Nonprofit Provider Extends Length of Stay with Telehealth Program

Senior living providers are always looking for ways to keep residents healthier and prevent move-outs to higher care levels. Lutheran Senior Services has achieved these twin goals through a telehealth program dubbed Project Wellness.

The nonprofit provider has achieved an 11% reduction in move-outs to higher levels of care and reduced hospitalizations by one-third among participating seniors since implementing Project Wellness at its nine affordable housing locations in metro St. Louis, where the company is based. The organization serves more than 11,000 seniors annually at 21 locations in Missouri and Illinois, including senior living communities, affordable housing buildings and home- and community-based services.

Project Wellness is centered around telehealth kiosks set up in the affordable housing buildings. The kiosk is a station with equipment to measure key health indicators, such as blood pressure and glucose levels. The kiosk uploads that information to secure, HIPAA-compliant cloud storage; individuals can access their information by using a PIN number. That provides a record they can show a physician or other health care provider, enabling better care.

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Thanks to grant funding, the first kiosk was installed in 2012 at a Lutheran Senior Services building with the capacity for about 120 residents, Susan Hutchinson, the company’s director of affordable housing, told Senior Housing News. About a year and a half later, a larger grant enabled kiosks to be installed across all of the organization’s affordable housing locations in St. Louis.

Each kiosk costs about $10,000 to install initially, then $2,500 each year to maintain the license, Hutchinson said. There also are costs associated with having nurses available to help people use the kiosks, which Lutheran Senior Services has found is a key to having a high level of consistent participation.

Currently, about 500 Lutheran Senior Services residents and 300 people from the surrounding community use the kiosks each month, exceeding initial estimates, Hutchinson said. One day a week, a parish nurse comes on-site, helps people use the kiosks, discusses their results with them, and initiates interventions if the metrics show something is abnormal.

Anywhere from a dozen to 25 people typically use the kiosks on these days, according to Hutchinson. However, the kiosks are available every day, around-the-clock. The equipment generates an alert if any readings are outside normal parameters. That alert goes to a nurse as well as a service coordinator, who can determine the most appropriate next steps.

There have been more than 3,800 interventions triggered through the kiosks, and at least 300 instances in which seriously adverse health outcomes were prevented, Hutchinson said. These interventions have enabled seniors to continue living in affordable housing units—driving the associated 11% reduction in move-outs to higher levels of care.

In fact, residents now are rarely moving to assisted living at all, because the kiosks are able to help them manage day-to-day health issues.

“If they go up a service level, they go into skilled nursing,” Hutchinson said. “We’ve been able to prolong their ability to stay home longer, and that’s a benefit to them, and a benefit to the Medicare and Medicaid system because they’re staying out of … the emergency room.”

Lutheran Senior Services has not yet calculated the cost savings to Medicare or Medicaid due to decreased hospitalizations or skilled nursing use, but it is considering how to obtain that data, and also how to expand the telehealth initiative to a larger population. That could help prove the program’s value to payors, such as supplemental Medicare insurance or Medicare Advantage plans, and motivate them to include it as a covered benefit.

Other providers, including New Jersey-based Juniper Communities, also have been promoting the role that senior housing organizations can play in driving down health system costs by supporting seniors’ wellness and managing chronic conditions more efficiently.

But that’s only one potential benefit of initiatives like Juniper’s Connect4Life program, or Lutheran Senior Service’s Project Wellness.

“From a business perspective, my unit turnover is reduced,” Hutchinson said. “From a moral and ethical perspective, it’s keeping people where they want to be, at home.”

Written by Tim Mullaney

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