New leadership in aging care

Betsy Johnson discusses long-term care with Nick Cooper, administrator at Masonic Homes Shelbyville.

The aging care sector of healthcare is an important part of Kentucky’s growing economy. Numerous reports, politicians and chambers of commerce will quickly point out that Kentucky is a center of excellence for companies providing long-term care. path to tomorrow’s care models will clearly run through the bluegrass state.

While we praise the innovative work at these long-term care companies, we must also take time to recognize the significant work being accomplished in the day-to-day operations at the healthcare facilities across the state. These facilities not only provide care to Kentuckians from Paducah to Pikeville, but they often serve as one of the larger employers in the region.

As healthcare evolves, many groups face their own legislative and regulatory battles. The long-term care sector is no different and often faces unique challenges. To get a better understanding of the state of the long-term care sector, we sat down with Betsy Johnson, the new president of the Kentucky Association of Health Care Facilities (KAHCF).

Medical News: Why did you decide to leave the practice of law and become president of the Kentucky Association of Health Care Facilities?

Betsy Johnson: My decision to leave Stites & Harbison and the practice of law was a difficult one. Working at Stites was a positive personal and professional experience. I worked with really smart people and I loved my clients. I grew professionally and personally during that time. However, I missed healthcare policy and strategy. I enjoy working on projects from start to finish. The practice of law is often issue specific – and usually (not always), a client only calls an attorney when something has gone wrong. I thought being the president of the KAHCF would allow me to be more involved in developing strategy to further the mission of our Membership, which is to ensure Kentucky’s long-term care providers are the high quality solution for Kentucky’s elderly population– and so far I have been right.

MN: How do you feel your background (as both Medicaid commissioner and healthcare attorney) will assist you in your new role?

BJ: I am a complete healthcare junkie – I love the complexity of the regulatory scheme in healthcare. Things are always changing and healthcare is important to all of us so we need to get it right. In healthcare, you never hear the same question twice and you get to dive deep into both state and federal laws, so what can be better for an attorney?

I spent 16 years of my career in state government—it was a wonderful experience. I understand how government works and honestly, I never thought I would leave. I also was fortunate to have learned from the best and brightest in the government healthcare policy world. If it weren’t for the people in state government who believed in me, mentored me and gave me phenomenal experiences, I wouldn’t be here today.

My experience as Medicaid commissioner is important to my new role because Medicaid is the largest payer of long-term care services. The Medicaid program is important for many vulnerable citizens throughout Kentucky. We need to work together to ensure its sustainability. But, my experience in state government generally will – and already has – assisted me in my role as the president of the KAHCF. The years I spent at Stites & Harbison as a healthcare attorney have also benefited me in my new role. Looking through the eyes of my clients, I saw firsthand how frustrating government can be for those operating in the private sector. is is something I would not have experienced if I stayed in government. I joke that now I understand why people gave me mean looks when I was Medicaid commissioner.

But, it isn’t the people in government – it is how government operates. Government doesn’t operate efficiently, which does cause a certain level of frustration for the private sector, especially when people in the private sector are trying to be innovative. It takes a while for government to catch up. While in private practice, I learned that people in government and people outside government do not speak the same language. I try to bridge that gap.

MN: How would you describe your leadership style?

BJ: Some of my former Medicaid coworkers would say I lead through humor – because that job was so impossible, all I could do was try to find humor in the everyday crazy of it all. Generally, I like to surround myself with smart people who are positive in their thinking and have a “can do” attitude. For anyone to be successful they must have a team of really good people. Within any organization, everyone has a role – one person can’t do it alone. I am fortunate to work for a Board of Directors that understands the long-term care profession and what our priorities should be. My job is to empower my team to work toward those goals. I don’t think anything is too big or too small to try (at least once).

MN: What have been some of the biggest surprises in your first few months on the job?

BJ: Although I had worked with some of the people at the KAHCF when I was Medicaid commissioner and also while in private practice, I did not fully understand the level of unselfish dedication within the Association. We have a volunteer board and our board members have very important “day jobs” but they come together to work for the common good of the long-term care profession.

MN: At a very high level, what are the largest issues facing the long-term care community in Kentucky?

BJ: We have let others define us through their negativity. I am a proud member of the Kentucky Bar Association – but some of the advertisements and actions taken by some other attorneys against the long-term care profession makes me less than proud. These predatory and mostly out of state attorneys use publicly available information in false and misleading ways for their own financial gain. We need consistency when it comes to liability and risk and that means passing tort and regulatory reform like other states in our region. Our caregivers should be allowed to put their full focus on providing care, not worrying about lawsuits.The regulatory scheme governing nursing facilities and other healthcare providers is very complex. Healthcare is heavily regulated and nursing facilities are singled out in many ways, which lead some trial attorneys to focus on them. We should work more closely with government regulators to ensure that everyone’s focus is on ensuring that our citizens receive high quality healthcare in Kentucky. I believe in common sense regulation.

MN: Some groups are starting to call for changes in the way aging care and long-term care are provided in Kentucky. What are your views on these requests and what impact do you feel it will have on the care provided?

BJ: My view is a simple one – you can’t change the way care is provided to the aging population without consulting the experts. Our Members are the experts. Who has been providing that care all these years? Our Members have. It doesn’t make any sense to me why our Membership wouldn’t be part of that conversation. We understand the needs of the populations and how it is changing. Talking points and report cards aren’t the answer. Working together toward the shared goal of providing the very best possible care for our residents is the answer. If we can all work together, we can achieve great things. If you leave people or groups out of the conversation, you can’t move the pendulum.

MN: Kentucky is home to a number of long-term care companies and many people claim that Louisville is a center of excellence for long-term care. What makes Kentucky so special? What does this mean for long-term care in Kentucky?

BJ: On a personal level, Kentucky is a wonderful place to live and to raise a family. What is not to love? From a business perspective, Kentucky has a business friendly environment and, therefore, has been able to attract several healthcare providers to locate their corporate headquarters in Kentucky. Our Kentucky Chamber is a great advocate for the business community, and we are lucky to have their leadership. e long-term care providers who chose Kentucky for their corporate headquarters did so for a reason. We need to ensure that the business environment in Kentucky remains friendly for them, which means addressing tort and regulatory reform.

MN: What would you like the healthcare community to know about the long-term care community that they may not know?

BJ: Long-term care will only grow in its importance. The healthcare community needs to work together to ensure coordination and a continuum of care that makes sense for the aging population. I am excited about the future of long-term care because of all the possibilities.