CCRC's, SNF's, and Elephants

I presented a keynote recently, at the Revenue Summit of the Maun-Lemke Group's clients, where I discussed the service-revenue imperative with a group of administrators from continuing care retirement communities (CCRC's) and skilled nursing facilites (SNF's) from across the US.  The presentation highlighted the need for this vital sector of the healthcare profession to start taking seriously, the provisions in the PPAAC bill related to CAHPS.

I stressed the importance of CAHPS as a lever to improve not only operations but also service and revenue, and gave a dozen or so cases where the administrators could act immediately (at little or no cost).  We discussed the reality of ACO's as an incentive to improve service quality, then moved on to the very real experiences of the hospital sector with HCAHPS.

I told the story of how HCAHPS evolved from 'something I'd read about once or twice' (where the mindset of most in the room sat), to the current reality of Value-Based Purchasing and the reductions in DRG reimbursements to every hospital.

"You think this isn't your future too?"

We then moved on to some practical tips on how to manage resident satisfaction proactively.  I'm sure that you know the answer to the old riddle about how to eat an elephant - one bite at a time.  Funny how the simple wisdom of childhood riddles can help us attack real-world problems sometimes - or at least get a perspective on them.

The 'eat an elephant' strategy can help a hospital, CCRC, or SNF improve HCAHPS or CAHPS scores:
  • using your survey vendor's data, find the highest volume unit

  • find scores by unit (if available)

  • develop an elasticity table in Excel (if not provided by your vendor)...if you improved the mean on (say) Unit1 by 1 point, what impact would it have on the entire hospital?

  • focus on the highest-volume units

  • get staff and leader input...which dimension of HCAHPS/CAHPS should we target first, that will give us the biggest payoff (eg: Communication re Meds, or Quiet at Night?)

  • which one does staff feel that they can most easily affect, based on their current training, resources, process improvements, and staffing levels?

  • what additional resources will be required, and can these be reasonably provided?

  • what are the likely root causes?

  • can the root causes be removed quickly and efficiently?

  • how sustainable will the outcomes be?

  • what type of interim measurement process can we bring to bear, to assure daily forward momentum?

  • are there any staffing issues that are affecting our current performance (eg chronic shortages, etc)

These are just some questions to challenge you to focus and act!


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