CaringForward

Excerpt 2 from "Improving Census and Efficiency with an Enhanced Focus on Admissions"

(This is the second in a series of excerpts from our recent LTC Performance Report, "Improving Census and Efficiency with an Enhanced Focus on Admissions." Email me at dwalker@patientplacement.com if you'd like a complete copy of the report.)

The A.G. Rhodes Homes receive many more referrals than average facilities, in part because they offer a broad spectrum of care that includes short-term sub-acute rehabilitation, long-term care, and specialized care for Alzheimer’s disease and memory impairments. The three A.G. Rhodes nursing homes have 418 beds and receive about 50 referrals daily from hospitals, doctors’ offices, families and other sources. Most originate by fax, with the average referral between 40 and 60 pages. That’s potentially 2,500 pieces of paper for the staff to track and manage each day.

And for A.G. Rhodes, it was more than just the paper pileups and slow manual processes.  The Rhodes Homes have an interdisciplinary team that reviews the incoming referrals to ensure that the care the patient requires corresponds to the openings that are currently available. Sharing information, including any comments from the staff, and then assessing and responding in a timely manner was difficult. Inefficiencies stood to hinder responsiveness and delay acceptance of qualified referrals.

Capturing meaningful data from each site for analysis was also difficult.

“With three facilities, reporting on referral sources, care requests, win-loss data and other valuable referral analytics can be a pain,” says Kellee Chassner, director of marketing for A.G. Rhodes. “Each location would separately compile information using different manual systems, making it tough to have consistent, timely operational intelligence for referral activity and admissions.”

A.G. Rhodes has an additional mission that affects admissions processes and referral review. Founded in 1904, A.G. Rhodes operates three of the few not-for-profit nursing homes in Georgia. Grants and charity funding contribute to Amos Giles Rhodes’ original vision of providing care to patients regardless of their ability to pay. This makes responsiveness and cost control in admissions all the more critical.

Excerpt 1 from "Improving Census and Efficiency with an Enhanced Focus on Admissions"

Skilled nursing facilities have always rightly focused on efficiency and accuracy in their clinical and financial systems. So where does admissions fit in the mix?

“We consider admissions to be an absolutely critical element of our overall operations,” says Jerry Patton, director of operations for A.G. Rhodes Homes in Atlanta, Ga.

“With multiple locations and the numerous specialized care services we provide, our admissions requirements are challenging. We have to be responsive and efficient, communicate effectively with our referral sources, and track admissions activity and performance at all of our locations.”

Patton’s objectives for admissions may seem straightforward, but nursing homes and other providers face significant challenges in achieving them. For most providers, admissions processes remain intensively manual and paper based. The fax machine and the telephone serve as the primary tools of the trade, along with handwritten logs, photocopies, sticky notes and disparate spreadsheets of information. Consider the admissions challenges and processes at a typical continuing care facility, based on responses to a summer 2007 admissions survey of nearly 400 facilities conducted by a long-term care software company:

• The average long-term care provider receives 1,040 referral inquiries annually—4 per day. Many larger facilities receive much larger volumes.
• The average referral comprises 22 pages of related documents. That’s 88 pages of referral documents every day. At 1,040 inquiries each year, that equals 46 reams of paper. That’s a stack of paper 8 feet tall for a typical admissions team to manage.
• 78 percent of continuing care providers rely on manual processes for admissions and referral management.
• 80 percent of initial referral inquiries arrive by fax or phone (and phone calls require subsequent faxing of documents). This reliance on faxes and phone calls makes keeping track of inquiries difficult and time consuming. Additionally, with 35 percent of all referral notifications occurring by fax, the impact of a fax failure or error becomes more severe.
• Nearly 30 percent say they lose potential referrals because of delays in responding to the referral source.
• 48 percent say they spend too much time on time-consuming manual tasks while managing inbound referrals.

When applied to the industry overall, these numbers paint a staggering picture. The roughly 18,000 U.S. nursing homes are managing, tracking and filing 412 million pages of paper annually.

“We can certainly relate to these findings,” says Patton. “A.G. Rhodes faced the same challenges with phone tag and long waits at the fax machine.”

(This is one in a series of excerpts from our recent LTC Performance Report, "Improving Census and Efficiency with an Enhanced Focus on Admissions." Email me at dwalker@patientplacement.com if you'd like a complete copy of the report.)

Doug Walker

Long-Term Care Purchasing Strategies for Tough Economic Times

Lots of professionals in long-term care are facing tightening budgets, Five-Star anxieties, uncertainty over healthcare legislation (and serious questions about it's affect on qualify of care), and discussions about the implications of pay for performance. All of these issues converge to present a seemingly contradictory mandate: Do a lot more for less.

Where to begin? Do you staff up now to improve ratios and quality measures for Five-Star ratings and performance-based reimbursements? All while budgets are tight and legislative guidelines are unsettled?

