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Becker’s Healthcare Podcast
Navigating Post-Acute Strategy and Workforce Pressures with Charles Ross
00:14:04
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- [00:00]
A
Hello and welcome to the Becker's Healthcare Podcast. My name is Chanel Bunger and today I have the pleasure of speaking with Charles Ross, a Chief Strategy officer and partner at TCM Consulting and Management, who joins the podcast today to share insights to his background. Trinity's keeping an eye on a bit more. Charles, thank you so much for joining me today.
- [00:18]
B
Thank you. Glad to be here.
- [00:20]
A
Perfect. Well, to get us started out, could you please introduce yourself and tell us a bit about your background in tcm?
- [00:26]
B
Absolutely. Thank you. I am Charles Ross. I'm the Chief Strategy Officer with TCM Consulting and Management. I actually began my career as a hospital discharge planner back in the 1990s and the unit I worked on was a geriatric unit and many of those patients were needing skilled nursing home care post discharge. So I got an introduction to that as a professional from the hospital side. And then eventually I went on to work for a not for profit hospital owned skilled nursing facility in a case management role and an operations role and a marketing role. So those, those sort of combined to bring me to my position now in strategy. I eventually worked my way up to become a nursing home administrator. Great position. Learned a lot doing that as well. And about 15 years ago TCM was founded. It was actually founded originally as transitional care management and we used TCM obviously as the easy shortcut. But over time we evolved and the company evolved and over those 15 years we really had the opportunity as a company to do a lot. And, and I think that's what's kept us relevant today is doing, you know, focusing on different areas and doing different things. We originally were focused on building state of the art post acute freestanding transitional care centers and becoming a full service third party management company for those and other centers. We still do full service third party management and that's still part of our business. But along the way we have run a home health care company, we've managed a hospice company, we've helped design newly built nursing homes and transitional care centers. And we've been and are currently a third party management company for skilled nursing homes, intermediate care centers, behavioral health care centers, and even a specialized mental health rehab center. And we've managed both for profit and not for profit entities. So we have experience with both. We've also consulted to hospitals on their skilled nursing strategy and consulted specifically around creating skilled nursing units with acute care and helping hospitals see if that's a good fit for them. And we do quite a bit of clinical consulting nationally or skilled nursing for assisted livings, senior livings and we found a real sweet spot with continuing care retirement communities that have skilled nursing units because skilled nursing has certainly a different set of demands from the rest of senior living products and a high level of regulation and a high level of clinical focus. So often groups will bring us in to help look at their clinical needs for their CCRC skilled nursing units, but also how to integrate those skilled nursing units programs successfully with the rest of the ccrc. And we do back of the house full service financial management for senior livings, for assisted livings and poor nursing homes. So we've been able to become, over the last 15 years, very versatile. I'm really proud of that. And we've been able to in some cases, anticipate the evolving market and other cases diversify because, you know, a need suddenly emerged and clients and customers were, you know, experiencing need. And we were able to fill those need. Particularly with a lot of the financial work that we do as a company. We find that we can really be a relief for clients who do front of the house. You know, they do an excellent job, but perhaps they need some help with finance and billing or what we're doing for one client. Create a plan where we can transition them from us helping them with the back office to them hiring their own team and doing it themselves. Our biggest divisions right now, in addition to the full service management, would be that back of the house financial management and our clinical consulting division. And then we also do recruitment as well. And that's pretty much the summary of where we are as a company today.
- [05:12]
A
Wow, that's amazing. It sounds like your team is involved in a wide variety of efforts. And with that, I'm curious to hear, what trends are you watching in healthcare currently?
- [05:21]
B
Oh, gosh, there's so much, and there's been so much to happened post Covid, but I do think there's still, and some of it's still lingering significantly. I think there's still a post Covid workforce pressure, which particularly puts pressure on physicians in nursing homes and senior living. And when we're looking for direct caregivers, there's definitely that pressure that we and our clients are dealing with. Also nationally, in the last 10 years, there's been a about a 5% rate of nursing home closing. And I'd say that that's not the big squeeze, but the squeeze is less about closing but more about the facilities that are left. How are they performing? There is a, you know, certainly a trend for people to find alternatives to nursing home care. So what you have is typically, you know, those with the Highest acuity or needing the most care will end up in nursing homes. And then there continue to be more and more options for those who may not need a nursing home level of care. Right now about 10,000 people are turning 65 each day, which will take us from 63 million seniors in the US to something like 73 million in 2030 and 95 million by some predictions in 2060. So the senior tsunami or silver tsunami is still at play, but there are more and more options for those people. I'd say additional trends would have more specifically to do with skilled nursing operators operating on very slim margins. And one of the way they often react to that is have leadership positions covering multiple roles and maybe fewer specialists and more generalists. That's often where we come come in hand for our clients as we can provide some of that specialization that they may not have in house, particularly let's say with the clinical needs they might have. And all this does create clinical needs. We see increased needs for clinical training, increased needs around AR and revenue cycle management. Oh, and there's one trend I have to mention that's sort of a trend in every industry now and that is AI. We have seen it really help and improve some processes. We're actually using an AI system with our admissions process in the buildings where we are a third party manager and seeing it being very, very helpful. And it does take pressure off in some areas. But I think we all have to watch that trend. Be careful, don't become over reliant because we've seen many examples in our own work where AI's answer isn't necessarily the end. It's a great tool, a great way to help process things, but I don't think we're at a point where we can rely on overly heavily yet.
