Brookdale Cuts Costs, Hospitalizations with Checklist Tool

The nation’s largest senior living provider has achieved cost savings and improved resident outcomes by utilizing a modified version of a free, well-known program developed for skilled nursing facilities. 

Brookdale Senior Living (NYSE: BKD) used a government grant to team up with researchers and pilot the INTERACT tool in assisted living settings. The provider, which operates about 1,100 facilities nationwide, conducted the pilot with researchers from the University of North Texas Health Science Center, Florida Atlantic and the University of South Florida.

The pilot’s positive findings were announced at the Gerontological Society of America conference in Orlando, reported Bill Myers, editor of Provider, the monthly publication from the American Health Care Association/National Center for Assisted Living.


At assisted living centers that implemented INTERACT, results included reductions in the mean number of hospitalizations, 30-day readmissions and emergency department trips.

These centers also saw the average total cost for each resident reduced by nearly $30 per day while the experiment was occurring, lead researcher Thomas J. Fairchild, Ph.D., a professor at North Texas, told Myers.

INTERACT—which stands for Interventions to Reduce Acute Care Transfers—was developed as a way for skilled nursing facilities to reduce hospitalizations by keeping closer track of residents’ health status. It utilizes checklists, leading Brookdale Chief Medical Officer Kevin O’Neil, M.D., to compare it to pilots’ pre-flight checklists.


The tool shows promise in terms of its scalability, although the challenges are not insignificant, considering that it involves changing workers’ habits, Fairchild told Myers.

While INTERACT is a well-known tool, it is not the only one developed with these goals in mind.

One recently launched online program, STRAIGHT LINE, was developed specifically to help assisted living providers slash hospital readmissions. It is the brainchild of Steven Fuller, M.D., who saw the need for it after starting a house call service for assisted living providers in Boise, Idaho.

While STRAIGHT LINE is not free—it requires a one-time $500 investment—Fuller says that other, more complex programs do involve hidden costs that come in the form of repeated staff training. STRAIGHT LINE involves three core video modules.

“What people who are not familiar with AL don’t realize is, if you try to impose a very complicate program on this industry, it’ll never work,” Fuller told Senior Housing News. “Because when you’re inside AL, you realize that these people are incredibly busy and don’t have time to implement another large program.”

Whether it’s INTERACT or a different option, it appears likely that assisted living providers will be looking for these sorts of tools. A variety of factors are making it a higher priority for assisted living providers to reduce hospitalizations and keep tabs on residents’ health conditions, Fuller noted, including rising acuity in AL and the need to partner with managed care organizations keeping close tabs on costs and outcomes. 

It’s an idea that O’Neil also brought up with Myers.

“I think the reality is, we’ve got to collect this data,” he said.

Written by Tim Mullaney

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