Providing High-Quality Care, Encouraging Growth, and Finding Success

As the Senior VP of skilled nursing Operations, Bruce oversees a high level team of operational experts, including Vivage’s Nursing Home Administrators. Bruce brings a wealth of post-acute and operational experience, serving twenty-four years as a recognized leader at Vivage and in other national corporations including Sun Health and Kindred. Bruce’s experience includes working in multiple levels of operations, including as Charge Nurse, Nursing Home Administrator and Vice President of Operations. Bruce has moved Vivage communities into a solid EHR system, incorporated technology into operational data collection, analysis and reporting, and has led in establishing core systems of performance management of Vivage communities to effectively prepare for new care and payer models. Bruce serves as leader in onboarding newly acquired facilities in the Vivage portfolio, leading project teams, and implementing new policies and procedures throughout the organization. Bruce has a solid working knowledge of both rural and metropolitan healthcare settings and has been successful in creating collaborative community partnerships in both settings. Bruce’s expertise includes revenue enhancement, program development, cost containment, contracts management, regulatory compliance, customer satisfaction and staff retention. Areas of responsibility include development and achievement of facility strategic plans and operational budgets, hiring, training and retention of facility administrators, and ensuring compliance with all state and federal regulatory requirements. Bruce’s team will be launching the Vivage Academy in 2016 to promote growth and development of corporate and facility leaders.

Dr. Gahm is a geriatrician serving as the Corporate Medical Director for Vivage and is a medical director for several of Vivage’s skilled nursing facilities. He attended the University of Colorado for undergraduate studies and medical school, followed by a residency in Internal Medicine in Arizona, a Fellowship in Administrative Medicine and Medical Informatics at Harvard, and a sabbatical in Clinical Preventive Medicine at Stanford.

Dr. Gahm is an Associate Professor of Clinical Medicine for the University Colorado Health Sciences Center and is actively involved in coordinating influenza recognition and treatment efforts in Colorado. In addition, he served as President of the Colorado Medical Director’s Association for four years and Chair of their CMDA Annual Educational Meeting.

Dr. Gahm has led a monthly Geriatrics Education Meeting since 2012. He serves on the Vivage Community Ethics Committee and has done research on influenza, appropriate UTI and Skin & Soft Tissue Infection diagnosis and treatment, and COVID-19.

Dr. Gahm has served on various community Task Forces run by CMS, CDPHE and/or Telligen, which have focused on inappropriate use of antipsychotics, Antibiotic Stewardship, improper medication use in LTC. And since March of 2020, he has been a Subject Matter Expert for the CDPHE COVID Rapid Strike Force.

Cynthia Coenen is a Registered Nurse and serves as Chief Clinical Officer for Vivage. Cynthia oversees a team of recognized clinical staff including registered nurses, licensed clinical social workers, certified therapeutic recreation specialists, and health information specialists. Cynthia is recognized for her outstanding leadership in regulatory compliance and survey management systems that have helped Vivage communities to achieve excellent outcomes in surveys and CMS star ratings. Cynthia has also led Vivage’s efforts to create transitional care management for our short stay rehabilitation guests from pre-admission to our post-acute communities to post-discharge home. Cynthia brings over 20 years of Nursing, Management and Survey experience in the long-term care. In her work as Vivage Consultant and in her past roles as Director of Nursing Services and Corporate Regional Director of Clinical Operations, she has consulted in over seventy Nursing and Assisted Living Facilities throughout the Western United States. Cynthia is frequently called upon as an Expert witness in defense of Nursing and Assisted Living Facilities involved in litigation. Cynthia’s areas of expertise include development and implementation of effective CQI programs, survey preparedness, management and correction, State and Federal regulatory compliance, wound treatment (both prophylactic and therapeutic), MDS and care planning systems, development and implementation of clinical systems and staff recruitment and retention.

Heather TerHark-Monreal has over 25 years of diverse continuum of care healthcare experience. Heather provides leadership and direction in ancillary support, business development for new projects in post-acute and senior living settings, managed care contracting, and transitional care oversight and guidance to Vivage/Wellage communities and Bridges Community Homecare, Hospice and Palliative Care. Heather develops key partnerships and strategic programming for innovations in a variety of care delivery models in regional and national markets.

Additionally, Heather has been an Assisted Living Executive Director and has directed large sales and marketing teams. Heather has experience in home care and hospice, having developed Medicare and private duty programs as well as geriatric case management. Heather obtained a bachelor’s degree in Business Administration with an emphasis on Healthcare Administration from Frederick Taylor University after attending Missouri State University, where she studied Recreation Leisure Studies with an emphasis on wellness.

Kevin serves as general counsel to Vivage and WellAge and has over 30 years of experience in representing health care providers, including nursing care facilities, assisted living facilities, home health agencies and hospices.

