Donika Schnell began her healthcare career in financing as a hospital consultant at KPMG and then in financial reporting with The University of Chicago Hospitals. She transitioned to lending to healthcare providers starting with working capital finance in lending operations and adding real estate and cash flow term loans soon after.
Donika moved into business development for Heller Financial, GE Capital and then CapitalSource building pipelines and relationships to providers and capital providers along the entire continuum of healthcare primarily in the Western half of the country. With rounded lending and industry experience, Donika was tapped to build two national healthcare lending divisions for banks before her recent focus on real estate lending at Greystone solely eyeing seniors housing, skilled nursing and hospitals.
Greystone is the number 1 HUD lender to the healthcare industry who also provides Fannie/Freddie and bridge term loan lending. Greystone additionally owns and operates about 4,000 seniors/skilled beds.
- Overview of the sources of capital available to providers:
- Equity – There is approximately $2T of pent up equity to deploy into the economy from the Private Equity sector. Healthcare is very attractive as it has proven to be recession proof and if supporting the right sectors and operators/managers, equity investments have been solid returns.
- Bank Debt – Community banks willing to work with smaller providers. Larger banks stalled with COVID first hit as they tried to assess existing portfolio risk and then what the pandemic meant overall to the industry. Took about 90 days or so but most banks are back to lending at usually lower advance rates and perhaps asking for increased credit enhancements. Pricing increased by 25 to 75 bps.
- Finance Companies – also stalled a bit when COVID first hit in March, but are back at lending at prior lending levels. Pricing increased by 50 to 100 bps.
- What does a lender look for in evaluating credit?
- Operator experience and track record
- Financial performance of the business historically. High emphasis on dealing with COVID in the business.
- For real estate such as skilled nursing, look to surveys and reports from CMS and especially Star Ratings and Special Focus Candidate lists.
- Occupancy trends.
- Projections/Proformas. Sources of revenue, thorough understanding of reimbursement, expenses especially any additional COVID costs such as increased staffing and PPE costs.
- Debt needs clearly defined.
- From a national lender’s perspective, how are the Seniors Housing and Skilled Nursing industries performing?
- Occupancy naturally down in ALFs and SNFs. With the drop in selective procedures, occupancy went down. Additionally, fewer discharges to SNFs after hospital stays affected occupancy. Independent living facilities have fared rather well with occupancy.
- Stimulus monies have helped ease the concern of working capital for providers so they can focus on caring for patients/residents and staff with needed safety measures.
- Have seen providers work closely with county and/or state health departments to provide for COVID only patients for care upon hospital discharge. Delicate balance to ask staff if they are committed to working in those buildings and wards – very collaborative efforts being made in communities.
- Future sees a high need for mental health services.
- Preventative services back to near pre-COVID levels such as with dentists, PCPs, ancillary services put on hold.
Hanh Brown: [00:00:00] Today, my guest is Dannika Schnell. Her career has taken many turns from hospital consulting at KPMG to healthcare provider lending to business development. So her most recent focus has been on real estate lending solely for senior housing, seeing, um, skilled nursing in hospitals. So if there Nika, thank you so much for joining me on boomer living, and I’m excited to learn from your diverse experience in the senior living space.
Donika Schnell: [00:01:39] Hi, this is a terrific series. I’m honored to be a part of your presentations.
Hanh Brown: [00:01:44] Great. Yeah. Thank you so much for your time. So let’s see. Can we start to have you share about your background information, where you’re from? Where does your expertise lie and how did you get interested in this business?