- [08:18]
A
Got it, Got it. Thank you so much for walking us through that. And now it's hard to believe that we're about a quarter of the way through 2026. And I'm curious to know what are you most focused on and excited about going into the rest of 2026?
- [08:31]
B
I know Thymus is really lying. You know what's very interesting about the work we're doing in the post acute space and working with hospitals and seeing some increased interest in working with post acute providers in a different way is back in 2014, September of 2014, myself and our chief Clinical officer at the time wrote an article for Becker's 10 Things Hospitals Should Know About Their Post Acute Providers. So it's kind of fun to be still talking to hospitals and Seeing how we've evolved over the last decade. And so I've been really excited about all things TCM consulting and management that are kind of have moved away from our traditional nursing home or post acute care only focus when we are really just looking at buildings, specific nursing home buildings. And I'm really excited about how we're reengaging with acute care, reengaging with providers across the continuum. One project that we've seen increased interest really starting the end of last year and this year is hospitals willing again to look at how skilled nursing fits with their strategy. And that goes beyond what's been in play for many years, which is a hospital's post acute network where they are engaged with community providers, but now actually looking inward at their current acute care beds and utilization and exploring whether or not having hospital skilled nursing units would fit their strategy. And we really love helping hospitals do that assessment. There's been a couple of systems, one in Illinois and one in Indiana where we were part of helping them explore whether or not having or keeping a hospital skilled nursing unit would fit with their long term strategy. We currently have a couple of other hospitals engaged in those discussions right now, so I'm really excited to see where that will go for us.
- [10:47]
A
Exciting stuff. And now I could tell in this short conversation that you're very driven and impactful in what you do. And with that I'm curious to know what advice you would give to evolving leaders looking to have that same impact and drive in their careers as you have.
- [11:01]
B
Oh, great question. I would say number one, be flexible. You survive by moving, being in a position to anticipate your clients needs and looking at trends, but just definitely being flexible, being versatile, really look number one at how to help those that you serve, whether it be the residents in a, in a nursing facility or an investor who owns, you know, the business you're helping manage. But really, really get to the heart of what your customer want and look for win wins and don't assume that others understand what the win win is. Sometimes you have to educate them. For example, a senior living community might just get excellent reviews, provide excellent care, have a fantastic occupancy rate, doing very well, but if they're failing with collecting the income, they're not going to be able to provide the services they want to their, their clients. So that's an idea where, where our company can come in sometimes and create a win win for the business and, and everyone does well. But I would say definitely also find a need, fill that need. Don't be afraid to do something outside of your core competency because you can learn it, your team can learn it. And as you heard, as my example of TCM consulting and management, what we've done over the last 15 years, you know, there's been a wide breadth of work we've done. Some of it we continue to do, some of it has evolved into different work. And that is what keeps things fresh and exciting. It's kind of funny. I started my career, you know, I told you about my first jobs. But I look back, and at age of nine, I was visiting my grandmother in a nursing home in rural East Texas, and we would make regular visits. And at that age, I kind of found it fascinating. I actually enjoyed the visits and the people I met. And I wish I had video from those days and could compare where skilled nursing has gone over the decades because we've evolved so, so much. So keep evolving. That's probably the best way to sum up my advice.
- [13:21]
A
I love it. That's excellent advice. Well, Charles, I want to thank you for your time today. But before I let you go, is there anything else that listeners should know?
- [13:28]
B
I'd love if you would reach out and follow us on LinkedIn. TCM Consulting and Management. We have a LinkedIn page with frequent posts and you can also find us via our website, tc-mgmt.com and thank you so much for the time to speak with you today.
- [13:53]
A
Thank you as well. And I want to thank you once again for joining me today and for sharing your insights on the Becker's Healthcare podcast. Thank you so much.
- [14:00]
B
Thank you.