Top 30 AL Providers Track National Trends Amid Pandemic, Occupancy Pressures<p>​After a year like no other, assisted living (AL) providers and the vendors that serve them are keeping a close eye on what most expect to be a gradual recovery in census amid the COVID-19 pandemic and subsequent decline in occupancy.<br></p><p>As this slow rebirth starts, <em>Provider</em> is publishing its Top 30 list of the largest assisted living companies by facility count, reinventing the annual measurement, which will be followed in July by a Top 30 list for largest nursing home companies. <br></p><p>The list contains many of the traditional large operators in the AL space, covering a wide swath of geography. Leading the way this year is Brookdale Senior Living. Based in Tennessee, the provider counts 35,126 units in 563 facilities across 43 states. Behind Brookdale in second place by a sizable margin is Sunrise Senior Living based in Virginia, which counts 14,550 units in 30 states and 274 communities. <br></p><p>Third rank goes to Five Star Senior Living of Massachusetts, which has 12,112 units in 31 states and 252 facilities. In fourth is Illinois-based Enlivant with 9,798 units in 210 communities across 26 states. And, rounding out the top five, is Atria Senior Living. The Kentucky-based provider has 9,673 units in 21 states and 141 communities.</p><h2>Charting the Recovery </h2><p>The number of beds and size and scope of these providers’ businesses—and all AL communities amid the pandemic— are of keen interest to vendors serving long term and post-acute care. One of those is MatrixCare,&#160;which provides post-acute electronic health record (EHR) software to more than 13,000 facility-based care settings and 2,500 home care/home health and hospice organizations.<br></p><p>Gary Pederson, executive vice president of MatrixCare, spoke to Provider on the trends in the AL sector, and overall care continuum for seniors, which his company covers from home health to hospice and nursing homes and independent living, among other care settings. <br></p><p>He said MatrixCare was tracking the impact that the COVID outbreak started to have on senior living even before most national media paid attention, and what they noted off the bat was that skilled nursing was taking a much heavier burden than AL, which led to more severe census declines.<br></p><p>“Skilled got hit hardest, and despite a slight uptick in September, the occupancy numbers have been bottoming out,” he says. “But recent indicators give hope that slowly and surely we are crawling out of the census hole, notably in skilled nursing with things like elective surgeries coming back.”</p><h2>AL Takes COVID Hit, Too</h2><p>For AL communities, Pederson says, MatrixCare didn’t see as much of a dip in occupancy as was seen on the nursing home side of its business, and from the data the company learned how the more technologically advanced of its customers fared better than others.<br></p><p>“If there is anything interesting in the trending data, it would be that the more modern the infrastructure of the facility and the provider’s ability to utilize engagement tools already in place, the more likely they were able to manage the intense need during the pandemic for handling the challenge of resident isolation,” Pederson says.<br></p><p>These tools include reliable Wi-Fi and the use of existing EHR to tap into engagement platforms for residents and families.<br></p><p>Pederson says because of the pandemic and the new need for even more up-to-date technology, the older-style AL buildings must decide on how to proceed.<br></p><p>“There are tough decisions coming up on investments in technical infrastructure to make sure their Wi-Fi is ubiquitous, as an example,” he says.</p><h2>EHR Takes New Turn</h2><p>MatrixCare also looked at its own services and systems during the pandemic and realized that it, too, would have to change. One thing Pederson says changed during the height of the pandemic was that many customers did not have the time to invest in new EHR upgrades. <br></p><p>So, MatrixCare spent time explaining to its customers how their existing platforms had many possibly untapped features that could be put to use, including in the areas of engagement. <br></p><p>“As our caregiver engagement tools were being widely utilized during COVID, we placed additional emphasis on family engagement, which is and was a huge need for our customer base during the lockdowns,” Pederson says. <br></p><p>“We also had all of this innovation available to our customers who may not have been using it to its full capability. They did not have time to buy new software during the COVID response, so it was an opportunity for us to show them how to make better use of their MatrixCare investment as we took on a more consultative approach to make use of this software.”<br></p><p style="text-align&#58;left;">Whatever the need, and no matter the size of the AL community, he says the EHR was put to use for meeting new regulatory requirements brought to bear by COVID and to make contact among and between family, residents, and staff that much easier.</p><p style="text-align&#58;center;"><strong><a href="/Topics/Special-Features/Pages/Top30Collect.aspx">Click</a>​ to access the Report&#58;</strong></p><p style="text-align&#58;center;">&#160;<span class="ms-rteThemeForeColor-5-4"><strong><a href="/Topics/Special-Features/Pages/Top30Collect.aspx" target="_blank" title="Top 30 AL"><img src="/Topics/Special-Features/PublishingImages/2021/Prv0621_Top30AL.jpg" alt="Click to access the Report!" style="margin&#58;5px;width&#58;170px;height&#58;170px;" /></a><br></strong></span></p><p style="text-align&#58;right;"><span class="ms-rteThemeForeColor-5-4"><strong><br></strong></span></p><p style="text-align&#58;center;"><span class="ms-rteThemeForeColor-5-4"><strong>Sponsored by&#58;</strong></span><a href="https&#58;//www.matrixcare.com/" target="_blank"><img src="/Topics/Special-Features/PublishingImages/Pages/Top-30-AL-Providers-Track-National-Trends-Amid-Pandemic,-Occupancy-Pressures/MatrixCare%20Logo_RGB_300%20DPI.png" alt="MatrixCare" style="margin&#58;5px;width&#58;185px;height&#58;65px;" /></a><br></p>2021-06-01T04:00:00Z<img alt="Top 30 Assisted Living" src="/Topics/Special-Features/PublishingImages/2021/Prv0621_Top30AL.jpg" style="BORDER&#58;0px solid;" />Caregiving;ManagementPatrick Connole​Assisted living communities with more advanced technology were better able to adjust to the demands for improved engagement with families amid the COVID-19 lockdowns.
