Julian Rich

What inspired you to pursue a career in healthcare administration? Why did you choose to specialize in long term and senior care? 

I was to some extent influenced by the do-gooder values of the 1960’s. After graduating high school I was looking for a summer job and a family friend suggested nursing home work. So I took a job as an “orderly” (before such staff was titled “nursing assistants”), which resulted in my developing an affection for seniors and senior care. I also realized that our society doesn’t always value elders the way other societies do. 

After attending college and graduate school, I was awarded a Masters degree in Health Care Administration. I began my career at a hospital in Paterson, NJ then had an opportunity to come to the Boston area . After becoming acquainted with professionals in the world of senior care, I was offered a job as the administrator of a non-profit facility just north of Boston.. I developed a passion for an d chose to dedicate my career to the quality of life of seniors. 

What trends do you see in senior care? 

There are so many options for seniors that require some sort of assistance with daily living that there is confusion as to what option makes the most sense. Because the organizations offering senior care are quite sophisticated in terms of marketing, sometimes the promotional aspects override the understanding of the care that needs to be provided. 

There can be conflicting values in the care that is needed and the financial priorities of facility management. Corporations invest funds in building senior care facilities and expect a return on investment.. Sometimes decisions become based more on ROI rather than an appropriate assessment of the care that is required for the prospective client. 

There is a need for these facilities to continue to evolve; newer generations of people that are aging have different requirements than previous generations. When I started in the field there weren’t many options other than nursing homes. Now home care has become more sophisticated so facilities are competing with that option. Assisted living facilities may offer numerous amenities and services but don’t necessarily have the appropriate and well trained staff in place to provide the more complicated needs that frail seniors have. 

Are there specific standards and regulations required in elder care centers? If not, should there be? 

Absolutely. The banking industry, the nuclear industry, and the nursing home industry are the three most regulated industries in the USA to my knowledge. Assisted living is not regulated to the extent of nursing homes but, is now subject to increased scrutiny. One of the most controversial issues is that assisted living clients change with time and might require care that is best provided in a nursing home setting. This can make assisted living organizations very vulnerable. 

In the cases you’ve provided testimony , whether for plaintiff or defense, what types of issues are most common in senior care litigation? 

As people become more frail, their care requirements increase and can become more complex. Therefore, facilities must be proactive in recognizing the increased vulnerability and resultant care requirements that necessitate adjusting the care plan so the person’s quality of life is maintained to the highest level possible. Falls are a common issue, as well as other injuries which indicate clients increasing dependency on caregivers to assist with activities of daily living. 

In 2013 you founded a consulting firm after retiring from operating facilities, and you have dedicated your time to consulting and providing expert witness testimony. You continue to maintain your license as a nursing home administrator. Why is this important to you? 

For one, it necessitates my maintaining a certain number of educational requirements., which ensures I’m familiar with trends in the field. It also helps me with my consulting and expert work. It deserves mention that I periodically accept interim executive assignments to complement and supplement my consulting work. 

I continue to be actively involved with the American College of Healthcare Administrators (ACHCA). In fact, in December 2016, I will be one of the instructors for a Certificate program for ACHCA that will provide nursing home operators with a better understanding of the litigation process and how they can be better prepared. 

What prompted you to launch J. Rich Solutions? What advice are clients seeking? 

I felt I needed a change to my career but still wanted to utilize the years and experience in senior care. 

As far as the advice clients are seeking, they typically want to know about regulatory and corporate compliance, appropriate allocation of resources to provide quality care, staffing patterns and training, and other issues that suggest that a facility may be in a vulnerable position. . My expertise is not just day-to-day operations and management but also governance, compliance, marketing, and referral development. I recognize and understand that facilities are under pressure to “put heads in bed”, so some admissions may be inappropriate and require complex care that challenge a facility.. 

Therefore, my role includes but is not limited to assessing how these facilities operate, how the care is provided, who is providing the care, and the maintenance of a safe environment for residents, clients and staff. 

Hospital EXPERTS is the only firm dedicated solely to healthcare administration issues. What are the benefits, from your perspective, that Hospital EXPERTS professionals bring into the courtroom? 

You are obtaining the perspective of professionals who have “been there and done that.” We have hands on experience but are also sophisticated enough to understand the ramifications of litigation. We have experience and understand the good, bad, and ugly of facility operations, which allows us to provide expertise for both the plaintiff and defense side. Clearly, being exposed to depositions and court appearances helps us in becoming more effective witnesses. The more I have been involved with expert work, the more I have developed a passion for what I do. 

What are your passions outside the healthcare industry? Are you active with any volunteer organizations etc.? 

I do volunteer work for homeless shelters and am very involved in my synagogue. I also continue to be involved with ACHCA and LeadingAge, which represents non profit senior care providers throughout the U.S. 

In addition to being a dog lover, I appreciate all kinds of music from all parts of the world. One of these days I will make the decision to take music lessons so I can become a rock star. If Mick Jagger thinks he can perform he’s got nothing on me.