Emmett Reed

Scott

Hey, I'd like to welcome this episode of our VIUM Capital VERSED podcast Emmett Reed, the President of the Florida Health Care Association. Hey, Emmett, thanks for being on our podcast.

Emmett

Good morning, Scott. Thank you for having me.

Scott

This is really fun today because we're old friends. We've known each other for, I don't know, 13 or 14 years, and we've got a ton of great fun war stories we could tell and take up a whole day. We're gonna talk about some important things going on in Florida today, and I want to hear for the listeners to know a little more about you and your background. But I was trying to remember, I started as the President of the Indiana Healthcare Association in 2010. We were in the same "pledge class", so to speak, right? With our friend Heath Boddy from Nebraska, who's been on our podcast before, too. You had started maybe that year, just a year before, is that right? Somewhere around then?

Emmett

Yeah, I started in 2009. That's exactly right.

Scott

Hey, before we get started, some substantive work hey, I know you're a really proud husband, a proud father. Tell me a little about your family and your kids and where they are right now.

Emmett

So I've been married to Heather for we celebrated 30 years this past October. Been together for 37 years. We're high school sweethearts, believe it or not. And she somehow decided to stay with me through college and everything else. So, three wonderful children. Our oldest daughter is Emily. All three of them graduated from Florida State University. Well, actually she graduated from Florida State University. I have two there now. But Emily is a registered dietician at a hospital down in the St. Pete Tampa area. And then my son, Everett is a senior at Florida State University, double majoring in mass media communications, got a music scholarship, and is actually tomorrow night is opening as the lead for FSU's School of Theater. Our youngest, Abigail, she's a sophomore majoring in business, and she's really just starting to come into her own, plugged in becoming very involved in her sorority, but also with the school as a student booster representative.

Scott

My kids are younger than yours, but I'd imagine as you see your kids become older and become adults, seeing them fulfill their mission in life and follow their passions and helping others, got to be really, really rewarding. That's got to be really exciting. In terms of your background, this is not your first association you've worked with, you've had some great experiences in the Chamber of Commerce world and also in the home builder world. Tell our listeners a little bit about that background and then what you think maybe led you to running the Florida Health Care Association and those experiences that made you a better leader.

Emmett

Yeah, that's a great question. I'm a big believer in Providence and really, you can't look back at my career and think that there wasn't a greater power. I was a less-than-stellar student. I tell people I graduated, thank the Law Day. But once I got out in the real world, worked for a couple of years for the state of Florida in the regulatory environment. So I learned that got a job at the Lakeland Chamber of Commerce for two years as their membership director. And we were really fortunate enough to break a couple of national records for membership recruitment in the Lakeland area, which Lakeland is located right between Tampa and Orlando, Florida. And it's smack dab in the middle. It was really a great opportunity.

It was a growing city whenever I worked for the Chamber. And then out of the blue, the former to Home Builders Association calls me and says, Hey, we want to interview you for a job and we want you to be our membership director. We don't really have a job description for it, but we see what you're doing there in Lakeland, and we're hoping you can replicate it on a statewide level. And so that was 1997. I can remember I was in Tallahassee, Florida. Tallahassee is about a four-and-a-half-hour drive from Lakeland. And so in my interview, they asked me would I be willing to move to Tallahassee. And I pulled a map out and I showed them all their local affiliates that they had, and they were much closer to Lakeland than Tallahassee.

And I would save them a lot more money if I could do something, which was really novel back then, and I offered to work from my home. And so I worked from my home for about five years. And then they came to me and said, look, we really like what you're doing. We really think and this was the CEO at the time said that if you move to Tallahassee, I'd like to bring you up to be the next CEO of the Florida Home Builders Association. And so that's how that happened. Did that for about three and a half years as the CEO, I was with them 11 years total. And then this opportunity came up and here I am.

Scott

Well, that's great. And again, I always love our listeners to know who we're talking to and the backgrounds they bring to the long-term care space. And I've got a friend who's got a great phrase that says, "There's no coincidence in Providence", right? So let's get into your work at the Florida Health Care Association. Tell us a little about the size of your membership because I have a sense you work with basically almost all of the SNF operators in the state. But give our listeners a sense of the size of the association. What are you working on right now? What are some top priorities for the session?