2021: Reimagining Rehabilitation Partnerships<h2><span class="ms-rteFontSize-3 ms-rteForeColor-2">ADVERTORIAL</span></h2><p>​Reliant Rehabilitation has built a reputation for providing best-in-class clinical programs and compliance processes. We will always focus on our core model, delivering the highest therapy outcomes to seniors in the most efficient manner possible to bring quality and value to payers and provider partners. 2020 brought to light new challenges and needs for health care operators, especially for skilled nursing facilities. Reliant proactively adapted by modifying existing processes and quickly rolling out new programs to meet the changing landscape. </p><h3>Combating Impact of Isolation</h3><p>As we move forward in this post-pandemic/transitional phase, robust therapy programs are crucial to meet all residents’ needs. Our most frail and elderly citizens are experiencing an increase in cognitive impairments, including disorientation, confusion, and decreased ability to follow directions. These declines cause increased risks of falls, poor decision making, and weight-loss concerns. Spending most of their time isolated to their rooms and many hours spent in bed the past year have caused severe declines in physical function.<br></p><p><img src="/Topics/Special-Features/PublishingImages/2021/RehabReimagine.jpg" class="ms-rtePosition-1" alt="" style="margin&#58;5px;width&#58;261px;height&#58;261px;" />The average senior loses 1 percent of lean muscle for every day they are bedbound. This generalized weakness, if left untreated, will cause additional safety concerns, including decreased ability to perform activities of daily living (ADLs), contractures, decreased ability to ambulate, incontinence, and falls.<br></p><p>Reliant's proprietary programs like Subtle Observed Symptoms (SOS) and No Patient Left Behind ensure timely identification and treatment of these functional changes. These programs include training for the entire clinical team, not just for the therapy department. A key component to success often missed is communication between departments. These programs, when implemented and supported by the team, produce better outcomes and reduce costly rehospitalizations. </p><h3>Adjustment to PDPM</h3><p>Before the onset of the COVID-19 crisis, our industry faced the most significant reimbursement change in 20 years, the Patient-Driven Payment Model, or PDPM. Just as our provider partners were learning how to manage the new, complicated system, the pandemic caused a shift of attention from reimbursement to crisis management.<br></p><p>In 2019, Reliant focused our resources on developing a PDPM model to support our clients in providing the best outcomes possible under the new reimbursement system. We created and implemented both Clinical Predictive Pathways (CP2) and Care+ models to meet the needs of our residents and clients. We invested countless training hours in our clinicians to become contributing members of the interdisciplinary team. <br></p><p>During 2020, we all had to adapt to the changing rules and regulations surrounding COVID-19. It is now time to refocus our attention on ensuring accurate coding of the MDS to reflect the real needs of the resident. <br></p><p>All Reliant Rehabilitation full-service clients benefit from PDPM-trained clinicians prepared with tools to facilitate communication between nursing and rehab for MDS coding accuracy. While listening to the needs and frustrations of skilled nursing facility operators across the country, we understand the need for additional support from qualified reimbursement specialists.<br></p><p>Reliant Reimbursement Solutions (RRS) provides post-acute providers with case-management and reimbursement specialists for each of their facilities, combined with enhanced analytics, and comprehensive claims management to ensure that operators achieve the highest appropriate reimbursement for the services provided to post-acute patients and long term care residents. RRS provides the peace of mind that claims are accurate, documentation is defensible, and manages your claims from ADR through all levels of review.</p><h3>Enhanced Communication</h3><p>During the pandemic, we realized a gap in our ability to effectively communicate therapy progress with family members. Historically, therapists work closely with key family members throughout their rehabilitation stay. This exchange of information is crucial to the long-term outcome of the resident. Upon admission and through the evaluation, family members give clinicians crucial historical information. During treatment, family members act as cheerleaders, encouraging their loved ones to participate in therapy, and as we enter the final days of a therapy stay, clinicians work with the family to ensure a safe discharge. <br></p><p>This ongoing information exchange ensures the most appropriate treatment plan and sets the resident and family up for success. To address this communication challenge, Reliant has partnered with an industry leader to create a proprietary family engagement solution, Reliant FamilyLink. With Reliant FamilyLink, our therapists can correspond with key family members via chat and video. Families are invited to attend live therapy sessions in a safe, virtual environment. Loved ones can also share the resident's history, including sharing memories and pictures. </p><h3>Census Development Support</h3><p>One final hurdle amplified by the pandemic is occupancy. We all know that long term care communities compete for admissions in a challenging market, even with the best care and outcomes. The media painted a horrific picture of our industry during the COVID-19 crisis. We must rebuild the trust and confidence of the consumers and referral sources. Considering this critical situation, Reliant has committed to being a trusted resource and trustworthy partner in rebuilding your occupancy levels and increasing referrals to your communities.