But challenging circumstances like these for long-term care can actually make some buying decisions smarter and easier. If you're evaluating long-term care software or technologies that can improve your census performance, marketing success, and ability to evaluate and admit patients that fit your optimal profile for clinical care and reimbursement, you potentially can't afford not to make the investment now so you'll be in the best position no matter what happens with healthcare legislation.

On that note, we have launched a series of LTC Performance Reports, which provide ideas, analysis and information that help long-term care providers take a fresh look at options for strengthening response times, efficiency, marketing results, census and overall performance.

The first report is called "Improving Census and Efficiency with an Enhanced Focus on Admissions." It highlights the challenges and inefficiencies in current long-term care admissions processes, with extensive data from recent long-term care industry research about admissions trends and metrics. It also profiles the success Atlanta-based skilled-care provider A.G. Rhodes has had automating admissions with a Web-based software service, and outlines five recommended steps for other long-term care providers to successfully automate admissions.

We'll be sharing excerpts from this report on the site in the coming weeks, as well as subsequent reports on admissions myths, ROI for software investments, industry survey results and encouraging technology adoption.

(Please email me at dwalker@patientplacement.com if you're interested in getting any of the full reports.)

Doug Walker

Virtual Tradeshows and Embracing Technology in Long-Term Care

Last week, we participated in the McKnight's Online Expo, a virtual tradeshow that provided valuable learning sessions (with CEU credits) and a full exhibit of vendors sharing solutions and information helpful to long-term care professionals.

We have to say, our friends at McKnight's put on a terrific show. About 1,400 people registered, and online attendees actively participated in the sessions and interacted with companies like ours in our virtual "booths." We connected with nearly 300 attendees eager to learn more about automating admissions and referral management.

It's encouraging that participation in online events such as this one is growing. We're seeing an increasing willingness in the long-term care industry to embrace the Internet and technology in general to advance our knowledge, operations, business success and quality of care. It's one of the reasons we launched this site, and we hope the trend continues.

And you can still check it out: The entire McKnight's Online Expo is archived here.

Doug Walker

Long-Term Care News Roundup

• The day has finally arrived: "[Japan] is about to create an army of robot nurses."

• The March cover story in Provider Magazine explores the inevitible adoption and application of health information technology in long-term care.

• Long-Term Living magazine has an interesting interview with Barbara Gay, director of advocacy information for AAHSA, and Cynthia Morton, senior director of congressional affairs for AHCA, about policy trends, funding, and how to fix the shortage of skilled clinical professionals in long-term care.

• John Halaka provides a nice healthcare IT primer on the Health Care Blog. He sorts through the acronyms (EHR, EMR, PMR), sizes up the status of the market and reviews components of pending HIT legislation.

Financial, clinical . . . admissions? Evaluating critical systems for long-term care

Skilled nursing facilities have always rightly focused on efficiency and accuracy in their clinical and financial systems. Automating the many steps that it typically takes to admit a patient can be just as important to efficiency and accuracy in patient care and financial profitability. As the number of patients and continuing care providers grow, and specialization of care expands, many skilled providers are addressing efficiency in admissions with the same rigor as with clinical and financial systems.

Consider the room for improved efficiency. Consultants working with a nursing home organization conducted research in 2008 that found the admissions process typically involves 160 steps: 69 handling steps, 36 forms to complete, four family trips to the hospital and 15 delays.

The research also found that making an offer of a bed in a nursing home involved 53 steps, five staff members, and nine forms.

The following is a short sample list of the steps, people and time that are involved to admit a patient to a continuing care facility:

 

Managing and processing patient referrals and admissions require a significant amount of time and resources. Today there are simple tools and technologies that streamline your admissions process, from initial inquiry to final decision. Automation gives greater productivity at lower cost. For a long-term care provider, automation would mean greater market share by capturing more referrals and admitting more qualified patients faster.

Doug Walker

Welcome to CaringForward.com

The long-term care industry has begun to embrace the Internet as a forum of sharing information and exchanging ideas. Long-Term Living magazine recently annouced a "Web 2.0" initiative, publishing sites on social networking sites such as LinkedIn and Facebook.

Both McKnight's and Long-Term Living now publish blogs to share opinions, analysis and information that's relevant to continuing care professionals. And several individuals have launched sites that engage lively discussion of general healthcare issues, technology in healthcare, long-term care issues and more.

So we're launching CaringForward.com to join the discussion. Our company, Patient Placement Systems, is committed to developing Web-based long-term care software solutions to improve efficiency and performance of providers by automating the admissions process. We've done quite a bit of industry research, asking providers for feedback related to best practices and opportunities to apply technologies to work smarter, faster and better.

We'll be sharing some of that research on this site, along with other information and fresh ideas about how long-term care providers can use technology to achieve their mission of care while improving business and operational performance. We encourage professionals from nursing homes, home health agencies, hospice providers and other continuing care providers to check in periodically for new industry information, tips, advice and discussion.

Doug Walker, Patient Placement Systems