Silverado is perhaps the most visible memory care provider in the country. They have been aggressively working to track and reduce hospital readmissions essentially since the beginning of the company but not for the reasons you might think. . .

Silverado is perhaps the most visible memory care provider in the country.  They have been aggressively working to track and reduce hospital readmissions essentially since the beginning of the company but not for the reasons you might think. . . In a few weeks the first ever National Readmission Prevention Collaborative Summit will take place in Anaheim, California, and Loren Shook, CEO of Silverado, will be one of the presenters (along with yours truly).  We will both be focusing on the largely untapped role assisted living can play (or in the case of Silverado does play) in reducing hospital readmissions.

Quality of Life is Paramount

In preparation for the summit I arranged a call with Loren to understand what Silverado is currently doing in the arena of preventing hospital readmissions.  Here is what he had to say:

  • Silverado’s goal is to prevent both emergency room visits and hospital readmissions.
  • The reason Silverado has been so deliberate about preventing all types of hospital transfers has nothing to do with Silverado’s bottom line or even ingratiating  their communities with hospitals or medical groups.  It is all about creating the best possible outcomes for residents.
  • There are two areas that have particularly helped Silverado reduce transfers to hospitals.

The first is that they have 24/7 licensed nurses in each building.  This means they have, immediately available, the technical expertise to evaluate a resident who experiences a change in condition and accurately communicate what is going on with that resident to the community physician.  It also means they are in a position to administer medications if needed.

The second is that they have a medical director for each senior community who is available for a phone consult.  This means that the nurse has an M.D. resource she can reach who can change or prescribe medications or other treatments.

  • Silverado has a physician model that is more commonly seen in a skilled nursing community than an assisted living community.  This means that just a handful of physicians see all of the residents in the community.  This has several advantages, the first being that there are physicians, physician assistants or nurse practitioners in their community several times each week.  It also means that those medical professionals have a better understanding of the kinds of interventions the Silverado communities can provide and they have a trust relationship with the Silverado nurses.
  • Consistent with doing what is best for residents is creating a environment that reduces the use of behavior modification to a bare minimum, last resort philosophy.  This means fewer medication-related problems, which means a further reduction in hospital visits.

The bottom line for Silverado is doing what is best for residents and, in doing what is best for residents, they are seeing tiny readmission numbers, with most Silverado communities having a 30 day readmission rate of under 3%.

You Can Do It Too

Ultimately, reducing transfers to the hospital or urgent care is the right thing to do for your residents and, just coincidentally,  smart business.  It increases average lengths of stays, it creates a compelling case for hospitals to refer residents to you and it makes families happier. If you are already cracking this problem it would be great to have you at the Readmission Prevention Summit to share your story.  If you are looking at how to take advantage of this opportunity the summit is a great opportunity. Steve Moran

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