Donika Schnell: [00:01:56] I’m from Chicago originally.[00:01:58] And when I was a senior in college, my accounting professor had told us. To come back with a resume for an internship. And I did, I was one of a handful of kids who came back to school with a resume. And I was asked, I, I was lucky enough to join the internship program at KPMG in their hospital consulting group. [00:02:17] So then when I graduated from college that turned into a full-time job as a consultant and we worked, we travel five days a week. It was pretty fun as a 22 year old and a lot of work learning about, I was a complete grunt. In hospital in the hospital space in person, specifically in the financial reporting department. [00:02:37] So we would come in and help accelerate AR turnover, collect cash on delinquent AR. So that was really great experience. And I had a terrific partner that I worked for, who just explained the history of healthcare, reimbursement, how insurance companies developed over time, the role that Medicare and Medicaid play in our communities and the overall healthcare system. [00:02:59] So that was. Just great. I worked there for a couple of years and then the travel did get to me. So I went and worked for the university of Chicago hospitals in financial reporting, which was also a grunt job, but the really great experience after what I just had a KPMG. So it’s, I, I wouldn’t say necessarily had a passionate first for all of this. [00:03:17] I think it just took my accounting degree. And found a position at a great firm and then that launched a career in healthcare. But then I was recruited in Chicago for a startup healthcare finance company. That’s that is when I got hooked into this industry. I thought it was fascinating. I loved, I love healthcare, how dynamic it is, how so many factors go into it’s a very complicated sector or industry. [00:03:44] And then every sector is complicated and special in and of itself. So then I worked in lending as an accountant, but then became an operations manager. I was a portfolio manager and eventually became a salesperson in the industry. And I worked for a number of great shops and then eventually moved to California because of the winters in Chicago had enough of those. [00:04:04] And I was a business development officer for Heller financial, and then we were acquired by GE. I’ve also gone through some acquisitions. I’ve been acquired three times. That is that. Once you get to be a veteran in your industry, we’ve all been through some acquisitions. So those are some interesting experiences as well. [00:04:22] Living in California was the primary business development officer for capital source for 11 years. And that’s where I really learned more about other sectors and more about other sources of capital and how they work with each other to help providers grow their business. So that’s a long winded. I also run a couple of national. [00:04:43] Lending divisions for banks. And that was great experience to bring it all together. Everything I had learned and then build leadership skills. The last place I worked for was acquired and the new, the new place wasn’t really for me. So I decided to focus on, I had. Some things go on with my parents. Like a lot of us have, I think we’re affectionately called the sandwich generation where we take care of our kids and our parents. [00:05:11] And I saw the healthcare system post-acute care for seniors personally, not just as a professional, but I saw it with my father and then with my mother. And when I was trying to figure out what to do. Greystone, which is a 30 year old company devoted to long-term care, real estate financing had come calling and I have a little great deal of respect for the company and the founder. [00:05:36] And I thought, you know what? This is a great way for me to actually try to do something for seniors without being a caregiver, which I, I wish I could do that, but instead I helped providers. And to find financing that’s fair and reasonable and meets their needs too, for what their goals are, whether it’s an acquisition or capital expense, an expansion of their properties, and I can help them find some other financing. [00:06:01] Given my background. Sorry. It’s a long introduction.
Hanh Brown: [00:06:05] it is great. What a journey, what a wealth of experience. Thank you for sharing that and congratulations too. So now you answer already. Um, my question was that. You know, how, what made you choose senior housing with skilled nursing and hospitals?[00:06:21] So I hear it, that it was primarily you’ve you had some caring for your parents and of course, I think we’re all caregivers, right? When you get children, you’re caring for them. When you have older parents with seventies, eighties or so, and you’re caring for them, but it’s not your solely day to day work.
Hanh Brown: [00:06:47] I, you know what, honestly, I did not consider that I am a caregiver day to day. Because I feel like as a parent, that’s just our privilege and our role, but I never considered that.[00:06:59] But I really think that we are though right. Every day and yeah. And then of course I’m caring for my mom. I have siblings who share the workload. I think we all either currently or will become caregivers.
