Tracking residents’ health has always been a major component of senior living. But new technology is allowing that tracking to become faster, more efficient, accurate and comprehensive, and some companies are saving by double-digit margins when they move to real-time monitoring.
“The care management piece is a huge component of revenue; it accounts for about 30-40% of total revenue per unit,” says Gustavo Sapiurka, senior vice president of strategic markets at RealPage, Inc. “Assessment of care needs can change based on age or specific circumstances; having [a care management] tool allows you to be accurate. It helps tremendously.”
While regulations vary from state to state, senior living providers in many areas are only required to do an annual resident assessment, following the initial assessment when someone moves into a community. But tracking changes in residents’ conditions as they happen is a much better method that can improve revenue generation by correctly logging services that are being rendered, Sapiurka says.
A typical 100-bed assisted living community using RealPage’s Care Manager tool can see an internal rate of return for direct care revenue in excess of 30%, he says, and bottom line performance improvement between 12-13%. The software automates the resident assessment process and helps providers calculate their exact cost of care to each resident, enabling them to accurately charge for services.
Sapiurka and Doug Fullaway, vice president of sales at RealPage Senior Living, estimate around half of senior living providers have adopted some form of resident assessment tracking, and the number is climbing.
“We definitely see the importance of closely monitoring residents for condition changes because it’s our experience that if you can identify a subtle change in a geriatric client before it becomes significant, you can avoid hospitalizations and decline in functional ability, and so forth,” says Francine O’Neill, senior vice president of resident care at The Arbor Company.
Around 18 months ago, The Arbor Company adopted certain aspects of the INTERACT system, aimed at incorporating all members of a senior living community’s staff into resident care. The operator adopted the “Stop and Watch” cards that are distributed to staff throughout the community who can jot down changes they notice in a resident’s condition and then give the card to the clinical team.
While O’Neill declined to provide numbers on the change in revenue The Arbor Company has seen from implementing tracking initiatives, she says it has definitely seen a shift in care levels. “We’re doing a better job of capturing care levels and the time staff is spending with more complex residents,” she says.
“The need is growing [for assessment tracking], as is the realization you need something, driven by residents being older and more frail when they move in,” Fullaway says. “Regulations increase every year, and you need to show the services and demonstrate what you’re doing with documentation.”
Syncing with Electronic Health Records
Because there aren’t federal regulations requiring EMRs or EHRs in assisted living, some organizations may be slower to see the benefits. But those benefits may be too big to wait for—one MDI Achieve customer said he believes his organization is missing out on $1 million a year by not tracking changes in resident conditions, according to Ben Malakoff, director of product management for MDI Achieve, operator of electronic health record solutions company MatrixCare.
“We see our assisted living organizations who have higher acuity residents and use technology to manage them are more successful because [they get] greater reimbursements and have a larger referral base,” he says. “There are a number of advantages to it.”
Chicago-based Senior Lifestyle Corporation uses Care Innovations’ QuietCare platform in many of the buildings it owns and operates as a way to gather information, along with RealPage’s Care Manager and EHRs across its communities.
“We are big believers in technology as it relates to being able to understand our residents,” says Patricia Foran, vice president of clinical services at Senior Lifestyle Corp. “It’s easier with an electronic assessment tool to capture those little changes in condition. You’re going in and modifying an existing assessment, [updating] the little areas that have changed in a resident, in a matter of minutes.”
Foran says Senior Lifestyle’s resident assessment schedule is “more aggressive” than most states’ requirements of every six months or annually, by conducting assessments pre-admission, at time of admission, every 30 days, and quarterly.
“If you’re strictly assessing based on state guidelines, I definitely think you’re missing out on change of condition assessments that could lead to capturing a higher revenue,” she says. “With elderly people, their needs change often, and you ned to be changing the care plan to make sure your staff are providing the right services. Otherwise, you’re always being reactive rather than proactive.”
By using several data tracking systems, the provider expects to see a return on investment in some key areas.
“We expect to gain not only labor hours and efficiencies, where we can hopefully turn that time back into providing hands-on care,” says Foran. “If you’re managing the needs of your residents you will have good outcomes. The technology absolutely helps you avoid errors and identify them when they happen. That’s the great thing about technology.”
While Malakoff could not disclose ROI numbers for senior living companies using MatrixCare’s EHR system, he did say that large organizations typically see the value very acutely.
“Technology can save time; it can shave four [total] hours a day off of the tasks of all individuals in an assisted living community,” he says. “When you have one community, that’s only four hours. But when it’s 100 communities, that’s 400 hours a day. It can be a really high ROI that scales pretty well if you have a large organization.”
Written by Alyssa Gerace