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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.
Top 30 Largest Nursing Facility Companies<p>In a new listing by the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) of the Top 30 largest nursing home operators by facility count, Genesis led the way by a sizable spread with 357 facilities in 26 states and some 41,977 beds.<br></p><p>The next two-largest skilled nursing providers were The Ensign Group with 219 facilities and 23,172 beds in 13 states and Life Care Centers of America with 209 facilities and 27,179 beds in 28 states. The rest of the top 10 are&#58; ProMedica Senior Care, The Evangelical Lutheran Good Samaritan Society, Consulate Health Care, Saber Healthcare Group, Sava SeniorCare, Trilogy Health Services, and Signature HealthCARE.<br></p><p>This new nursing home list in the July <em>Provider</em> follows a Top 30 count for <a href="/Topics/Special-Features/Pages/Top-30-AL-Providers-Track-National-Trends-Amid-Pandemic-Occupancy-Pressures.aspx" target="_blank" title="Top 30 AL Companies">assisted living companies</a> in the June issue. <br></p><p>To offer some insight on what it means to serve both types of facilities, which can often be in the same complex or nearby physical setting, is Gary Pederson, executive vice president of MatrixCare, who also details how his company attempts to innovate and educate in the electronic health record (EHR) space as the senior living sector emerges from the COVID-19 pandemic.</p><p style="text-align&#58;center;">Click to access the report&#58;</p><p style="text-align&#58;center;"><a href="/Topics/Special-Features/Pages/Top30SNFCollected.aspx" title="Click to access the report." target="_blank"><img src="/Topics/Special-Features/PublishingImages/2021/0721/Top30SNFs.jpg" alt="Top 30 SNFs" style="margin&#58;5px;width&#58;165px;height&#58;165px;" /></a><br></p><p style="text-align&#58;center;"><span class="ms-rteThemeForeColor-5-0"><strong><span class="ms-rteThemeForeColor-5-4">Sponsored by&#58; </span><a href="http&#58;//matrixcare.com/" target="_blank"><img src="/SiteCollectionImages/logos/MatrixCare.png" alt="" style="margin&#58;5px;width&#58;161px;height&#58;60px;" /></a></strong></span><br></p>2021-07-01T04:00:00Z<img alt="" src="/Topics/Special-Features/PublishingImages/2021/0721/Top30SNFs.jpg" style="BORDER&#58;0px solid;" />ManagementPatrick Connole​‘There has to be a return on investment; providers have to see how things like reduced readmissions factor into lower costs.’
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.