Long-Term Care Providers Must Improve to Attract Health Care Partners

With the increase in the senior population, plus increasing numbers of individuals with chronic conditions and Alzheimer’s, the total number of Americans requiring long term care will more than double from 13 million in 2000 to 27 million in 2050, says a new report.

While demand for such services is projected to increase, reputation will be key to a long term care provider’s success in the long run, finds the 2014 National Research Report: Empowering Customer-Centric Healthcare Across the Continuum. And demonstrating an organization’s value will mean going beyond resident and family satisfaction surveys.

“Potential for greater intelligence is wasted when no steps are taken to enact improvement initiatives,” the 2014 National Research Report notes. “For those who do attempt improvement plans, many don’t know average rates of improvement, set unrealistic improvement goals, and then become discouraged when they fall short.”


The report provides data profiles for skilled nursing, assisted living, independent living, home health and hospice. Most experts, including the Agency for Health Research and Quality (AHRQ), agree that quality can be defined by three main categories of measurement: structure, process, and outcomes. 

However, one of the primary challenges associated with the effort to quantify or measure excellence in long term services and supports (LTSS) is that there is no consistent standard or set of indicators recommended for assessing quality, and in fact there are more than 200 indicators currently being used by a variety of stakeholders with a vested interest in the level of reliability and value offered by various home and community-based service providers. 

And while CMS measures quality through three categories, those evaluations only apply to skilled nursing homes and home health agencies.


While providers must initiate new measures to improve quality to compete in a changing senior living landscape — with its increasing focus on healthcare — satisfaction surveys still play an important role.

“They gather perspectives from multiple stakeholders, residents and patients (or consumers), but also family members and staff,” the report says.

Answers of “excellent” are associated with greater customer loyalty, while responses of “good” or “sometimes” indicate opportunity for improvement.

Across all survey types there is more variation among providers when considering “excellent” responses compared to just positive responses, the report finds.

The range of positive scores, or “good” and “excellent” combined, between with the lowest and highest scores among the middle 50% of assisted living and skilled nursing providers according to resident feedback, is 11 points for assisted living communities (half of all communities fall between 86% and 97%), but the range of “excellent” scores is 26% (half of all communities fall between 32% and 58%).

And relationship across different areas of performance is less clear among home health agencies, the report finds.

Overall, as long term care models become the cornerstone of America’s healthcare delivery system, providers must be prepared as hospitals, physicians and other providers carefully select a handful of long term care service providers to partner with, the report says.

Responsiveness of management is one of the top three drivers of independent living, assisted living and skilled nursing resident recommendations, the report found. In addition, home-like atmosphere and commitment to independence is key in independent living; choices and home-like atmosphere is important in assisted living; and competency of staff and concern of staff drove recommendations from skilled nursing residents.

“This means your brand, reputation, and resident experiences no longer begin and end with admission and discharge,” the report says. “Measuring staff engagement is essential. Customer and staff experience measurement and improvement plans are one of the best ways to invest in building brand reputation.”

Statistics contained in the report are from National Research Corporation data assets, including surveys of skilled nursing, assisted living and independent living customers and employees. 

Read the report here.

Written by Cassandra Dowell 



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