Emmett

In Florida, you have 700 SNFs, Skilled Nursing Facilities, and we represent just over 600 of them. We also represent some ALFs. And then of course we have about four to five hundred depending on the year and time of year of our associate members. So we've represented over a thousand members, and we represent obviously a large majority, about 86, 87% of the nursing homes in the state of Florida. We'd love to represent them all, and that's our goal. And I think one day we will I really do believe that we think that we can help every single nursing home in Florida become a higher quality, higher revenue care center. So we are in the middle of session. We've got about 15 days left. But who's counting? It's been a very interesting session this year.

Basically, we had two issues this year. Number one is reimbursement. That was a huge issue. We are still not receiving our costs for Medicaid. And there's a delta there. And back in the old days, Medicare would make up for that. But, now that we've got the Vantage programs and all those good things going on that's all balanced out. And so we really do need to be reimbursed for the cost of taking care of our frail and elderly and the residents of our nursing homes. So reimbursement is our top issue. And we are fighting diligently for that. The biggest hurdle is we've had a lot of success with reimbursement over the last four years in particular. And so the legislature is an interesting body.

They've been very good to nursing homes in Florida. So I want to make sure that this is framed the right way. But it's just hard to understand the pressures that everybody is feeling. They not only have to worry about nursing income, they've got to worry about hospitals. They've got to worry about the development disabled and on and on. They've got to worry about farmers, and it's incumbent upon us to compel them and to help them to understand why we need that reimbursement. So that's number one. And number two is we had just a small little regulatory bill. We introduced a PCA program the Personal Care Attendant program. And while we are required to do reporting on the PCAs it's hard for the lawmakers to find where that reporting is. So we're just putting it all into an area that's easy for them to find.

Scott

On that point you raised though, I've heard you talk about how great the Florida General Assembly has been to members and operators in Florida. Say a little about where you've been the last couple years so that you've been able to realize some significant Medicaid increases to date, and that shows their full commitment to the sector too, especially during and post-COVID. Tell us about the increases you've been able to receive.

Emmett

Yeah, it's been really good. They've been very thoughtful in the last four years. It's been about a $660 million increase to nursing homes in Florida. It's been well over a billion dollars in the last 10 years. There've been three staffing bills passed over the past three years by the legislature. And some of those have had a positive fiscal impact on the bottom line while still maintaining a high level of quality, which is super important to this legislature and it's important to our members.

Scott

You clued in on a couple of things I want to make sure we talk about. One in particular is, I think when we talked about the impact of covid to the entire sector, one of the things certainly that became very true to light was the chronic underfunding of Medicaid state-to-state. Others have really struggled. Some states and general assemblies have just not really understood that Medicaid is the prevailing payer for long-term care on the skilled side. And that robust Medicaid rate really does improve and realize higher outcomes. The money is much needed in order to make sure we're taking care of this baby boomer generation coming through. So congratulations on all your wins to date. You mentioned the staffing bill. Certainly one of the hot topics that we're all facing here coming up is we're waiting to see President Biden's minimum staffing ratio bill at the national level. I know you did some really good work with your State General Assembly to make sure the staffing ratios at the state level were achievable and realistic. Tell our listen a little about what you do have there in in Florida in place.

Emmett

Let's go back to the CMS we're really concerned about that because it could undo some of the good work that we've done in Florida. But what we've allowed with our staffing bill to do is for credit to be given to the proper disciplines that are actually giving the care. So instead of just having a small box of what you're allowed to count for your hours toward that patient care, yeah, you're allowed to bring in the speech therapist or any other discipline that actually has hands-on touching of the residents that's able to free up nurses to do their jobs. Not everybody wants to be a CNA. PCA is kind of like a glide path into becoming a CNA. They don't have to be a CNA to start. They're allowed to dip their toe work with the CNAs under the guidance of nurses and then after a certain amount of time, if they like it, they stay in, they take their CNA test and they've got a career now.

