHCA would give us a chance to help them in that journey,” he said. “There’s no room for providers who aren’t committed and passionate about providing great care and are willing to make the sacrifices and take the time to do it. If the sector turns its back on that, it does not deserve to be funded.”
Pride in innovation
Parkinson figures some of his longest lasting influences may have sprouted during the last five years.
First is the development of in-state provider networks, designed to leverage better contracts with Medicaid and Medicare managed care companies.
“That’s gone very well,” Parkinson said. “Right now we have eight or nine networks and we’ll probably have another four or five that start in 2024. I wouldn’t be surprised if we end up with 25 or 30 networks four or five years from now that will really provide great service.”
The second innovation he touted is a deep dive into population health management, which he called “incredibly exciting.” AHCA/NCAL created a population health management council and has a growing corps of members setting up their own Institutionalized Special Needs Plans (ISNPs) and similar risk-sharing programs.
The third special point of pride is the start-up of the association’s own, currently very successful, group purchasing organization about three years ago, he said.
Staying put, sort of
Parkinson said his post-retirement plans include remaining in the Washington area, where he’ll continue to consult with the new AHCA top executive for a limited time and also work with “companies committed to doing great care.”
He urged providers to remain focused on their patients and residents to find success.
“My advice is to continue to be passionate about the care of the residents, be mission-driven, make decisions that are in the best interests of the residents and if you do that, you’ll do well,” he said. “If you don’t do that, you probably won’t do well. When you look at the outlier companies, whether it’s skilled nursing or assisted living, the first thing that jumps out about all of them is there’s a genuine passion for taking care of their residents. They talk a lot more about the care they’re providing and the quality that they’re providing than their bottom line.”
Living near the nation’s capital also will allow Parkinson to remain close to the immediate family.
He and his wife, Stacy, both lawyers, have three children. Older son Alex and his spouse both practice law in the District of Columbia, and have contributed a grandson and a granddaughter to the mix. Son Sam is finishing his law degree at the University of Maryland and has a home in Baltimore with his spouse. Daughter Kit, meanwhile, graduates from veterinary school this semester and Parkinson hopes she and her spouse will settle somewhere nearby as well.
The first big move after retirement, however, will be a long-awaited trip to India, a place he said he’s always wanted to visit. The journey might take place while his beloved Kansas City Chiefs are attempting to become the first NFL team to threepeat as NFL champions.
“We’ll do some traveling and hang out with the kids and grandkids a lot more,” he said. “Just being able to spend more time with family and missing fewer things will be great. There are some things we want to do, and you have to do them while you’re healthy. I think it’s the right time.”
