As a publisher, writer and speaker I am a conference junkie.  They are places to find new readers, meet current readers and interact with sponsoring partners and potential partners. Finally they are a fountain of ideas for new articles.

Right now I attend 10-15 conferences each year. Two of my favorites are the Marcus Evans Long Term Care CXO summits that take place in Florida in July (haven’t quite figured out the Florida in July thing) and Las Vegas in January. These two events are my favorites because I get a chance to have meaningful interactions with industry leaders on both the senior living operator side and vendor side.

9 Partnerships

One of the most intriguing presentations at the Florida event was by Scott Middleton, the CEO of Agape Senior Living, a North Carolina provider. His proposition is that if every assisted living provider (though many of these would also apply to skilled nursing) had nine essential partnerships, they would have fuller buildings, happier residents and families, more satisfied staff and make more money.

9 Partnerships
Introduction – This Article
1 – Therapy / Home Health
2 – Physician Group
3 – Skilled Nursing Facilities
4 – Pharmacy
5 – Home Care Companies
6 – A Real Estate Company
7 – DME & Ambulance Companies
8 – Hospice
9 – A Coach

I asked Scott if he would allow me to turn his speaking notes into a series of articles and he gladly agreed.  Here is his story.

I sat down on a Saturday morning in 2012 and I started reviewing our books and I thought, “This is horrible!” 

I was looking at an 80-bed assisted living community that I bought, renovated and added on to then reopened 3 years prior and my census was still only 53.

I had to increase my census in order to get permanent financing and I wasn’t on track to make that happen. Over the years we’d built new communities, renovated some and always filled them up within the first three years. Out of our 14 communities we’d never had a problem like this.

I started to realize I could lose everything. If I couldn’t fill this facility I might not be able to refinance when its loan came due.

I gathered my key leadership team to determine why we still had such a low census.  The first thing we did was to look at our marketing team. It seemed likely they simply were just not bringing in enough people.

So we looked look at how many move-ins we’d had in that community, month-by-month for the entire 3 years. What we discovered was that we had more move-ins in that community than all our other buildings. In reality this marketing team was the most successful in our company!

Marketing was not our problem

Our next thought was that a lot of people must be moving out so maybe there was something wrong with our customer service and we had a management problem.

We reviewed all the move-outs for the past year and found that all our residents were staying in our facilities and dying there. We also reviewed our customer satisfaction surveys and saw that our residents were happy with the community, services and care.

That wasn’t our problem

Next someone pointed out that people in the market area had lower incomes than other market areas where our communities were located so they suggested that people must be putting off moving into this community for financial reasons and were admitted in poor health.

We reviewed the levels of care for people on admission and could see that the residents in the community did not have higher care needs.

We were stumped

When I started Agape Senior I believed that if we had a great sales and marketing team, great facilities and provided great care, we would maintain high occupancy and be successful.

We looked at all the usual suspects: management, marketing, customer service and care, but the problem wasn’t there.

The problem turned out to be hiding in plain sight

We did a comparison of the average length of stay for each of our communities and found it to be 20 months. 

We even found one community that had an average length of stay (ALOS) of 26 months. The problem was now obvious. Now the truth became clear – my problem facility had the lowest ALOS – it was only 12 months! That meant that the residents in that building were not living as long as they did in our other facilities!

Through further investigation, coaching with my staff and trial and error, we discovered not only how to fill that facility, but a simple, and powerful, way to sustain census that wasn’t related to marketing, sales or customer satisfaction.

What we discovered was that lasting success in this industry lies in increasing resident longevity.

And when we started increasing our resident’s longevity consistently that empowered us to dramatically boost our census, rates and revenue without any substantial investment or expenditures at all.

The strategy for increasing residents’ longevity (and possibly yours too) can be summed up in one word – Partnerships.

We discovered that by engaging in partnerships with other healthcare providers and  holding them accountable for the care and services of your residents you can improve and extend their lives (even doubling their length of stay); significantly enhance your profitability; and increase your attractiveness to your customers and accountable care and managed care organizations.

Scott Middleton