From Chaos to Clarity: Transforming Healthcare Finance

There may be errors in spelling, grammar, and accuracy in this machine-generated transcript.

Doug Lewis: Okay. All right, so if, uh, if we have any dogs barking, we'll we'll forgive you. Don't worry. Okay. Don't worry. Get into it. But in the interim, uh, and our makeshift, uh, stages, I guess today. Uh, Matt, you look way too official for the unofficial Sage Intacct podcast recording. For those of you who are just listening and not watching, he's got his [00:00:30] official unofficial Sage Intacct podcast shirt on today, which is, uh. That's new. I like that. It's a good look.

Matt Lescault: I figured, you know, I thought this morning, you know, I don't usually think in most mornings, but getting up, I was like, I'm going to try to actually dress somewhat decently today. That makes sense for the podcast. So here we are. I have the shirt. I still think we owe Doug a shirt. I'm just saying, I think Becky's listening to this. I think he's still owed a shirt, uh, a.

Doug Lewis: Shirt and a, I think a company car, if I'm not mistaken.

Matt Lescault: Company car. Good. Good thing we don't actually have a company [00:01:00] for the podcast.

Doug Lewis: Just a lease. Just a lease is fine.

Matt Lescault: I don't want to take you away from whatever car you run in. A Pinto, maybe.

Doug Lewis: Uh, yeah. But I've. I've had some upgrades over the years. So it's it's it's it's it's it's great. Uh, I don't want to make you feel bad. Tell you what car I drive, Matt, I really don't, I don't it's whatever car you want me to drive in your head. And if it's a Pinto, I'm happy to do that, I really am, but, [00:01:30] uh, it's not a Pinto, I can promise you that.

Matt Lescault: So it's. What's funny is my, uh. Uh, director of people and culture. We're having a meeting a couple of weeks ago. She goes, what's the first thing you visualize when you think about somebody going through a midlife crisis? I said a 55 year old man that has just bought a Mazda miata.

Doug Lewis: I guess if they're if they're on a budget going through the crisis.

Matt Lescault: See, this is this is how I'm aging myself. Because this is what happened when I was a kid. Is that [00:02:00] the, uh, the middle aged men were doing the Mazda miata. Well, then she shows me a picture of her buying her high school car, which was a CRV, which was just kind of random. I was like, I thought that was pretty interesting.

Emily Madere: I have nothing to add to this conversation. I know nothing about cars except.

Doug Lewis: You ride an.

Emily Madere: E-bike in my cars.

Doug Lewis: Oh. Oh, good. So you do have a car? Perfect. You hit a lot of things. Or just curbs. I mean.

Emily Madere: Other cars.

Doug Lewis: No people. Cars.

Emily Madere: No people, [00:02:30] no people.

Doug Lewis: Not yet. You got some wood there?

Emily Madere: Yeah. Knock on wood.

Doug Lewis: Yeah. Oh, well, this is this is riveting. Running people over. Yeah. This is disgusting cars. Really interesting way to kick this off. Yeah. Sage technology. Right. Running people over the car wasn't it was it was an EV. So we'll tie in technology to the conversation there. Let's just assume the last person you hit Emily wasn't an EV. Uh, but that being said, I mean, we can just drone on for probably days about absolutely nothing, but maybe we should get to the important [00:03:00] kind of stuff that we're talking about here today. Uh, now, we talked through how to pronounce our our very important guest name here today. And so I'm not the one who accidentally screws it up, Emily. I'm going to I'm going to throw the ball over you. Why don't you introduce our special guest today?

Emily Madere: Yes, I am happy to introduce. And I'll give you a little intro. So, um, I met this individual probably about two years ago. Maybe [00:03:30] a year and a half ago, I would say, um, she was, you know, looking for intact. She's going to tell a little bit of her story today. She'd come from a previous firm that we implemented intact for us, but I am I am pleased to introduce, uh, Mina Maynard, uh, the CFO of legacy.

Doug Lewis: Oh, you just took the easy way out, Mina. You took you. You went with me.

Emily Madere: I didn't want to say it wrong, I didn't I say it, I say it. Humana but I don't I that's just the way [00:04:00] my my mentor had said it, so I don't, I don't know, but it's nice to have you on.

Ximena Velazquez Maynard: Thank you.

Doug Lewis: Well now, why don't you actually give us the correct pronunciation of your name? How about.

Ximena Velazquez Maynard: That? It is Jimena or Mana.

Doug Lewis: Mana?

Ximena Velazquez Maynard: Yes.

Doug Lewis: Yeah. You took the easy way out. Emily, you took the easy way out.

Emily Madere: No, I know which I'll.

Doug Lewis: I'll. I'll follow you this entire way because you led that. And I'll do this. So, mana, pleasure to have you on. Really excited to get you. You do some pretty interesting things. If I'm not mistaken. We did a little prep today, so I'm kind [00:04:30] of excited. Usually we don't prep whatsoever. I mean, this is just fly by night operation here, which is why it's the unofficial Sage Intacct podcast. But that being said, Nina, why don't you give us a little background? Who are you? Why are you arguably the most important person in the world today?

Ximena Velazquez Maynard: So, yes. So, um, my career, throughout my career, I have basically, um, been either the chief financial of various companies or held some role that was very similar in smaller companies. Um, and oftentimes [00:05:00] I've been brought in, um, to some kind of disaster field in their accounting.

Emily Madere: And so you're a Swat. The Swat team.

