Growing Your Post-COVID Occupancy – Perspectives from the Field

 

The pandemic has wreaked havoc on long-term care organizations which subsequently tarnished their reputations and created a ripple in how families view long-term care as a suitable option for their loved ones.  As a result, long-term care organizations are experiencing dips in their occupancy rates and now grapple with how to increase those rates to pre-pandemic levels.  Although long-term care providers are cautiously optimistic about occupancy rates rising, August 2021 statistics indicate occupancy rates are hovering only around 72.5% (AHCA, August 18) to 73% (Brown, 2021).

Healthcare Academy recently hosted a live webinar in which we gathered two leading industry experts who shared their insights to help long-term care facilities grow their occupancy rates.  The first expert was Kim Barrows, RN, BSN, LNHA; she is founder and President of KB-Post Acute Strategic Specialists (KB-PASS). The second expert was Patty Klingel, PhD, LPN, CPHQ, CRM, CHC; she is Executive Director of compliance and clinical services of United Church Homes, Inc.  Each of these experts agreed the pandemic was the biggest challenge they’ve ever faced and recognize the long-term care sector will be navigating to find a new normal for some time.  Erin Moonen, COO, Healthcare Academy joined our experts for a panel discussion on questions received from webinar participants.

Both experts echoed similar themes about the challenges long-term care organizations are facing while finding a new normal which include:

• Staffing / turnover
• Increasing Census
• Obtaining necessary supplies and safety of residents / staff
• Financial security of operations
• Continued COVID-19 fear by residents, staff, and families

These challenges may seem daunting but both experts were optimistic long-term care organizations have opportunities to be successful in increasing post-COVID occupancy rates.  While they offered several solutions to the challenges indicated above, transparency emerged as one of the most important tactics for organizations to regain the trust of residents, families, and staff!  Meaning, residents, families, and staff desire communication about the measures facilities are taking to maintain or improve standards of care.

SOLUTIONS TO GROW YOUR OCCUPANCY RATES

There is not a ‘one size fits all’ approach when addressing the challenges above.  However, both experts offer solutions for these challenges while emphasizing the importance of choosing those solutions that fit your organizational culture.

Staffing / turnover. Solutions should focus strongly on staff retention.  It is especially important to bolster staff retention efforts since long-term care organizations could face more staff turnover due to the Biden Administration recently announcing COVID-19 vaccination will be required for all long-term care staff or facilities will not receive reimbursement from the Centers for Medicare and Medicaid Services (CMS).  During the webinar, Kim Barrows provided many staff retention solutions.  Frontrunners from that list are staff education and training, referral /retention bonuses, and offering resources to help staff deal with stress and/or loss experienced during difficult times such as the pandemic.

Increasing Census. Census solutions involve efforts to keep existing residents or attract new ones.  Barrows stressed the value of partnering with other entities (i.e., home health, hospice services, and acute care facilities) to establish a constant referral stream for new residents.  If new referrals would like to see your facility and you’re unable to accommodate an in-person visit, offer a virtual tour.  As far as keeping existing residents, Dr. Klingel identifies communication with residents, families, and staff as the key tool for achieving census goals.  Since the pandemic forced many organizations to limit or restrict visits from family or loved ones, Klingel emphasized the need for long-term care organizations to integrate technology into resident care.  This includes daily or weekly zoom visits to facilitate resident and family communication and/or daily huddles to facilitate strong communication between staff and each resident.  If you are struggling to streamline this communication, stewardship or angel programs are a way to provide one staff member as a point of contact for residents and/or families.  Additionally, after hours telehealth visits are a favorable option to more frequently connect residents with their primary physician or other health professionals such as a rehabilitation specialist.

Obtaining necessary supplies and safety of residents / staff.  Safety solutions involves securing the appropriate supplies and equipment to ensure staff can safely and continuously provide all components of care.  Barrows suggested reviewing managed care contracts to ensure suppliers can deliver the products or services your facility negotiated.  Again, technology was mentioned as a solution that connects residents with family or loved ones without risking exposure to COVID-19 or other illnesses.  Telehealth also increases safety by offering residents a chance to communicate with their physician or other providers outside of typical visits.  This allows residents to address any concerns without having to wait until their next visit.

