Creative Solutions in Healthcare

What Creative Solutions in Healthcare does

Creative Solutions in Healthcare is a family-owned, Fort Worth, Texas-based post-acute care operator founded in 2000 by Gary and Malisa Blake with the acquisition of Granbury Care Center. The company operates 182 long-term care communities across Texas — making it the largest skilled nursing operator in the state and the 5th largest post-acute care provider in the United States — and serves seniors and post-acute patients with skilled nursing, assisted living, short-term rehab-to-home, long-term care, memory/dementia care, respite care, and ventilator care services. Its product surface is organized across three operational divisions (East, West, South), and the brand is built around five core values, with the proprietary White Glove cleanliness program running continuously for over 20 years.

Underlying the operating footprint is an AI-enabled clinical and financial workflow: in April 2026 the company rolled out the ExaCare AI preadmission platform company-wide, processing structured referral data and natural-language patient summaries to deliver a 30-minute response benchmark, ~62% auto-approval of referrals, and 1,500+ referrals in the first 48 hours. The company's prior internal software analytics business (formerly Data IQ) was used by roughly 10% of U.S. nursing homes before being acquired. Therapy services are delivered through a partnership with QRM (Quality Management Resources), which provides on-site physical, occupational, and speech therapy, clinical specialist training, and outcome tracking.

The business model generates revenue across three streams: skilled nursing facility services reimbursed via Medicare, Medicaid, managed care, and private pay across 182 SNFs and assisted living communities; assisted living placements; and Medicaid supplemental payments through the Quality Improvement Payment Program (QIPP), expanded from 58 to 161 SNFs under former CFO (now CSO) Chris Eamiguel. Patient revenue grew from under $500M to over $1.1B in less than four years, supported by a HUD-centric buy-and-operate acquisition strategy that has delivered an average of 18 facility acquisitions per year and a $218M appraised real estate portfolio with an expected $155M+ HUD-insured permanent debt pipeline; the company is currently formalizing a PropCo/OpCo bifurcation ahead of a stated trajectory to exceed 200 total locations before year-end 2026.

Name

Creative Solutions in Healthcare

Legal name

Creative Solutions in Healthcare

Website

https://creativesolutionsinhealthcare.com

Company type

Private

Founded year

2000

Operating status

Operating

Headcount range

5,001–10,000 employees

Short description

Creative Solutions in Healthcare operates 182 skilled nursing and assisted living facilities across Texas — the largest SNF operator in the state and 5th largest post-acute care provider in the U.S. — serving seniors with long-term, rehabilitation, memory, respite, and ventilator care reimbursed primarily through Medicare, Medicaid, and private pay.

Ownership category

akta.pro rank

Product category

Skilled Nursing and Long-Term Care

NAICS

Nursing Care Facilities (Skilled Nursing Facilities) (623110), Continuing Care Retirement Communities and Assisted Living Facilities for the Elderly (6233), Nursing and Residential Care Facilities (623), Continuing Care Retirement Communities (623311), Other Residential Care Facilities (6239)

SIC

Services-Skilled Nursing Care Facilities (8051), Services-Nursing & Personal Care Facilities (8050), Services-Health Services (8000), Services-Home Health Care Services (8082), Services-Misc Health & Allied Services, Nec (8090)

akta.pro primary industry

Transitions of Care Management (Hospital/SNF/Home) (HLADALAD)

akta.pro secondary industries

Care Coordination, Referral Management & Transitions-of-Care Pathways (HLACAGAL), Assisted Living with Memory Care (Mixed Campus) (HLADABAB), Care Transitions Management (Hospital/SNF-to-Home) (HSABAIAC), Care Navigation & Service Coordination (Medical, Social, Community) (HSABAIAB), Assisted Living with Enhanced Care / High-Acuity (Aging-in-Place) (HLADABAC), Dementia/Alzheimer’s Respite Care (Specialized) (HLADAKAG)

Keywords

• Skilled nursing services
• Assisted living care
• Long-term care facilities
• Post-acute rehabilitation
• Memory care services

Headquarters

HQ city

Fort Worth

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Infrastructure, Supply Chain, Technology or R&D, Marketing or Sales

Revenue model

1. Skilled Nursing Facility Services: The company generates revenue through the operation of skilled nursing and rehabilitation facilities providing post-acute care. Revenue is derived from Medicare, Medicaid, managed care, and private pay sources across its network of 180+ long-term care communities. The company grew patient revenue from under $500 million to over $1.1 billion in less than four years.
2. Assisted Living Services: Revenue from assisted living communities offered alongside skilled nursing options, serving seniors across Texas with both short-term and long-term care placements.
3. Quality Improvement Payment Program (QIPP): Medicaid supplemental payment program participation. Chris Eamiguel expanded participation from 58 to 161 SNFs, significantly improving the company's bottom line through optimized reimbursement performance.

Go-to-market motion1 record

Distribution channels3 records

Marketing channels6 records

Core offering

Creative Solutions in Healthcare operates a network of 182 long-term care communities across Texas, providing skilled nursing, assisted living, short-term rehabilitation, long-term care, dementia care, respite care, and ventilation care services to seniors and aging adults. The company supplements its clinical operations with the White Glove cleanliness program and an AI-powered preadmission platform (ExaCare AI) that streamlines hospital referrals across its skilled nursing facility network.

Product overview

Creative Solutions in Healthcare operates a network of 182 long-term care communities across Texas, offering skilled nursing and assisted living services through multiple care programs. The core offering consists of skilled nursing, assisted living, short-term rehab-to-home, long-term care, dementia care, respite care, and ventilation care services. The company differentiates through its White Glove cleanliness program and supplements clinical care with therapy partnerships (QRM) and an AI-powered preadmission platform (ExaCare AI) that automates referral processing across its facility network.

