By JULIE MINDA
In an era of increasing cooperation between long-term care and hospitals, the long-term care and senior housing services organization Benedictine Health System has selected a leader who has spent much of his career in acute care.
Rocklon "Rocky" B. Chapin took over as president and chief executive of the Duluth, Minn.-based Benedictine Health System on Jan. 1. Chapin has been a health system executive, a hospital administrator and a health care consultant. He joined Benedictine Health System in January 2013 to head strategic planning. In fiscal year 2013, Benedictine Health System had 3,324 nursing beds and 2,137 assisted living and independent living units; and it had operating revenues of $258.8 million and operating expenses of $258.1 million.
Chapin says he intends to visit all the facilities that Benedictine Health System operates in 40 communities in Minnesota, North Dakota, Wisconsin, Missouri, South Dakota and Illinois. To that end, he's been on the road every week meeting with managers and staff. He spoke with Catholic Health World about what's ahead for long-term care.
Q. What is Benedictine Health System doing to position itself for the future?
A. We're dealing with increasing acuity because (hospitals want) to discharge (patients) to a safe environment fast, so we see a lot of short-term skilled nursing or transitional care. We're working on the competencies of our staff, for instance by working with community colleges who are involved in the training and development of our nurses.
Also, we're working on innovation. Our foundation's board endorsed creating a center for innovative practices, to create a funding source for innovative practice. This could be done with performance improvement grants from the state of Minnesota. Those grants can deal with reducing hospital readmissions and with seamless transitions in care. Additionally, we would self-fund to develop team member ideas to improve care. This money could help free up staff to develop their ideas.
We're enhancing our partnerships with major acute care systems, including the possibility of partnerships as risk-sharing accountable care organizations. Benedictine Health System is well-positioned to be part of others' ACOs. Enhanced partnerships would mean that we're at the table with them as they're negotiating rates with payers. Without partners, we are "just a vendor," and it's a purely economic relationship. With enhanced partnerships, we partner in the establishment of protocols and care pathways regarding timely and appropriate care.
We're developing facilities on the campuses of acute care providers.
Q. How is your thinking influenced by your acute care background?
A. Some colleagues view themselves as competitors, or "your world versus mine," when it comes to acute and long-term care. I think I can bridge the two and serve as a kind of translator between the two.
In acute care there is a big need for partnerships with long-term care. If we're going to coordinate care, we need to be at the table with all the elemental partners.
My background is in inter-organization collaboration, and leaders need this background today. Many organizations are not ready to merge, and so we partner, but first you have to check the alignment.
I bring knowledge of the imperative that acute care brings. (That imperative has to do with) how to manage population health. They're beginning to understand — "I need to be concerned with post-acute care." We're saying that we can help you do this.
Q. What are some of Benedictine Health System's strengths in today's market?
A. Our history is one of the main forces working in our favor. Benedictine Health System has evolved since its formation almost 30 years ago. We started as a consortium of acute care and long-term care providers. In 2008, Benedictine Health System began to focus on senior services, including care of the elderly, skilled nursing facilities, independent living facilities and other services. There was a time that we had acute care, and that history and knowledge creates openness to partnerships, as if we were cousins.
Q. What challenges will the system face in the short-term?
A. The main challenge is the availability of capital — how to fund this work in our individual facilities, which have very low margins. We have to use others' dollars, through partnerships.
It's easy to do the math, to see the trends, and see that we won't have the capital we need to maintain our current course. (We have to be innovative in) better responding to the desires and needs of the people we serve. There has to be a sea change, because there is a change in the expectations for care.
People are choosing other venues like assisted living, that rival what skilled nursing facilities provide. We're likely to see a lot of churn in skilled nursing — an increase in admissions and discharges. And people used to stay a year, now (they stay) just a few months. In skilled nursing there's a lot of rehab and end-of-life care, and not as many long-term stays.
Also, there are different generations we're looking at. There were those who fought in World War II, who are dying. And there are fewer from the next generation to take their place. In the 1930s, for the first time ever in American history, there were fewer people born than in the previous generation. So for 10 years, there's a demographic trough between generations — between the World War II generation and the Baby Boomers.
Q. How are residents' expectations of long-term care changing?
A. People used to accept sharing rooms; now they're less accepting. So we have to reconfigure, and we need money to do that. And people not only want private rooms, they want private bathrooms.
(Families) want to move their parents just once, and people want to age in place. And so some, but not all, of our facilities are colocated with assisted living. Facilities with the full continuum — they are doing the best now. So we're seeking to establish this.
Q. What emerging challenges have you identified?
A. The new challenges we're just beginning to see have to do with the continued specialization of medicine. Now, physicians stay within their specialized segment, rather than making themselves available in the outpatient, ambulatory, hospital and nursing home to see their patients. Sometimes nursing homes have to turn away an admission because there is no physician available. We're looking into alternatives, such as Skype and other technology to link with physicians, since lack of physician supply is a concern.
Q. Part of your career has been in Catholic health care, and part outside of the ministry. What are the main differences?
A. I am Lutheran, and I have been active in my church and community over the years. Benedictine Health System allows me to express my faith at work -- that this is God's work. Benedictine Health System encourages us to openly express our faith, and the motivation behind our work. We can talk openly about that, and that is so freeing.
Q. Is there anything else you would like to share?
A. I've learned over my career that it's important to lead from the center -- in other words, the solution is within our organization, it's within our staff. And that is a St. Benedict value -- to involve a lot of people in the solution. So there are lots of conversations and opportunities for input and discussion. It's been fun visiting our facilities and talking with people. During introductions I ask why they come to work every day, and I hear similar themes. They say they enjoy the people they work with. They say they feel they're doing God's work. And they say they value the relationship that develops over time with those they serve. Those major themes are so affirming for me. It shows we're all children of God, and we all have worth.
Chapin knows acute care
Rocklon "Rocky" B. Chapin, president and chief executive of Benedictine Health System, has worked as:
- Senior vice president, business development and strategic planning, for Benedictine Health System
- Executive vice president and senior officer of the hospital division for Essentia Health East of Duluth. In January 2008, an Essentia subsidiary called Essentia Community Hospitals and Clinics acquired all of Benedictine Health System's hospitals and clinics.
- National director, health care services with Minneapolis' Ryan Companies, a building and real estate firm
- Executive vice president and chief operating officer, St. Luke's Methodist Hospital, Cedar Rapids, Iowa
- President and chief executive of Cedar Rapids' VHA Iowa/HealthEnterprises of Iowa, a health care consultancy
- Senior administrator, Abbott Northwestern Hospital, Minneapolis
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