When the first assisted living (AL) community appeared in the early 1980s, the idea of data collection and analysis to guide resident care would probably have been alien. AL care settings were based on a social model, not medical care delivery. Approximately fifty years later, health care and clinical services are a key component of assisted living, and data plays an essential role. The Long-Term Care (LTC) Data Cooperative lets AL communities combine clinical and operational data with a wide range of local, regional, and national data to maximize quality and improve outcomes for their residents.

The Numbers Tell a Story

The acuity of AL residents has increased over the years, and this has impacted how communities function and what information and data they need. Today, nearly half of residents have a diagnosis of Alzheimer’s disease or another form of dementia, three in ten have heart disease, about 30 percent have depression, and nearly 50 percent have hypertension. In addition to needing support services to provide such necessities as meals and transportation, many AL residents also need help with medication management and activities of daily living, such as bathing, walking, and dressing. 

“The collection of data now versus when I started working in assisted living in 1994 is vastly different,” said Jennifer Svoboda, director of quality and compliance at Areté Living. Back then, she said, “we would write up an incident report if, for example, a resident had a fall.”

For repeated incidents, the team would have to conduct some sort of root cause analysis without the benefit of detailed data. Now, she said, “if we have someone who falls even once, we can go to the vitals tab in the electronic health record, and we can see things like the presence or history of high blood pressure or a fever.

“We have the ability to look at all these different factors, which is so important when we have people with many co-morbidities coming into our buildings. Cross-referencing data in a person’s EHR [electronic health record] is essential to conducting a targeted root cause analysis and devising an effective care plan,” she said.

In the early days of assisted living, resident and family satisfaction was generally assessed by in-person feedback or comments deposited in a drop box at the front desk. Today, Svoboda explained, “we have data we can review, and we can survey residents on a regular basis.” If there’s an issue, that data can be used for problem-solving and benchmarking. 

Tracking Trends on a Broader Basis

While EHRs are more common than ever in assisted living, they aren’t a panacea, especially when used alone. For instance, Gerald Hamilton, owner and operator of BeeHive Homes, said, “I’m an independent owner, and our communities are small, but we have EHRs in all of them. We can pull some data from them, but we also collect some data manually that we can use from month to month. We collect some data points to submit to LTC Trend Tracker, and that’s been helpful in terms of defining what criteria to collect.” 

LTC Trend Tracker, an exclusive benefit for American Health Care Association/National Center for Assisted Living (AHCA/NCAL) members, is a web-based tool that enables providers, including those in assisted living, to access data such as AHCA/NCAL Quality Initiative goals and more.

Data-related resources are incredibly useful, Hamilton stressed. “Using a tool such as Trend Tracker enables us to benchmark ourselves against our own history and against others. We can look at the numbers and see how things are changing over time. For example, if falls numbers have been steady from month to month and, all of a sudden, we have a spike, we know that’s something that bears a little more scrutiny.” But he added, “It’s still not the kind of data access that nursing homes have.”

Enter the Data Cooperative

It’s time to give AL providers a leg up on data collection and analysis, and the Long-Term Care Data Cooperative gives them that and more. Governed by AHCA/NCAL and funded by the National Institute on Aging, the cooperative is a provider-led initiative designed to harness the power of EHR data from long term care facilities nationwide, including AL communities. 

By aggregating and analyzing this information, the entity aims to enhance clinical care, streamline operations, and support research that improves resident outcomes. Participants receive actionable reports on quality measures, at-risk resident profiles, and medication usage, and they can participate in quarterly town halls to facilitate connections between providers and researchers. All this enables informed decision-making and better care quality.

Hamilton said, “The advantage to using the data cooperative is that there are more data points, so it expands the scope of the information. This helps us identify areas within our communities where there are opportunities for improvement.”

This is particularly useful for smaller AL communities that don’t have access to data from a large network of communities. Through the cooperative, smaller organizations have access to data from similarly sized entities, as well as from larger ones and national chains, without having to deal with interoperability challenges that often plague efforts to share and access data.

“This cooperative is critical for several reasons,” Hamilton noted. “It helps us to continue to evolve and meet the needs and demands of residents as assisted living moves from a social model to include more clinical and medical services and amenities. We are better able to stay on the cusp of changing demands. It also helps us improve our quality and better market our services.”

Before the LTC Data Cooperative was developed, Svoboda suggested, the ability to gather data from outside sources was challenging at best. “We hadn’t been able to compare with other outside communities on clinical data and see, for instance, the average number of falls across the nation,” she said. “As we get more providers in the cooperative, it will be more substantial.” 

Svoboda also stressed the ability of researchers to use information from the cooperative for broader studies about assisted living, resulting in a greater understanding and resolution of issues and challenges in this setting. “Researchers have never been able to do this before, and we all can benefit from more and more in-depth studies,” she said. 

Sharing the Data

More than ever, AL staff welcome the opportunity to access information that helps them assess and improve care and services. “It’s important to share data with staff,” Hamilton said. “They’re the ones who implement quality-improvement efforts, and it’s beneficial for them to see the results of their efforts.”

Once they see where they are making progress, they may be motivated to look for other areas to improve. When the data shows improvements, he stressed, it is meaningful to recognize and celebrate even little successes. 

Staff aren’t the only ones who can benefit from data. Hamilton explained, “It’s a great idea to share information with residents and family members. We can use this to help them understand what improvements we make and how we work to ensure quality and safety.”

At the same time, data can be used by physicians and other practitioners to identify problems in real time—such as cognitive decline or the need for assistance with activities of daily living—and get individuals into assisted living earlier.

Another Tool in the Data-Driven World

“The Long-Term Care Data Cooperative is what we’ve been needing for years,” said Svoboda. “We now have a means of gathering information and comparing it against our peers without federal oversight. It also allows us to be part of the research sector in a much more vibrant way.” 

Hamilton urges his colleagues to get involved with the cooperative “to improve the quality of care and life for your residents.” He continued, “You also will improve employee satisfaction by sharing metrics with them and getting them involved in quality improvement.”

Additionally, he observed, the LTC Data Cooperative is another tool that helps AL facilities distinguish themselves from the competition. This is especially significant, he maintained, in a market where providers are seeing more and more potential customers coming in after they’ve conducted their own research. 

“They call and ask us for a tour, but they’ve done their homework and already know a great deal about our communities,” Hamilton said, noting that this is in part because of their ability to access data, view ratings, and read reviews and other information. In a tech-savvy world, he stressed, AL communities need to be at the cutting edge.