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There are things Senior Living Organizations can do to attract and retain residents longer 

Did you know that recent data shows the average cost to get a potential resident interested in senior living (“SL”) services is $431, and only 30% of the people who show interest  ultimately decide to move forward and use those services1,2  Known in marketing as the “cost of acquisition” this is a significant investment for senior living operators.  Combined with the fact that the average stay in an SL community is only 22 months3, means real operational pressure. Thus, beyond improving the “conversion rate” to be greater than 30%,improving the average length of residency represents an even more significant opportunity to both reduce costs and drive greater efficiency. Length of residency ought to be a top-of-mind matter.

A resident’s move to assisted living signifies a major change in life(style) and is not made lightly.  When they enter a community they hope their presence there will continue for the longest term possible, potentially until their last day, filled with support, joy, and a sense of community.

The duration of stay in assisted living is notably influenced by many factors such as rehospitalization, required care level, financial considerations, and the resident & their family’s (aka, “client” or “patient”) general satisfaction.   

Let’s delve into how senior care facilities can strategically achieve this goal.

Preventing Rehospitalization: A Holistic & Proactive  Approach for Assisted Living

Declining health is often the trigger to move into an assisted living community, frequently after hospitalization.  Once in a post-acute setting such as assisted living, unaddressed clinical issues can quickly escalate to require hospitalization.  For example, approximately 23.5% of patients discharged from an acute care hospital to a SNF are readmitted back to the hospital within 30 days. 

Additionally, hospitalization often results in significantly declining health after discharge, requiring a move to a higher-acuity facility or even death.  This suggests that reducing the rehospitalization rate can extend the overall length of residency, benefiting the resident’s well-being and their and their family’s satisfaction.  

The hospitalization rate can be mitigated by adopting a proactive and holistic approach to resident health management and care coordination.  Some of the major risks of hospitalization include:

  • General declining health status
  • Fall Risks
  • Uncontrolled chronic conditions
  • Infection Controls including STDs

These and other risks can be mitigated through procedural controls and improved communication amongst staff, external providers, and even the patient and their family directly.  Here are some simple examples of where communication can help:

  • Making sure all parties know the resident is at “fall risk” so they take extra precautions to avoid injury.  Making sure visiting family don’t expect to take mom for a walk inappropriately. Requesting that housekeeping ask for assistance with  mom when changing the bed linens are just a few examples where real-time communication and coordination amongst staff can help a lot.
  • Making sure everyone knows that the latest lab results showing elevated blood sugar may require an immediate and in-the-moment change to the diet.  Dietary staff may not have recognized the change in status in the EHR, or a change to the dietary plan may not have yet been entered into the chart.  A simple but secure message to the family to bring something with less sugar than dad’s special cake on Sunday when they visit can go a long way to avoiding issues.
  • Staff recognizing that a resident’s elevated temperature and discomfort in urinating along with staff recognizing the resident’s social activities may be suggesting an STD infection.  If staff are not holistically aware of the resident’s comings and goings – things not necessarily in the EHR – the linkage between the symptoms and the behavior may be overlooked, leading to a more severe infection requiring hospitalization.
  • Letting the provider know that for unforeseen reasons the resident won’t be available during today’s standard rounding time, thus allowing her to attend to other patients, and return to check on mom later.  Absent such awareness, the physician or NP comes to mom’s room, finds she’s not there, and won’t return until the following visit, potentially delaying important care.
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These are but a few examples of how a more unified and holistic approach to care can improve outcomes and length of residence.  Communication beyond what is maintained in and accessible via the patient’s chart for the entire team supporting the patient is a key attribute of this.  Engaging residents and families in care plan development is another key example, as it cultivates resident independence and contributes to a more fulfilling assisted living experience.

Financial & Legal Guidance; Translates Into Residents’ Longer Stay

Financial concerns can also impact a resident’s decision to both choose and stay with a community. Senior living communities can improve both through offering guidance and advice from financial professionals that can help the residents in choosing and remaining with the community at all phases of a resident’s engagement.

