Although rehabilitation hospitals today face greater challenges than ever, HealthSouth CEO Kevin Spears believes the best way to address them all is simply by doing an exceptional job of patient care.
Whether approaching stronger and more productive partnership connections, increasing patient volume or dealing with the changing Medicare rules and guidelines, Spears has discovered the key to success is great outcomes.
He points to improved relationships with Memphis partner hospitals in the Methodist system. “Great outcomes and shorter lengths of stay, as needed, make us a good partner,” he said.
Shoring up what had been a weakened partnership was one of the first critical needs Spears faced when he assumed the CEO title in June 2014.
“We’re a free-standing rehab facility, even though we are 50-50 partners with the Methodist system and are joined by a crosswalk to Methodist University Hospital,” he said. “Although we’re partners, they still refer to other people.”
The closing last September of Crittenden Regional Hospital resulted in increased patient volume from east Arkansas, which, with downtown Memphis and North Mississippi, comprised HealthSouth’s major market. Many of those patients use Methodist University Hospital.
“We admit from anywhere, but 60 to 70 percent of our referrals come from across the street, so that relationship was extremely important,” he said.
He added that joint quarterly meetings with Methodist University’s leadership have helped, and plans for their campus expansion include HealthSouth.
HealthSouth’s outcomes – best nationally and locally, says Spears – are also an advantage in addressing Medicare pressures:
“Bundled payments and care initiatives and fee for service are coming up, and we try to stay one step ahead of the changes. If someone wants to bundle, they’ll want to partner with us because we do have good outcomes and we get our patients back home quickly.”
As a former high school baseball and football coach, Spears understands the importance of getting results. Raised in Marianna, Arkansas, he earned his BS in education from Arkansas State University, then taught and coached – first in Arkansas, then near Birmingham, Alabama.
When one of his quarterbacks broke a hand, Spears’ interest in therapy led him to pursue a BS in occupational therapy at University of Tennessee Health Science Center (UTHSC) in Memphis. He then served as staff OT and program director over inpatient and outpatient acute care therapy departments at the 139-bed Helena Regional Medical Center in Arkansas. In 2010, he joined the 50-bed HealthSouth North Memphis facility as therapy director.
“After the first couple of years working in therapy,” Spears said, “I knew what I wanted to do. I discovered quickly when I took the job in North Memphis that you can’t treat patients eight hours a day and improve processes, too.”
HealthSouth soon promoted him to regional program director, tasking him with troubleshooting and establishing best practices for a 17-hospital region before offering him the CEO position at HealthSouth-Central Memphis.
His early experience helped him achieve a noteworthy feat. “The hospital was on the verge of layoffs when I started, just because volume was so poor," he said. "But we’ve been able to mitigate all that without layoffs, even though we were about 18 full-time-equivalent employees over where we needed to be. We were able to improve the volume, maintain staff and grow quite a bit.”
Although their average daily census is about 64 or 65, Spears has growth strategy in place. “We want a great patient experience and great outcomes; we don’t have the staff to fill 80 beds now and make each experience great. As we increase staff, we’ll increase volume — at about 6 percent each year. That’s our goal.”
Part of the volume challenge is due to changes in Medicare guidelines, regulations and cuts.
“When I started in rehab 10 or 12 years ago, 30- or 40-day stays were not uncommon — a knee replacement was two or three weeks," he said. "Now, by day two or three, you’re walking 150 feet and getting ready to go home.”
Although their average patient age is over 70, “We’re not a nursing home,” Spears emphasized. “We’re a free-standing inpatient rehab facility. No one stays here forever, even if they want to, and we can’t keep the people who don’t participate in therapy within three days. There’s a very strict Medicare guideline.”
Spears’ facility also boasts an outpatient clinic that does a significant volume, perhaps because of an increasingly rare attraction — a swimming pool.
“Although insurance companies don’t reimburse for pool therapy, it’s a service to the community that we offer,” Spears explained, “and the therapists love it!”
Since recent data show that his facility treated more ortho patients than any other rehab or skilled nursing facility in Memphis, Spears is searching for more therapists to expand his staff. He is also hoping to recruit a pediatric rehab physician and a physical medicine and rehab (PM&R) physician. Since his facility may be the only unit in the city certified for stroke and brain injury treatment by the Joint Commission, a physician qualified and willing to lead the brain injury program would also be welcomed.
Data show that HealthSouth at Methodist University is “the lowest cost of any nursing home or rehab within 200 miles," Spears said, "but we also have the best outcomes and the shortest length of stay. So patients stay less time, spend less money, they have better outcomes — and they can go swimming!” he said.
Married with two children ages 8 and 15, Spears is pursuing his MBA at Harding University and is pleased that his daughter plans to follow him into the profession as a therapist. When he’s not following their sports activities and taping up their injuries, hunts, fishes and plays at Greers Ferry Lake with his ski boat and jet ski, four-wheeler and dirt bike.
RELATED LINKS:
Methodist University Hospital, www.methodisthealth.org/locations/methodist-university-hospital;
HealthSouth Memphis, www.healthsouthmemphis.com;
University Joint Commission, www.jointcommission.org