Donika Schnell: [00:07:15] Yeah Or overseers, or it just doesn’t for us. It doesn’t. And, and that’s okay. I think you’re right.[00:07:21] I love how you said that it’s an honor and a privilege to have these on our plates. I don’t think of them as burdens. Like I think some people might, but I think that they’re on there. It’s great. Being a parent. It’s great. Being able to help your parents as they age too, and you’ve become an adult.
Hanh Brown: [00:07:38] I think it’s full circle.[00:07:39] It is an honor. It is a privilege and it is tiresome, but that’s so great. We accept all of it.
Donika Schnell: [00:07:46] Yeah. I always say I’ll sleep when I die, so it’s okay. I try not to get too tired.
Hanh Brown: [00:07:51] I really think more so now during the last nine months on a personal note, when I see people are dying, it just makes you want to just not only live more, but live Bay on your feet.
Donika Schnell: [00:08:03] Oh, that’s great. Yeah. Or the suffering we have around us too, from the consequences of this year. Yeah, it does. It makes you really want to. Get up because you can catch it. Yeah, exactly.
Hanh Brown: [00:08:17] Let’s see. So can you give us an overview of the sources of capital available to providers? In other words, what are some of the things that providers should take into consideration when selecting between getting capital through equity to the bank debt or financing companies?
Donika Schnell: [00:08:34] The world of capital’s quite large, I’ll start with equity because if you have an equity partner, you really want to make sure you guys it’s like a marriage right. Of a business. So there is a lot of money in the equity world. Right now. There’s over $2 trillion sitting out there. Needs to be put out to use.[00:08:52] Normally there causes valuations to go up. And I think that has in lots of sector or the valuations have maintained high, have stayed high in many sectors, like behavioral health. As we know out of this year, there’s a need today. And for many years to come, we will need a lot of help with mental health services. [00:09:10] And so there’s a lot of equity out there. There’s also real estate investment trusts. That can come in as an equity partner. So you just have to be mindful of who they just really know who they are because you are entering into a marriage. You’re going to get into very deep contracts. You’re going to have to learn how to talk with, make sure you talk with each other. [00:09:28] I use equity sources only for once they have a deal together and they need debt. That’s when I see the equity source, I don’t know necessarily place equity. I know enough people to help point providers in the right direction. The bank debt has been interesting. Banks are lenders realize and so do equity investors. [00:09:48] That healthcare is a very recession proof industry. It has proven itself time and time again. It’s really Achilles heel, the Achilles heel in healthcare, and especially in senior, in skilled nursing and hospitals is reimbursement and regulatory requirements. Those can bog down the regulatory stuff can bog down a provider. [00:10:07] So we don’t want to bury providers with a bunch of administrative work. And then the reimbursement side, obviously sometimes we take away too much reimbursement and they don’t have enough money. Fortunately, this year that has not happened. For providers, a lot of stigma. In fact, yesterday another billion dollars was announced to prop up the skilled nursing industry. [00:10:26] Some more. So they’re not hurting for money. That’s good. That way they can focus on care for their patients and their staff for COVID. But bank debt. So banks are comfortable. They did stall almost there. It’s just like, all of us did back in March. We’re like, Oh boy, what does this mean? So the banks stalled and they took about 90 days to go, okay, everything’s going to be okay. [00:10:47] We just need to understand our. Borrowers, what are they doing for COVID? How are they handling it and what do they need? So it took them about 90 days. They came back into the market with a couple changes. They’ve reduced their loan devalue. So pre COVID, they were lending about 75 to 80% loan to value. [00:11:06] After COVID started there closer to 65 to 70%. Now, there still are some banks out there at pre COVID levels. So that’s great. They are not scared. They feel very confident about the sector. And those tend to be banks that have been doing this for a very long time and they were committed team, but the other banks have they’ve come back a little more timid, but they’re there doing deals. [00:11:28] If they’re down the fairway, the finance companies, they assess their portfolio risk. A lot faster than the banks did. And they came back also pretty much pre COVID levels. Actually, I think I haven’t seen the finance companies like Greystone were one of those, we’re a finance company. So we did pause for a while, just like everyone else came back and we’re back at the 85% loan to value all the interest rates have gone off though. [00:11:53] I don’t, no matter what sources from they’ve decided we’ve taken it up upon the industry. The capital industry has increased interest rates a bit. By anywhere between 25 and 75 basis points, I think they see there’s a little more risk and that’s why the rates go up. That interest rate usually reflects the risk in the credit. [00:12:13] Yeah. So they’ve the lending market is thriving. And if you have a situation though, that’s a turnaround, they’ve had really bad census. Poor financial reporting financial performance. They’re going to have a hard time finding a loan, I think, but there’s creative ways around stuff.