Ximena Velazquez Maynard: Yes. It came kind of my niche that I would find these companies and that I would help build them up. And several of them, we actually built them up to such a degree that we were able to sell them for a huge profit. Um, sometimes it took us 1 or 2 years. Sometimes it took us 4 or 5 years. Um, it is never what I am searching for. And actually, before [00:05:30] I took this position, I told my boss, if you're planning on selling in the next 20 years, I am not taking this job. And, um. And we are just excited to grow the company and to make it something amazing. And that is exactly what we're doing.

Doug Lewis: So you're just attracted to damaged companies or are they attracted to you? I was a little unclear on that.

Ximena Velazquez Maynard: It's probably a little bit of both.

Doug Lewis: Got it.

Ximena Velazquez Maynard: I like fixing them up. The whole reason why I fell in love with accounting is because there's so much right or wrong, correct. In many industries, [00:06:00] there's a lot of gray areas. In accounting, you're either doing it right or you're doing it incorrectly. There's many forms of doing it, and I think that Sage Intacct allows us to do everything in an easier format. But at the end of the day, you're hoping to get to the same numbers or then you're in the wrong field.

Matt Lescault: So I'm assuming you're more of a build it person than a maintain it person.

Ximena Velazquez Maynard: I am, I get bored very easily.

Matt Lescault: So so I've always had this theory, especially when it comes to CFOs. You either have the CFO that loves to build [00:06:30] and they're kind of that maverick that's just going to make change and create automation and all that other stuff. And you have CFOs that really are comfortable taking something that that Maverick built, and just make sure it keeps operating smoothly and at a high level. So that makes me not believe that you're going to be at this company for 20 years.

Ximena Velazquez Maynard: Hey, with the with the degree that we keep pushing and growing. I think that I will be there for a good while.

Doug Lewis: That's what everybody says until that offer comes in.

Ximena Velazquez Maynard: Yeah, [00:07:00] you.

Doug Lewis: Know what I mean. And then,like, nobody's.

Doug Lewis: Selling until they sell. And, uh, I don't know. I always find that kind of interesting. And. Emily.

Matt Lescault: Emily's going. Stop! We love her. This is not the conversation.

Emily Madere: Shut up.

Ximena Velazquez Maynard: Emily probably doesn't mind because she knows wherever I go next, if they don't have Sage Intacct, I'm going to be calling her and telling her. Hey, I got another one for you.

Doug Lewis: So you're incentivized to get her to leave?

Ximena Velazquez Maynard: I have received nothing.For ever using Sage intacct.

Ximena Velazquez Maynard: All my personal benefits [00:07:30] from it.

Doug Lewis: I do love that.

Emily Madere: Let's talk a little bit about legacy too. You mentioned that they have a lot of growth. Um, for our guests listening, this is, uh, kind of a large nursing home healthcare operation. So let's talk a little bit about that.

Ximena Velazquez Maynard: Yeah so we do specialize in the nursing home industry with legacy. They began in the 80s. They actually started with two locations, and those locations were more kind of like run as a mom and pop. And they did that for years. And it wasn't until about, [00:08:00] um, 2018 when the Boston Sun took over. And he probably a lot like me, is an innovator and said, what we're doing here is awesome, but what we could be doing here would be so much greater. And so they since 2018, we have gone from two nursing home facilities to 11. We have nine in Louisiana and we have two in Texas. Uh, we also own and run a pharmacy, and we run a mobile X-ray [00:08:30] company. And we have several things on the books now that are up and coming as well.

Matt Lescault: So how many entities does that make you? I just like to get the.

Ximena Velazquez Maynard: So we have 11 facilities and then two other companies that are not nursing homes. Okay. Uh, but then on top of that we have the management company, which we do everything from. We have, uh, five holding companies. We have property companies. So all in all, at one point [00:09:00] we had probably 30 QuickBooks files.

Matt Lescault: So you came from QuickBooks.

Ximena Velazquez Maynard: So the company had QuickBooks. That's how they started. And it worked well with the two companies. Before I came on, they had moved the 11 nursing homes to a third party nursing platform that is used and very well known in the nursing home industry, called Point Click Care. And they had built and developed a side of it that was supposed to be the financials and the GLP and all of that. Uh, those companies in that software [00:09:30] ran independently, so they did not. Those 11 companies did not speak to each other even though they were in the same software. So when I came on in early 2023, I immediately in the interview told them, it's, I hear your issues, I hear what you're doing. It's not working because you don't have the software you need. And so, you know, they were like, sure, sure, something we can talk about. But within the first three months I got in there and I saw, this is a disaster. [00:10:00] There's no way we were going to grow. Um, at the time we only had, um, eight facilities and we put on three more. Since then, there's no way we're going to continue to grow and evolve. We have so many, um, requirements because of what we do that we have additional audits, additional cost reports, all these things. And it was taking us months and months just to accomplish the very basics.

Matt Lescault: I didn't know that point click care even had a financial back end.

Ximena Velazquez Maynard: It's [00:10:30] really bad.

Ximena Velazquez Maynard: It was not.

Ximena Velazquez Maynard: Created by a very good accountant.

Doug Lewis: They are they are not a sponsor on the show that.

Doug Lewis: Uh, doesn't look like they ever will be at this point. Uh, but I gotta ask, so obviously, you know, you connected with Emily here a couple years ago when you implemented Sage, you know, inside legacy. At the other, I'll call it dumpster fires of organizations that you turned around in the past.

Ximena Velazquez Maynard: Yes.

