“Separators” that Predict Health Related Attrition in Retirement Communities

SeparatorsTo preserve its census, a Retirement Community (Independent or Assisted Living) must proactively work to preserve the health of its residents.  Indeed, 92% of residents who leave Assisted Living Communities do so because of failing health.  [Reliable data for Independent Living Communities are not available].

Chronic Health Conditions (CHCs) are the leading cause of illness and death of seniors.  And seniors with multiple CHCs are 100 times more likely to have a preventable hospitalization than someone with no CHC.  All seniors in Retirement Communities have multiple CHCs, the 10 most common of which are:

  1. High Blood Pressure
  2. Alzheimer’s disease and other dementias
  3. Heart Disease
  4. Depression
  5. Arthritis
  6. Osteoporosis
  7. Diabetes
  8. COPD and allied conditions
  9. Cancer
  10. Stroke

But not all CHCs equally increase the risk of failing health.  Some conditions can be managed and remain stable for years, while others pose a much greater risk.  Analysis of the House Calls data base in Boise, Idaho has revealed 5 CHCs that separate the residents living independently from those living in Assisted Living Communities.

The most common Chronic Health Conditions in our data base are shown in the next figure:

Aggregate CHCs

 

By identifying those residents with any of the Chronic Health Conditions that are “Separators”, a community can then focus the attention of its employees on these residents so that everyone will be especially aware of any signs of declining health.  This will allow for early intervention that will stabilize a resident’s condition and thereby avoid losing the resident to an ER, hospital, or nursing home.

Kevin Williams wrote about the enormous value of a Retirement Community’s data base in a recent article in McKnight’s Long Term Care News.  He was right – this data base is golden.  And when combined with residents’ anonymous health information and then data mined, insights are revealed that will help preserve census by reducing health attrition.

 

 

Early Benefits of Analyzing Your Retirement Community’s Data Base

Data Mining - The FutureIn order to preserve census in Retirement Communities (Assisted and Independent Living), a detailed knowledge of the healthcare needs of every resident would be invaluable.  The importance of this knowledge cannot be over-emphasized, since the National Center for Assisted Living tells us that 92% of residents who move out of Assisted Living Communities (ALCs) do so for health reasons.

An understanding of Chronic Health Conditions (CHCs) will improve a Retirement Community’s ability to maintain the health of its residents.  Chronic Health Conditions are those that last a year or more and require ongoing medical attention and/or limit activities of daily living.  The most common CHCs are:

  1. High Blood Pressure
  2. Alzheimer’s disease and other dementias
  3. Heart Disease
  4. Depression
  5. Arthritis
  6. Osteoporosis
  7. Diabetes
  8. COPD and allied conditions
  9. Cancer
  10. Stroke

Chronic health conditions account for more than 75% of all healthcare spending in the US and are the driving force of healthcare for older people.  Eighty percent of independently living seniors have 1 CHC, and 50% have 2 or more according to the Centers for Disease Control.  At some point, the burden of CHCs overwhelms the ability of independently living seniors to care for themselves, so many seek Assisted Living.  At this point, the typical resident has at least 2-3 of the most common CHCs.

Assisted Living Communities are charged with addressing very complex healthcare issues in addition to the challenging responsibility of providing residential care that includes a wide variety of services and amenities.  The services that ultimately have the largest impact on resident retention, however, are healthcare services.

Data mining the known information about a Retirement Community’s residents can provide extremely valuable insight that can guide and assist healthcare management.  Our experience with data mining ALCs and ILCs (Independent Living Communities) of various sizes in Boise, Idaho has enabled us to:

  • Discover which CHCs are the most common in each specific ALC or ILC.
  • Establish a ‘health risk profile’ that is specific for each resident.
  • Based on the ‘health risk profile’, design interventions that may help preserve census by reducing health related attrition.
  • For ILCs, discover which CHCs pose the highest risk for losing a resident to an ALC, and then most importantly…what to do about it.
  • Gain insight on which residents nurses, aides, and other employees should focus their time and attention based on the health risk profile.
  • Compare the health risk profile of a specific ALC to national statistics.
  • Gain marketing insight based on the health risk profile of current residents of ALC’s and ILC’s.

Our next several blogs will show specific examples of the kinds of information retrieved by data mining Retirement Communities.  We will then demonstrate how this information can be used to create the health risk profiles discussed above.  We look forward to your feedback.

42 doctors for 55 residents??? What???!!!

FrustrationHouse Calls first exercise into data mining an Assisted Living Community (ALC) immediately found this:  a moderate sized ALC has a census 55 residents who are cared for by 42 different primary care physicians!  Nearly every resident has a different physician.  No doubt every ALC is in a similar situation.  And if you count the multiple office staff in each physician’s office who answer the phones and take messages, as well as the usual staff turnover, and also the physician’s call partners and their offices and staff, then this exasperated ALC nurse may literally have hundreds of medical personnel with whom to interact when performing or overseeing routine care for her residents.  And this is just one of her many duties!

No wonder a task as simple as getting an answer about a lab result, or a simple medication question, or getting a signature on a form, or especially getting a physician’s response to a resident’s acute medical complaint can consume the nurse’s attention for hours and sometimes days!

Years ago, hospitals found the solution for the inefficient and often times unacceptable care resulting from many physicians caring for many patients:  Hospitalists.  Most hospitals now hire a small group of physicians called Hospitalists to care for their in-patients.  Each Hospitalist generally provides most of the care for about 15 patients.  Nurses for the patients know exactly whom to call, and they get a prompt response from a physician who is knowledgeable and dedicated to this group of patients.  Hospital care has not only improved for the patient, it has also improved for the nurse.

ALCs would do well to take a lesson from the Hospitalist model.  Although it is neither necessary nor financially feasible for an ALC to hire a group of physicians, there is a way to vastly improve the current situation most ALCs are burdened with:  that is, having a glut of disconnected and unfocused medical personnel to sift through whenever a physician response is needed.

Data Mining Message

PARTNERSHIP.  ALCs must be proactive in reaching out and establishing a working partnership with just 1 or 2 local primary care physicians – that’s all that’s needed.  Physicians who would be willing to be the primary care providers for any resident voluntarily wanting to take advantage of their services.  Yes, a small financial investment by the ALC may be required to support the physician’s administrative costs required in developing a portion of his practice at the ALC.  But this investment is small and easily and quickly recovered by more efficient communication with physicians who are focused on YOUR residents, thus freeing your staff to attend to other activities.  Physician partnership also serves as an important market differentiator for current and prospective residents.  Residents and their families will feel comforted in knowing that your community has a special relationship with local physicians.  This is a partnership in which EVERYBODY WINS!

 

Critical Insight Revealed by Data Mining Your Retirement Community

data mineHave you ever considered “DATA MINING” your assisted living or independent living community?  That is, ‘going deep’ into all the information you have at your disposal about your residents – demographic, social, health…everything.  Your retirement community…every retirement community has a treasure trove of unused information about its residents that could be used to improve your business, your marketing, your services, and your amenities in ways that will positively impact your bottom line – census.  And these data are specific to YOU and YOUR COMMUNITY.  Unveiling this information by data mining, then organizing and analyzing it, and then finally comparing it to data from other communities as well as national data available in the literature, will reveal a specific profile, not only of your community as a whole, but also of every resident living in your community.

In the coming weeks, I will post blogs on the House Calls website that will chronicle our experience of data mining independent and assisted living communities in Boise, Idaho.  I will highlight the kinds of valuable information that is available to every retirement community and the recommendations that can positively impact performance and census.  I look forward to thoughtful feedback and provocative discussion.