Hanh Brown: [00:12:29] So give me just a typical example, a sale of a new development in senior housing, and then one debt is a refi or an acquisition of an underperforming one.[00:12:39] So just give me a typical capital stack of what you see right now.
Donika Schnell: [00:12:43] So if you’re ground up construction, ground up construction is a little harder to find right now. I think because of the performance in assisted living this year was census. That sector has been hit. The hardest is in terms of occupancy, lenders are looking a lot closer to construction.[00:13:00] What is the market need? Do they have a really deep. Market study done it. How, what are the absorption rates in that market? So how many beds when they build the beds? How many of them are needed truly needed in that market? So the credit has tightened around construction, but when it is done well, I’ve seen our construction lending levels at six, about 65% loan to cost. [00:13:25] There is a product through HUD has stayed open for business from the minute they never stopped lending. So it’s actually been a record year for HUD loans in this country. Now, Fannie Freddie pulled back, they actually pulled back a bit on their loan to costs loan, to value a loan to value, and they added some debt service reserve funds that were not there in pre COVID. [00:13:46] That’s fine. They’re a big one. They’re much larger than HUD. So how to actually has an 85, 80 to 85% loan to cost. Product for construction. And the only thing is it takes a long time to get through the government. It could take up to 12 months to get that deal done. So the earlier you bring up bringing a Hudlin and we happen to be a HUD lender, bring in a HUD lender, the better, but construction, you could still get them done. [00:14:09] They’re just a lot lower loan to cost. Right now it’s 65% is about where I’ve seen them at and they do require recourse. If you’re getting a bank loan, the recourse is pretty much through lease up. Now it used to burn off after you got your certificate of occupancy, but now the requiring recourse a little long. [00:14:27] And that makes sense. Cause there’s a lot of uncertainty about leasing those up. So they like to S so it depends on the projections, the performance on that property. I usually, I think in my personal experience, we consider it stabilize at about 75%. Census, obviously, if the goal is like, typically you want it in the nineties and that’s really when it’s thriving, but we’ll see it start to stabilize. [00:14:52] It depends on where the projections show breakeven as app. So right now, a stabilized property that’s already established, refinancing those much easier today. That’s probably 70 to 80% loan devalue. It really depends on where you go a bank that doesn’t have deep roots. Or commitment to not that they don’t have a com. [00:15:15] Everyone says they have a commitment to healthcare lending, but then the proof is in the term sheets they issue. So if there, if there are deep long-term bank in the industry, they’re still there back to 75, 80% loan to value. The finance companies are closer to 85% loan to value the money’s still there, the community banks and banks that haven’t been in this that long they’re closer to 70% loan to loan, to value on a stabilized property.
Hanh Brown: [00:15:41] And you probably going to see a lot more of that in the 2010 and 21 for acquisition.
