Senior Living: Decreased Hospitalizations, Increased Length Of Stay, And You

By Dr. Allison Cohen, PT, DPT, and Dr. Will Dieter, PT, DPT, GCS, FSOAE

The World Health Organization, in the World Report of Ageing and Health, describes the maintenance of functional ability as the most important physical attribute for successful population aging. What does that mean for your residents? It means access to services that impact functional wellness is paramount. So paramount that it could result in 39% fewer hospitalizations, 44% shorter SNF stays and a subsequently increased length of stay in your community.

Hospitalizations are a problem in Senior Living. Most residents who leave Senior Living (63.9%) are hospitalized or move to a nursing home, rehabilitation or sub-acute facility. If hospitalized residents are functionally able to return, the cost of care endured in the hospital could leave them unable to afford the move. 16.8% of older adults leave Senior Living due to finances – and the rising cost of healthcare is a contributor.

As an operator, the silver lining is in your hands. You have the ability to directly impact the functional wellness of your residents by facilitating access to outpatient rehabilitation and wellness in the comfort of your community. How?

Medicare Part B – the insurance that pays for outpatient services – covers physical, occupational and speech therapy services in the home of older adults. Services are the same as those delivered in outpatient clinics – and produce identical, if not better outcomes. It is common to confuse this with Home Health Services, which are covered by Medicare Part A. These services are also provided in the home, but differ in frequency, duration, and functional impact.

Why is this distinction important?

Science shows that older adults require 12-16 weeks to improve strength, 50 hours of balance training to protect against falls and 150 minutes of moderate-intensity exercise per week to maintain aerobic fitness. Do your residents currently engage in this?

As a Geriatric House Calls practice, FOX Rehabilitation partnered with OptumLabs and Optum Advisory Services to analyze its data. OptumLabs is a CMS Qualified Entity that evaluates provider performance to enhance the quality of healthcare. This third party analysis of data was staggering – it looked at 10,145 Senior Living residents who received Medicare Part A or Part B therapy services at home.* The group that received Part B services were found to have 39% fewer hospital admissions and 44% shorter SNF stays. These outcomes support the need for access to outpatient therapy services in Senior Living communities.

“Therapy and wellness services have revolutionized our communities,” says Mike Allen, VP of Operations for Kaplan Development Group. “The impact is truly palpable. It is entirely evident that services facilitate aging in place and lengthen the stay of residents.” Take Julien, for example, who moved into Senior Living at 99 years old. He had multiple chronic conditions, a history of falls, and was limited to his wheelchair for mobility. Now, at 102 years old, Julien walks with his walker and is safe to leave the community to visit his family. He is thriving, aging in place, and a regular participant in exercise programs.

Today’s seniors and adult children are demanding personalized, high-quality services and amenities. According to Senior Living Executive, 12% of residents leave Senior Living “being displeased with the level of service.” Access to therapy and wellness onsite can improve both your customer’s perception of value and, more importantly, the functional wellness of residents. It is clear today, more than ever before, that engaging in high-quality programs will decrease hospital admissions, facilitate aging in place and increase length of stay.

*Based on Advisory Board and Optum Advisory Services analysis of CMS’s Standard Analytic files. Medicare FFS data only

Results are based on the 100% beneficiary sample that is contained in CMS’s SAF Carrier file.

REFERENCES

Avers D et al. Strength training for the older adult. Journal of Geriatric Physical Therapy 2009; 32(4):148-52, 158.

Sherrington C et al. Effective exercise for the prevention of falls: a systematic review and meta-analysis. Journal of the American Geriatrics Society 2008; 56(12): 2234 – 2243.

Garber CE et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine & Science in Sports & Exercise 2011; 43(7):1334-59.

World Health Organization. World Report on Health and Aging. WHO Press, 2015.

Philips, C et al. “U.S. Residents Leaving Senior Living: Descriptive and Analytic Results From a National Survey.” Department of Health and Human Services, 2000.

How does your senior living community stack up? https://www.argentum.org/news/how-does-your-senior-living-community-stack-up/, 8 September 2015.