Establishing partnerships between assisted living and other post-acute care providers—particularly rehabilitative services—is essential going forward in the senior living industry, a panel of senior care executives told attendees of ALFA Community 2012 session in Dallas on Wednesday.
While there are many different components of the post-acute care continuum, the relationship between rehabilitation and assisted living is crucial, especially in light of healthcare reform, they said.
Accountable care organizations and the concept of managed care will have a huge impact as hospitals begin to launch efforts toward avoiding costly readmission penalties by discharging patients to trusted partners with proven outcomes. Having an on-site rehabilitation clinic in an assisted living community can help improve not just a senior living provider’s partnership profile, but can also be useful in marketing to prospective residents.
For some assisted living communities, this can be done by leasing space to a rehabilitation provider. That provider can offer physical therapy, occupational therapy, and speech therapy about five times a week, and it’s very convenient for residents who can visit the clinic right in their community rather than having to go off-site.
Outsourcing to third-party providers can be wise for senior living providers as it allows them to coordinate care for their residents while remaining focused on their own strengths (rather than becoming licensed to provide rehabilitation services).
“To master what rehab does is a totally different skill set [than providing assisted living services]. From my perspective, we’re going to outsource with quality companies,” said Jon DeLuca, president and CEO of Chicago, Ill.-based Senior Lifestyle Corp. His company uses Genesis Rehabilitation Services in most of its communities for what DeLuca terms a “win-win” situation.
Being able to tout a state-of-the-art rehabilitation center can help woo residents, and Senior Lifestyle Corp. is working with Genesis to make their gyms more visible, rather than treating them as an afterthought and placing them in out-of-the-way locations.
“Instead of an institutional look, it’s a hip place,” DeLuca said. “You’re doing something great for the resident. If that’s going on when a potential resident is touring, it’s powerful; you can talk to them about all the things you can do [at your community].”
A good partnership with another service provider can help.
“We want to help you get move-ins by saying, ‘Here are the services you can receive on-site. You can stay at your home and get these services,’” said Dan Hirschield, President of Genesis Rehabilitation Services.
Using data to track outcomes
Tracking residents’ data is extremely important, especially when looking for care continuum partnerships. Despite the fact that most assisted living providers don’t benefit from Medicare reimbursements, the assisted living population “is the Medicare population,” Handelson said—especially for those who partner with rehab services.
Assisted living communities send a lot of people to emergency rooms, she said. That’s partly because of regulation and partly because of staffing, but there needs to be a lot of emphasis on preventing episodic events.
In Genesis Rehabilitation Services’ experience, most people are concerned with falls—a commonly occurring incident that can send residents to the ER.
“Typically, independent living and assisted living providers don’t have those statistics [on falls]; in the past, they haven’t had to track that, so it’s hard to get a baseline,” explained Hirschfield.
After pulling its data, New England-based Benchmark Senior Living realized that about 75% of its residents were using some kind of walking device, according to its president and COO Stephanie Handelson. At Benchmark, it’s important to focus on preventive care.
“It’s the right thing to do to preserve their current health, or maintain their health so they don’t decline,” she said.
About three to four months ago, 10 Benchmark communities began providing rehabilitation services onsite. Of those, nine have had “significant progress and great outcomes,” said Handelson.
Even if a community doesn’t have to worry about being penalized for readmissions or having Medicare reimbursements get cut, it needs to prove to those who do have “skin in the game” that it will be a good partner, she continued.