Some say everything is bigger in Texas, and that holds true when talking about Creative Solutions in Healthcare. The largest skilled nursing company in Texas and one of the biggest in the country, Creative recently acquired five more skilled nursing facilities. 

That brings its collection of properties owned or managed to 174 — 153 of which are skilled nursing. All are in Texas.

The facilities are 4- and 5-star rated in the Centers for Medicare & Medicaid Services’ quality rating system, Chief Executive Officer and founder Gary Blake said. Each building is unique, with the four newly acquired facilities ranging from 60 to 169 licensed beds. Their total bed count is 475.

The new facilities are spread throughout the state, ranging from Houston and Lockhart to Lampasas, Yorktown and Luling.

The buildings were previously operated by Diversicare, which outsourced housekeeping and dietary departments, noted Leila Jones, Creative’s vice president of communications. Creative prefers to keep all functions in-house, including therapy, Jones noted.

The company notified the facilities of the management transition in mid-May and immediately began to streamline the transition by hiring new staff, training workers on company standards, ordering new equipment and purchasing beds for all residents, Blake explained.

When Creative Solutions takes on new properties, it retains current workers. It honors the tenure of every employee since they began in their position, instead of restarting a tenure time-clock, Blake said.

“It is not a transaction that should impact their amount of time and dedication that they’ve paid to the facility and to the residents,” he explained. “That’s important to us.”

The company roster now sits at just under 15,000 employees. The firm wants workers who have a desire to learn, and then will grant them opportunities to do so, Blake said. 

He encourages communication between employees and residents and also gives out his phone number to every employee, resident and family member. He quickly acknowledges this has led people to ask him if he has lost his mind. (The company’s average daily census is around 10,890 residents.)

“I’m actually in a sound mind when I think about honoring the employees who choose to work for us, and honoring those families and residents who choose to live with us,” Blake told McKnight’s Long-Term Care News. “It’s an honor for me to share my cell phone number with anybody that wants it.”

He said Creative Solutions has every intention of growing further. That means even beyond four more buildings it will take possession of in September and three more in December.

The steady growth is not unlike that at Ensign Group, though its locations are scattered around numerous states. Believed to be the nation’s biggest skilled nursing provider, Ensign has shrugged off pandemic and post-pandemic challenges to balloon to 343 healthcare operations. 

Blake founded Creative Solutions in 2000 with a single facility and has expanded it to virtually every corner of Texas. Like Ensign leaders, he has stated outright that there is no set final goal or number of facilities in mind.

One of the most rewarding aspects of acquiring new properties is seeing how the residents get excited over the changes the company makes, Blake said. For added good measure, the town also typically rallies around a new acquisition, he added.

“People need those positive changes and influences in their life,” he said.