Some things you might not (or might) know about rebuilding census in long-term care

Updated: Jan 31


Regardless of where you fall in the spectrum of long-term & post-acute care—a skilled nursing facility, a memory care unit, or assisted living —the last two years have been rough in terms of maintaining census. Covid has been devastating, and it has reduced many operators down to razor-thin margins.


But there are some techniques out there for rebuilding census.


First, Keep an Eye on Census


Check your census daily. Set measurable census targets and look at attainment daily. Most EHRs will track your census automatically. To make it really easy, you can pull the census information into an operational system to compare your actual vs. targeted census categories. Keeping an eye on where you are every day helps eliminate surprises and arms you with the knowledge you need to spot trends and make positive adjustments.


Is there a referral source that is especially prominent in sending you new residents? Most often, these are acute care hospitals. Other sources can be in-home caretakers, relatives of a patient already at one of your facilities, or maybe even religious clergy.


When you discover a referral source, take the time to follow up. Call and thank them. A gift card to a local coffee shop, a restaurant, or even Amazon works wonders. Take a few minutes to find out why they referred your facility. You never know what you will find out.


Do you have a high-performing admissions officer? Obviously, they have discovered the secret sauce. Talk to them and find out. Maybe it is a secret worth sharing with the rest of the staff.


Are admission visits more successful at certain times of the day? A person in upper management told me that she dug deep and found a distinct correlation between successful admissions visits and the presence of a recreation therapist her facility had on contract for once-a-week visits. This therapist would engage the residents in bouncing balls or playing with foam noodles, with music playing in the background all the while. She often danced with residents. The manager was tipped off that if a family visit came in during that time and witnessed the smiles of residents, it almost always closed the deal.


"I doubled her contract," the manager told me. "She's now coming twice a week, and my staff has instructions to make sure that family visits are conducted in whatever building she is in. Our census growth rate spiked in that facility. She is the best sales tool I've ever had! She's well worth the investment."


Engage Your Staff


Your staff is another sales tool. Make sure they know that you are all in this together.


Be a coach. Stress the importance of bright, cheery smiles and warm greetings. It's clear when family visits are happening in the building. Emphasize the importance of them greeting you and greeting the families. Even a few words will reassure them as they struggle with what we all know is a difficult decision.


Reward those who go the extra mile. Did a nurse or caretaker go out of their way to help a patient or reassure their family? Again, those gift cards work wonders. Also, make sure at your staff meetings that you tell those stories. What one staff member did as an incredible act of kindness could serve as an example for everyone else.


Look at Your Facility as an Outsider


First impressions matter. Is the main entrance to your facility warm and cheery? Make sure it is; potted plants, flowers, even a welcome sign. Remember, the family members are stressed. This is a tough decision for them. Even if they don't recognize it, they will appreciate the comfort of padded chairs and fresh cookies.


The most important person in your facility. The person at the front desk sets the tone. They are the first impression. They answer the phone and greet people when they come in the first time. And if they do their job well, they welcome those same people when they come back to visit their loved ones. A lot of care needs to go into selecting this person —stress how important their job is.


Make regular inspections. It's the little things that count; loose doorknobs, a cracked window, a non-functioning doorbell to the memory care building. These are all things that people notice. Another tip: Use soft yellow lighting where possible. Harsh fluorescent lights are tough on the eyes and look institutional. Are you considering repainting? Think soft colors.


Call into your facility from the outside. See how the phone is answered. How quickly is it picked up? Do you have to wait on hold forever? What is the manner of the person answering? If you have done your job in staff training, you should be pleasantly pleased.


The Value of Networking


Word of mouth is always the best form of advertising. Encourage your facility managers to join a local service group—Kiwanis, Rotary, Chamber of Commerce. These groups tend to be leaders and influencers in the community. They have lots of connections, and people listen to them.


Start a self-help group for caregivers. Especially if their loved one is still at home, family members are under a great deal of stress and dealing with a boatload of guilt and grief. If you have a social worker on staff, encourage them to start a weekly group for caregivers. It is a source of support for them, and once again, a way for you to get your facility noticed.


Watch Your Five-Star Rating


We could do an entire column on the five-star rating from Medicare, but suffice it to say that it affects everything. From how much you get paid and how many referrals you get to how much you can borrow against your facilities and your ability to attract investors.


Census is an Ongoing Effort


Covid has hit long-term care facilities hard. You will not recover overnight, in a week, or a month. Rebuilding census is a constant, never-ending process requiring your facility always to wear its best face. It is a multi-pronged effort, and it never ends.


Also, Watch the Numbers


The power of data analytics is no joke. Long-term and post-acute care leaders are talking about this more and more. Whether you manually track census performance in spreadsheets or take the next step to automate the process, it's important to have access to frequent census performance data so you can make the right choices based on real data and impact positive change in your census performance.


How can we help?


CareWork is an operational platform that brings together all of the information housed in the other systems you use. Instead of looking at your data categorically, one system at a time, and manually comparing it to company targets, CareWork gives you a single login to view holistic data in a 360-degree view. Whether you are a skilled nursing facility, assisted living, or CCRC, we give you an easy-to-use single source of truth for the health of your operations.


Ready to make care work easier? Contact us today.


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