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Success of SNF-at-Home Will Hinge on the Quality of the Data

As with so many other things in our society, the COVID pandemic has impacted the senior care industry and prompted changes that had only been vaguely considered previously. We all know the stats. An article earlier this year in the New York Times cited more than 181,000 deaths of residents and employees at SNFs. That number is now well above 200,000.

In addition to the deaths, families and other loved ones of senior care residents pulled their relatives out of SNF facilities. The combined result has been a devastating drop in SNF census of 11% nationally.

There is relief coming to the industry, but senior care and LTACFs will have to evolve.

And the evolution to SNF-at-home will be much easier and will have fewer hiccoughs if they collect good data and pay attention to what it tells them.

Recent Developments on SNF-at-Home

SNF-at-home has been talked about for several years now. More seniors are citing their desire to “age in place.” The senior care industry has always been tentative about home services, concerned about CMS reimbursements that are frighteningly low.

In March of 2020, as the country reeled from the early pandemic numbers, CMS got religion when it announced its Hospitals without Walls program. The ruling allowed hospitals to provide patient services in settings other than in the physical boundaries of the hospital.

By the end of 2020, with no pandemic relief in sight, CMS announced Acute Hospital Care at Home, allowing hospitals more latitude to treat patients at home.

Early Results Positive for Heathcare at Home

Indeed, SNF-at-home was talked about before the pandemic. In a small study in 2019, only recently reported on by Home Health Care News, a new acronym was introduced to the industry: RAH, which stands for rehabilitation-at-home. Ten patients were assigned rehabilitation-at-home care in a random selection process.

David Levine, Director of Internal Medicine and Primary Care at Brigham and Women’s Hospital, said that patients saw an improvement to their functionality. Levine was one of the authors of the study.

Levine also revealed financial savings. The median cost of care for patients receiving RAH was $8,404, compared to $9,215 for the SNF residents.

Additional Studies Report Success

Ziegler, a Chicago-based specialty investment bank, released a report earlier this year. Their results were also positive, and the savings they observed were greater than the previously cited study (results of which may have been affected by the small sample size):

In Hospital at Home’s brief operating existence, the economic benefits and outcomes have been overwhelmingly positive. Early studies by Johns Hopkins Medicine show that Hospital at Home patients experience better clinical outcomes including lower mortality rates, lower use of sedative medication, and lower use of restraints. Patients and family members are left more satisfied, and less stress is put on the caregiver. On average, total costs have been shown to be between 19% and 30% lower than in traditional inpatient care due to lower lengths of stay, fewer lab and diagnostic tests, reduced emergency department visits, transitional care unit avoidance, fewer Medicare observation stays, and higher clinical quality.

The industry may be on to something here.

There Will be Wrinkles to Smooth Over

The Ziegler report does point out that the reports cited, as well as CMS’s recently announced programs, only refer to acute care situations.

The Hospital at Home model provides full hospital level care within a patient’s home

• In contrast to other home-based services, Hospital at Home care is largely acute and episodic versus longitudinal

The question is, will CMS extend this program to more specifically cover SNF residents and their needs. One has to think that this is an inevitability, given the successes in acute care, as well as a public and a patient base that is increasingly open to the concept.

McKinsey recently summed it up in a report released earlier this year:

Based on a survey of physicians who serve predominantly Medicare fee-for-service (FFS) and Medicare Advantage (MA) patients, we estimate that up to $265 billion worth of care services (representing up to 25 percent of the total cost of care) for Medicare FFS and MA beneficiaries could shift from traditional facilities to the home by 2025 without a reduction in quality or access.

The senior care industry needs to evolve in order to meet these needs. If there is one thing we know for sure, if SNFs don’t respond quickly to this developing market, other entrepreneurs in healthcare will develop services to answer those needs and address changing trends.

In the End It Will Come Down to the Data

Making sure that everyone is on the same page is one key to the success. It’s a matter of everyone reading the same book. But there are two types of datasets here. CMS will want to see savings, efficiencies, and patients receiving care.

The other dataset is for the SNFs providing care. As the Zeigler report states, “Care is provided by a full team of clinicians including physicians, Nurse Practitioners (NPs), skilled therapists, care coordinators and home health aides.”

With all those players, therein lies the potential for a lot of silos and a lot of systems not talking to each other. Data needs to be centrally gathered and interpreted to insure the best outcomes.

That’s Where CareWork Comes in

CareWork specializes in bringing together all the datacenters and presenting them in a format that is easy to understand and interpret. Regulators like CareWork because reports are quick and easy to understand. Leadership in senior living and post-acute care, SNFs in particular, like CareWork because the data helps them make smart decisions about staffing, patient care, growing census, and all of the other facets of a well-run operation.

CareWork’s software platform pulls together all the data silos in your operations, whether you are an SNF, long-term care, or senior housing. CareWork provides leadership and management teams the ability to see vital information and make the best decisions.

Interested? Call us today or visit our website.

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