Differentiator

Problem solved

Functional benefit

Products and services

• Rehab-to-Home Short-term rehabilitation program designed to help patients recover and return to their homes after illness, surgery, or hospital stay, offered across the company's Texas facilities.
• Long-Term Care Ongoing care and support services for residents who require extended assistance with daily activities and medical needs, provided in the company's skilled nursing facilities.
• Assisted Living Residential care services for seniors who need assistance with daily activities while maintaining independence, providing a balance of support and autonomy across the company's Texas communities.
• Dementia Care Specialized memory care services designed for residents with Alzheimer's disease and other forms of dementia, providing structured support in a safe environment.
• Respite Care Temporary care services providing relief for family caregivers, offering short-term stays for seniors who need supervised care.
• Ventilation Care Specialized respiratory care services for residents requiring ventilator support and respiratory therapy.
• Skilled Nursing Services Long-term care services provided across skilled nursing facilities offering 24-hour nursing care, medical treatment, and rehabilitation services for residents requiring ongoing clinical support.
• ExaCare AI Preadmission Platform AI-powered platform that centralizes referral management, automates patient admission decision-making, analyzes admissions packets, and streamlines reimbursement workflows across skilled nursing facilities.

Quantifiable outcome

• Processed over 1,500 patient referrals within the first 48 hours of ExaCare AI deployment
• +6 more outcomes

Named customers1 record

Segments4 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability6 records

Feature3 records

Partnerships

Three partnerships are on record, tiered core and supporting.

• ExaCare AIcoreTechnology or Integration · 1 April 2026Creative Solutions deployed ExaCare AI's AI-powered preadmission platform across all 160 skilled nursing facilities to accelerate hospital referral decisions and meet a 30-minute response benchmark. The system processed 1,500 referrals in its first 48 hours with approximately 62% automatically approved. ExaCare AI consolidates referral sources, generates AI summaries of patient journeys, and processes high referral volumes with improved efficiency.
• NSGOs (Nursing Facility Skill Group Operators)supportingStrategic or Co-development Partner · 1 January 2024Chris Eamiguel built partnerships with Nursing Facility Skill Group Operators (NSGOs) to expand QIPP participation from 58 to 161 SNFs and improve all QIPP splits for every NSGO partnership, significantly improving the company's bottom line.
• QRM (Quality Management Resources)supportingStrategic or Co-development Partner · 1 January 2023Creative Solutions partners with QRM for in-house therapy services including physical, occupational, and speech therapy. QRM provides on-site regional support, weekly operational calls, facility visits, regular clinical specialist training, and therapy outcome tracking. The partnership aims to improve patient outcomes and provide needed support to skilled nursing facilities.

Scale indicators10 records

Recent moves8 records

Expansion highlights6 records

Direct peers

• Genesis HealthCare: Genesis HealthCare is one of the largest U.S. skilled nursing operators with skilled nursing, assisted living, and rehabilitation services, directly comparable in scale, payer mix, and post-acute service offering to Creative Solutions.
• The Ensign Group: The Ensign Group operates skilled nursing, assisted living, and home health operations across the U.S., closely comparable to Creative Solutions' continuum-of-care SNF/assisted living model with similar operational and clinical differentiation focus.
• National HealthCare Corporation: NHC operates skilled nursing facilities, assisted living communities, and home care programs primarily in the southeastern U.S., offering a directly comparable SNF operating model with similar payer mix (Medicare/Medicaid) and clinical service offerings.
• PACS Group: PACS Group operates a large network of skilled nursing facilities across multiple U.S. states with similar buy-and-operate and acquisition-driven growth strategy, making it the closest direct peer to Creative Solutions in scale and operating model.
• Brookdale Senior Living: Brookdale operates the largest U.S. senior living portfolio with assisted living, memory care, and skilled nursing offerings, overlapping with Creative Solutions' assisted living and memory care services for seniors.

Others

• Ventas: Ventas is a healthcare REIT with significant senior housing and SNF property exposure, comparable to Creative Solutions as a real estate capital peer relevant to its PropCo/OpCo bifurcation and HUD-financed acquisition strategy.
• Welltower: Welltower is a healthcare REIT that invests in senior housing and post-acute care properties, directly relevant as a capital partner peer given Creative Solutions' HUD-financed real estate strategy and growing $350M+ portfolio.

Broad incumbents

• Encompass Health: Encompass Health is the largest U.S. operator of inpatient rehabilitation hospitals, overlapping with Creative Solutions' Rehab-to-Home short-term post-acute rehabilitation services and serving a similar hospital discharge referral ecosystem.
• Select Medical Holdings: Select Medical operates critical illness recovery hospitals, inpatient rehab, and outpatient rehab, comparable to Creative Solutions in the post-acute care continuum and hospital discharge referral dynamics.

Emerging players

• The Pennant Group: Pennant operates home health, hospice, and senior living services across the U.S., with an acquisition-driven growth model comparable to Creative Solutions' but with a smaller, more distributed footprint.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks7 records

Key highlights7 records

Customer concentration

• YouTubeyoutube.com/channel/UCyY4Xjos_PME-7hNFz3IxOQ
• Facebookfacebook.com/CreativeSolutionsinHealthCare
• LinkedInlinkedin.com/company/creative-solutions-in-healthcare
• Instagraminstagram.com/csnhc_/?utm_medium=copy_link

Revenue estimate

Valuation estimate

Number of profiles

Profiles19 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Creative Solutions in Healthcare