The senior living sector is increasingly driven by quality, with providers across the board seeking concrete ways to measure it. Such efforts prove worthwhile, too, given that quality closely ties to a community’s profitability.
“They’ve always correlated,” Juniper Communities Founder and CEO Lynne Katzmann tells Senior Housing News. “If you do things well, people will buy your product.”
That was the premise of a panel discussion in which Katzmann participated during the National Investment Center for Seniors Housing & Care (NIC) National Conference in October in the Washington, D.C. area. The presentation centered on how quality care results in value and different ways that quality can be assessed.
SHN followed up with Katzmann and panelist Chris Cummings, Ventas Inc.’s (NYSE: VTR) senior vice president of asset management, to delve further into their take on quality care and sustainable returns.
Data Informed, Not Data Driven
Data is the name of the game when it comes to evaluating quality—but that’s not to say that data sets the agenda, Katzmann says. Rather, she says it’s important to use data to effectively manage the care administered, as well as attract referral sources.
At Juniper, close rates from marketing is one particular targeted metric, and data shows that Juniper at one point came up short when generating new qualified leads, Katzmann offered as an example at the NIC Conference. As a result, Juniper began tracking the number of external face-to-face calls marketers make and set goals on how many new people to meet each week.
Juniper also maintains a quality benchmark scorecard of sorts, which Katzmann says is looked at monthly and rolls into quarterly reports. It consists of 650 metrics, including the number of drugs taken in a day and the number of med errors, for example, all of which are used as the basis for Juniper’s training and community-based best practices assurance program.
That being said, highly utilized computer systems meant for tracking quality, particularly electronic health records (EHRs), are data mines, producing unlimited amounts of information to sift through. As such, determining what drives success takes “human judgment,” and therefore qualified personnel, Katzmann says.
Cost becomes a significant concern, in terms of both staffing and the systems themselves. Money needs to be fronted for infrastructure, but also for the support network, training people to use the infrastructure and troubleshooting, Katzmann tells SHN, and that adds up.
“We spend a lot on data; we spend a lot on our systems—more than I ever thought imaginable,” Katzmann said during the presentation at the NIC Conference. “But our profitability has increased, and I have to believe it’s because of the metrics.”
She expects the cost of the systems to come down over time, but for now, she says the payoff is palpable. In fact, over the last three years since Juniper began electronically monitoring quality, Katzmann says Juniper has seen EBITDAR margins increase by 0.5% to 1%, and the company’s assisted living margins are as high as 48.9%.
“This is the new world in which we live,” she tells SHN. “We need to be able to document our quality.”
A REIT’s Role
For real estate investment trusts (REITs) like Ventas, which have limited involvement in day-to-day operations with senior living provider partners, quality still stands as a top priority. This has prompted the need for creativity in how such partnerships work, including capital investments in technology, perhaps increasing access to data overall, Cummings said in a statement to SHN.
“We have invested and intend to continue to invest with our key operator partners in technological solutions that will improve profitability as well as the resident experience and quality care,” he said.
When Ventas invests in its operators, though, they need to then make investments, as well, particularly when it comes to staffing to ensure quality.
“You can’t afford not to do it,” Cummings said during the NIC Conference presentation. “You have to invest in good care providers; you have to invest in good systems to succeed. People will pay for quality, and that’s what then pays for your systems and your staffing.”
Choosing the best operators with which to partner is crucial for REITs, as well. Cummings said Ventas focuses on three components in particular when looking at new operating partners: reputation, survey results from regulatory authorities and internal process and systems in place to measure quality.
“Ventas knows that quality care for patients and residents is a starting point for success,” Cummings told SHN. “Seniors housing, particularly assisted living due to its care component, is very much a word of mouth and referral-based industry.”
Written by Kourtney Liepelt