CaringForward

What Should Your SNFs Target for Medicare Patient Length of Stay?

We've heard from many prospects and industry experts about skilled nursing facilities increasingly seeking shorter stay, high-therapy Medicare patients (see step one in this Long-Term Living Magazine article we previously linked to). One client has told us they are successfully (and dramatically) increasing the number of Medicare or Medicare HMO admissions, while seeing the average length of stay for those patients dip to the sub-20-day range. (How, you might ask? By using our Web-based Referral Management System to automate and accelerate admissions and referral management, and report and understand key referral source and payer trends. End commercial.)

However, we recently heard from another client that bucks this emerging trend toward higher acuity Medicare patients. In reviewing length of stay data, this multi-location SNF COO was encouraged by seeing consistently longer average stays for Medicare, within the 100-day window. Why? He said, with their case mix, his SNFs were being reimbursed at higher rates under the new rules. They realize greater returns, with less cost and effort in new patient acquisition, by managing a longer-term Medicare case mix.

So, I'm curious to hear: What's the average Medicare length of stay at your nursing homes/SNFs today, and what would you like it to be? What are the strategies and trends at your SNFs to best manage quality census and Medicare reimbursements? Have they changed? Are you expanding your rehab and therapy services at your skilled nursing facilities, and does demand for those services continue to grow?

Coming To Your Census: Step 7 of 8—Embrace Web-based solutions

Here is excerpt number seven from our new free eBook, "Coming to Your Census: 8 Steps to Excellence in SNF Census and Marketing Performance." Step seven explains why you should embrace Web-based solutions to automate marketing and admissions for your nursing homes.

Subscription, Web-based software solutions can save time and cost. Web-based solutions require no upfront capital investment nor annual maintenance costs. System upgrades are automatic, and subscription fees are consistent and predictable. Many healthcare organizations are already embracing Web-based systems for low costs and simplicity. Furthermore, they do not have to invest in internal IT resources to manage networks, hardware and software.

Skilled care providers also benefit from rapid rollout with Web-based solutions. For example, Greystone Healthcare Management rolled out the PatientPlacement.com Referral Management System for 25 locations within just three weeks of the project kickoff, with all users across all locations trained and managing all inbound referrals using the system.

 

Congrats, and a Good Cause: PPS Partner Royal Health Group's CEO Jim Mamary a Candidate for "Man of the Year"

Congratulations to the CEO of our partner in census building Royal Health Group. James Mamary has accepted a nomination for the Leukemia & Lymphoma Society’s “Man of the Year.” The campaign raises critically needed funds for blood cancer research, education and patient services.

Check out the details--and most importantly how to dontate--here on the Royal Health Group Web site. A great person and a great cause.

If You Work in a Nursing Home, You are a Salesperson. All the Time.

An excellent post by Tony Sexton on his Senior Advocacy blog about the nature of sales in skilled nursing facilities. It turns out everyone working at a nursing home is in sales. His analogy based on this quote from Tony Hsieh, the CEO of successful online retailer Zappos.com, sums it up:*

“Over the years, the number one driver of our growth at Zappos has been repeat customers and word of mouth. Our philosophy has been to take most of the money we would have spent on paid advertising and invest it into customer service and the customer experience instead, letting our customers do the marketing for us through word of mouth.”

It's interesting how this retail service philosophy applies so aptly to nursing homes. We see it in the top performing SNF providers we partner with. They understand that every interaction with every person makes an impression that sells the care and life experience at their facilities. They coach facility staff at every level and position to think about the impression they are making on patients, families, doctors and case managers with every interaction. A patient feels like your nurses don't care? That patient tells friends to stay away from your facility. An administrator seems distracted or disinterested in a meeting with a family? That family doesn't send a loved one there for care. Admissions coordinators responding too slowly to case managers? Those case managers start sending more referrals to the building down the street. That's why it's so important to instill that sense of a sales culture at every level of your organization.

Sometimes SNFs still struggle with the "sales" concept in skilled nursing. Some how it seems cold, and at odds with the mission of quality clinical care and life experience. How do you reconcile marketing and census management with quality patient care?

It's a false choice. Successful SNF operators know they can't do one without the other—they must invest in the best facilities and clinical care personnel to attract patients and provide exceptional care. They also must market smarter and outcompete other facilities to build and manage quality census (not just occupancy, but case mix and reimbursements) to fund the investment in those people and facilities.

*I know that Zappos.com is a successful online retailer because I find a Zappos box with freshly delivered shoes on my doorstep about once a week. Suffice to say my wife is a dedicated fan.

10 steps to success in the ACO world (from Long-Term Living Magazine)

Are your skilled nursing facilities prepared for the new realities of accountable care organizations (ACOs)? Healthcare reform has ushered in a reimbursement model linked to clinical care as every stage of the care cycle—acute, post acute and long term. Glen Roebuck, senior vice president of operations for Health Dimensions Group, shares 10 steps to success in the ACO world in this terrific article just posted by Long-Term Living Magazine:

"The Patient Protection and Affordable Care Act may prove to be the single most impactful piece of legislation for post-acute care since the Social Security Amendments of 1965 introduced Medicare and Medicaid . . . It is time for responsible and forward-thinking providers to become partners in making this evolution a success for the American people.

Which organizations form Accountable Care Organizations (ACOs), and how they are formed and managed, will differ from market to market. It is critical that post-acute providers understand this nuance of healthcare reform. It will be imperative for leaders in post-acute care to be aligned to ensure they are 'at the table' when formal partnerships and alliances form over the next 2-3 years."

He goes on to share 10 important things SNF management needs to be thinking about now to prepare, including the changing roles of hospital discharge planners and a new dynamic where today's perceived competitors (home health, assisted living) will evolve into your partners in care as part of ACOs. It's an excellent read, sure to give SNF management lots to think about. 

Coming to Your Census: Step 6 of 8—Buy your liaisons laptops or netbooks today

Buy your SNF liaisons laptops or netbooks or some other suitable Web-enabled devices. Now. 

Netbooks in particular are so cheap now it you can’t afford not to equip liaisons with them. Dell and others have powerful netbooks that weigh less than three pounds for less than $300 now. Most also have cheap mobile broadband options available from multiple carriers, so they can be Web-connected wherever they are. A single extra patient day could cover the cost of that investment. 

We've seen the results with our SNF clients. Clearly, it makes our Web-based system for automating and tracking marketing activities, and accelerating the referral-to-admissions process, even more powerful. Liaisons make assessments, verify coverage, accept patients in the field, and trigger alerts to admissions staff to follow through immediately. The improved responsiveness and turnaround times can mean the difference between admitting a well-qualified patient, or losing that patient to another facility. 

Even for our clients that don't give liaisons full authority to accept a patient in the field benefit tremendously by giving their marketers Web devices. Enabling them to enter the referral information/documentation online at the hospital, and triggering the assessment and approval process at the facility, improves admissions rates and patient mix. 

We've heard SNF executives argue that it's just too costly to equip liaisons with laptops. If their effectiveness makes or breaks your census goals, you might rethink that perspective. Netbooks for everyone!