<br></p><p>ReliantGrow gives our partners the tools and support they need to have a sophisticated marketing approach. The ReliantGrow team is led by seasoned professionals who will work with your existing marketing team to identify barriers and uncover opportunities to build your business. ReliantGrow is a multi-faceted approach that includes a consultative review of your competitive marketplace, training on interpreting the data, and outcomes and success stories for both referral sources and social media. Reliant's unique approach and proprietary programs like Model 10 and A Year of Wellness are proven tools to drive attention to your communities.<br></p><p>Reliant Rehabilitation is committed to providing the highest level of professional therapy services to your residents in the most efficient, cost-effective way. Our pricing models and programs are customized to your needs and budget. We pride ourselves on offering an all-inclusive model directly tied to your reimbursement, with no hidden costs. Think of Reliant as a risk-share model where our incentives are aligned with outcomes.<br></p><p>Please contact us today at <a href="mailto&#58;sales@reliant-rehab.com" target="_blank" title="Email sales.">sales@reliant-rehab.com</a> if you would like to learn more about our innovative programs. We would be happy to analyze your current situation and provide feedback about the best program for your specific needs.&#160; Visit our website at <a href="https&#58;//www.reliant-rehab.com/" target="_blank">https&#58;//www.reliant-rehab.com/</a>.</p>2021-05-27T04:00:00Z<img alt="" src="/Topics/Special-Features/PublishingImages/2021/RehabReimagine.jpg" style="BORDER&#58;0px solid;" />Caregiving​Reliant RehabilitationModified processes and post-pandemic programs are helping reimagine rehabilitation partnerships in a changing landscape.
PharMerica’s PropacPayless Brings Local Focus Aligned With National Presence<p>​In David Welker’s world, the importance of a long term care pharmacy partner begins with the relationship, the ability of the provider to trust that medications will be on time and in the right supply, and that any problems can be rectified in quick fashion.<br></p><p><img src="/Topics/Special-Features/PublishingImages/2021/DavidWelker.jpg" alt="David Welker" class="ms-rtePosition-1" style="margin&#58;5px;width&#58;145px;height&#58;186px;" />As chief executive officer of Brookfield Health and Rehabilitation&#160;of Cascadia in Battleground, Wash., he has entrusted his residents and staff with just that partner, the PharMerica company PropacPayless. <br></p><p>Welker says since PharMerica acquired the Pacific Northwest pharmacy PropacPayless, his skilled nursing facility has benefited greatly from not only the speed and efficiency of their customer service, but also the localized attention from pharmacists and nurse consultants that is complemented by PharMerica’s national scope and scale. <br></p><p>“This is the best relationship I have ever had with a pharmacy. The meds are on time, and we receive daily invoices showing really low costs,” Welker says. Still, beyond the bottom line there is the consistency of the PharMerica team that in normal times is visible in the facility, and now, during the pandemic, just a virtual visit away.<br></p><p>“It is so helpful to first and foremost know who the sales rep is and the nursing rep. Tons of things come up and usually late at night or after hours, and they respond immediately to emails and texts,” he says. “Other companies may get back to you the next day and it is too late. I really enjoy the response I get from our PharMerica team.”<br></p><p>As in most businesses, the continuity is vital as is the expertise. “We get emails from actual pharmacists. It is so nice to have them on our side; it feels like they have a significant role in our fight to provide top-quality resident care.”</p><h3 class="ms-rteElement-H3B">Oregon Provider Likes the ‘Personal’</h3><p>Nearby in the same Pacific Northwest region is where Andrew Becker, vice president of operations, Sapphire Health Services in Portland, Ore., tells his own story of how PharMerica’s PropacPayless has kept pace with his growing business.