Doug Lewis: Had you implemented Sage Intacct before? Was this the first go around? [00:11:00]

Ximena Velazquez Maynard: We did about, um, eight years ago. I worked for a company. It was NTT testing. Um, it was a big company here in town that has since sold off. But they while they didn't have all of these many entities that we have where I'm at now, it was a very complex company. We actually it was harder for us to implement Sage there just because of the different products that they offer. The way that payroll ran, the files that were coming in from all the major, you know, Dow, [00:11:30] shell, all the big companies around here. And so it was it was life changing for us there as well. Um, and so I knew what the implementation process was. I knew the team pretty well, and I knew that this is what we needed to implement at legacy.

Doug Lewis: Now, was that a one horse race when you implemented it? Legacy was it just I mean, were you test you can you can tell now that, you know, we're a couple years into this thing so Emily won't get her feelings hurt, but were you shopping it around? [00:12:00] Were you testing against other options? You know.

Ximena Velazquez Maynard: The first time Sage the.

Ximena Velazquez Maynard: First time I implemented it, or the second time?

Doug Lewis: The first time when you're. When you're out there.

Ximena Velazquez Maynard: The first time.

Doug Lewis: In the world.

Ximena Velazquez Maynard: When I was a premium inspection and testing. Yes. We were shopping it around. Um, we were not sure if this is the route that we were going to go, but we were pretty sure that it was what was going to work for us. And they had a great team who came in weekly for a while and sat with us and held hand-held us step by step with [00:12:30] what was going to need to happen for us to be successful.

Matt Lescault: What were the other products that you were evaluating at that time?

Ximena Velazquez Maynard: Oh God, it was such a long time ago. I think at the time,

Emily Madere: Eight years ago.

Emily Madere: A lot of things have happened.

Ximena Velazquez Maynard: I think Great.

Ximena Velazquez Maynard: Plains was still out there.

Ximena Velazquez Maynard: Was one. There was only about three. But. Yeah.

Matt Lescault: Okay. And just for for fun. I mean, you've been using Sage Intacct now for eight years. How different is intact from a user experience today [00:13:00] versus when you first started in the implementation eight years ago?

Emily Madere: Well, I think, I think and before you begin, so our viewers know there was a lull when she didn't work at intact at all. And then you kind of came back. So a lot of things have had happened in that. What would you say, like two, three, four years.

Ximena Velazquez Maynard: Four and a half years that I did not use Sage Intacct in the middle. So it was it was very different product. And I was also using it in a multi entity environment, which I did not the first time around. So it made it even more of a [00:13:30] game changer for us.

Doug Lewis: The dark Ages I think is what you refer to them as.

Doug Lewis: Right?

Doug Lewis: Was that it? Did that make sense? Um, so, you know, you keep thinking about, you know, multi entity, I guess the first time around when Sage end up ended up winning above everybody else. What was the differentiating factor? I mean, why Sage Intacct versus whoever else you were looking at at the time? You know, eight years ago, was it just better people, better process, better implementation, better price point? What is it that really drew you to [00:14:00] intact?

Ximena Velazquez Maynard: It was definitely, um, better implementation. The team that we had eight years ago was phenomenal. Uh, one of our main points of contention in that company was the way that we the massive amount of, uh, employees we had in payroll issues, that we had the different payments plans that we had depending on what department you were in. And those things were huge, um, huge [00:14:30] issues in when we were implementing and being able to do downloads. That made sense. So what Sage Intacct does really well, and I'm sure they've gotten even better at it over the last eight years, is that they integrate with other software really well, and there is always some kind of solution that they can find you. Whether my payroll system is not going to work with this. Okay. Well, we'll we'll recommend which one you should do and which one that will speak well with Sage. Um, there's plenty of other things we know Bill.com other third party softwares [00:15:00] that are really well known. They integrate really well with Sage. So that makes it easy that if Sage does not have what you need, there's someone out there that can team up with Sage and it can become part of the platform that will make you a winner.

Matt Lescault: With that, can you sort of talk about your current tech stack that you guys are deploying? You know, you have Intacct, obviously what payroll provider you mentioned? Bill.com what is your your, your current financial tech stack look like?

Ximena Velazquez Maynard: So we actually have another software called Smartlynx. [00:15:30] Smartlynx and I solve both kind of run hand in hand for our payroll and HR. So even though our employees are paid and housed in Isold, we use Smartlynx for all of our scheduling, which in the nursing home world. Labor is the absolute biggest expense that we constantly struggle with. Right. We are required to be providing a certain level of care and a certain amount of hours of care. And [00:16:00] in order to run that well and efficiently, you have to have really good scheduling. And so we have smartlynx that has, um, a software that we use in combination with intact. Um, we do use Bill.com, but we only use it for the credit card. So we wanted to clean up our credit card process. So that.

Emily Madere: Divvy.

Ximena Velazquez Maynard: Divvy. Yeah. Um.

Ximena Velazquez Maynard: So all of.

Matt Lescault: Our links and intacct integrated at this point.

Ximena Velazquez Maynard: Yes.

Matt Lescault: So you're bringing all of your, your scheduling data [00:16:30] over and using that from a costing perspective, things of that nature.

Ximena Velazquez Maynard: So they work a little bit independently Smartlynx kind of runs all of that for us on the side. And we just bring in the, you know, the payroll journals.

Ximena Velazquez Maynard: And use both in combination.

Matt Lescault: Awesome. And when it comes to intact and I'm might be getting too much of the nitty gritty like what's your module set look like? Maybe Emily can jump in here for us. I just, I think it's interesting to understand the kind of the complexity or the way you use intact. Um, [00:17:00] and how other healthcare organizations could, could emulate some of what you're doing.

Emily Madere: I think the modules that you have are very simple. I think you have core intact. I know we want to get to talk about one a little bit later. That's EMR connect. I think you have a couple business users, um, employee users. But I don't think you have anything crazy.

