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Weighing the Benefits of a High-Acuity Strategy for Post-Acute Care Operators


With fewer hospital referrals coming in and a sicker patient population post-COVID-19, some operators are finding ways to stand out. The ability to accept more referrals for high-acuity patients and the competencies to treat them while keeping readmissions to a minimum is becoming essential for operators to remain competitive.


Creating specialized programs in big need areas like respiratory and cardiac, bringing in medical experts, and aligning with local specialists and hospitals are just a few ways Skilled Nursing Facilities are attempting to change their identities and prove they can take on higher-acuity patients.


The trend in the acuity of the patient population is rising. While much of the data on increasing patient acuity makes sense as a byproduct of the pandemic, more should be looked at to ensure SNFs prepare for potential hurdles.

In a recent study completed by PointRight, they analyzed the changes in rate driver percentages year over year within their SNF customer base from the fourth quarter of 2019 (pre-PDPM and pre-pandemic) and the fourth quarter of 2020 (post-PDPM and post-pandemic).

These were the results:

  • Extensive services (which includes isolation, trachs, and vents) increased nearly 5x – (2.2% to 10.2%)

  • Depression increased over 2x – (4.9% to 11.3%)

  • Cognitive Impairment increased 4x – (13.0% to 52.2%)

  • Restorative Nursing increased almost 2x – (1.6% to 2.6%)

  • Swallowing Disorders increased almost 4x – (4.7% to 17.4%)

The data is clear, but for many operators accepting higher-acuity patients poses challenges.

  • Staffing Considerations: We all know the industry is facing significant staffing challenges. Beyond the obvious, some nursing associates lack the training and confidence to care for higher-acuity residents, and sometimes facilities do not have access to specialists based on their location.

  • Cost of Care: Equipment and care requirements can sometimes be so expensive that the reimbursement doesn't cover the cost for the SNF.

  • Compliance Concerns: Higher-acuity residents have the potential to increase hospitalizations, which could impact value-based purchasing and penalties.

So how can SNF's work through these challenges?

  • Partner with local hospitals

  • Foster physician-led relationships for additional referral sources

  • Establish appropriate clinical protocols for at-risk residents

  • Focus on accurate reimbursement

Here are some technology-based solutions that can help SNFs manage complex care requirements:


o Telemedicine: Giving direct care teams access to specialists can increase confidence to manage higher-acuity residents effectively. Residents and nurses report a higher level of satisfaction when the resident can be immediately seen and treated.


o Contact-Free Monitoring: Treating higher-acuity patients can be done more efficiently and at a lower risk with remote monitoring solutions. Continuous monitoring gives facilities the tools to provide advanced clinical attention and efficiently extends their existing labor resources across more complex patients.


o Learning Management System: Adding specialties for both direct and agency staff could require additional training and certifications. Giving teams access to an LMS not only gives direct care staff access to certifications that are free to them but allows leadership teams to track progress centrally.


o MDS Scrubber: Implementing an MDS scrubber helps take the human error out of reimbursement. Some benefits include improved quality measures, more accurate reimbursement, more individualized care planning, and compliance checking.


o Operational Systems: Leaders need quick and easy access to things like quality and reimbursement metrics and a holistic view of operations without duplicating work. An integrated operations platform allows operators to do more with fewer resources.


Post-Acute and Skilled Nursing facilities that adopt these practices can see an increase in revenue by accepting and caring for high-acuity residents. Alternate care facilities can no longer afford to be selective about their mix of residents; they need to work aggressively to admit every patient while managing the risks associated with higher- acuity patients.

So how can we help? CareWork gives teams automated tools to increase quality, control costs, track compliance, manage labor, reduce waste, and get jobs done faster. The best part is we integrate with the systems you already use and give providers a straightforward way to manage operations in one place strategically. We make care work easier.

Ready to operate efficiently? If so, contact us today.


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