QUESTION: What is the most effective way to preserve census in a Retirement Community (AL, IL, or CCC)?
ANSWER: Learn as much as you can about the #1 reason for losing residents, and then develop specific solutions.
Failing health far exceeds any other cause for losing residents in Retirement Communities. The average resident takes 7.6 different prescription medications and has at least 2-3 or more chronic health conditions (CHCs), and this provides ample opportunity to lose a resident to the ER, hospital, or nursing home. Proactive approaches aimed at stabilizing CHCs and reducing problems with medications have the most promise for keeping residents as healthy and functional as possible and thus preserving census.
Exploring a Community’s data base yields invaluable insight into maximizing residents’ health. Doing so allows the creation of a HEALTH RISK PROFILE for every resident. Combining the details of the residents’ CHCs, the medications they are prescribed, and some basic demographic information identifies residents as being either high, medium, or low risk for failing health. If every resident is assigned to one of these Health Risk categories, then proactive approaches designed to counteract the threats in each category will offer residents their best chance at maximal health and independence. This also increases their lifetime value to the community.
Here are 3 very relevant questions that can be answered only by a detailed analysis of a Community’s data base:
- How many CHCs does each of your residents currently have, and which ones pose the greatest risk for loss of independence?
- A PROACTIVE intervention program for residents with these specific CHCs will have the biggest impact in stabilizing health and improving resident retention.
- What is the average number of medications each of your residents take, and which classes of medicines pose the greatest risk for complications leading to loss of resident independence?
- A focused awareness and caregiver education of the most high risk medications will alert co-workers to be especially watchful for signs of side effects and declining health.
- Which resident demographics provide insights that may lead to improvements in marketing and the services you provide?
- Learning whether money is being spent marketing services that very few of residents actually use allows the reallocation of these funds to services having a broader appeal.
Our previous blog highlighted 5 CHCs that raise residents’ health risk and separate them from residents with lower risk CHCs. Our next blog will identify higher risk vs. lower risk medications. And a following blog will combine the information we have obtained from our analysis to suggest a Health Risk Profile for every resident that can be used to benefit every Retirement Community.
We believe that this type of methodical approach in the use of a Community’s data base offers a unique and creative opportunity for preserving census and increasing profitability.
House 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!
Have 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.