David O’Brien, Market CEO, Kindred Hospitals of South Florida

Invest: spoke with David O’Brien, Market CEO of Kindred Hospitals of South Florida, about the role long-term acute care (LTACH) hospitals play in South Florida’s healthcare continuum, the importance of strong referral and physician partnerships, and the pressures shaping the region’s workforce and policy environment. “I think Kindred Hospitals are positioned to be a strong and active participant in the healthcare continuum that we need to offer the public as a whole,” O’Brien said.

What is Kindred Hospitals’ footprint in the Miami market, and how are you expanding your presence through partnerships?

Kindred Hospitals operate long-term acute care specialty hospitals across Florida, and we have four facilities in South Florida: Kindred Hospital South Florida – Coral Gables, Kindred Hospital South Florida – Hollywood, Kindred Hospital South Florida – Fort Lauderdale, and Kindred Hospital The Palm Beaches in Riviera Beach. Both the Coral Gables and Hollywood facilities serve the Miami market. Our partnerships in the healthcare community include Baptist, Mount Sinai, Jackson Memorial, the University of Miami, the HCA system in Kendall, and the Memorial System.

As a post-acute care provider, we provide valuable services to acute care hospitals. We take care of a specific, specialized type of patient who needs to be discharged, helping people get back into the community. We are super proud of our partnership in Miami. Our employees are a diverse group, which represents the Miami community as well.

Along with that come some of the challenges of big-city life. It is an interesting time for us in Miami. There are a lot of growth opportunities. Miami is booming economically, and demographically, it is becoming more diverse as more people are moving there from around the country. Florida has become a desirable location for businesses in many sectors, which is creating a need for greater enhancements in our healthcare community as well.

How are you adapting care delivery models to better serve patients with complex conditions?

All four of our buildings in South Florida are specially certified by the Joint Commission, which is one of our governing and regulatory bodies. We specialize in respiratory care, stroke, and sepsis, and we have specialized certifications in respiratory failure and sepsis.

We partner with the community to take patients with those complex medical conditions – including many who are critically ill and coming directly from the ICU of a traditional hospital – and we pride ourselves on our ability to help those patients transition to the next, lower level of care. Quite often, that is home. We are especially proud of the work we do around respiratory care. Over 80% of the patients we admit come to us on a ventilator, and over 50% of those patients go home off the ventilator.

That is a testament to the high-quality work that we provide to the community. It is also something that the short-term acute care hospitals rely on us to do because they do not have the time or capacity to take care of patients at that specialized level.

What role do long-term acute care hospitals play in the South Florida healthcare ecosystem?

It is not a secret that we have an aging population. We also have a population that is being kept alive longer with more complex medical conditions. The need for our type of long-term acute care services is growing every day. Because we specialize in respiratory care, many people in the community who are suffering from long-term respiratory illnesses are eventually going to need a service similar to what we provide.

We always put the patient first. Patients and families are at the center of everything we do. As I said, many of our patients come to us on respirators, and many are completely dependent on their caregivers. But our team specializes in working with this medically complex population and can help patients recover and regain independence. Across the country, only about 2% of all hospitalized patients qualify to come to an LTACH hospital. We are taking care of a small, specialized subset of patients in the overall healthcare continuum.

Our goal is to transition them to the next level of care, whether that is home, acute rehab, or a skilled nursing facility. Unfortunately, sometimes that also includes hospice, because some people are making end-of-life decisions and we sometimes are the last hope for wellness.

What rehabilitation approaches are helping improve patient outcomes and recovery times?

While we are licensed as acute care hospitals, all of our facilities also function as rehab hospitals. We use sophisticated ventilators to help people breathe when they cannot breathe on their own, and we also provide physical, occupational, and speech therapy for every single patient in our buildings.

The continuum of care is helped by our ability to get patients out of bed and get them moving. We have an early mobility program, where we actually get people out of bed within 24 hours. It is not uncommon to see patients walking around our hospital with a ventilator being pushed behind them, which is not something that the short-term acute care hospitals have the time or capacity to do.

It is about bringing our innovative techniques, our specialty, and our specialty designations by the Joint Commission to work every day to help people get as well as they can.

What are the biggest challenges facing post-acute and long-term care providers in South Florida today?

The government and political headwinds in this country are well-known. There is a lot of debate in Washington and at the state levels about what healthcare should look like now and moving into the future.

Managed care has presented additional challenges to those of us in the healthcare sector. In some instances, that has worked out really well, and in other ways it has been challenging, not only for the healthcare sector but also for consumers.

We are engaged at the state level with the Florida Hospital Association to make sure that our voice is being heard, not only with our local politicians in the state, but also with the federal government in Washington.

If I had to pick the one thing that keeps me up at night, it would be figuring out what the healthcare policy in our country is going to look like. I am an aging American myself, so what is healthcare going to look like for all of us in this country in five, 10, or 20 years? That debate needs to happen.

How are you approaching workforce development of specialized clinical staff?

We have a low turnover rate in our South Florida market because we employ specific employee-friendly policies. We take really good care of our employees. The biggest challenge we have is that the cost of living in South Florida has gone up exponentially since COVID. With the growth of the economy and people moving there from around the country, real estate has gotten super expensive.

It is getting harder for our workforce to be able to afford to live in this market. Our recruitment and retention strategies are strong. When we find employees who fit our model and are a good cultural fit for us, we do everything we can to help them want to stay in this community.

Miami specifically has gotten to be expensive, so our employees do struggle with that. As they keep inviting more people to move to Miami on the higher end, they are going to have to figure out how the service businesses are going to stay solid with employees. It is becoming more expensive, and people are commuting farther to work than they used to.

What is your vision for the future of post-acute and rehabilitative care in South Florida?

I am highly optimistic. I think the growth in South Florida is going to continue to create a need for healthcare services. Because of what we offer, and with the aging population, I think Kindred Hospitals are positioned to be a strong and active participant in the healthcare continuum that we need to offer the public as a whole.

We are a good partner for the community, our referral sources, and our employees and physicians. I am super excited about the future, and I think Kindred is going to have a successful time in South Florida.