It is well known that in the world of assisted living, uncompensated care costs communities tens of thousands of dollars in lost revenue each month.
Here is what happens
On move-in a resident is assessed for level of care and a service package is developed and included in the payment agreement.
It is well known that in the world of assisted living, uncompensated care costs communities tens of thousands of dollars in lost revenue each month.
Here is what happens
On move-in a resident is assessed for level of care and a service package is developed and included in the payment agreement.
Often this initial assessment is, at best, an educated guess and because everyone wants to make sure the move-in happens, there is a tendency to underestimate amount of care needed. Further compounding the problem is that as residents age, it is inevitable that over time the residents needs will increase. In an effort to stay on top of the problem, most communities use some form of a primitive paper and pencil approach that relies on a combination of care givers making estimated guesses as to the amount of time spent and the interventions delivered and a care supervisor, often a nurse, doing periodic assessments. It is well known that care givers and nurses when doing “eyeball reassessments” tend to significantly underestimate the amount of care being provided. The final problem is that because these reassessments are based on guestimates rather than hard data, families and residents will challenge attempts to increase charges.
CareTime Analytics
A few weeks ago while doing some research for Vigil Health Solutions Emergency Call Systems I came across the website for CareTime Analytics. There website was so terrible that I was intrigued enough to dig deeper (go look, you will see). I received a quick return email from the owner Doug Baynham which led to a phone conversation. I was blown away by his brilliant, simple and elegant solution to the uncompensated care problem. Here is how it works:
- Doug goes into an assisted living building and puts a barcode at the door of each resident’s room.
- He then gives each care provider an Apple iTouch that has a specially developed application that allows caregivers to easily track how much time they spend on each resident and what those cares are.
- Each time a care giver enters a resident room to provide assistance, they scan the bar code on the resident’s room, then when they leave the room they scan out and choose one or more of a dozen or so possible care activities.
- The application is designed so that if care is provided away from the resident’s room that information can also be captured.
- CareTime does this survey over a period of 30 days at the end of which, they have around 10,000 lines of data. The data is then analized and compared with the actual resident care plans. The final step is to make recommendations as to where the community might make adjustments to the care plan and charges, more accurately reflecting the care being provided.
As a rule of thumb they typically find about 25% of the care being provided is uncompensated. That represents a lot of money. It can make the difference between being able to provide a good program and a spectacular program for residents. On Thursday I will provide a case study for on fairly typical building that took advantage of CareTime Analytics.
If you like this story it would be a great honor to me if you would subscribe to our email list. Steve Moran
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Finally: If you know anyone who is looking at emergency call systems I would appreciate the opportunity to talk with them about Vigil Health Solutions.
From LinkedIn Groups
Group: Senior Assisted Living Sales, Marketing & Operations
Discussion: Solving the Uncompensated Care Problem
Very interesting… Are you seeing that more assisted living homes are going to a flat rate instead of having “levels” so they aren’t missing out on this financial problem?
Posted by Becky (Reenders) Gibbs
From LinkedIn Groups
Group: Caring for Arizona Seniors
Discussion: Solving the Uncompensated Care Problem
I wonder if the system you described could be tweaked to analyze skilled nursing residents, and provide hard data when discussing appropriately leveled compensation with case managers…hmmm.
Posted by Louise Johnson, MBA, LNHA
From LinkedIn Groups
Group: Boomers: Aging Beats The Alternative
Discussion: Solving the Uncompensated Care Problem
Sounds like a good idea. But, the deeper problem is that care needs change frequently and families balk at paying more money.
Posted by Lorie Eber
In the middle of this problem right now. The building was opened without levels of care and I’m now trying to install such a system. The Admission Agreement allows for extra charges, but it’s somewhat nebulous. I just did a quick paper and pencil version of what was done.
Let’s see how much resistance to price increases I will face.
I’d like to see how other places are setting this up. I’ve been researching for a few months and am finding little consensus. There’s only so far we can raise rates as an industry before people really look hard for other options.
@Becky–are you finding that places are just raising their base rates to compensate?
Hi Mary
I will publish an actual case study on how this worked for one community and how they addressed the issue of talking with families about the increases. I hope it will help you a bit.
Steve
Thanks.
Mary
From LinkedIn Groups
Group: Executives in Long Term Care
Discussion: Solving the Uncompensated Care Problem
Medicaid Pending residents kill your bottom line with write offs. As an Executive Director you have to start the Medicaid application process from the start before admission to your facility. You cannot trust the information the hospital DC Planners send you. If Obama makes us take these residents NF/SNF will not be able to survive.
What is the solution to care for the very poor in our society. If we could only get more people working.
Posted by John DeLuca
From LinkedIn Groups
Group: Executives in Long Term Care
Discussion: Solving the Uncompensated Care Problem
From an Accounts Receivable perspective, the SNF can take a proactive approach to the Medicaid pending issue from the point of inquiry forward. Our staff at Richter Healthcare Consultants provides Admissions-Best Practices training via webinar all across the U.S. Perhaps you have attended one of our complimentary webinars this past year. If so, you learned that every Medicaid pending resident represents $4000-5000 per month of revenue that is not yet collected. We have some sample scripts that can be used by the Admissions/Social Service staff during the inquiry and admissions process to address the subject of payment and Medicaid application process. It is vital that the facility become a resource broker and HELP the resident/family to get information, complete the application, provide the evidenciary documents and follow up with any appointments to review the application with a caseworker. The facility can easily provide information via a website, bulletin board, resource materials in the admission packet, family night, newsletter, etc. CMS has materials already available that can be easily downloaded and used in all states. The Medicaid Caseworker or area social workers can offer a quarterly presentation, “Thinking about applying for Medicaid” that will offer families an opportunity to learn more before the time comes. Put a note in your newsletter and on your private statements to residents/families with a message, “Need information about Medicaid? We’re here to help. See Kathy in the Business Office or call XXX-XXXX. Or See Kathy in Social Services. We’ll walk you through the process. Don’t wait until private pay residents just stop paying their bill and then are several months in arrears before you learn that they want to apply for MCD and perhaps don’t have all of the info, the correct application, the evidenciary documents, etc. Help them. It is an investment in your facility well being. Need info on the scripts that I mentioned above? Email me at [email protected] and I will send them to you free of charge.
Posted by Carolyn Lookabill
Does Carolyn have another e-mail address so that I could contact her. The posted address would not connect. Thanks