CEOs: Staff correctly to avoid acuity-related issues

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The Colorado Convention Center beckons attendees of Argentum's Senior Living Executive Conference.
The Colorado Convention Center beckons attendees of Argentum's Senior Living Executive Conference.

Senior living operators who have defined their target populations and maintain that focus are more likely to avoid acuity creep challenges that can lead to trouble for their companies and make a bad name for the industry, said four CEOs who participated in a closing general session discussion at the Argentum 2016 Senior Living Executive Conference in Denver.

“This industry is made up of multiple levels of programs, philosophies and strategies, and that's what makes this industry strong, because it appeals to the consumers wherever they're coming from,” said Loren Shook, Silverado founder, president and CEO. Operators who accept or keep residents for whom they are not prepared to care are trying to maintain occupancy but ultimately end up driving people away, he added. “And they're giving a message to every other resident in that community, and they've giving a message to every staff [member] as to who they are,” said Shook, the new chairman of the Argentum Board of Directors. “That is a culture failure. ...And so we really need to be attentive to that. You'll do better by moving people along.”

Brenda Bacon, president and CEO of Brandywine Senior Living, said: “We've got to be clear on what we're doing and then provide the care. Those who don't … are probably responsible for 80% of the headlines.”

John A. Moore, CEO of Atria Senior Living, said that his company has a 700-question quality tool as well as a 12-member quality team that performs two rounds of audits a year at the communities. “That's let us keep the acuity level in our business at pretty much the same level,” he said, adding that the quality efforts are appreciated by families and help with sales.

Healthcare services

Being focused doesn't mean that senior living operators cannot stray from the hospitality model and offer medical care, the panelists said. But operators who want to go beyond the traditional model of assisted living — and not all will — must staff and equip their communities accordingly, they added.

Telehealth is one way that providers can offer more services to residents without adding full-time healthcare personnel, Shook said. Having a healthcare professional available for a consult at any time could reduce trips to the emergency department and help attract residents, he added.

Atria has created the Atria Park brand for residents who have higher-acuity needs, Moore said, and those communities are staffed to deliver that level of care.

Silverado, Shook said, wants to be a “trusted value partner” for health systems. The company, which employs healthcare personnel in its memory care communities, is a primary referral site for “revolving door” dementia cases, he said.

“We have a … 30-day readmission rate of less than 4% with those kind of cases. That's a huge value proposition,” Shook added. Also, the Medicaid program can realize savings of $2,000 to $3,000 per resident per month over a nursing home for such cases, he said.

Rehabilitation and hospice services are other areas where senior living providers can help the government realize savings — and residents see improved quality of life — if they are staffed and equipped appropriately, he said.

Standards, credentials

Argentum's community-level standards and executive director credentialing program will improve the industry, Moore said.

“Don't run from this professional standards issue, because it's coming,” Pat Mulloy, chairman and CEO of Elmcroft Senior Living, advised those attending the session. Mulloy said that he and others recently had the chance to meet with two attorneys general, “and the first thing they said was, ‘Thank you very much for taking the lead on this.' ”

“There are bad operators in every state in the United States. ...There's a time to argue with regulators, but most of the time it's to have a meaningful, thoughtful conversation and find common ground, and so we've got to self-regulate, self-police and not tolerate bad behavior,” he said.

Mulloy described Argentum's phase one standards as “basic stuff” and said “the rubber is going to meet the road as we debate the professional standards in phase two and continue this conversation over the course of the next year.” He encouraged Argentum members to participate in that discussion.

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