Donika Schnell: [00:15:47] I think acquisitions have picked up this year and the last quarter. So that’s really great. There’s been some larger portfolio acquisitions and the REITs, some of the readership and shedding portfolios. So operators are picking those up a pretty good value.[00:16:00] So yeah, so there’s been, I think next year is going to be another great year from an a yeah. Look, this is, these are homes. We need nursing homes in particular. We have about 15,000 nursing homes in the country. That’s the same number we had 30 years ago, but we have a growing elderly population, 11,000 people a day are going on Medicare. [00:16:18] So we absolutely have a need for these facilities. We have a need for memory care when you have, as we both know from our personal. Families that when you’ve a loved one with dementia, there’s no, you can’t take care of them at home. It’s very difficult. So we absolutely have a need for memory care as well, as long as we can afford it. [00:16:38] It’s the independent living has done well this year. I think, I think that’s a very interesting model and option for seniors. And then I think assisted living is the one. That’s always been the one that could fall that teeters first, but. They’re doing okay. They seem to be, even though their occupancy is down, most of the Alps are hanging on, so they don’t have as much stimulus support as the nursing homes do.
Hanh Brown: [00:17:03] That’s very true. I can see why there’s a growth in the later quarter, as far as the acquisition. And there’s going to be a lot more in 2021. I think the folks that either didn’t have the reserves in 2020, didn’t have the management and the operation or however. COVID has impacted them that didn’t allow them to say stay above.[00:17:26] That was going to be a lot of acquisition.
Donika Schnell: [00:17:28] Yeah, I think you’re right. So there was a trend after the affordable care act, which took 10 to 12 years to really roll out the affordable care act. And the last. Part of it was really the effect on post-acute care. So what we saw as effective that is a congregation or a roll up of larger skilled nursing operators, assisted living operators.[00:17:51] They were rolling up much larger across the country. Now COVID and health healthcare is local. But I think with COVID now we realize the regional operators are very important. We’ve seen a lot of collaboration this year with providers and County health inspectors, city health inspectors. They’ve had to work very in and providers. [00:18:12] So hospitals have had to work really closely with nursing homes because when they treat a COVID patient. Once they’re off. Once they’re discharged, they, many of them still need some recovery, some rehab. So they go into a local nursing home that nursing home has to be prepared for COVID and how to treat them. [00:18:28] And they are typically cause they were already ready for flu season. They deal with a lot of flu season patients we’ve seen now, healthcare. Again, now go back and go back to a regional, but the moment pump the single ones, they didn’t have the technology. They didn’t have the staff that could really handle this whatever’s happening in each of our communities. [00:18:49] Then I think you’re right. Those are prime for picking. We’re seeing that, or we’re seeing larger operators. They may have, might have a home. Say in Reno and it’s their only one in Nevada, right? So that’s very difficult to manage from a distance if they’re based in Chicago, so that they’re doing like these quiet sales of these homes, where there is a guy in Reno, who’s got five facilities and this actually fits the continuum of care in his business model. [00:19:16] So I find that there’s really neat opportunities out there. I think I love the collaboration among providers. I think that’s very, that’s been, uh, Oh, really nice blessing to see actually to see hospitals working with nursing homes. I’ve heard stories of nursing homes calling their County health inspector going, listen, I’ve got the right building. [00:19:35] I have a wing it’s closed off. We can put your COVID patients here. It really is. And they didn’t do it for money. There’s a lot of. Stuff out there, noise out there about reimbursement and reimbursement is higher for a COVID clinical code. But when I talked to these, they did it before all that they called immediately and said, look, we can help.
[00:19:54] This is, this was in LA. This was in lots of cities. I heard this. That was a nice it, those nice.
Hanh Brown: [00:20:02]We need to encourage
[00:20:05] and cheer. And it’s all about caring. We are in a caring business and I know you’re the financing sector, but ultimately our residents is the customer right in, and at the end of the day, it’s a caring business.[00:20:18] You caring for the older adults. I was the daughter that was seeking care for my mom. We’re past that. Place now, I think what’s really important in the midst of seeking for a home. If the particular community that I was looking at, if they don’t have anything available or maybe it’s not a good fit, it’s very important for that community to know their surrounding. [00:20:40] I don’t want to call it competitors because it’s, we all need each other. It is. Yeah. But I think ultimately you still need each other. Because what you don’t want to do is just wash your hands off and say, Hey, we can help you. You don’t want to wash your hands off from that family who is seeking for it. [00:20:54] So it was very important for any given community to know their surroundings. It’s very important because it’s such an emotional time. You want to be instrumental in the help as much as you can.
