Future Leader: David Young, Managing Director for Health Care Finance, Greystone

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David Young, managing director for health care finance at Greystone, has been named a 2024 Future Leader by Skilled Nursing News.

To become a Future Leader, an individual is nominated by their peers. The candidate must be a high-performing employee who is 40 years-old or younger, a passionate worker who knows how to put vision into action, and an advocate for seniors, and the committed professionals who ensure their well-being.

Young sat down with SNN to talk about how variations in Medicaid reimbursement are impacting the landscape of skilled nursing care, as well as the effects of the increased push for diversification of services provided by skilled nursing facilities (SNFs) to compete with long-term acute care facilities (LTACs).

To learn more about the Future Leaders program, visit https://futureleaders.agingmedia.com/.

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SNN: What drew you to this industry?

Young: After graduating with my MBA, I was looking to go into investment banking. I started with Lancaster Pollard, which was a boutique HUD shop. And from there, I did a host of HUD loans and other financing, and helped them start up their first equity fund. And so after that, I did everything from underwriting to working on the analytical side, and then decided to go into the industry because it’s one thing to be able to underwrite a deal, and another thing to be able to look at financials and gauge performance and have some confidence around how you can structure the debt. And, it’s yet another thing to actually understand how it’s operated, how those financials actually come to be created. So I wanted to go into the operations side, and then that kind of launched my journey.

SNN: What’s the biggest lesson you’ve learned since starting work in this industry?

Young: The lending is about who you lend to, not necessarily what you lend on. That’s the biggest thing I’ve learned, particularly while going through the COVID-19 pandemic.

SNN: If you could change one thing with an eye toward the future of skilled nursing, what would it be?

Young: The market perception of a 5-star rated facility. A 5-star rated building does not mean you get better at clinical outcomes and [managing] staffing. Having more staff doesn’t necessarily mean you have better outcomes.

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SNN: What do you foresee as being different about the skilled nursing industry looking ahead to 2025

Young: It’ll be a continuation of a shift to states where operators feel it’s profitable to operate in many states just with a [certain] Medicaid-Medicaid mix. Now this obviously doesn’t work for Texas, so there are some states for which this clearly doesn’t work. That said, there are many states whose Medicaid rates are strong now where it does work, like Virginia, Florida, and Washington, for instance.

SNN: And so in a word, how would you describe the future of skilled nursing?

Young: Strong. I believe demand is just going to continue to increase, and hospitals and [long-term acute care] LTACs will continue to drive patients towards that model, and skilled nursing providers will continue to look for different lines of business, whether it’s ventilators on site, dialysis or taking away market share from LTACs and other acute care.

SNN: What quality must all Future Leaders Possess?
Young: Courage.