Scott

Well, I think for our listeners, you can see what Emmett's been able to achieve in Florida is really sort of a market-based approach to what makes sense for operators in Florida. And this top-down sort of one-size-fits-all rule coming out of CMS is going to be a complete disaster for the sector going forward. None the least of which there's no funding for it, and also just the workers aren't there. And what you've been able to do in Florida is really acknowledge that there are a number of people that work in the building that contribute to quality. I know you're gonna be front and center on the advocacy side going forward when we see that rule. So thanks in advance for all the hard work. You've seen a lot in your 15 years, hurricanes, COVID, you've had a governor that's run for president once or twice. I mean, you've seen a lot. What's been your greatest challenge you think you've had to face head-on? It may sound like an obvious question to answer, but I'd be curious to hear what you think or see.

Emmett

We do face a lot of challenges, especially with hurricanes and natural disasters and things of that nature. We've got a very robust association and a very active emergency response team here. At the association. I think Covid, hands down is without question the biggest challenge that I've seen us face as a profession, as a country. It was catastrophic, especially in nursing homes. You know, we were a ground zero, for lack of a better term. I was honored to serve on the governor's task force for reopening nursing homes. That was a real honor. And we worked through that. And we were one of the first states to open up visitation to nursing homes again. The governor was extremely sensitive to the fact that we had staff that were scared, staff that were compromised and were going in and risking their lives every day.

So it was a fine balance. It wasn't perfect by any means. The agency here that regulates all of the nursing homes and assisted living facilities called upon the Florida Healthcare Association to host COVID calls and sometimes they'd be twice a week. But we hosted over 500 calls to give updates from the agency, constant communication and we opened it up to members, not members. It didn't matter to us. It was it was an emergency situation. And, that's why the association, is one of the reasons we existed and still exist. I'm real proud of the way that we handled covid, but it certainly took its toll on our profession. And my team too as well. So glad we're on the back end of it anyway, the manageable end.

Scott

Well, thanks for sharing that perspective. I think you provide such a unique lens into the front lines of the battle of covid and your run in Florida for sure. And I remember when I was at AHCA/NCAL, all those late-night national conference calls we had with all the state execs and their emergency response teams and clinical resources. You guys were front and center and I know a lot of states were pulling pages from your playbook. So thanks for your leadership during that time and all you continue to do also, Hey, speaking of leaders, I know you and I both felt the same way this week when we saw the headline that Mark in fact is officially retiring, Mark Parkinson beginning of 2025. We all knew it was coming, but I joked some today, now that I've seen it in writing that it's actually now happening. What a tremendous leader for our sector during the times which the country needed him the most. Say a little about your thoughts about Mark Parkinson as a leader. His work, the work he's done for the association.

Emmett

He was picking my brain and he was stealing stuff from the Florida Health Care Association and using it up at national, and I felt good about that, like, wow, here's the governor here coming in using our stuff. It didn't take very long from him calling me for advice to me, calling him for advice. I mean, that guy is one of the best leaders I've ever known and been around and he came into the American Health Care Association when they were in flux, let's put it that way and they needed somebody that was going to be able to commit to 10 or 15 years to, to help really stabilize the association. We did not have 86, 87% of the membership, but a lot of members that weren't members of the association because they were not happy with the way that the American Health Care Association was being run.

If we go back to the beginning of this podcast my background is sales, and so, if you give me something good to sell, I can sell it. Mark was able to create a program at the American Healthcare Association that was not only sellable, but you could almost prove that it was necessary to be a member of this organization if you really wanted to thrive. And so best people I've ever had the honor privilege of working with a great mentor, he has transformed long-term care in the last 15 years, and I'm happy for him. Of course, we'll miss him, but he set the standard. We know what it looks like now to have a professionally well-run organization, and I don't think our members will ever accept anything less.

Scott

I was on a call with Mark a couple of days ago with the National Constituency call, and, true to form, his work, he's not mailing in this year. He is working hard at the front lines for the sector, big still to come with the Medicare payment rule coming, obviously the minimum staffing ratio bill a national election coming up. And Medicaid battle state to state. So true to form, he's gonna work until the day he walks out of the office. And 66 is really young these days, right? So he's got a lot of time left. He's still doing a lot of good work.