Some examples of things SL organizations might do to lengthen the residency term include:

  • Offer clear information about all associated fees not just to the resident, but to their Power of Attorney or other fiduciary parties with appropriate responsibility. This builds confidence and allows residents (and families) to make informed financial decisions without surprises.  
  • Collaborate with benefits counselors to help residents maximize their benefits through Medicare and Medicare Advantage plans, potentially extending their stay.
  • Inform residents and families about accessing their rights and facility inspection reports through CMS resources. Knowledge empowers residents and cultivates trust.
  • Encourage residents to discuss future care preferences, including living wills and healthcare proxies.
  • Open communication ensures residents’ wishes are respected.

Clear and improved communication with potential and current residents can make a world of difference in terms of successfully converting those ‘ shopping’ for a community, and lengthening the time of residency once they select your community.  Enabling a simple and secure communication ‘channel’ with residents and their families, advisors, and their personal ‘care team’ in which materials can be shared even before they become residents is a great way to convert that ‘interest’ into a decision to join the community, building confidence in the organization’s transparency and commitment to a positive experience.

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Beyond 22 Months; Optimizing Resident Satisfaction

Another factor contributing to a resident’s decision to leave is simply their satisfaction with the community/facility, along with their family’s satisfaction.  If the organization is not meeting all of their respective expectations, like all of us they will seek another provider of that service.   

Some key opportunities to enhance the resident experience include:

  • Knowing your residents’ expectations, needs, and preferences in order to address them.  This may incorporate questionnaires or surveys prior to and upon their initial onboarding in the community.  But are the results readily available and known by all members of the care team?  Did the questionnaire or survey include family members who may provide greater context and clarity on the information?  Are you routinely updating the process as a resident’s needs change over time, and they ‘settle in’ to the community? 
  • Building on the above, making sure all members of the care team are well-informed, prepared, and able to deliver personalized care to the extent possible, aligning the resident’s preferences with their care plan. This might start with the simple notion of ensuring skills competency for caregivers.  According to a survey by the American Health Care Association and National Center for Assisted Living (AHCA/NCAL),  71% of the workforce lacks interest or qualifications associated with delivering personalized care.
  • Engaging the broader ecosystem of clinical and related support for residents, including pharmacists, physical therapists, care coordinators, social workers, and psychologists, and encouraging residents’ families and friends to visit more helps the residents’ morale and spirit.
  • Enabling real-time communication between staff members as well as family to ensure smooth execution and performance.  A simple thing such as letting the team know you just learned it is a particularly special day for the resident, or a change in their mood can go a long way to align care delivery for other members of the team.  Better yet, allowing the family to confidentially and easily communicate with staff will go a long way to making them feel involved (to the extent they wish to be) which can dramatically improve satisfaction scores.  No one wants to share what might be sensitive information about mom or dad in a general email or voice-mail box.  They want to directly communicate with the nurses and doctors they know and trust, even if these individuals are not employed by the organization and move between different facilities and organizations.
  • Dignified care is also based on clear and simplified communication. Residents need dedicated time to voice their needs, and staff must actively understand each resident. Empowering residents with cognitive impairments or limited speech to actively participate in their care plan development utilizing alternative communication methods will also greatly enhance their experience, as well as their outcomes.
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By 2030, the baby boomer generation will all be over 65 years old, adding 73 million potential residents to Senior Living communities. Attracting this population and differentiating your community’s unique attributes to aid in their choosing your community will be crucial.  Furthermore, maximizing residents’ length of residency also requires proactive and strategic measures like holistic health management, offering financial guidance, and focusing on improved satisfaction through personalized care. These strategies not only enhance resident well-being but also foster trust, independence, and a sense of community. As demand for senior living services rises, prioritizing resident satisfaction benefits assisted living facilities through increased occupancy rates and enhanced industry reputation.

Communication technology specifically designed to serve the unique needs of post-acute care and senior living can play a vital role in all of these initiatives. Consider using platforms like Hucu to bridge the gaps in communication between each resident’s unique care team of staff, physicians, pharmacists, etc., as well as the residents and their families themselves.

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