Each quarter, Health Dimensions Group profiles a client to offer an insider’s view of one organization’s strategies and decision-making on timely topics of key importance in health care today.


Ascension Living, part of Ascension and based in St. Louis, is a mission-driven senior care and living provider deeply connected to its Catholic faith. Ascension Living’s mission calls the organization to provide spiritually centered, holistic care to seniors, particularly those most in need. Ascension Living offers a wide range of programs tailored to meet the unique needs of older adults and make their lives joyful, enriching, and satisfying. With more than 50 communities in 11 states and the District of Columbia, Ascension Living ministries are continually developing and adopting new best practices in care that enhance the experiences of their residents, program participants, and patients.

Ascension Living engaged Health Dimensions Group (HDG) for assistance in improving the person-centered care that Ascension provides to its residents. Ascension Living wanted to ensure the Centers for Medicare and Medicaid Services (CMS) Final Rule (also known as the Mega Rule) guidelines were met across their skilled nursing facilities. The Final Rule revised the requirements that long-term care facilities must meet to participate in the Medicare and Medicaid programs and included three dates for phased implementation.

“Health Dimensions Group’s core competency is the intersection between serving as operators and serving as consultants.”

HDG’s work included assessing Ascension Living’s Mega Rule Phases 1 and 2 education and implementation status in each skilled nursing location; developing and implementing additional strategies, tools, and processes to meet regulatory compliance; and reviewing the implementation of the new tools and processes. Following this consulting engagement, Ascension Living engaged HDG to provide interim leadership and regulatory support to several senior living centers, as well as to analyze and update organizational policies and procedures under the CMS Mega Rule.

Our team spoke with Danny Stricker, president of the Post-Acute Services Division, to reflect on the Mega Rule compliance engagement and to learn about the role of HDG throughout the process.

Health Dimensions Group (HDG): What brought you to select Health Dimensions Group as you sought assistance to review your person-centered care strategy for Mega Rule implementation?

Danny Stricker (DS): Health Dimensions Group is a recognized name by our team, and we had previous experience engaging with them. We value that HDG is both a long-term care facility operator and a consulting firm. The strategies HDG recommends are tried and tested in their own facilities, and we benefit from that implementation experience. In addition, HDG offers accountability for the results they promise, which we find unique from other firms. Given this, HDG certainly rose to the top of our list.

HDG: As you think about those factors that led you to seek additional assistance, is there anything specific that comes to mind?

DS: The overarching factor for us with Mega Rule Phases 1 and 2 was organizational capacity to successfully meet the required implementation due dates. We have the necessary internal resources to now focus on the implementation of Phase 3.

HDG: From an operational perspective, as it relates to the Mega Rule implementation, what makes Ascension Living unique from other senior living organizations?

DS: One key aspect that makes Ascension Living unique, not only in the Mega Rule implementation but also broadly as we complete other initiatives, is our dedication to be present in our ministry and to help our communities navigate a significant change. Our leadership ensured that HDG met with our teams on site. The HDG team’s presence to provide information and share competencies with our associates in person was very helpful. On-site education may be more unique than communicating through webinars or conference calls, but given the importance of this particular change in our industry, we believed it was imperative.

HDG: How would you describe the working relationship and experience your team had with HDG consultants during this engagement?

DS: Our working relationship and experience with the HDG team was collaborative and flexible. As we had conversations with HDG, our initial focus on how Ascension Living wanted to proceed changed, albeit for the better. This also led to changes in timeline, tools, means of implementation, and education. The HDG team was very accommodating to the changes and responded rapidly to provide the support we needed.

“Our relationship and experience working with Health Dimensions Group’s team was collaborative and flexible. The HDG team was very accommodating to the changes and responded rapidly to provide the support we needed.”