Senior couple relaxing outside

At a time when the cost to provide health care is soaring, the 81 skilled nursing facilities owned by or related to Brius LLC are spending 5.1% more on patient care than the average facility in California, according to surveys of the Office of Statewide Health Planning and Development.

If all facilities in the state spent as much as Brius and its related organizations, post-acute and long-term care patients in California would enjoy an additional $350 million in expenditures on their care.

The company’s level of spending is one reason why Brius ranks 4th among the 15 largest nursing home companies in California in terms of the nursing hours it provides its patients.

“Our organization, together with the company we hire to provide services at our facilities, continually strives to maintain the highest quality of care and to make our skilled nursing homes safe and comfortable for our patients,” said Shlomo Rechnitz, founder of Brius. “If any of my immediate family members required the services of a skilled nursing facility, admitting them to any one of our facilities would give me peace of mind.”

Mr. Rechnitz, a Los Angeles-based philanthropist and entrepreneur, has become the largest owner of skilled nursing facilities in the state, controlling one out of every 14 beds in California.

The company targets distressed facilities and invests resources to turn them around. Of the 81 facilities Brius or its related entities have purchased since entering the business in 2006, 59 were insolvent, on the verge of closing, or facing decertification for patient care issues at the time of acquisition. None of them came with the top, five-star rating from the federal government that is based on on-site Medicare inspection results.

As a result of improvements made by Brius, serious deficiencies at all 59 of the troubled nursing homes it purchased dropped an average of 65% in the first 12 months of an acquisition and 40% after 48 months, according to Mr. Rechnitz.

A case in point is a facility in Fullerton now known as The Pavilion at Sunny Hill, which had been cited by regulators in October 2013 for 52 health deficiencies, eight of them serious. A year after Brius bought the troubled facility in December 2013, deficiencies dropped to 17, none of them serious.

Another Brius facility, Norwalk Skilled Nursing & Wellness Center, had two successive deficiency-free surveys, an exceptional record of compliance that may well be a first in state history. And when Brius acquired the decertified Granite Hills Healthcare & Wellness Center in El Cajon, it managed to earn recertification for the facility within five months because of quick upgrades in patient care.

In fact, for the last three years, Brius’s level of demonstrated success led the California Department of Public Health to appoint the company as one of only a handful of temporary managers the state calls upon to quickly stabilize failing nursing homes. “On numerous occasions, we were contacted by CDPH about failing facilities and asked to consider lending our expertise to turn the facilities around,” Mr. Rechnitz said. “We were always willing to do so, whether as a temporary manager, receiver or taking over the facility.”

In addition to improving the quality of care, Brius’s turnaround strategy saves jobs and prevents the transfer of patients to new residences–a process that can be traumatic, even life threatening. Without the intervention of Brius at these distressed facilities, 6,342 patients would have been forced to transfer and approximately 6,000 Californians would have lost their jobs.

To be sure, turning around troubled facilities can be challenging, taking months and sometimes years because of complex factors that range from the physical disrepair of these structures to entrenched cultural and management issues that are difficult to root out.

What is more, a significant number of patients admitted by Brius facilities have secondary psychiatric diagnoses that present unique and complex challenges.

“There are not nearly enough facilities that accept these patients, who are often needy, ultimately leaving them in environments that are unsafe and detrimental to their health,” said Mr. Rechnitz. “We believe these patients have the same rights as the rest of us to get physically healthy. But they are much harder patients to manage and their behaviors can be very unpredictable.”

Brius has recently experienced some difficulties at three of its facilities, and the media’s emphasis on these isolated negative outcomes sometimes has resulted in portrayals of the company’s operations that are incomplete. Given the organization’s model of acquiring distressed facilities and often caring for challenging patients, Mr. Rechnitz says his facilities can be easy targets for criticism.

According to Mr. Rechnitz, his organizations remain committed to achieving the highest quality of care among California’s skilled nursing facilities. In conjunction with the Centers for Medicare and Medicaid Services and the California Department of Public Health, Brius is working on continuous quality improvement as well as new approaches to post-acute and long term care designed to meet the needs of the fast-growing population of elderly in California.