Spotting and Stopping Revenue Leaks in Your Assisted Living Community

Running an assisted living community is not for the faint of heart: your services include hospitality, entertainment, and medical care. Like the USPS, you aren’t stopped by snow or rain or heat – but you also work Sundays.

One of the top challenges executive directors face while juggling all this is keeping costs under control so that residents can receive appropriate care and staff can receive appropriate compensation for a reasonable cost. Historically, revenue leaks were often discovered by accident – or not at all. Today, you can be more deliberate about finding savings opportunities, thanks to the tools available in EHR systems.

Here’s an overview of four common revenue leaks that plague assisted living communities and how you can leverage your electronic health records system to pinpoint and eliminate the problems.

Revenue Leak 1: Staff Turnover

The cost of turnover is a big headache for healthcare administrators, with as many as 65 percent of CNAs reporting that they’re constantly on the lookout for other job opportunities.

We’ve written before about how adopting an EHR can help reduce staff turnover, so we won’t go into the specifics here, but the big takeaway is this: employees increasingly consider technology an important factor in workplace experience and cite lack of sufficient technology as a reason for workplace burnout.

An EHR system can address these problems in multiple ways:

• Directly, EHRs tend to improve the workplace experience of CNAs and other frontline staff, offering them efficient, modern ways to chart.
• Indirectly, an EHR can reduce overall time spent documenting work, which can help prevent burnout.
• Data gathered from an EHR can help you identify common turnover triggers, if they exist, which lets you proactively address them.

Revenue Leak 2: Inefficient Patient Care Documentation / Charting

Paper charting is inefficient and (more importantly) often inaccurate. A simple charting mistake like failure to document medication can lead to mistakes (like medicating a resident twice) that can cause serious resident harm and trigger costly malpractice claims against your community.

An EHR system solves many of the paper-related charting problems that can cause revenue leaks, thanks to features such as…

• Automated date-and-time recording for every entry.
• Use of typeface rather than handwriting, which prevents later attempts to decipher illegible writing.
• Consistent, uniform documentation among staff.
• Unalterable entries.

Of course, no system is perfect and some introduce as many problems as they solve. If your community is considering adopting an EHR system, make sure it offers the following:

• Ability to enter data from mobile devices, so staff can easily chart on the go, between rooms.
• Full cloud storage, with the ability to work offline, so staff can chart even with spotty WiFi.
• Charting options tailored for an assisted living or memory care facility so your staff doesn’t have to click through dozens of unnecessary screens.
• Automated reporting capabilities so that you receive regular status reports as well as automated notifications whenever certain events are documented.
• Adequate training and customer support to ensure your staff gets the assistance it needs to learn and apply the EHR system efficiently.

Revenue Leak 3: Unnecessary Hospital Admissions and Readmissions

Research suggests that as many as 75 percent of hospital readmissions are preventable. That matters to assisted living communities because readmissions (and admissions) can have a profound impact on revenue: for elderly patients, hospital admissions correlate with increased cognitive problems. That means increased care needs when they return to your community, or, in severe cases, a need to move on to an elevated care level.

This isn’t just hypothetical, either: declining resident health is the leading cause of turnover, and is now the cause of 92 percent of turnover. That’s up from 72 percent in 2001. Given that the average stay at an assisted living facility fell from 36 months in 2001 to 22 months in 2010, it’s clear that keeping patients medially healthy is crucial to the financial health of communities.

EHR systems can help achieve this in several ways:

1. Highlight changes in care requested or administered. Often, an increased need for assistance in ADLs is the first sign that a resident may need to be moved to another level of care. Whether that need stems from a temporary condition like an infection or a chronic one like progressing dementia, digital charts show it more clearly than paper charts can. In fact, most EHRs allow you to set up automatic alerts for various events – like when a resident repeatedly requests additional care from a CNA. When changes in condition are this easy to spot, you can address them before they become problematic.
2. Identify trends around incidents that lead to hospitalization. Imagine, for example, that resident falls are triggering hospital visits. Without an EHR, this might not raise eyebrows. But with an EHR, you may notice that the falls are all happening in a similar location. That can trigger an inspection, which could reveal a tripping hazard or insufficient lighting. You’re then able to resolve the problem and prevent additional hospitalizations.
3. Streamline communication following a hospitalization. Remembering that 75 percent of re-hospitalizations are preventable, the EHR becomes a powerful tool for aiding in that prevention. By standardizing charting, the EHR helps streamline communication among staff shifts and between staff and leadership. It helps ensure a new care plan is executed appropriately and can trigger alerts if a resident’s condition changes for the worse.

Revenue Leak 4: Improper Level of Care Classification

We mentioned above some of the benefits of digitized charting. The natural culmination of improved charting is the ability to identify changes in a resident’s needs or demands sooner than would otherwise be possible. So if a resident asks a CNA to help her bathe three times in a week when her care plan only calls for one day of assistance, it’s highly visible with the EHR’s interface.

This can help avoid two types of revenue leaks: first, when a CNA provides care that isn’t in a resident’s care plan, the community is losing out on revenue. Further, the CNA providing that care may end up overworked because she’s doing more than her schedule dictates. That could lead to overwork, burnout, and turnover, as well as care mistakes with other residents.

The second revenue leak that can be stopped by easily visible chart data is preventable hospitalizations. Let’s say a resident asks for additional assistance but the CNA doesn’t provide it because it’s not in the care plan. If the resident actually needs additional assistance but doesn’t get it, they’re at increased risk of a fall or other incident that could lead to a hospitalization – obviously not a desirable outcome for anyone.

Having a way to easily translate data into visual trends can be transformative for residents, caregivers, and the community as a whole.

Realizing Cost Savings with an EHR

Thee ability of EHRs to capture large swaths of data and present it visually translates to greater overall visibility into the wellbeing of individual residents and your overall community. If you’re wondering how long it will take your community to see a positive ROI from adopting an EHR system, get in touch with us. We’d love to chat.