Ximena Velazquez Maynard: Nope. We're a simple company

Doug Lewis: That was a missed opportunity for you, Emily. You should have said it's the most complex thing in the world.

Emily Madere: No.

Doug Lewis: You need [00:17:30] to bring me my.

Emily Madere: My philosophy as a salesperson is to be as truthful as possible. So, no, I'm not going to oversell somebody.

Matt Lescault: Well, I also think, Emily, to be fair, it's not only being truthful, but sometimes keeping it simple is the best thing for a client. And, you know, I always try to talk to people about, like, if you can keep it simple, you can always build on top of it. You try to do too much up front. You you can sometimes get yourself into a worse position than you are currently. So, you know, don't don't [00:18:00] undersell your your approach. Don't undersell your sales.

Emily Madere: Yeah.

Ximena Velazquez Maynard: And we did look at the purchasing uh module.

Emily Madere: Yes. Yeah.

Ximena Velazquez Maynard: In Sage. And that's still on the table. It's actually been a huge topic of conversation lately. But we wanted to get everything in there. We were buying buildings at the time. We had new staff. We had all these things that we were trying to turn over. At the same time, we said, hey, let's get Sage all the basics in flowing well first, and then we can look at things like adding, purchasing and other things that may be available [00:18:30] to us.

Emily Madere: And that's that phased approach. So, um, we still talk about that approach in our sales cycle is like, let's get you set up for what you need today. And then in a year from now, once all your users know how to use the system once it's been implemented. Okay, let's let's move on to some of your other goals. But one thing mesna in your tech stack for Nttac specifically is EMR connect. Yeah. So I want to talk a little bit about that. Um, so for our listeners, EMR [00:19:00] connect is a is a skew that Sage sells and it's its ability to connect in your EMR, in Sage Intacct to pull, um, financial and statistical data from EMR to intact. Um, but Mesna, do you want to kind of take it from there?

Ximena Velazquez Maynard: Sure.

Ximena Velazquez Maynard: So our accounts receivable still lives in point click care because of HIPAA, because what we're dealing with residents lives and their health, we have to have our receivables in a nursing type software. So that's where it lives. And [00:19:30] our hope and our desire was to have complete visibility. Reporting Dashboards and Sage that would be fed in from point click care information so that we could be efficient in our accounts receivable. You can imagine that is second to labor. One of our biggest, um, headaches is trying to manage our receivables, making sure that they stay in line. We have sometimes bi [00:20:00] weekly meetings, definitely monthly meetings with every single facility trying to gain control over our HR. And so they one of the options for us was EMR connect. That is the route that we went. They had a really great selling point. They had a great um, call they did with showing us dashboards and examples of reports that we're going to be able to come out of it. Unfortunately, we have not gotten there with EMR connect. Um, [00:20:30] the most that we're getting out is basically journal entries coming over. And outside of that, we don't have any of the cool dashboards. The reporting is not other than some basic reports that are already in Sage showing us these are your totals, which doesn't help give too much insight there. Um, so that's probably been our only challenging point throughout the integration was the part where we chose to use EMR connect.

Doug Lewis: You [00:21:00] mentioned something there to I want to completely throw a curveball at you. Shift gears entirely. Uh, so be prepared. Uh, you know, you mentioned, you know, HIPAA being a being kind of a, a nuisance, especially in the healthcare space, especially from a compliance perspective, you know, working in the nursing home industry, the greater healthcare space. What are some of the nuances that really make the financial reporting and compliance component just a little more complicated than some [00:21:30] of the other industries or verticals out there?

Ximena Velazquez Maynard: Well, like I mentioned, you have to make sure that you're you have all of their health information contained in some kind of nursing software platform. Um, there's also resident trust funds that you have to manage, and you have to make sure that those funds are meeting all audits. We are audited monthly. They're meeting all requirements for that person's, um, own funds that are being managed within the building. Uh, we are in a lot of rural, rural areas. [00:22:00] That's kind of what we specialize. And so we from beginning to end, are leading residents and families through the Medicaid process and trying to get them through that. And if you know anything about that process, it is long. Sometimes you're waiting one month, sometimes you're waiting six. And so you have all of these complexities of trying to get residents through the process who cannot afford it, who need Medicaid in order to even be in the building. We have residents who do not have family members and sometimes cannot even [00:22:30] really be coherent themselves enough to make certain decisions, and we are the ones who are there protecting them. We are there wanting the best for them and hoping that that we can, uh, provide the absolute best care. And so with that comes all the other things, um, in compliance and making sure that we are reaching certain star qualities and reaching health measures that are required by Medicaid, Medicare, that we are following the billing process. We have wonderful billers, but it is a very complex [00:23:00] problem. We're also dealing with hospice companies. We're dealing with sometimes with worker's comp. And so it's a very complicated system.

Doug Lewis: So if feeding on that I'm sorry to cut you off, Matt, but on this train of thought, you know, because the narrative around nursing homes and assisted living facilities and some of the other, you know, elder care, uh, healthcare programs out there is there's rampant fraud, just rampant fraud. Now, from your point of [00:23:30] view, working inside that industry, is that something that is warranted? Are there some bad players out there doing it? Is it a couple bad apples? Is it all over the place? You know, from your experience, just financial fraud? Is that a prominent issue inside the industry you work in?