Donika Schnell: [00:21:06] And I think that goes with the staff too. So you might be in a facility and this, unfortunately our staff and our nursing homes and assisted living, they’re fortunate, they’re young and they have children at home too.[00:21:18] And they have, so now their kids are home from school and they have to work. If you have a shortage of staff in your facility, you got to work with the other providers in town. Cause you might need to. Swap out, figure out how you’re going to balance your labor needs. And we are seeing that in almost every well communities I’ve talked to community owners. [00:21:38] They’ve been really great about working with other providers, all kinds of providers.
Hanh Brown: [00:21:43] I love what that you said. Folks are working with the local hospitals, because here’s the thing. If your residents go into the hospital and the COVID positive, they have to be quarantined X amount of days in a separate.[00:21:56] Area, whether it’s a wing of the building or it could be a separate building. Who’s got that third building available. So you’ve got to work with your locals, could be at a hospital wing. It could be another facility that’s not in you. So it’s really important to be in partnership with the healthcare local to you and your competitors.
[00:22:16] And know what their services are and what their capabilities are, so that you can work together to figure out how you’re going to meet the needs of that community. So that’s been really nice to see[00:22:27] what are some of those things a lender looks at when evaluating credit worthiness, how much of these criteria are determined by the person? [00:22:37] Or the LLC credit, as opposed to, let’s say external trends in the capital market.
Donika Schnell: [00:22:42] believe it’s more important who you lend money to than what you lend money on sometimes because that person or that team, that executive team, that management team, that Don that administrator, they’re the ones who really like this is the year that it really was put to the test when there was a something that happened.[00:23:00] How did they perform and are they able to navigate out of the mess? The recession, the great recession that started in 2008, that was another test. So we look at character of the borrower characters, absolutely important. What’s their experience. Have they gone through. Some tough times. And how did they navigate through that and what did they do through good times? [00:23:20] So the experience and the borrower character, number one, and then we look at collateral as a collateral values. Are we going to be in the money and then cashflow very important because that’s how we get. Repaid initially, or essentially the primary source of repayment is from your cash flows. So we look to make sure those are solid cash flows. [00:23:39] And this year with COVID expenses and COVID reimbursement, we do like to see separate those separated out so we could see how the home or the facility performs on its own without COVID. Extra expenses due to COVID or some reimbursement that may have had. And then, so those are primarily what we look at and projections. [00:23:59] We want to see where they think they’re going. And then we scrub through those projections pretty well.
Hanh Brown: [00:24:03] Great. Great. So today, From a national lenders perspective, how are they senior housing in the skilled nursing industry performing? And of course, what impact do you predict COVID will have on the future of this industry?
