When the Chips Are Down, Partners Come Through<p>​<span><img src="/Monthly-Issue/2021/September/PublishingImages/0921_ChrisFerreri.jpg" alt="Chris Ferreri" class="ms-rtePosition-1" style="margin&#58;5px;width&#58;160px;height&#58;200px;" /></span>During this past year, relationships and partnerships took on new significance. Local organizations with strong national connections were able to rise above the challenges and maintain a human touch when isolation was the norm.<br></p><p>Chris Ferreri, chief operating officer of The Osborn Group, a continuing care retirement community in Westchester, N.Y., experienced this firsthand. In the midst of the pandemic, access to personal protective equipment (PPE) was at a premium, and finding a laboratory that could get COVID testing results in short order was nearly impossible.<br></p><p>Yet, Ferreri and his team were able to get both, thanks to a strong relationship with a national partner.</p><h2>A Partner Can Help </h2><p>“We were doing 600 COVID tests a week, and PharMerica connected us with a reliable laboratory company that was able to get us results in 24 to 36 hours,” he says. “PharMerica also helped us find PPE suppliers that were able to get us what we needed for affordable prices.” <br></p><p>PharMerica’s national connections made a difference for Ferreri and his local community. “What they did during the pandemic was beyond the bounds of what a pharmacy provider does,” he says, adding, “They see themselves as a partner, and their efforts demonstrate this time and again.”</p><h2>Quick Access to Dwindling Supplies</h2><p><img src="/Monthly-Issue/2021/September/PublishingImages/0921_LenRuss.jpg" alt="Len Russ" class="ms-rtePosition-2" style="margin&#58;5px;width&#58;160px;height&#58;200px;" />Len Russ, owner/administrator of Bayberry Care Center, a New Rochelle, N.Y.-based partnership specializing in skilled nursing, subacute, and in-patient short-term rehab care, agrees. His partners at PharMerica jumped right in to help ensure Russ and his team had adequate PPE, and they kept pharmacy services functioning without delays. This included ensuring drivers could drop off drugs safely and without personal contact.<br></p><p>Russ says, “Last year was trial by fire, and we came through it stronger.” Ferreri adds, “There were people who were looking to profit from the pandemic, but PharMerica’s focus was on helping our residents and enabling us to survive and thrive.”<br></p><p>“We knew what we were dealing with in early March,” Russ recalls. “We were scrambling to manage, and PharMerica helped us access their supply chains, which we wouldn’t have been able to do on our own.”</p><h2>Vaccine Access Assured</h2><p>The “crème de la crème” of PharMerica’s support during the pandemic, Ferreri says, involved COVID-19 vaccines. “Rochelle [Stern, RN, PharMerica director of client services] made sure we got enough vaccines for all of our residents, including those in independent living,” he says. Even after six vaccine clinics with Walgreens, PharMerica came in and did three more onsite.<br></p><p>“The clock was ticking, and PharMerica stepped up to ensure we had access to all the vaccines we needed. They understood our goals and made a commitment to get us shots in arms,” he says. <br></p><p>Russ adds, “After the initial free clinics, we had no way to get more vaccines for those who still hadn’t gotten vaccinated. PharMerica deployed vaccines to us on a weekly basis in the doses we needed. Ultimately, no one had to wait for a shot.”</p><h2>Survey Support and Beyond</h2><p>While survey activity was down during COVID, PharMerica continued to provide remote survey support. Surveys are stressful for even the best buildings. Having the experience of a national organization that understands the ins and outs of surveys and what surveyors are looking for at any given time can alleviate some of that anxiety and enable leaders like Russ and Ferreri and their teams to focus on what they do best—providing the best possible care for their residents. <br></p><p><img src="/Monthly-Issue/2021/September/PublishingImages/0921_RochelleStern.jpg" alt="Rochelle Stern" class="ms-rtePosition-1" style="margin&#58;5px;width&#58;160px;height&#58;200px;" />As a former director of nursing, PharMerica’s Rochelle Stern knows what happens on the skilled nursing side and how to prepare for surveys. <br></p><p>“This was one of the benefits PharMerica brought to the table,” says Ferreri. “While it’s great to deliver great pricing and helping our bottom line, it comes down to relationships and partners that can help in all aspects of our work, and survey support is part of that.”