Latest / Becker’s Healthcare Podcast / Navigating Post-Acute Strategy and Workforce Pressures with Charles Ross

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Navigating Post-Acute Strategy and Workforce Pressures with Charles Ross · Becker’s Healthcare Podcast

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Hello, and welcome to the Becker's Healthcare podcast.
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My name is Chanel Bongern. Today, I have
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the pleasure of speaking with Charles Ross,
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a chief strategy officer and partner at TCM
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Consulting and Management, who joins the podcast today
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to share insights to his background, Trancy is
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keeping an eye on a bit more. Charles,
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thank you so much for joining me today.
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Thank you. Glad to be here.
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Perfect. Well, to get us started out, could
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you please introduce yourself and tell us a
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bit about your background in TCM?
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Absolutely. Thank you. I am Charles
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Ross. I'm the chief strategy officer with TCM
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Consulting and Management.
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I actually began my career as a hospital
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discharge planner,
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back in the nineteen nineties. And
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the unit I worked on was a geriatric
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unit, and many of those
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patients
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were needing,
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skilled nursing
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home care post discharge. So I got, an
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introduction
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to that as a professional from the hospital
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side. And then eventually, I went on to
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work for
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a not for profit hospital owned skilled nursing
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facility
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in a case management role and an operations
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role and a marketing role. So those those
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sort of combined to bring me to
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my position now in strategy. I eventually worked
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my way up to,
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become a nursing home administrator.
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A great position.
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Learned a lot doing that as well.
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And about fifteen years ago,
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TCM was founded.
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It was actually founded
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originally as transitional
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care management, and we,
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use TCM, obviously, as the easy shortcut.
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But over time, we evolved and the company
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evolved.
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And over those fifteen years, we really have
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the opportunity
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as a company to do a lot. And
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I think that's what's kept us relevant today
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is doing, you know, focusing on different areas
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and doing different things.
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We originally
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were focused on building state of the art
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post acute freestanding
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transitional
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care centers
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and becoming a full service third party management
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company for those and other centers.
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We still do,
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full service third party management
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and that's still part of our business. But
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along the way,
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we have run a home health care company.
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We've managed a hospice company.
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We've helped design
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newly built, nursing homes and transitional care centers.
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And we've we've been and are currently a
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third party management
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company for,
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skilled nursing homes,
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intermediate care centers,
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behavioral
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health care
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centers,
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and even a specialized mental health,
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rehab center.
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And we've managed,
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both for profit and, not for profit
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entities.
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So we we have experience with both.
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We've also
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consulted
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to hospitals on their skilled nursing strategy
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and consulted specifically around creating skilled nursing units,
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with acute care and helping hospitals see if
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that's
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a good, fit for them.
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And we do quite a bit of clinical
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consulting
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nationally
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for skilled nursing, for assisted livings,
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senior livings. And we found a real sweet
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spot with, continuing care retirement communities that have
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skilled nursing units because,
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skilled nursing,
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has certainly a different set of demands from
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the rest of senior living products and a
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high level of regulation
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and a high level of clinical focus. So
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often groups will bring us in to help,
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look at their clinical needs for their CCRC
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skilled nursing units, but also how to integrate
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those skilled nurse units programs successfully
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with the rest of the CCRC.
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And we do back of the house full
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service financial management for senior livings, for assisted
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livings,
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and for nursing homes. So we've been able
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to
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become over the last, fifteen years,
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very versatile. I'm really,
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proud of that. And we've been able to,
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in some cases, anticipate
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the evolving market and other cases diversify
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because,
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you know, a need suddenly emerged and clients
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and customers were, you know, experiencing
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need and we were able to fulfill those
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needs, particularly with a lot of the financial
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work that we do as a company. We
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find that we can only get a relief
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for,
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clients who do front of the house. You
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know, they do an excellent job, but perhaps
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they need some help with finance and billing
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or what we're doing for one client, create
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a plan where we can transition them from
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us helping them with the back office to
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them hiring their own team and doing it
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themselves.
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I our biggest,
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divisions right now, in addition to the full
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service management, would be that back of the
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house financial management
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and our clinical consulting division. And then we
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also do, recruitment as well.
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And that's that's pretty much the summary of
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where we are as a company today.
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Wow. That's amazing. It sounds like your team
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is involved in a wide variety of efforts.
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And with that, I'm curious to hear what
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trends are you watching in health care currently?
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Oh, gosh. There there's so much and there's
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been so much that happened
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post COVID, but I do think
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there's still and and some of it's still
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lingering,
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significantly. I think there's still a post COVID
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workforce pressure,
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which particularly puts pressure on
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positions
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in nursing homes and senior living. And, and
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when we're looking for direct caregivers, there's definitely,
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that pressure that we and our clients are
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dealing with.
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Also, nationally, in the last ten years, there's
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been about a five percent rate of nursing
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home closing.
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And I'd say that that's not the big
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squeeze, but the squeeze is is less about
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closing, but more about,
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facilities that are left. How are they performing?
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There is a, you know, certainly a trend
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for people to find,
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alternatives
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to nursing home care. So what you have
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is typically,
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you know, those with the highest acuity or
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needing the most care will end up in
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nursing homes, and then there continue to be
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more and more options for those who may
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not need a nursing home level of care.
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Right now,
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about ten thousand people are turning 65
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each day,
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which will take us from sixty three million
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seniors in The US
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to something like seventy three million in 2030
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and
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ninety five million by some predictions in 2060.
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So the senior tsunami or silver tsunami is
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still at play,
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but there are more and more options for
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those people.