Ximena Velazquez Maynard: I think it's a very contained issue. I think that when you are really operating from a standpoint of wanting to commit fraud in this space, it's going to [00:24:00] show in your facility, it's going to show in your ability to give care. And there's some mom and pops out there that we actually try to go after and buy, because we know that we can make it better. You know, one example is we bought a facility in Saint Christina that had the absolute worst reputation. The building was falling apart. I went in there on the first day and they had a ramp that went down. And instead of fixing that so that patients wouldn't get harmed, [00:24:30] they put padding on the wall in case they the wheelchair slid into it, the pad would catch them. And I was like amazed. I was like, this is terrifying. And we have completely turned that building around. We spent so many millions of dollars on making the building better, on making it safer, on making it better for the resident to live in on them having their own bathrooms. And so I do think that there's good guys out there, of course. And there's always going to be a couple bad apples. Um, I came [00:25:00] across one of those bad apples once, actually. They tried to hire me before legacy did. And then, um, all these things happened with Katrina, and I won't name the company, but let's just say that they were not treating their residents right.

Doug Lewis: Are they still around today?

Ximena Velazquez Maynard: Oh absolutely not. No. Thank God.

Matt Lescault: Well, I was gonna ask you mentioned 11 locations or 11 facilities that you guys currently have. What's the average number of, uh, tenants or occupants that you have within each, uh, location?

Ximena Velazquez Maynard: We [00:25:30] have some that are as small as 80, and then we have some that are as big as one 4150.

Matt Lescault: Well, I mean, so you guys have well over probably a thousand residents across your different properties. Yeah. And you know, my experience in healthcare, just from being around different CEO groups and things of that nature is it's not so much the fraud that that you that's the bad stories. It's the level of complication that that's required by the facilities to report, especially when we're talking about [00:26:00] Medicaid, especially when we're talking about that kind of stuff. That really almost drives down profit margins to a way that makes it difficult for organizations to thrive to to really be profitable. And I'm, I'm, I'm wondering how potentially an intact especially coming out of point click care being your financial back end has helped sort of shed light, create transparency into the financials to allow you guys to operate better, to make those decisions, [00:26:30] to decide to be on this growth path. That will keep you at the organization for 20 years.

Ximena Velazquez Maynard: Sure.

Ximena Velazquez Maynard: So let me give you one example. Um, in the nursing care industry, we have to be concerned with floor spending. So there's a certain dollar amount of floor spending that we are required to spend per resident every year. And if we don't then they essentially the government takes that money back. So we want to be able to be spending the [00:27:00] necessary amount per resident so that we don't end up owing $300,000 at the end of the year, which has happened to us, by the way, before. Um, but we also don't want to just throw money into things, right? Okay. So let's just go buy 72 new medical machines, because we need to make sure we spend this money and are able to show it in our books by X date or else. So it's a it's a balance. You want to be spending the right amount. And we did not have any visibility into our floor [00:27:30] spending. I mean, we could see our financials, but we could not see easily on a month to month basis where we were trending on our floor spending requirement per facility, which varies greatly. And so in Sage, as soon as we got in there, it wasn't only a couple months later that I was able to create my own report. I created a floor spending report. And it's an easy report that we can look at every single month. And we do. We analyze it. And especially quarterly we're able to make decisions on okay, are we do we have the right amount [00:28:00] of staff? Do we need to increase staffing. This is what it'll do to our floor spending model if we do that by the end of the year. And so we're able to make much better and better informed decisions just on that one area that we just simply did not have before.

Matt Lescault: Are you then tracking kind of floor spending by. I don't want to say by resident but by number averaging by residents. So you can sit there and say this facility has 80 people. We've spent $80,000 in floor [00:28:30] spending. I'm making up really silly numbers here, but, you know, for purposes. So we have a per.

Ximena Velazquez Maynard: Our census is in. Yes. Our census is absolutely in that report. And it's a line that figures into the equation of, of our floor spending.

Matt Lescault: And so are you now having all your census data in intact statistical accounts. And so you're seeing that from, from that sort of dashboard components. You kind of have your scorecards, you have your, your, your, your green arrows and your red arrows and.

Ximena Velazquez Maynard: Smiley faces and frowny faces.

Emily Madere: Mhm. [00:29:00]

Matt Lescault: Well and I think that's really where that power comes from for organizations, you know, whether you're in healthcare or other ones, it's like for you as a CFO to be able to look at something and quickly be able to identify where a potential problem is well before it is the problem. And that's where, uh, where we see it. Um, I don't want to I don't want to jump back and really focus on too much. But you know, that EMR connect, you know, I'm sure Emily seen many times. We've seen it many times. I, [00:29:30] I implore you to try to figure out what the what the challenges are, because getting that in real time and getting that data in real time from that system, and I'm less worried about AR data as I am the census data, quite, quite frankly, um, from it is such a game changer for many organizations. And it's a it's a bummer to hear that you're you're running into challenges on that. Um, now, it is a product that is developed and delivered by a third party as well. So there's, you know, there's some limitations [00:30:00] that that, uh, customers and partners have when it comes to it. It's not that Sage, uh, owns that, uh, from that perspective, but, uh, we've had we've heard a lot of great, uh, great stories and great use cases. So I hope that gets fixed.

Ximena Velazquez Maynard: Me too.

Doug Lewis: And man, I got a question for you on kind of the broader, you know, nursing home assisted living facility industry. So it's no secret that the baby boomer generation is aging, getting older. Um, and there's [00:30:30] going to be what I envision a massive increase or influx in, you know, residents in a lot of these facilities nationwide, you know, from your point of view, again, working inside the industry from a scalability perspective, are we going to struggle with with this next kind of 5 to 10 years here? Uh, you know, accommodating all the needs there? What what's your thought on that?