<br></p><p>While PharMerica goes above and beyond pharmacy services, its national footprint helps its local clients have quick access to the medications they need when they need them at the right price. How important is this? Russ stresses, “Pharmacy is the lifeblood of care.” It needs to function flawlessly, he says.<br></p><p>“We count on them every day for medications. Pre-COVID, we had 600 admissions a year and, with that, comes a tremendous amount of medication tracking, management, and monitoring,” says Ferreri. “That is the basis of our relationship.”</p><h2>Teamwork? Priceless</h2><p>In long term care, says Russ, “teamwork is everything. It’s key to successful relationships and the delivery of care. It’s an essential part of doing business in this industry. The value of having a pharmacy provider that threads the needle between the infrastructure of a large company and providing very personalized service is priceless.”<br></p><p>“These relationships are extremely close,” Stern says. “One thing that distinguishes us is that we put ourselves in our customers’ shoes and look at things from their experience. We’re more than just a pharmacy.”<br></p><p>Crises test relationships. As Ferreri says, “Things change so fast, your head spins. You need to be able to have knowledgeable people who are hooked into networks across the country. Having a team to help us weave through all of the obstacles is key.” </p><p style="text-align&#58;center;"><img src="/SiteCollectionImages/logos/PharMerica.jpg" alt="" style="margin&#58;5px;width&#58;179px;height&#58;39px;" /><br></p>2021-09-01T04:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/0220_News2.jpg" style="BORDER&#58;0px solid;" />Caregiving;COVID-19During this past year, relationships and partnerships took on new significance. Local organizations with strong national connections were able to rise above the challenges and maintain a human touch when isolation was the norm.
Becoming a Proactive Provider in a Value-based World<p>​What do accountable care organizations (ACOs), hospitals, and health systems participating in value-based payment models (such as the Bundled Payment Care Improvement Advanced) look for when referring patients to a post-acute care (PAC) facility? They want a reliable partner who not only shares their goals of well-coordinated care, improved patient outcomes, and reduced costs but also delivers with proven results.&#160; </p><p>It’s no secret that post-acute providers, especially skilled nursing facilities (SNFs), are facing more challenges than ever before. The steady decline in occupancy and critical staffing shortages were exacerbated by the pandemic. According to the NIC MAP Data Service, SNF census hit an all-time low last December, and while the numbers are stabilizing, occupancy is down 13 percent from pre-COVID levels.<br></p><p>Recruiting and retaining quality physicians, nurses, and certified nurse assistants post-COVID will only get tougher with nursing homes in almost every state reporting significant staffing limitations. These issues, compounded with the actual cost of fighting the pandemic, further escalate rising operational expenses. <br></p><p>Yet, as value-based care models (VBC) continue to evolve, ACOs, hospitals, and other payers expect their post-acute network partners to improve the quality of care and deliver better clinical and financial outcomes. This puts SNFs under even more scrutiny in their efforts to gain referrals, operate efficiently, and retain staff. </p><p>To remain an essential provider in the market and earn steady hospital referrals, SNFs must adopt a value-based care mindset across the entire organization. Technology is one of the keys to this VBC transformation—in the form of data analytics. By using meaningful data to better manage patient care, SNFs can become a stronger partner for their residents, referral sources, payers, and the communities they serve. <br></p><h3>Moving the needle on key performance metrics using live data </h3><p>In order to perform well under bundled and other VBC payment models, ACOs and hospitals are inherently tied to their post-acute facilities’ ability to improve patient outcomes—namely readmission rates and length of stay. That’s why these entities are turning to their high-performing network partners to improve the patient experience and maximize potential savings. <br></p><p>And because acute care providers are responsible for managing patients during the post-acute stay, they are targeting the costliest line item—skilled nursing facilities—to reduce costs. As reported in the MedPAC July 2020 Data Book, skilled nursing alone accounts for almost