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? Access to services that impact functional wellness is paramount – so paramount that it could result in 14 percent fewer hospitalizations and a subsequent increased length of stay in your community.

Hospitalizations are a problem in senior living. Most residents who leave senior living (63.9 percent) are hospitalized or move to a nursing home, rehabilitation facility, 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 percent of older adults leave senior living for financial reasons—and rising healthcare costs are a factor.

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 within the walls of your community.

HOW CAN OUTPATIENT REHABILITATION BE PROVIDED?

Medicare Part B, the insurance that pays for outpatient services, covers physical, occupational, and speech therapy services in older adults’ homes. Services are the same as those delivered in outpatient clinics—and produce identical, if not better outcomes. This is commonly confused with home health services, which are covered by Medicare Part A. These services are also provided in the home but require homebound status.

WHY IS THE DISTINCTION BETWEEN MEDICARE PART A AND PART B 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 health care. This third-party analysis of data was staggering. Looking at 2,886 senior living residents who received Medicare Part B therapy services at home*, this group was found to have 14 percent fewer hospital admissions than the comparison group of senior living residents reported on by Argentum’s “Senior Living Resident Profile.”

FOX also looked at senior living residents exposed to its concierge wellness program and found a 35-percent decrease in hospital admissions over 12 months of program exposure. These outcomes support the need for innovative wellness programming and, at a minimum, 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, 99, for example, who moved into senior living. He had multiple chronic conditions, a history of falls, and was limited to his wheelchair for mobility. Now at 102, 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 older adults and their grown children are demanding personalized, high-quality services and amenities. According to Senior Living Executive, 12 percent 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. Today, more than ever before, it is clear 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 5 percent beneficiary sample that is contained in CMS’s SAF Carrier file.