Ximena Velazquez Maynard: It's funny you say that because there's honestly there's so many nursing homes out there. There really [00:31:00] are. Um, and we've just heard of a group who has come in and bought 150 of them at one time, and it's actually in Texas. And we were just laughing about how almost ridiculous that was to successfully purchase 150 homes and think that that's going to go well. This is from various, um, sellers, by the way, so they're dealing with a headache of complications when it comes to just. [00:31:30]

Doug Lewis: Integration and.

Doug Lewis: Yeah, sure.

Doug Lewis: Yeah. Understood.

Ximena Velazquez Maynard: So, you know I do think that when those things don't work out, it will give companies like us who are trying to do this the right way and grow smartly, but still taking care of our residents. It will give us more opportunities to take on more homes. Um, and as I said earlier, there's always going to be the good cookies and the bad cookies out there, and you just have to try to do your best. Um.

Emily Madere: So do you in the the nursing home industry, it's a lot of [00:32:00] back, or do you think there's going to be a lot of PE backed homes?

Ximena Velazquez Maynard: Yes. We are finding, um, there's for some reason, a lot of interest from the Jewish community and people with a lot of money on that realm who are coming in and buying up nursing homes. So.

Matt Lescault: Um, that's a big player in it. And to Doug's point, and you're probably seeing it as, you know, as our our average age increases our our our life expectancy population. [00:32:30]

Doug Lewis: Sure.

Matt Lescault: Well know our life expectancy. So not only are we having more people coming into the need of services like this, we're seeing more people stay longer needing services like this. So I mean, this is one of those industries that, at least for the for the near future, has a upward trajectory. Now, at some point you're going to have a reverse on that. You know, if you look at historic economics of like Japan and how they had their baby boomer activity, uh, much earlier than we did, and then how that how that's impacted sort of, [00:33:00] uh, the economy and everything else over the long term. But it's, uh, it is one of those industries and and I've seen it too, where you have some of, uh, some, uh, Jewish conglomerates that are coming in and really buying up a lot of, uh, a lot of homes and, and service providers and things of that nature. And I agree with you. Trying to buy 150 homes at once, probably a mix of 15 to 20 different entities. Could [00:33:30] you imagine you having to do that and try to figure out every single EMR and how to get that into it, and how to create like.

Emily Madere: I feel like mana would like it though. Like I feel like you.

Ximena Velazquez Maynard: And I have the wisdom enough to not step into something that makes no sense. So.

Matt Lescault: So I have to know if you're currently using intact from a core perspective, do you have your eyes set on any any upgrades in the near future? Has Emily been knocking on your door recently about the next, [00:34:00] uh, the next phase?

Ximena Velazquez Maynard: Not really. Other than the purchasing module, I'm not sure that, um, we have a huge need for anything else. You know, one of the great things that Intacct did for us is that even though we are one company, we are a legacy management group. We do have different ownership structures with the different facilities. They're not hugely different, but they're slightly different and different, important enough for us to be able to keep them separate. And so what was happening in our old software is that we had, for example, [00:34:30] a bill that was to be split up between 11 locations where we were making 11 different entries into 11 different files just to correctly or 11 different due to due from entries, and then they would never, ever reconcile in the end. And one thing that was life changing for us was just the way that Sage Intacct handles due to due froms in the background for you. I even still have to remind some of my accountants sometimes when they come to me with something and they're like, well, do I need to create a do to do? I'm like, no, that was the last [00:35:00] decade.

Matt Lescault: Don't post those accounts.

Ximena Velazquez Maynard: Oh no Sage does it for you. It handles it all for you. Just put it in and pay it and call it a day. And so that that for us was one of many things that was life changing for our process.

Emily Madere: And you bring up a good point. What does your current accounting team look like?

Ximena Velazquez Maynard: So in our office, we only have, um, we have two main accountants, a senior accountant and a staff accountant. We also have an HR director. We [00:35:30] currently have 11 payables payable people in every single building. And we are actually thinking of bringing that in-house. So we're going to hire an AP person who's just dedicated director of AP to handle the AP portion of our business. Um, and then we have our, um, executive vice president, and she actually has been there since they started this all this building and has been there from the beginning. And, uh, she, she's [00:36:00] heavily involved in the accounting and financial side of things.

Matt Lescault: So you said something interesting before that. I always like to ask organizations, you talked about allocations. And one of the things that I think Intach does better than any system out there is allocation management, whether that's from from a simple transaction allocation or more dynamically. Tell me a little bit about how you guys are now using that to not have to have ten different entries on a on on a transaction or anything about your allocation kind of approach.

Ximena Velazquez Maynard: Yeah. [00:36:30]

Ximena Velazquez Maynard: So the really simple thing that we've done is just create an entire entity report that we can pull every month. So at the end of every month we pull the enter into your report. We double check that some of the things are correct, that nothing looks wonky, but other than that we're just doing the transfers. So we're not having to do all these millions of entries for all the things that happen on a day to day business level that might involve two companies, four companies, a holding company, whatever. It's all happening [00:37:00] in the background for you, and all you have to do is bank transfers at the end of the month.

Matt Lescault: And when you said allocations, I'm assuming you're saying like you would purchase something and then allocate that purchase across multiple entities.

Ximena Velazquez Maynard: Correct.

Matt Lescault: And so how are you doing that now within uh, with an intact.

Ximena Velazquez Maynard: Well intact. Makes it simple.

Ximena Velazquez Maynard: You just yeah. You can just pick the the facility that it goes to or the holding company or the management company or whatever entity that you have in your software. You can just stick it in there [00:37:30] and it just does all the work for you. Um, it also allows you to create different account groups. So like I told you before, we have different structures for different companies and we've just created those account groups in the background. And so it's easy for us to identify if something has gotten a little off. Something went to an account group that it was not supposed to go to because it has different ownership structure. So those account groups in in intact also help you, um, keep things clean.