half of Medicare fee for service post-acute hospital expenditures, thus representing a prime target for payers to reduce total health care dollars. &#160;</p><h3>There’s a real opportunity for SNFs too. <br></h3><p>Many SNFs have a massive amount of patient and facility data readily available in their electronic health record (EHR) that—when gathered and analyzed in real-time—can reveal meaningful information and help move the needle on key performance measures. They just need the right software to use it to their advantage. <br></p><p>By using data analytics to leverage EHR data, post-acute facilities gain valuable insights that empower care teams to make more informed clinical decisions. Equipped with actionable patient and facility-level data, SNFs can improve coordination efforts among transitioning providers and shorten patient stays. <br></p><p>For example, care teams can proactively identify and stratify residents at high risk for readmissions, particularly during the first 72 hours of transition to the SNF when they are most vulnerable. With timely, evidence-based, and actionable alerts, the care team can treat them in the facility before the patient’s status worsens. <br></p><p>And with the right data, SNFs can establish clinical pathways to reduce variability in the way conditions are treated. By using interventional analytics to understand how the patient is doing in the moment compared to an established clinical baseline of when they arrived, clinicians can intervene in a more timely fashion to mitigate the risk of decline and need for hospitalization. With a better clinical line of sight based on live data, SNFs can also reduce length of stay by making even more informed decisions on when the resident would be safe to transition back to the community. </p><h3>Proving value as an ideal PAC partner</h3><p>Aging adults entering nursing homes and assisted living are sicker and frailer than ever before, which makes the PAC facilities that care for them an increasingly vital component of the health care continuum. <br></p><p>Simply relying on claims or the Minimum Data Set (MDS) to inform patient care is no longer an option; instead, staff need immediate access to actionable information at the point of care. The typical SNF EHR is so fragmented, finding the “must have” clinical information is like searching for a needle in a haystack. <br></p><p>Clinicians need live, continuous data analysis that helps keep the entire team well-informed on the highest risk patients based on their status today and not based on their most recent claims or their latest MDS, often weeks to months old. With actionable data that helps care teams assess and prioritize patient needs in real time, staff can target specific at-risk residents on rounds while offering a brief greeting to others. <br></p><p>To see the big picture—and prove their value as a preferred network provider—SNFs also need dashboards and reports based on information as recent as the day the data is entered into the EHR instead of pulling data from the MDS that may be three months old.<br></p><p>And SNFs need to share that data with their health care partners. Data transparency and interoperability allows all providers invested in patient care to monitor clinical status along the care continuum and drive collaboration when needed. &#160;<br></p><p>With interventional analytics software that assesses live patient EHR data 24/7/365, SNFs can better coordinate with their referral partners to effectively transition patients between care settings, shorten length of stay, and keep residents out of the hospital, ensuring patients return to their homes safely. <br></p><p>Do you have the right technology in place to effectively coordinate care, improve patient outcomes, and reduce costs so that you can get the referrals you measurably deserve? <br><br><em>As chief medical officer, <strong>Steven Stein, MD,</strong> draws upon his vast knowledge of both the post-acute and payer markets to guide the clinical advancements of Real Time Medical Systems’ Interventional Analytics platform for post-acute providers, health systems, accountable care organizations, physician groups, and managed care organizations. Stein served on the White House Council on Aging for both the Clinton and Obama administrations. Stein is board-certified in internal medicine and geriatrics.</em></p>2021-08-04T04:00:00Z<img alt="" src="/Topics/Special-Features/PublishingImages/2021/SteveStein.jpg" style="BORDER&#58;0px solid;" />QualitySteven Stein, MDWhat do ACOs, hospitals, and health systems participating in value-based payment models look for when referring patients to a post-acute care facility?
