Seeing a need for higher level clinical capabilities in long-term care facilities that has only been accentuated by the COVID-19 pandemic, Birchwood Healthcare Partners has bolstered its clinical platform, MPAC Healthcare, and is ripe for significant growth in 2022.
Owned by Birchwood since 2018, MPAC Healthcare provides medical and mental health clinical services in skilled nursing and assisted living facilities. MPAC deploys nurse practitioners and licensed clinical social workers full-time in participating facilities through its on-site model.
MPAC Healthcare’s ultimate goal is to reduce hospitalizations and enhance clinical outcomes, according to CEO Tim Martinez.
“I think Covid’s really highlighted the need for an increased level of support from the medical and mental health perspective for our clients, which are skilled nursing and assisted living operators,” Martinez told Skilled Nursing News. “That is driving a lot of our growth.”
MPAC has executed term sheets which will double the number of facilities it serves, which currently sits at more than 100, according to Birchwood founder and CEO Isaac Dole.
The clinical service comes “free of charge” to the facility as the treatment is billed through a patient’s insurance – similarly to an emergency room or hospital, Martinez said.
In addition to its already existing NP and LCSW program, MPAC is in the process of creating a psych component focused specifically on medication management and gradual dose reduction – working in collaboration to bring a holistic approach to the patient population, he said.
“It’s been something that’s been on our radar for a bit and we’re excited to get this rolled out, hopefully in the next couple months,” Martinez added.
Juggling the higher acuity patient with staffing challenges
As patients in long-term care become increasingly medically complex, the need to partner with and grow MPAC seemed like a no-brainer, Martinez said.
Especially at a time when long-term care facilities have lost more than 400,000 caregivers since the start of the pandemic, working with a group like MPAC is one way to boost staffing, and more specifically, shore up a facility’s clinical operations.
“Having that higher clinical capability to lean on during times of turnover among the DONs and other clinical leaders, has been hugely impactful for stabilizing clinical operations,” Dole said.
The NPs and LCSWs are “embedded” into a facility’s clinical team and are able to coordinate with the staff on a regular basis.
In addition to its on-site program, MPAC has a telehealth platform that is available to both rural facilities and those who need after hours assistance.
“MPAC’s telehealth capability has been equally as impactful, especially in rural communities, to identify changes in condition faster, and in many instances, prevent discharges to hospitals,” Dole said.
MPAC has also in some cases sent one NP and LCSW to cover multiple communities in areas that don’t have the volume for one full-time provider, he added.
And as the industry continues to find creative ways to recruit staff, in addition to retaining current employees, MPAC has been able to work around some of these challenges by building “a more robust recruiting function.”
“RNs and LPNs are incredibly challenging to recruit these days as are pretty much every other position, which is another reason why operators are turning to MPAC as a way to stabilize their clinical teams,” he said.
‘The larger the building the more effective we can be’
While there is a considerable amount of variability in the portfolio’s building size and quality mix, larger can be better in certain aspects, Dole said.
“The larger the building, the more effective we can be because there’s a larger population base our clinicians can care for,” Dole said. “We target larger buildings on average and then we also pay attention to geographic concentration so we can build more infrastructure in that market.”
Geographic concentration, scale, clinical sophistication and a desire to push the industry forward are considered key factors when pursuing a successful partnership, according to Dole.
And as skilled nursing providers look for ways to better position themselves in an increasingly value-based world, that’s a place where MPAC thrives, Martinez said.
“As I like to say it, we have to survive in a fee for service world, but our programs are really designed to thrive in value based care as the sort of needle continues to shift in that direction,” he said.
Dole said Birchwood ultimately invested in MPAC Healthcare because its value “fits squarely into the future of this industry.”
Raising capital for future growth
In addition to Birchwood’s growth on the clinical side through MPAC, the investment firm this year plans to raise capital in one fund that encompasses all of its investment activities.
This would include senior housing and SNF acquisitions, a venture component, as well as the acquisition of additional ancillary businesses, Dole said.
Birchwood already has a hospice company and a small home health company, in addition to the MPAC NP/LCSW program.
“As we assess other opportunities, we are looking for those areas where we can make the maximum impact on our stakeholders,” Dole said.
That will also likely include the improvement of the average quality of their physical plants through renovation, addition and replacement, in addition to acquisition.
This is all part of Birchwood’s plans to become not only the employer and provider of choice through clinical capabilities and culture, but also a best in class physical plant, Dole said.
“2022 is going to be a turning point for us as far as ancillary companies are concerned,” he said.