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I'd say additional trends
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would have some more specifically would to do
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with skilled nursing operators
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operating on very slim margins.
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And one of the way they often react
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to that is have leadership positions covering multiple
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roles
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and maybe fewer specialists and more generalists.
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That's often where we come come in hand,
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for our clients as we can provide some
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of that specialization
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that they may not have in house, particularly,
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let's say, with the clinical needs they might
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have.
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And all this does create clinical needs. We
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see increased needs for clinical training,
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increased needs around
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AR and revenue cycle management.
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Oh, and I there's one trend I have
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to mention that's sort of a trend in
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every industry now, and that is, AI.
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We have seen it really help and improve
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some processes.
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We're actually using an AI system
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with our admissions process,
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in the the buildings where we are a
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third party manager
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and seeing some some it being very, very
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helpful.
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And it does take pressure off in some
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areas, but I think we all have to
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watch that trend. Be careful. Don't become overreliant
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because we've seen many examples in our own
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work where,
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AI's answer isn't necessarily the end. It's a
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great tool, a great way to help process
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things, but I don't think we're at a
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point where we can rely on as overly
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heavily yet.
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Got it. Got it. Thank you so much
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for walking us through that. And now it's
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hard to believe that we're about a quarter
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of the way through 2026.
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And I'm curious to know, what are you
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most focused on and excited about going into
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the rest of 2026?
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I know. Time is is really flying.
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You know what's very interesting about the work
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we're doing in the post acute space and
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working with hospitals
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and and seeing some increased interest in,
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working with post acute, providers in a different
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way is back in, 2014, September 2014,
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myself and our chief clinical officer at the
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time wrote an article for Becker's, 10 things
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hospitals should know about their post acute providers.
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So it's kinda fun to be,
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still talking to hospitals and seeing how we
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we've evolved over the last decade.
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And so I've been really excited about all
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things TCM consulting and management that are
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kinda have moved away from our,
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traditional
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nursing home, you know, or as post acute
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care only
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focus, when you're really just looking at buildings,
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you know, specific nursing home buildings. And I'm
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really excited
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about how we're reengaging with acute care,
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reengaging with providers across the continuum.
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One project that we've seen increased interest, really
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starting the end of last year and this
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year
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is hospitals
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willing again to look at how skilled nursing
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fits with their strategy.
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And that goes beyond,
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what's been in play for many years, which
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is a hospital's,
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post acute network where they are engaged with
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community providers,
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but now actually looking inward
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at their current acute care beds and utilization
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and exploring why we are not having hospital,
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skilled nursing units would fit their strategy.
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And we really love,
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helping hospitals do that that assessment.
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There's, been a couple of systems, one in
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Illinois
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and, one in Indiana where we were,
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part of helping them
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explore whether or not having
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or keeping a hospital skilled nursing unit would
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fit with their long term strategy.
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We currently have a couple of other
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hospitals engaged in those discussions right now. So
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I'm really excited,
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to see where, that will go for us.
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Exciting stuff. And now I could tell in
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this short conversation that you're very driven and
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impactful in what you do. And with that,
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I'm curious to know what advice you would
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give to evolving leaders looking to have that
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same impact and drive in their careers as
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you have.
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Oh, great question.
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I would say, number one, be flexible.
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You survive by moving,
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being in a position to anticipate
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your clients' needs and looking at trends, but
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just definitely being flexible,
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being versatile.
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Really
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look number one at how to help
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those that you serve, whether it be the
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residents in a in a nursing facility
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or an investor who
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owns, you know, the business you're helping manage,
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but really,
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really get to the heart of of what
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your customer
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wants and look for win wins.
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And don't assume that others understand what the
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win win is. Sometimes you have to educate
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them.
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For example,
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a senior living
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community
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might just get excellent reviews, provide excellent care,
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have a fantastic,
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occupancy rate, doing very well. But if they're
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failing with, collecting the income, they're not gonna
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be able to provide the services they want
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to their their clients. So that's an idea
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where where our company can come in sometimes
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and create a win win
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for the business, and and everyone,
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does well. But I would say definitely also
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find a need, fill that need,
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don't be afraid to do something outside of
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your core competency
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because you can learn it, your team can
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learn it. And as you heard as my
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example of TCM consulting and management, what we've
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done over the last fifteen years, you know,
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there's been a wide breadth
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of work we've done. Some of it we
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continue to do. Some of it has evolved,
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you know, into different work. And that is
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what keeps things fresh and exciting.
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It's kinda funny. I started
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my career, you know, I told you about
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my first jobs, but I look back and
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at, age of nine, I was visiting my
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grandmother
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in a nursing home in rural East Texas,
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and we would make regular visits.
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And at that age, I kind of found
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it fascinating. I actually enjoyed,
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the visits and the people I met. And
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I wish I had, you know, video from
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those days and could compare
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where skilled nursing has, you know, has gone
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over the the decades because we've evolved
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so, so much. So, keep evolving. That's probably
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the best way to sum up my advice.
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I love it. That's excellent advice. Well, Charles,
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I wanna thank you for your time today.
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But before I let you go, is there
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anything else that listeners should know?
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I'd love if you,
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would reach out and follow us on LinkedIn,
13:33
TCM Consulting and Management.
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We have a a LinkedIn page with, frequent
13:38
posts. And you can also find us via
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our website,
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tc-mgmt.com.
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And thank you so much,
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for the time to speak with you today.
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Thank you as well. And I wanna thank
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you once again for joining me today and
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for sharing your insights on the Becker's Healthcare
13:58
podcast. Thank you so much. Thank you.