Recouping Business Post-COVID-19<p>It’s no secret long term care (LTC) facilities were among those hit the hardest by the COVID-19 pandemic. As of June 1, <a href="https&#58;//www.nytimes.com/interactive/2020/us/coronavirus-nursing-homes.html" target="_blank">more than 1.38 million people</a> across approximately 32,000 LTC facilities in the United States had contracted the virus.</p><p>Thankfully, widespread vaccinations have drastically slowed down the spread of COVID-19 in nursing homes and other LTC facilities. In fact, data from the Centers for Medicare and Medicaid Services show there has been a nearly <a href="https&#58;//data.cms.gov/stories/s/COVID-19-Nursing-Home-Data/bkwz-xpvg/" target="_blank">99 percent decline</a> in new COVID-19 cases among nursing home residents from Dec. 20, 2020, to June 14. <br></p><p>With this clinical crisis now largely under control, operators have been able to turn their attention to the pandemic’s longer-lasting business ramifications. For one, occupancy in skilled nursing facilities hit an all-time low in December after dropping 13.3 percentage points from February 2020, according to the <a href="https&#58;//info.nic.org/nic-map-skilled-nursing-data-monthly-report?utm_campaign=2020_09_29_NIC_MAP_skilled_nursing_monthly&amp;utm_medium=email&amp;_hsmi=114192658&amp;_hsenc=p2ANqtz-8YAyAyDstYx8XRceHcRDt9-wXePJTa3p-AUE8AO716sAudmq27v_RpSFlhFGZ3iqGc74RpzLrbnZFul5DNr7YOXuw92EB1hUsjVZpP4gahEwPKm-k&amp;utm_content=114192658&amp;utm_source=hs_email" target="_blank">National Investment Center for Seniors Housing &amp; Care.</a></p><p>Today, census is ticking upward, and LTC facilities remain essential care settings for aging Americans. But with relatively low margins in the skilled nursing and senior living sectors and a worsening national caregiver shortage, operators of these facilities are at a pivotal point where recovery is key.</p><h2>Securing State and Federal Support </h2><p>To support the industry’s recovery, it will be critical to get more funding for providers at both state and federal levels in 2021, said American Health Care Association/National Center for Assisted Living (AHCA/NCAL) President and Chief Executive Officer Mark Parkinson at MatrixCare’s Inspire 2021 event, held virtually March 5-6. </p><p>The $1.9 trillion stimulus bill President Biden signed into effect on March 11 included $350 billion for states, territories, and localities. According to Parkinson, this funding provided an opportunity for states to shore up their Medicaid programs and continue supporting LTC facilities within their states. For those that hadn’t provided adequate support, it was an opportunity to step up to the plate.</p><p>ACHA and NCAL are continuing to advocate for more federal relief as well. Parkinson noted at Inspire that there is approximately $32.5 billion left in the provider relief fund, and he hopes that organizations will be able to access that fund to provide additional support for both skilled nursing and assisted living communities. <br></p><h2>Taking Action Internally</h2><p>With external factors continuing to evolve, it’s important LTC facilities employ their own strategies to rebuild occupancy and recoup business this year. Technology is a good place to start, as it’s one of the only solutions that can promptly and effectively address the myriad challenges providers find themselves facing today. Below are three key areas providers should consider as they evaluate their current technology or others on the market based on their abilities to aid in recovery.</p><p><em>Leveraging Data Analytics&#58; </em>With resources tight, it’s critical LTC facilities operate as efficiently as possible. Data analytics allow providers to replace manual number crunching with targeted action by producing tailored insights that can serve as a road map for improving business and resident care.</p><p>For example, predictive analytics can analyze patient data and guide clinical workflow toward the highest-risk residents, while traditional analytics can track key performance indicators in real time and identify areas for improvement.</p><p><em>Strengthening Referrals&#58;</em> Referrals are critical for rebuilding census. Interoperability, namely electronic data sharing, is a key factor for acute and ambulatory care providers when choosing where to send their patients in post-acute care. In fact, <a href="https&#58;//go.matrixcare.com/LP-CORP-2021-03-Interoperability.html" target="_blank">78 percent of referring providers</a> said they’re likely to send more referrals to skilled nursing facilities that can support advanced interoperability workflows and seamless electronic data exchange. With this, adopting interoperability becomes a business strategy for capturing and maintaining a steady flow of referrals.