Hey, this has been really fun today. I got two more questions to ask you, and let's go back to one of the topics. I know you're a huge Florida State fan, you can't tell, but I'm gonna step up a little bit. I'm wearing my Notre Dame vest for you today. I know there's a lot of turmoil with Florida State right now in terms of say what do you think? What conference are they going to in the future? And what's gonna happen here?

Emmett

Really, things are actually incredibly positive here in Tallahassee. I'm great friends with a lot of leadership and you'll never convince me that the college football playoff wasn't an invitational this year. I don't care what anyone says, it was the biggest snub ever. And that hurt, I tell you had Florida State lost Coach Norvell, I think things would be feeling a lot differently right now. Coach Norvell committed to 10 years, everything you see about him on TV is true. I've never seen the guy not be positive, not be energetic, not be a man of his word. If I were a betting man, I'd say Florida State's gonna end up at the Big 10. The snub happens and half the team doesn't show up for the Orange Bowl. And I was having lunch with a former wide receiver, Kez McCorvy, who also played in the NFL, and I asked him about that.

I said, what are your thoughts on that? He said, well, those guys came in. They all decided instead of going pro to come back one more year to win the national title, they weren't raised FSU fans. They came in to win a title. And that was taken away from them. They just said we're not playing, we're not gonna do that. We're not going to risk injury. We're not going to risk our future. He's reloaded this year. I think we're gonna surprise a lot of people. Yeah. I think it's going to be a fun time to be a Seminole.

Scott

Yeah. And you got a good insight track to all those thoughts. And I'll tell you what, VIUM Capital, which by the way, is a very proud associate member of the Florida Health Care Association, love being a part of what you're doing there in Florida. We're headquartered here in Columbus, Ohio. And so, boy, a Florida State - Ohio State game sometime here in Columbus would be really fun too. Boy, imagine, imagine that game.

One last question. I always ask all of our guests what's on your nightstand? What are you reading right now? Is there a book that changed your life? Is there something you recommend to other people? I'm always just looking for new things to read, but just what's influenced you, and maybe what do you read right now?

Emmett

I love to read which was not the case till probably about 27, 28 years old, I listened to a speaker named Brian Dodge, and he talked about readers being leaders. And he wrote a book called The Obvious Choice, which was super easy read, but it got me to reading. So on my nightstand, now I have the Bible on my nightstand. I'm reading through Proverbs right now. Last year I did read through the Bible in a year. A book called The Power of Moments. Really excellent book, especially for anybody that has anything to do with customer service. If I were to recommend books, the 21 Irrefutable Laws of Leadership as a huge book if you're having challenges with your team, the Five Dysfunctions of a Team, truly help transform this association. We worked through that my first year. You're in a position where you're stuck and you wanna move forward. What got you here won't get you there. Just a few off the top of my head that I referenced. And I'm always trying to read something.

Scott

You give me some great thoughts here. I'll throw one back at you. I'm in the middle of an amazing book right now called Build the Life You Want. There's a professor at Harvard Business School named Arthur Brooks. He teaches a course on happiness. He teaches at actually Kennedy School of Government too. And he just released a book with Oprah. They co-author his book based on his research at Harvard and all of his work over the years, but also Harvard just released an 80-year study on what really gives people satisfaction in their work and their life and what's meaningful. He kind of boils it down to, he said, there are four pillars to happiness: your friends, your family, your faith, and work that serves others. And he's got the data to prove it. And he's just incredibly articulate and a very interesting guy.

So I really highly recommend Build the Life You Want. It is so good. I'm actually slow reading it. I don't even want it to end. I know you are super busy in the middle of your legislative session and spend some time with us, our listeners, means a lot to us. Thanks again for all you're doing there in Florida on the national stage. It really means a lot to me personally and your friendship over the years. I'm a better person because of your friendship and your council. So thanks for all you've done for me. Boy, I just can't thank you enough for your time today,

Emmett

Scott. Thank you. This has been great. It's super easy because that's truly talking with a true friend. So thank you so much.

Scott

And for our listeners, thanks for turning into this episode of VERSED, the VIUM Capital podcast. Be sure to turn in next time when we continue to talk to leaders that are moving in our sector and making things better for our operators and and owners across the whole country. Emmett, thanks again for your time.