Donika Schnell: [00:24:18] Well, that’s tough. I wish I had a crystal ball I’ll thought. Yeah. So I think I’ll go back to, I know there’s a need for these facilities. I think. I personally think skilled nursing is going to be okay. I think hospitals are probably going to also be okay. They’ve had a dip in census. I think it was really scary for awhile when, when procedures that were locked out, like we were only treating COVID patients and that, that of course caused other problems.[00:24:44] So I’m glad that’s not. Other waves that we’re having, they’re not locking down other services, but the, the services that we do, like preventative services and optional stuff that we want to have done, that’s still going to continue. And I think that’s great for hospitals and yeah. Nursing homes. I still think assisted living is going to, might struggle a little bit longer, but as. [00:25:07] As we move out now that we have vaccines, as we move out of this and people can start to come out of their homes and go back to life. I think the assisted living will eventually be okay in most parts of the country. I think the we’ve overbuilt in certain parts of the country. Those will probably struggle. [00:25:22] That’s the natural cycle of an economy. They’ve all fared thankfully for the government. Sending out those stimulus monies, they’ve been able to not worry about capital so they can go buy their protective gear. They can hire who they need to, they could do whatever they need in their buildings to protect their patients and their staff. [00:25:42] I think they’re going to be okay. I do fear for our clawback. Of some of those monies. And so I hold providers, I actually was just reading this morning. Providers are doing okay, even without stimulus money over. Most of them are, some of them are not, there’ve been lots of stories of some that are struggling and they’ve been hit hard with COVID. [00:26:01] So I think it’s going to be eventually we’ll all get out of this mostly because they’ve all been working together. I always think teams win. So if they’re all working together, they’re going to be, we’ll figure out how to get out of this. So I’m hopeful. I think they’ve done well, occupancy is the one that’s. [00:26:15] Not surprising has dipped.
Hanh Brown: [00:26:17] I agree. You mentioned the effect of the government stimulus and how it’s helped the providers. So you want to do a deep dive on that? Cause I know not that government stimulus didn’t go for everybody. It had an effect on helping providers care for the patients and residents in a certain skill nursing.[00:26:37] But what about private pay? Can you just explain the distinction where it did help and where it didn’t help ?
Donika Schnell: [00:26:44] I do think from the perspective of CMS, if. They provide services to Medicare and Medicaid patients, or they pay for the services and Medicare Medicaid patients receive that’s primarily from CMS.[00:26:58] I think CMS has thought was we got to help the providers who care for our Medicare, Medicaid patients. So that’s where I think that’s where the thesis comes from, that they have to ask Congress to make sure we don’t fail. People who rely on Medicare and Medicaid to pay for healthcare services or they’re there, the death rates would be much higher. [00:27:17] I think if those monies had not been issued, and then we heard the stories right away, there was not enough protective gear for our medical professionals. And that was everywhere. I, my brother-in-law’s an ER doc. And when this first started in March, he was using the same mask. Yeah, those stories we heard about masks and paper bags, and that was just a reality. [00:27:36] Nobody was really, truly prepared. So they, they were able to, those monies were issued so that they could pay their people, whatever they had to pay to keep them working, whether it was a bonus or increase their pay. And I had heard that a lot of that had happened, bonuses were given increased pay and then the, so they could buy protective gear. [00:27:55] CMS understood that right away. They’re very cognizant of the needs of the providers and the users of Medicare and Medicaid, private pay. I think the perspective is it’s private pay. The government doesn’t necessarily need to prop it up. Now. I think some monies were given. I haven’t looked that closely because I do tend to look at skilled nursing and hospitals a lot closer, and the hospitals receive stimulus monies too. [00:28:18] They also receive them through reimbursement. So if a patient comes in and test positive for COVID, they can use a different CPT code, a different billing code and get a higher reimbursement rate. So that that’s how the hospitals are tapping into more reimbursement is through those billing rates. And that’s where I think that thesis is from now. [00:28:34] I do know the assisted living industry has been very vocal and I’m not sure if I’ve seen around of stimulus for them, not as much as I have for nowhere near as you have for the nursing homes.
Hanh Brown: [00:28:46] I share your sentiment. That’s what I heard and seen. And I just wanted to get your thoughts and then coincide with what I’ve seen as well.[00:28:55] Now, what advice would you give to someone who is passionate about creating development or a company that would have a great positive impact on the lives of seniors, but just doesn’t have as much background or I guess find in a financial aspect of it.