Matt Lescault: I think that's really important because good data structure allows for good reporting, and it probably gives you the ability [00:38:00] to easily run reports, audit that information and say, yes, I'm comfortable with how this has been posted. I'm comfortable with how these these financials are going to look, whether I look at it from an individual, uh, entity or, uh, legal structure perspective or as a group, uh, in general.

Ximena Velazquez Maynard: Right.

Matt Lescault: And so I'm assuming you then have sort of like your different dashboards, like your main CFO dashboard, but maybe your reconciliation dashboard, maybe your finance manager dashboard. How did you kind of structure your reporting [00:38:30] views from that from that perspective?

Ximena Velazquez Maynard: So we have one main corporate dashboard that is only visible to those of us on the executive team. And that contains all the data. Right. All the things that we don't necessarily want everybody to see is on that dashboard. Um, we also have a dashboard for our administrators. So possibly the most important position outside of anyone in the corporate, um, office is our administrators. They are the ones on the front line every single day [00:39:00] trying to run those buildings and running in circles. I mean, I do not know how they do it sometimes, but they are trying to put out fires. They are trying to make sure everyone's safe. They are. And then at the end of the day, we're asking them why they're over budget.

Ximena Velazquez Maynard: And.

Ximena Velazquez Maynard: Sometimes they just look at me like I had some text this morning of let me know what you need now for month end clothes. That way I don't get in trouble. And so they're able to go to those dashboards and kind of remind themselves, oh, these are the things that [00:39:30] I need to do before month end clothes that I need to make sure are done, whether it be reviewing and approving, um, AP, correcting things that might have gone in to the wrong month or the wrong account, whatever it may be, they're able to go in there and look on their dashboard and see things that might be red flags.

Matt Lescault: And they're giving you kind of feedback of what's working. Well, what's not updating those dashboards as, as more information is available.

Ximena Velazquez Maynard: They like those are the administrators like to keep it as simple [00:40:00] as possible. So I make a very simple dashboard for them. And don't throw too much at them because they have enough on their plate.

Matt Lescault: That makes sense.

Doug Lewis: You're right. I mean, that's a that's a really good segue into kind of one of my last questions that I was really curious about, you know, in the broader healthcare care industry. So actually I want to I want to jot something down while I ask this to see if I'm right. So I'll do it ahead of time before I ask the question. But from your point of view, you know, being in the financial operations side of the healthcare industry, what do you think is the largest [00:40:30] challenge facing the healthcare industry as a whole? I jotted one down on a post-it here. I jotted, I jotted what I think you're going to say down, but I want to hear your thoughts.

Ximena Velazquez Maynard: Our largest challenge is the labor force.

Doug Lewis: Oh, staff. Labor.

Doug Lewis: Look at that.

Emily Madere: Wow. Perfect.

Doug Lewis: Now, more importantly, how are you combating that internally at Legacy Management Corp.?

Ximena Velazquez Maynard: Oh. [00:41:00]

Doug Lewis: It was quite the smirk. Right. It's going to be a phenomenal answer. I can already tell. But what are you doing to try to right the ship internally.

Ximena Velazquez Maynard: Right.

Ximena Velazquez Maynard: So currently we're having major discussions about just our wage scales, our wage scales where they need to be with changing the wage scales really bring in more, better labor. Or are we just throwing money at something where we're not? That's not what the people are looking for. So that's what we're looking at right now. We're [00:41:30] really seeing what are the wage scales around the areas that we're at. Are we in line with those wage scales? Could we improve the wage scales? We have done a lot of that over the last two years, and we've had several corrections that we've had to make in some facilities of, you know, this department is ridiculously low. We don't even know how that happened. Um, and then large scale, we have at times looked at every single employee, um, to see what what needed to be improved. So finding good labor is hard. And, and in [00:42:00] this industry, what I've learned very quickly is that many people just go from place to place, right? If you're looking for an administrator, they've probably actually worked for us before. They just kind of rotate to company, to company and sometimes they come back. So we would like to have employees that are want to be at legacy, and we're trying to figure out how we can do that better.

Matt Lescault: Is burnout a big challenge when it comes to staff retention?

Ximena Velazquez Maynard: Absolutely.

Ximena Velazquez Maynard: We have some facilities [00:42:30] that are, you know, always understaffed. And so then we have to bring in agency. So then we're dealing with that and we're paying people, you know, 55, $65 an hour, um, for agency last minute. And so we are really looking at our metrics in, um, smartlynx now for that to see how we can better control agency. But, um, you also have to be staffed, right? So sometimes there's just nothing you can do.

Doug Lewis: Well, do you see a path forward where maybe you could [00:43:00] supplement your staffing with some of those robotic dogs? You know? You know what I mean? Those things are really freaking cool. And you're not going to hit burn out with them, you know. Is there a path forward there?

Emily Madere: You may have to charge them. Yeah.

Ximena Velazquez Maynard: Their hands would be kind of rough for diaper changing or some of the, you know, harder things that they have to do in those facilities. So the residents might not like that or they might love it. I don't know.

Doug Lewis: So Boston Scientific needs to really work on that is what I heard.

Ximena Velazquez Maynard: Yes.

Matt Lescault: I thought I was going a [00:43:30] different direction. I thought I was going to ask for a job, but, you know.