<br></p><p><img src="/Topics/Special-Features/PublishingImages/2021/AndrewBecker.jpg" alt="Andrew Becker" class="ms-rtePosition-2" style="margin&#58;5px;width&#58;145px;height&#58;186px;" />A regional group that now has 20 facilities covering the full slate of senior care settings, Becker says the personal ties forged between the PharMerica consultants based in the same communities in which he operates have made all the difference. <br></p><p>Naming the consultants by first names, he says knowing who they are and for many years is a key part of the top-notch customer service that Sapphire’s nursing centers receive. <br></p><p>“We really have grown to appreciate the customer service and what they do for us. I mean you can pick up the phone and get an immediate response. It is the small things even, like when we had a pill crusher break. We asked if they could help, and they said they would be right out with a new one,” Becker says.<br></p><p>The nursing staff, he jokes, have become spoiled by the attention PharMerica’s nursing consultants pay the facility. Medication carts are checked and supported without fail.<br></p><p>“When PharMerica acquired PropacPayless, I was worried that some of the local touch would not be there anymore, and I have been more than pleasantly surprised to realize those things that I really loved have not changed. John [PharMerica rep] is still roaming the halls and checking out the carts, and Paul or Judy are there to help on pricing…”<br></p><p>And, when there is a tough client, the first step his team takes is to call the PharMerica consultant pharmacist and do a drug regime review to see if there is something missing that could help the resident. “Hopefully, we can get it resolved and at least move in the right direction to help our residents to get a better outcome.”</p><h3 class="ms-rteElement-H3B">National Scope </h3><p>The company, Becker says, truly has a national footprint with a local focus. An example is the way in which information on the COVID-19 pandemic has flowed nonstop from PharMerica, with national and state regulations and rule changes being communicated quickly and ahead of the curve.<br></p><p>And, the actual way in which PharMerica worked with the provider changed fast and seemingly without effort, he says. <br></p><p>“They jumped right in and adapted when the pandemic hit. This shows how their national presence helps. </p><p>There might be a lag in certain areas of the country with the rollout of a pandemic response, but a company like PharMerica with a national footprint can move some of those agendas quicker than others,” Becker says.<br></p><p>This was seen with the move from in-person to virtual visits and updates, which have proven to be very valuable in ways unforeseen before the pandemic.<br></p><p>“At times it was hard to have the time for a nurse to do a training in-person, but now with Zoom and other virtual methods, we can record a training and use it anytime,” he says.<br></p><p>Other PharMerica changes included using cardboard boxes for medication shipments as the regular totes could be an infection control issue as they were moved from facility to facility. “A lot of things had to change and had to be done quickly and seamlessly. The cardboard versus tote might not seem like a big deal, but it makes a big difference,” he says.</p><h3 class="ms-rteElement-H3B">It Is a Big Deal</h3><p>In the end, Cascadia’s Welker says there are many components in building a high-quality care operation to serve the needs of the elderly and those with disabilities who make up a nursing facility. It is with PharMerica, he says, that the pharmacy component of this quest is satisfied.<br></p><p>“It really plays to our ability to be a Five-Star facility. All cylinders have to fire to get to that level, you cannot be lacking in any one area, and PharMerica is one of the reasons why we are the highest-rated nursing home in Clark County,” he says.<br></p><p>“People are happy with the service they are getting, and if the pharmacy was failing, they would not be happy with their stay here. It is a really big piece of what we do,” Welker says. “We may not have the fact PharMerica is our pharmacy partner out on a banner out front, but it is a big deal.”</p><p><br></p><p style="text-align&#58;center;"><img src="/Topics/Special-Features/PublishingImages/2021/PharMerica.jpg" alt="" style="margin&#58;5px;width&#58;190px;height&#58;39px;" /><br></p>2021-04-01T04:00:00Z<img alt="" src="/Topics/Special-Features/PublishingImages/2021/0421-PharMerica.jpg" style="BORDER&#58;0px solid;" />ManagementPatrick Connole​The importance of a long term care pharmacy partner begins with the relationship, the ability of the provider to trust that medications will be on time and in the right supply, and that any problems can be rectified in quick fashion.
Providers Set Their Sights on Path to Financial RecoveryNobody saw the pandemic coming, but each long term and post-acute care (LT/PAC) provider is planning on how its business will emerge from the most challenging year for the profession in history. <a href="https&#58;//pagepro.mydigitalpublication.com/publication/?m=63330&amp;i=695596&amp;p=4" target="_blank">Read more.</a><br><p></p>2021-03-01T05:00:00Z<img alt="" src="/Monthly-Issue/2021/March/PublishingImages/Recovery.jpg" style="BORDER&#58;0px solid;" />Finance;COVID-19Patrick Connole​Nobody saw the pandemic coming, but each long term and post-acute care (LT/PAC) provider is planning on how its business will emerge from the most challenging year for the profession in history.