Donika Schnell: [00:29:11] Go get experience, go work for a larger company where you can.[00:29:16] Work your way. If you’re an administrator and you want to be able to go out and that, that I love new. Providers as the older generation ages out, there’s gotta be a new crop of, of administrators and owners and operators. And then they should have a chance to build their wealth to, and build their portfolios. [00:29:36] But you have to have experience first as an operator. Can you run nursing homes can or assisted living facilities, whatever your asset classes, get that experience. I see the most. The most effective ones, they’ve actually worked at a larger company. So they’ve worked at a larger provider or a regional operator and moved up. [00:29:57] So they started with a few nursing homes and then they’re opening, they’re running a region and they end up being, when you’re running a region, you actually have some financial performance. Responsibilities too. So that’s how you gain that and just be smart and listen, and talk to people. The young guys who just talked to everybody are terrific. [00:30:16] Yeah. I’d say sticker, go find veterans, find mentors. So this is a big thing. That’s come out this year. Build your own personal advisory board. A lot of professionals, especially young professionals. You could go find mentors and ask them, could you be available? I just need guidance in my career. I need guidance in my, my business that I want to build, or I’m building now build that small advisory board and people who are like me. [00:30:41] I love helping young people try to figure out their paths in life as professionals so that they can be the next ones who provide care in our communities. And maybe they’ll do it better. That’s right. That’s what we want our kids. We want them to be better than us, so right. We want that generation to do it better and more innovative and all the technology involved today, they’re there. [00:31:01] Hopefully they’ll be able to figure out how to pull it all together, bolt them on and provide even better care like telemedicine. I think some of that’s here to stay permanently and we need those in rural areas. And other parts of our country.
Hanh Brown: [00:31:13] I wholehearted a little bit of what you’re saying. Folks, let’s say I’ll have this conversation with you.[00:31:19] Here’s what I can add value to you. If you need help in this and that I can provide you some expertise that I actually entrust and execute myself. And then here’s what I don’t know. Can you provide counsel expertise, feedback on these areas? And I think. When a time like this, where we can collaborate and compliment each other’s strengths, because when there is a situation that comes up, you know where to go to?
Donika Schnell: [00:31:46] No, I agree. I think what you’re doing is great. This is exactly like connecting people to each other and having interesting conversations. And you never know what you’re going to hear or just to know you’re not even alone. So, so these thoughts you have are like, Oh, there’s a lot of us who think like this, that’s terrific.[00:32:02] We’ve lost that connection, unfortunately, because of this year. But now as I love all this, I think it’s great.
Hanh Brown: [00:32:07] great. I may have told you this offline for the longest time. I’m very anti-social media. Especially when my kids were younger, I’ve always told them what you do with your business, what other people do as their business.[00:32:18] And you just don’t put it out there. They’re older now. And the irony is that I’m on social media. Good Lord. And then my children are like, Oh my gosh, mommy’s on social media and she’s talking about aging and they first sure are getting off of social media. [00:32:35] That’s smart for them. Why I do it is I get to meet people like you, it’s just so much learnings, you know?
Donika Schnell: [00:32:43]So yeah but this is a healthy use of social networking, my personal opinion. We’re sharing positive. Positive industry sector, you just, everything, all these people that you bring together. It’s very fascinating. Yeah.
Hanh Brown: [00:32:55] Thank you. Would you like to add anything else?
Donika Schnell: [00:32:58] I want to say, thank you. If anybody needs money for financing, call me.[00:33:02] I’m very happy to help find it for you or place it for you, or just point you in a direction or a, you need a sounding board. Be happy to be there. There’s lots of people who lend in this country and have. Deep experience in healthcare. So just make sure it’s somebody who understands your business, not someone who has only been doing healthcare as a lender for a year or so. [00:33:23] Go find somebody who truly has knuckle dragging experience.
Hanh Brown: [00:33:27] I’ll echo that. So I’ll make sure to add all this information in the show notes so that people know how to get ahold of you.
Donika Schnell: [00:33:33] Thank you, hon so much for everything. All right. Great afternoon. Thank you. Thank you.
Hanh Brown: [00:33:41] Thank you so much for joining us this week on Bloomberg living podcast.