Financial security of operations.  Barrows mentioned 75% of long-term care facilities are unsure about sustainability.  Meaning, they are at-risk of closing.  One financial solution includes facility administrators having a thorough understanding of the MDS assessment.  The MDS assessment impacts both reimbursement and the 5-star rating so administrators need to be accurate with MDS assessments to optimize financial reimbursement for services. A second financial solution emphasized educating and training staff to provide a higher complex care model effective for meeting the needs of higher acuity residents while reducing their risk of a 30-day readmission. Marselas, 2021 specialized programming by stating “the rise of accountable care organizations and managed care’s increasing prevalence are also creating opportunities for skilled providers, especially those who can demonstrate prowess with cardiac, pulmonary, renal failure, sepsis, and neurologically impaired patients.” Additionally, new service lines was a third solution offered for driving growth.  This includes developing partnerships with therapy services or substance abuse programs to offer residents a more complete package of care by bringing those services in-house for greater accessibility to residents.

Continued COVID-19 fear by residents, staff, and families.  Covid-19 fears will continue to circulate especially as new variants evolve.  Solutions for reducing fears with residents, staff, and families requires continued and frequent infection control training, enhanced sanitation and monitoring of sanitation, and availability of vaccination and testing opportunities for those residents who desire to get vaccinated or tested.  Dr. Klingel cited her facilities use of Healthcare Academy’s eCompetencies® product as supportive in her facilities’ efforts to assure staff knowledge and competency on infection control.  Vaccinations are now mandatory for all long-term care employees, but facilities should also offer testing for staff.  Another piece to alleviating fears associated with COVID-19 ties back to transparency.  Families, other loved ones, residents, and staff all want to know changes or updates to infection control protocols so establish a consistent and reliable method of communicating pertinent information to them.

HOW TO SELECT SOLUTIONS FOR YOUR LONG-TERM CARE FACILITY

While there are many solutions provided for increasing occupancy rates, remember to choose options that fit your organizational culture or those that make your organization stand out.  Ask yourself, what is my organization trying to sell? Or what is my organization doing differently from other organizations to set us apart from what they offer? Finally, you have to market those differentiators to allow families and residents choose your facility as part of their care needs.

If you’d like to access the full webinar recording including a panel discussion on how to rebuild trust with residents and families and using specialty rehabilitation services to grow occupancy, click here.

The importance of staff training and education were cited by both of the webinar experts as a solution to restoring resident and family trust in care.  Learn more about Healthcare Academy’s complete online education platform and the AHCA/NCAL Infection Control Certificate Program and AHCA RoP eCompetencies® for staff and competency skill development in the long-term care setting.

References:

AHCA/NCAL (2021, August 18) Retrieved August 24,2021. https://www.ahcancal.org/Data-and-Research/Pages/default.aspx

Brown, A. (2021, August 13). SNF occupancy increases for fourth straight month: NIC report. Retrieved August 20, 2021 from https://www.mcknights.com/news/snf-occupancy-increases-for-fourth-straight-month-nic-report/?utm_source=newsletter&utm_medium=email&utm_campaign=MLT_DailyUpdate_20210818&hmSubId=Z_JjoTSJrqI1&hmEmail=ePEWjfwbr0iN62aGJPg2j7EXMr9_CeBu_APad9WqyxA1&email_hash=39ae12fc5f69b1cc63d98032f8178146&mpweb=1326-20851-712827

Marselas, K. (2021, August 3). Skilled nursing census-drivers found, but integration more critical than ever due to COVID.  Retrieved August 20, 2021 from https://www.mcknights.com/news/skilled-nursing-census-drivers-found-but-integration-more-critical-than-ever-due-to-covid/?utm_source=newsletter&utm_medium=email&utm_campaign=MLT_Weekly_20210806&hmSubId=Z_JjoTSJrqI1&hmEmail=ePEWjfwbr0iN62aGJPg2j7EXMr9_CeBu_APad9WqyxA1&email_hash=39ae12fc5f69b1cc63d98032f8178146&mpweb=1326-20698-712827