Skilled Nursing: Who Are Your Partners?

The more things change, the more they stay the same . . . .

This series on skilled nursing partnerships is based on a speech by Scott Middleton, the founder and CEO of Agape Senior, based in South Carolina. He has a deep commitment to the idea that when senior living communities partner with other community organizations, they end up doing a better job of serving residents and the marketplace community; and they provide an improved bottom line for the senior living organization. – Steve Moran

Setting The Stage

1982  8:30 AM Rural South Carolina. I arrive at the nursing home. I push open the door to a sea of old people lined up and down the hall, sitting in wheel chairs, leaning on walkers, slumped over, some asleep, others talking to themselves. As I walk, they start grabbing me, pulling at my coat and yelling, “Help me, help me.” I was 25 years old and the day before I had performed my first worship service as a new minister. After the service a woman had handed me a list of names and told me that these people are in a nursing home, and to please go and see them.

I struggle past the elderly screaming for help and look for someone to direct me to my parishioners. I found out later that the residents were lined up because it was “Doctor’s Day.” Every Monday the doctor on call would make rounds and would go down the hall with a nurse, patient after patient. The nurse would tell him what the patient’s issues were and suggest medications. Then the physician would write prescriptions. When the residents saw me they weren’t asking for my help as a minister – they thought I was the doctor, they were in pain, and that’s why they were screaming for me to help them.

The World Has Changed

The problem is that although our patient population has changed radically in the past 20-30 years, our model of care hasn’t.  Twenty years ago 90 percent of our patients lived three to five years in our nursing homes. Today the average length of stay (ALOS) for long-term care (LTC) patients is 12 months. Twenty years ago less than 10 percent of our population was receiving Medicare Part A rehab services. Today 50 percent of our patients are on short-term Medicare. Twenty years ago the average hospitalization was seven to ten days, they were seen by a physician daily, and the patients came to the nursing home in somewhat stabilized condition. Today the average hospitalization is 3.5 days. The patients are admitted to a skilled nursing community in unstable condition, and they are only seen once or twice a week. Essentially we are still doing “Doctor’s Day”!  

Better Ways

There is a better way and you’re going to discover what that is. You’re going to learn an elegantly simple and easy way for your skilled nursing communities to achieve more prosperity than ever before while effectively preparing for the coming changes. The secret is engaging in five strategic partnerships – partnerships that will empower you to decrease your hospitalizations, Medicare length of stay, pharmacy and staffing costs while enhancing your census, referrals, reputation, and the quality of the care and services you deliver. Let me share an experience that will give you a glimpse of the future and what these partnerships will enable you to achieve.