Nursing homes must manage against stigmas; diversify community presence
It can be really unfortunate – that is the stigma associated with nursing homes – that began 50 years ago and in the minds of many lingers into 2014. Many of these facilities operate in a cash negative position with the national average for nightly care as low as $195.00 in some locations, $287.00 or so in long-term beds in some parts of Michigan. Even the latter amount is hard to consider as progressive considering the level of care so many patients need.
Of course nursing home chains and independent operators have to take some responsibility given the slow and non-helpful approach to marketing. The message sent has been one pointing more to convalescence than what the skilled nursing home environment really can be, long-term and short-term. Millions have benefited from focused rehabilitative regimens while others have been able to expedite recuperation from injury, both auto, work related and home related.
The “Minute Clinic” is both smart and easily marketable as part of a drugstore chain
You do have to be strategic to communicate what we call the sub-business that may operate in an existing business that may not be as well-known. This is especially important if the business model such as a nursing home has for decades been associated with negative feedback. Perhaps a good example are the Minute Clinics located within CVS Pharmacies. Many believe these are wonderful ideas and will more than replace any revenue loss from getting rid of cigarette sales but it does more.
It provides another incentive for people to come into the store – yes non-smokers – including parents with children for flu shots or to check on a fever as that same child insists on getting a new toy off the drug-store shelf. Let’s face it, who says no to a sick child? The parent is the most vulnerable during these periods. Its what we often call “umbrella marketing” in the care business where we wrap services together or place as much as we can under one roof in order to create a real “one-stop shop” experience.
Adult day care is being effectively used to accomplish the same things for the skilled nursing center. Once the center becomes known as more than a place for rehab after a hospitalization or a long-term bed for someone whose family cannot or will not care for them, new horizons crop up. In addition to that the very building becomes a beacon of quality care in the community.
True, revenue does follow. This is especially important when the center operates an Adult day HEALTH model which means the day care is a medical model program. Complete with a clinic that focuses on geriatric and physical medicine so it appeals to the elderly and those with the 
vulnerabilities of catastrophic injury, the reach will be wide. Some areas such as the U.S. State of Georgia have outstanding medical model protocol on the books and the average reimbursement for adult day participation is $1322.00 per month which would not include the separately billed rehabilitative items. When the program doubles as a CORF (Comprehensive Outpatient Rehabilitative Facility) its impact upon the lives and healing of many can be incredibly effective since the services of nurses, physicians, medical social workers and others can be billed and people legitimately benefit.
When conservatively rounding up the revenue to $1750.00 per month considering the number of services a person can benefit from over and above their adult day health attendance, its no secret that 75 people per day adds a gross monthly revenue to the corporation of $131,250.00 or $1,575,000.00 annually. More importantly a patient and their family continues to be drawn to your facility for all long-term care needs. When a sudden illness or injury requires convalescence, the first facility on that family’s radar is the one this patient is already accustomed to. Yours.
With the business and clinical end of things already in place, blending a related service is not insurmountable
Since a nursing home already has the business mechanism in place for handling a patient’s pharmacy needs, transportation for any required day-time specialty visits, billing and more, the development of an adult day health center within the existing or in an adjacent property can be assimilated without significant hassle. Add physician care in an established clinic and those preventative items including shots for flu, pneumonia and shingles and suddenly the Costco of care is created.
In some cases, the nursing home contracts with established adult day health operators to run the program for them. They contractually work out ways to develop a landlord/clinical advisor relationship which can work well.
There is the political side. Many in the adult day care community believe it should not be allowable for an assisted living or skilled nursing center to have an adult day care center on their premises, especially without having to obtain a separate adult day license. This has raged in Florida for several years. Current providers cite a competitive advantage. Others are OK with it as long as services are only available to existing residents or patients and their services are not marketed to or available to the public.
Regulators have been sort of in the middle in many locations concluding that an assisted living or skilled nursing license contains ample requirements for corporate governance and regulatory oversight making the issuance of another license a work of redundancy. This debate will likely take on many forms and perpetuate for years to come.
In the meantime those in the skilled nursing and adult day care arena who have an interest in learning the dynamics associated with a blended existence can attend the webinar scheduled for this subject on December 16, 2014 entitled, “Ethically Blending Adult Day Health into the Skilled Nursing Environment.” The manual and recorded event available December 17, 2014 at midnight. (The titles link to the applicable registration and product purchase pages)
Co-existence need not be a threat. And when it is properly pursued and managed, you will own your neighborhood and growth will be the fruitage of smart strategy.
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