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StoneGate Senior Living

StoneGate Senior Living: Providing Skilled Care, Compassion

Kevin Doyle, Senior Editor

StoneGate Senior Living emerges as an industry leader in its first decade of operations
StoneGate Senior Living: Providing Skilled Care, Compassion

As the length of a hospital stay shrinks, the need for providers of skilled nursing care for patients not ready to return home increases accordingly. That trend galvanized John F. Taylor’s decision to establish Lewisville, TX-based StoneGate Senior Living in 2001.

Taylor, StoneGate’s President and CEO, drew on his previous industry experience to help his new company define its market position. He had previously co-founded Torch Healthcare in the 1990s, departing after the company’s merger with a Seattle, WA group.

“Torch had its beginnings in skilled nursing and then moved into assisted living. I was trying to determine how to re-start and a colleague of mine suggested that I take a look at the skilled nursing space again and follow a similar business model as we had developed (at Torch) for assisting living,” Taylor recalls.

“Nobody was developing new skilled nursing assets on a large scale and the industry longed for a new product. Once we determined the numbers made sense, we were off to the races. From the time we started (on Nov. 1, 2001) we opened our first building 30 days later. It was quite accelerated,” Taylor says.

StoneGate Senior Living owns or operates 30 facilities in Texas, Oklahoma and Missouri. The company employs approximately 4,000, accumulated $250 million in gross revenue last year and will open four new facilities in the first quarter of 2012.

Setting themselves apart

While StoneGate’s physical inventory is impressive – the oldest building opened in 1985 – Taylor says human capital differentiates the company from its competitors.

“It’s always the people. We ensure that we’re attracting the right people and have been extremely fortunate and blessed to pull together a team across our sites committed to providing a high-quality product,” Taylor asserts. One hundred forty employees in Lewisville provide system-wide support.

“The hardest thing to replicate is the people. We’ve made big commitments in terms of the people we’ve brought on board, those with the ability to care for acutely ill patients who come to us right out of the hospital,” he stresses.

That care is provided in aesthetically pleasing state-of-the-art facilities that are an industry gold standard.

“We have a portfolio of new to newer assets and own or operate everything except one building. There are a number of reasons we like doing new assets. Family members shop with their eyes first. Before anything else, the environment has to pass the test,” Taylor says.

Patients’ families are provided a tour of the grounds and introduced to caregivers who explain the depth of care and services provided. “From that point you have to deliver on the image you’ve presented,” says Taylor. “Each day a patient is in our care provides the proof of whether the family made the right decision.”

What they do

“Our core business is skilled nursing. We’re not developers and operators of freestanding assisted living and memory care facilities. When we do that, we prefer to do it in a campus setting, in a way that provides a continuum,” Taylor says. “We now have four properties that have that continuum. We are enthusiastic to provide those services if the needs are under-served in that market.”

Skilled nursing facilities occupy approximately 60,000sf with between 80 and 120 beds. Continuum campuses are nearly double that size, housing 180 to 200 beds in buildings of approximately 110,000sf. The company has 3,642 licensed beds across its network.

Care includes 24-hour nursing, pulmonary management, rehabilitation programs, IV therapy and pain management, inpatient and outpatient physical therapy, occupational therapy and speech therapy. The length of a patient’s stay depends upon who is paying the bill.

“Medicare and Managed Care patients may stay from 20 to 25 days, Medicare Part A is twice that, and longer-term patients are closer to 20 to 24 months. It’s a high-turnover environment and a challenge to the staff. We’re becoming more like long-term hospitals,” Taylor says.

The company is laying the groundwork for future affiliation with Accountable Care Organizations, or ACOs, that provide a care continuum across several institutions.

“We’re in a rapidly changing environment. We’re very dialed into acute care hospitals and attuned to their thoughts as to how they see these networks evolving. We want to position ourselves to be part of those. It’s not real clear yet what they look like but we’re beginning to see evidence that they are evolving,” Taylor says.

Upgrading technology

The company implemented AccuNurse Voice developed by Vocollect at two pilot facilities in September. System-wide installation will be completed later this year. The technology provides real-time information access and allows caregivers to make quick, accurate decisions.

“It has resulted in much better and more accurate documentation of services rendered the patient. It’s live charting. Our industry has been slow to embrace technology but it’s now happening at a very rapid rate,” says Taylor.

Doug Harper, StoneGate’s VP of Sales and Marketing, says “we’ve seen improvements in nurse’s aides’ ability to increase the amount of time spent in direct care and their ability to communicate in real time with supervisors and co-workers.”

An iPad bedside assessment tool, rolled out on Jan. 1, allows external marketers and clinical liaisons to send a patient’s pre-admission information to those evaluating and deciding if an individual is a good fit for StoneGate’s services.

People and Training

Recruiting is done through industry contacts, often by  senior staff members . Additionally, the company continually grooms employees for internal promotion.

“Attracting high-quality personnel is the biggest challenge we face. You have to have a license to be a nursing home administrator, but it takes a year or more to become licensed. It’s always a fixed pool and a large number of these folks have not had the experience we would like for them to have in running a business of this nature. We have to develop those skills,” Taylor says.

The company offers competitive compensation and tuition reimbursement and provides continual training across disciplines via methods such as online webinars and the use of consultants.

Moving forward

Constant concerns about the Federal budget and the nagging uncertainty of adequate annual funding notwithstanding, StoneGate is on solid ground.

Taylor says expansion opportunities exist in states StoneGate already has a presence and will likely be new buildouts rather than acquisitions. “It is hard to find an acquisition where the physical assets meet our standards. The buildings are functionally obsolete and to spend money to fix them doesn’t make sense,” Taylor says.

“We want to continue to evolve and to provide the level of service the system expects. To the extent that there is a sensible reimbursement system in place, we will take patients with higher needs as quickly as the system needs us to take them. Hospitals are keeping people less these days and there has to be someone to take those patients,” he concludes.

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