Nexion Health – Business Focus
Leaning on decades of healthcare industry experience, in 2000, Francis Kirley set out to create a new, progressive provider of short-term rehabilitation services and long-term care. With a focus on proven yet innovative operating solutions, the organisation – Nexion Health – set its sights on becoming a ‘local leader in nursing and rehabilitation’ for the US communities it would serve.
Looking back over 25 years of Nexion Health, it is safe to say that Fran (President & CEO) and his team achieved their goal. In 2025, Nexion delivers patient-centred, compassionate care across 57 skilled nursing facilities in Mississippi, Louisiana, and Texas. Innovative and culturally diverse, the award-winning organisation is nationally recognised as a quality operator.
“Just this week,” Fran says, “one of our facilities in Texas was named on Newsweek’s Best Nursing Homes 2025 – a reflection of the quality of this company and our staff.”
Culturally driven, Nexion was built on what it calls ‘The Five Cs’. These are Clinical Excellence, Census (occupancy), Cash Flow, Customer Service, and Culture. These values have acted as a compass for Nexion, guiding the organisation towards its goals.
“Our culture has really distinguished us from other nursing home companies,” Fran asserts. “We work hard to reward the right behaviour, mentor people, and give our colleagues all the resources they need to be successful.
“Arguably the greatest impact of our culture is how it benefits employee retention. We have a very stable workforce and most of our senior leadership has been with us for over 20 years, while our average turnover for administrators is eight years – against an industry standard of just a single year.”
Fostering a Strong Culture
Having fostered such a strong culture within Nexion over the last 25 years, one of Fran’s greatest challenges is maintaining it. It is a process that begins with recruitment and continues throughout an employee’s tenure.
“We’ve learnt that you can’t just hire somebody, give them a job description, and say, hey, have a good day,” Fran states. “We spend a lot of time on the initial hiring and then, for the first 120 days of their tenure, employees take part in a programme called Retain, which features in-house mentoring and an interview every 15 days to gauge feedback and discuss progress.
“If new hires make it through the initial 120-day period, they almost always stay for a long time, and that gives us real stability. The Retain programme makes use of our experienced team members as trainers and mentors, so they also get a chance to revisit best practices and discover paths to improvement. It is a continuous learning process for everyone.”
Nexion’s cultural strength, and the high levels of retention it generates, is a cornerstone of the company’s success. The organisation’s long-term, people-centric approach is perhaps best exemplified by the Nexion Foundation – a body that contributes financially to the educational, social, civic, and humanitarian goals of eligible Nexion Associates and their immediate family members.
“The Nexion Foundation began at the same time as the business, and during that period, we have contributed hundreds of thousands of dollars to employees and their families in the form of scholarships, charity, emergency relief, and financial support.
“Launching the foundation is the best thing we have ever done in terms of community engagement. We operate in a lot of small American towns and rural areas, and we want to be good community citizens. Whether it is funding education or financial support in a time of need, the Foundation’s work can be really life changing.”
As a company with a significant presence in Louisiana, Nexion and its foundation stepped up to help employees in the aftermath of Hurricane Katrina. Support during the 2005 disaster is just one example of the Foundation in action.
“Every employee that lost a home during Katrina was handed a big cheque for downpayment on a new home to help them get back on track,” Fran reveals. “In response, we had many messages from family members telling us that they appreciate what we did, but for us, it was just the right thing to do.”
Digital Transformation
Backed by its dedicated team, Nexion entered 2025 ready to tackle new challenges, including the industry implementation of a new reimbursement system known as the Patient Driven Payment Model (PDPM). PDPM rollout began in July and is one of the most significant changes at Nexion in the last decade.
“It has been important for us to educate all our clinical staff on PDPM and how to capture the appropriate information on the patient’s condition in order to get paid appropriately,” Fran reports. “Louisiana began implementing the system on 1st July, Texas on 1st September, and Mississippi on 1st October.
“PDPM is based upon the previous quarter’s clinical data, and as we capture this data, it drives reimbursement going forward. For us, it is all about collecting more data, providing better care, documenting that care, and getting paid for it.”
PDPM at Nexion has been accompanied by a digital transformation of the company’s own. After 25 years, the organisation opted to overhaul its payroll system to ensure employees are remunerated correctly, reliably, and on-time.
“It’s a major project that has seen us update all our financial software systems and introduce various infrastructure upgrades,” Fran explains. “Alongside reimbursement implementation, these payroll updates have been a key internal focus.”
Evolve, Modernise, and Grow
While systems and technologies may change, Nexion will continue to provide high-quality care in communities that need it. Cognisant of the room for improvement present in any organisation, Fran hopes to collaborate more closely with Nexion’s customers in shaping the future of the business.
“We’re a very customer-focused organisation and we are always out there listening to our clients. We are constantly assessing our work with patients and their families – how can we communicate better? How can we minimise negative outcomes?
“As an organisation, we have introduced innovative insurance programmes that take risk away from patients and put that responsibility on the company, but we would like to work even more closely with families to help us become a better, more connected healthcare provider.”
In the short-term, Nexion’s next steps will include strengthening relationships with its supportive partners and developing its internal operating model to maximise revenue. In the longer-term, Fran is aware of numerous potential opportunities that could help Nexion evolve, modernise, and grow.
“We haven’t been in growth mode for a while, but we are beginning to talk about some opportunities to grow the business, including potential additional facilities. However, bigger is not necessarily better, so rather than 300 buildings, we would like to oversee around 60–75 modern, energy-efficient, quality-driven facilities in total.
“In terms of our customers, we see our referral base growing in an aging America, and we are well-positioned to serve that demand. We currently run at about 82% occupancy, but it would be nice to get closer to 90%.
“Best of all,” Fran concludes, “we have a workforce we can rely upon, and that is passionate about caring for people. At a leadership level, my son Chris and our COO Meera Riner are taking a much more active role in the day-to-day running of the business as I transition towards a Chairman role. It has been a great 25 years, and we look forward to some really exciting times ahead.”
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