</p><p><em>Scaling and Diversifying a Business&#58;</em> An important strategy for LTC facilities this year and in the years ahead will be leveraging core competencies to differentiate and diversify care models and offerings. Diversifying care into adjacent programs, such as skilled nursing at home, will allow facilities to tap into the rising demand for aging in place and recover business faster. Working with a technology provider that offers purpose-built solutions for a number of post-acute care settings is critical to this strategy, making it easier to scale while keeping operations streamlined under one core solution.</p><p>While it’s impossible to control external factors like federal relief and regulations, facilities today have an opportunity to evaluate their technology strategy with an eye toward maximizing existing resources, improving connectivity, and scaling for the future. Doing so will help providers recover in the near term and succeed for the long term.<br><br><em><strong>Gary Pederson</strong> is executive vice president, Facility Division, at <a href="https&#58;//www.matrixcare.com/" target="_blank">MatrixCare</a>, the country’s largest post-acute care technology provider. He has over 25 years of experience in health technology, including time spent at Cerner, Toshiba Medical Systems, and Siemens Medical. Pederson can be reached at <a href="mailto&#58;Gary.Pederson@matrixcare.com" target="_blank">Gary.Pederson@matrixcare.com</a>.</em><br>​</p>2021-07-14T04:00:00Z<img alt="" src="/Topics/Special-Features/PublishingImages/2021/0721/0721_MatrixCare.jpg" style="BORDER&#58;0px solid;" />COVID-19;Management;PolicyGary PedersonWith the clinical crisis largely under control, it’s time for providers to assess what technical strategies they will need to adopt to rebuild census.
Celebrating National Skilled Nursing Care Week 2021<p><img src="/Topics/Special-Features/PublishingImages/2021/0721/0721_NSNCW-LaurelHills.jpg" class="ms-rtePosition-1" alt="" style="margin&#58;5px;" />National Skilled Nursing Care Week® (NSNCW) began on Mother’s Day, Sunday, May 9, and was celebrated through the following Saturday. </p><p>Founded in 1967 by the American Health Care Association (AHCA), the observance highlights the important role of nursing homes in caring for America’s seniors and individuals with disabilities. This year’s celebratory week is <a href="/Topics/Special-Features/Pages/Words-From-Our-Sponsor.aspx" target="_blank" title="Words from Our Sponsor">sponsored by Essity</a>.<br></p><p>“We are grateful to Essity for their generous support of National Skilled Nursing Care Week, which was an important celebration recognizing the compassionate care provided by nursing homes and their staff during this unprecedented time,” says AHCA/National Center for Assisted Living President and Chief Executive Officer Mark Parkinson.<br></p><p>COVID-19 made this past year unimaginable for skilled nursing care centers, many of which were hit hard by the pandemic. Throughout it all, however, staff members across the country cared for residents around the clock as challenges such as social distancing rules prevented residents from in-person visits with loved ones.<br></p><p>Recognizing the amazing work of certified nurse assistants, nurses, food service workers, and other nursing home staff is at the root of NSNCW. The theme, Together Through the Seasons, honored the collaboration and commitment of skilled nursing care facilities and their staff in providing compassionate care to their residents every day during this challenging year. <br></p><p>While not all nursing homes were able to celebrate the week, many developed creative and inspiring ways to celebrate their staff and residents during NSNCW. Social media posts, photos, and videos depict a multitude of wonderful activities and events corresponding to the Together Through the Seasons theme.</p><h2><span class="ms-rteForeColor-10">Outdoors Together</span></h2><p>For many skilled care centers, being together outside was the safest and simplest way to maintain social distance while still hosting activities and special events. Themed parties, cook-outs and barbeques, drive-by parades, classic car shows, Olympic games, balloon launches, dance celebrations with young and old, concerts, sing-alongs, and award ceremonies were just a few of the ways staff and residents celebrated.