Doug Lewis: I mean, I I'm not close enough to the facilities. That's that's the only reason why it just wouldn't work out that way. Uh, but yeah, staffing, labor, that's I think that's tough across pretty much every industry vertical right now. But you know, it's there's no silver bullet to really fix that. So last question then I promise you I'll shut up. Mina, you know, from your point of view, what is kind of one piece of advice that you could offer to other healthcare [00:44:00] finance professionals or operation professionals who are on legacy systems today to really explore what those options look like? How should they go about this process? What what questions should they ask? You know, how can someone shift from a legacy platform to a more modern approach to managing their systems?

Ximena Velazquez Maynard: So the first thing is that they can't be afraid of the cost, because in all reality, the cost of not doing it is probably greater. [00:44:30] The hours that are going to be spent by your CFO, by your controller, by your accountants trying to do manual things or things in Excel that could be automatic is it's going to end up paying for itself. So asking yourself the question of, you know, is cost the only thing that's keeping me from doing it? If so, it shouldn't be. And if it's not cost, is it fear of not knowing how the implementation is going to go, uh, having to do it yourself? You [00:45:00] know, we are very lucky that on my team, um, several of us love data, and we're just kind of data maniacs. And you give it to us and we're going to figure out how to put it in the right format and stick it in the software. A lot of people might not have that on staff and their companies, and they might think, this is going to cost me an arm and a leg to hire additional people to help me and the team specifically that we've worked with both times that have done this implementation are just wonderful. You know, they point you in the right direction. They tell [00:45:30] you step by step what you need to do, and they and you're able to integrate the software, um, rather quickly. This implementation was super fast. I think we implemented everything within 2 to 3 months really.

Doug Lewis: So the price point from shifting from legacy to a more modern system. Granted, it might be a tough pill to swallow, which I thought was good for this. Uh, but don't let it don't let it stop you from exploring these options and ultimately moving forward, because it's going to cost you more to stay on legacy systems.

Ximena Velazquez Maynard: Absolutely. [00:46:00]

Doug Lewis: That's that's a good way to put it. Don't be afraid of spending money. And I like that. It's a.

Ximena Velazquez Maynard: Very it's my motto.

Ximena Velazquez Maynard: At home with my husband, too.

Doug Lewis: So are you. Every relationship has a spender and a saver. Are you a spender or a saver?

Ximena Velazquez Maynard: I'm actually not. My husband is actually the spender.

Doug Lewis: He's the spender. Yeah, you're the responsible one.

Ximena Velazquez Maynard: I am. Okay.

Ximena Velazquez Maynard: Except for right now, because I really need a pool in my house. And so I told him we're doing it.

Doug Lewis: Now, I heard in my [00:46:30] house.

Ximena Velazquez Maynard: Well, at my house.

Doug Lewis: That's okay. Because, I mean, if it's in your house, that's a different level than.

Ximena Velazquez Maynard: Yeah no. I'm not reach that level.

Doug Lewis: Okay. Well, you know.

Emily Madere: So I know, I know your husband likes to cook. Like, can you imagine, like, the cookouts by the pool? Like, I feel like he. He would be. He would be into that.

Ximena Velazquez Maynard: I know. Exactly. It's community service. We have people over all the time.

Doug Lewis: So community service. That's a good way to. That's a good way. I have to share that with my wife. Um, man, we have we have taken up enough of your time, which cannot thank you enough for jumping [00:47:00] on here and sharing your experience. Um, you know, for better or worse, we've decided to end every single one of these things with just a terrible dad joke. Now I always throw it out to to the peanut gallery. If anyone else wants to take a stab at throwing one out, I'm happy to do it, but I figured I'd give you the offer if you have a terrible mom joke on hand for you. I'd love to hear if you have something. If not, don't worry, I'll jump in.

Ximena Velazquez Maynard: Oh, my husband's the funny one in our relationship. My wit does not land well. My husband probably has one. I should [00:47:30] have asked.

Doug Lewis: Matt. Emily. I'll throw it to the two of you again.

Emily Madere: Nope.

Matt Lescault: This is your thing. That's why it's dad jokes by Doug.

Doug Lewis: Well, they're not good. I just did. Okay, so I, for whatever reason, since we started talking, cannot stop thinking about the 110 pound doodle that you have. Uh, so we got something in the dog world. Uh, what's it? What's a terrible dad joke? Uh. With dogs. Oh, okay. What is a dog's favorite instrument?

Matt Lescault: A bugle?

Doug Lewis: That's [00:48:00] good, that's good, but it's not it. Any other guesses? It's a trombone.

Emily Madere: Oh!

Doug Lewis: Come on.

Emily Madere: That one was bad.

Doug Lewis: Come on right.

Matt Lescault: I was I was so proud of myself, I thought I had that one.

Doug Lewis: No, I was actually way better guess.

Doug Lewis: Than I was expecting from me. Normally, they're way worse than that. Uh, so congratulations on getting better. You asked a good question today, Matt, and you had a good guess on a dad joke.

Emily Madere: Yeah. Look at you. Go buy a lottery [00:48:30] ticket.

Matt Lescault: Winning today. Now, that's. That's my wife's job. I don't do lottery tickets.

Doug Lewis: Geez. What are you gonna do? I cannot thank you enough for joining us. Uh, sharing your insight. Hope to have you back down the road and share the, uh, inevitable experience when you ultimately sell legacy.

Doug Lewis: Because that's. What are you doing?

Ximena Velazquez Maynard: How dare you Doug. How dare you

Doug Lewis: Thank you for joining.

Doug Lewis: And, uh, look forward to talking again in the future.Take care.

Ximena Velazquez Maynard: Thanks, guys.