As the VIVAGE Chief Administrative Officer, Drew provides contracted VIVAGE communities with integrated operational process management, purchasing guidance, vendor relations management, Risk management and overall behind-the-scenes support to produce successful, safe, and profitable outcomes. Drew has served as a key leader in positioning Vivage and its communities to be efficient players in accountable care, value-based purchasing and new payer models, through careful evaluation of business partner relationships and related quality of service delivery and costs. Drew also serves as Vivage Corporate Compliance Officer and leads an interdisciplinary team in ongoing evaluation and assurance of compliance areas and management of all compliance requirements. Drew oversees a dynamic team of administrative staff that excel in a high level of corporate customer and employee relations as they manage the day to day workings of the corporate office. For over 25 years, Drew has focused on the senior care environment through time spent as a Medicare Operations and Reimbursement consultant and as the Director of Finance in a national managed care organization before joining QLM in 1999 as their Chief Operations Officer. Drew’s diverse skill set and wealth of top knowledge has made him a “go-to person” with his hand in nearly every aspect of Vivage Operations from contract management to group purchasing, employee safety and Corporate Compliance.

John Brammeier began his career in healthcare after receiving his BS of Accounting from the University of Colorado, Boulder. John gained much of his early experience working for national firms, including Blue Cross Blue Shield as a Medicare auditor and as a consultant/auditor for Deloitte and Touche. His financial leadership experience includes several years in hospitals both as an accountant/business office manager as well as a senior manager in consulting for Hein and Associates. In 2000, John became the CFO for Piñon Management which provided management and consulting services to skilled nursing healthcare and senior housing operations. In 2012, John was instrumental in the merger of both Piñon Management and a local competitor Quality Life Management to form a new company call Vivage Senior Living. John serves as CFO of Vivage and part owner of the company. Today Vivage Senior Living manages, owns and operates 28 skilled and senior living communities; with 19 of these communities in the Denver Metro area. Vivage has 4 senior living projects in various stages of development along the front range and another 4 on the western slope of Colorado. Vivage owns its own ancillary pharmacy, home health and is developing a hospice in order to offer a complete post-acute continuum. Vivage has created care coordination with transition coordinators managing our patients within our own network with the goal of significantly reducing unnecessary re-admissions to hospital partners and improving the care of our patients. John is a CPA and a Fellow in the Healthcare Financial Management Association. He was past President of the Colorado Chapter in 2000 and currently serves on the American Health Care Association – Finance and Reimbursement Committee. He is actively engaged in developing Medicare and Medicaid policy both locally and nationally. John was recently honored by the Denver Business Journal as a Finalist for CFO of the Year in Denver.

Jay Moskowitz is nationally-recognized as a successful business owner and operator in skilled senior healthcare and housing profession. With a commitment to leading the post-acute profession in innovation, service standards, operating, and customer engagement, Vivage Senior Living, has become one of the largest provider of skilled nursing facilities in the state of Colorado and has expanded long-term care services into other parts of the country.

Jay saw the rapid changes in the everyday needs of our Seniors and realized this population was moving to other levels of care. It was at that point that Jay and his team developed WellAge. The WellAge communities were built to serve the needs of the Senior population that do not require long term or short stay skilled care. To date, WellAge has partnered with the development and management of seven Independent Living, Assisted Living and Memory Care communities throughout the State of Colorado and they continue to work on projects in other states.

In addition, Vivage founded Bridges Home Care Communities and Bridges Hospice. Bridges assists residents at home once discharged from a skilled community and to provide hospice care to those at the end stages of their life. Through the company’s extensive options for senior housing and healthcare service, Jay’s companies are equipped to meet the diverse needs of today’s seniors and are favorably positioned for continued growth.

As of May of 2019, twenty-one of Vivage’s skilled communities have received the highest rankings by CMS of 4 and 5 stars. Jay takes great pride in this achievement and knows it is a direct reflection of leadership and team members that work within those communities to attain these results. With consistent high rankings, Vivage communities have met the needs of a number facilities throughout the region. Vivage works closely with CMS to provide oversight and assistance, to bring troubled communities back in compliance when they have had a history of poor survey outcomes. Vivage’s team of consultants have worked in nine other states in the western region to provide their services and expertise to improve clinical outcomes and achieve key business objectives.

The majority of Vivage’s communities are Eden Alternative® certified facilities. Also, Vivage opened the first Green House Home in Colorado, located in the city of Loveland. This is a direct reflection of the unique programs, leadership and staff who have dedicated themselves to enhancing the lives of the residents who reside in their facilities.

Jay is a hands-on leader who enjoys high levels of engagement with his teams, customers, and business partners. He visits his facilities regularly and his team members know him as being someone who takes the time to listen to others and demonstrates genuine care and understanding.

Jay is an advocate for our profession and the residents we serve. He is involved in local, state, and national legislative affairs. Jay is former President and active Board Member of the Colorado Health Care Associate, as well as an active member of various local and national organizations and associations including the American Health Care Independent, Multi-Facility Advisory and CCAP Boards. He is the recipient of many awards both locally and nationally, including the coveted Colorado Health Care Vesta Bowden Award for outstanding service in the long-term care profession, received the prestigious “Lifetime of Service” Award from the U.S. Department of Health and Human Services and recognized by the Denver Post as the 2019 Top 25 Work Places.

Jay is a devoted Husband, Father and Grandfather. Above all else it is his family that brings him the greatest joy!