<br></p><p>Other events focused on seasonal celebrations like spring planting, with staff and residents working side-by-side to plant flowers and vegetables in both planters and dedicated gardens. Visits from furry friends were also extremely popular. Four-legged friends that made their way into many nursing homes and into the hearts of staff and residents included therapy dogs, horses and ponies, bunnies, pigs, and even baby goats.</p><h2><span class="ms-rteForeColor-10">Celebrating Together</span></h2><p>Across the country, residents and staff were delighted finally to be able to gather together safely for the first time in over a year. At the Florence Hand Home in LaGrange, Ga., residents were thrilled to be together again to share laughs and s’mores at a festive outdoor garden party. <br></p><p><img src="/Topics/Special-Features/PublishingImages/2021/0721/0721_NSNCW-Painting.jpg" class="ms-rtePosition-2" alt="" style="margin&#58;5px;" />Other fun and imaginative celebrations included large group memory and Bingo games, themed costume parties, movie nights, Native American ceremonial dancing and music, and luaus.<br></p><p>Many other activities focused on past decades, featuring movies and musical gatherings from a particular time period, such as the hippie years of the 1960s.<br></p><p>Treats and special meals were also part of the celebrations, with ice cream trucks and s’more parties at the top of the list. </p><h2><span class="ms-rteForeColor-10">Creating Together</span></h2><p>From art to apple butter, residents were invited to engage in joint creative projects. Building on the Together for the Seasons theme, residents at Lee Health and Rehab in Penning Gap, Va., spent one day painting and constructing a “4 Seasons Art Project” and the next day planting tomatoes, bell peppers, and watermelons in a special garden.<br></p><p>Creative projects were not limited to painting and drawing but also included yarn crafts like God’s Eyes, button art, popsicle-stick architecture, and colorful felted flowers planted in decorative flower pots.<br></p><p>Other creative events included staff theatrical productions and costume parties. In many nursing homes, residents honored their staff and caregivers in both heartfelt and humorous ways. Staff received hand-made cards, signs, and video-taped messages and were treated to special lunches.<br></p><p>At Azria Health Woodhaven in Ellinwood, Kan., caregivers received certificates of heroism as well as lottery tickets with a note attached that said, “We hit the jackpot with staff like you!”</p><h2><span class="ms-rteForeColor-10">Connecting Together</span></h2><p>From coast to coast, elected officials made special proclamations in honor of NSNCW. In the words of Gov. Ralph Northam, “the Commonwealth of Virginia is thankful to the dedicated workers… [and] for the heroic contributions they make every day to the well-being of the residents and families they serve.”<br></p><p><img src="/Topics/Special-Features/PublishingImages/2021/0721/0721_NSNCW-photo-contest.jpg" class="ms-rtePosition-1" alt="" style="margin&#58;5px;" />Some proclamations were more local and targeted. In Darke County, Ohio, “Proclamation Day” was designated on May 10, encouraging county residents to place calls to friends and family in local care facilities with messages of love and support. The week also served as a special time to recognize staff in Darke County.<br></p><p>In a quote for the <em>Sydney</em> (Ohio) <em>Daily News</em>, Senior Administrator Kristy Earick of Versailles Rehab said, “Our entire team went to extraordinary lengths protecting our residents’ health, not to mention that of our staff themselves and their families as the pandemic intensified. We cherish the work they do every day; however, during these special weeks of honor, we especially focus on their compassionate care.”<br></p><p>The week was recognized in many unique and creative ways, but across the country, the primary focus was to honor and recognize the compassion and dedication of skilled care staff, especially during these hard times, and to celebrate the lives of residents in their care.<br></p><p>To view all the ways that NSNCW was recognized this year, please visit #NSNCW, Facebook.com/#NSNCW, and NSNCW.org. ■<br><br><em><a href="mailto&#58;lhohenemser@ahca.org" target="_blank" title="Email Lisa!">Lisa Hohenemser,</a> MPH, is marketing manager for the American Health Care Association. </em><br>​</p>2021-07-01T04:00:00Z<img alt="" src="/Topics/Special-Features/PublishingImages/2021/0721/0721_NSNCW.jpg" style="BORDER&#58;0px solid;" />CaregivingLisa HohenemserFounded in 1967 by AHCA, NSNCW highlights the important role of nursing homes in caring for America’s seniors and individuals with disabilities.