In 2018 Ascension Health Homes needed to make changes or close. The income covered expenses when all the beds were filled with residents. When a resident was hospitalized or when a bed became available, income did not cover expenses. Two of the three homes were not profitable. There was a great fear the homes would need to close if the trajectory continued. The magic of a turnaround started when a strategic plan was put in place.
The goal was to create increased sales and profits, increase visibility in the community for a broader scope of seniors and adults to consider living at Ascension Health Adult Foster Care Homes, and cover necessary wage increases to hire and retain staff.
Every lasting endeavor starts with a great foundation. The minimum cost per resident to cover overhead was recalculated. An expected profit margin was also included in this calculation. Future admissions would not fall below this number.
A more structured Pre-Admission new resident screening process was put in place to ensure rates matched the needs of the resident.
Changing the course of how Ascension Health Homes did business was critical to achieving our goal. We evaluated the percentage of total income per agency and private pay residents. We created a plan to diversify the agencies representing the residents that typically calculated daily rates at a lower amount.
We established relationships with local placement agencies for exposure to more private pay residents.
We added contracts with local waiver agencies. Our goal was clear to increase the exposure to more residents that could meet and exceed the minimum cost to cover overhead and profit and increased wages.
Private rooms are a preference for many residents, especially those that are private pay. Common living areas were evaluated at each home for conversion to private bedrooms. Licensing was contacted to approve the proposed changes. Construction started to add additional bedrooms. After construction was complete, each home was converted from 3 shared rooms to 2 private and 2 shared rooms.
Residents, family, and their care managers are more likely to place someone they care about in a home they know, like, and trust. A Facebook page was created to post activities and information to create community trust. A relationship was started with Home Care Pulse to ensure our team met and exceeded expectations.
Monthly reports were reviewed with staff to increase how to serve our residents better. During COVID, video tours of the homes were created to allow virtual tours for potential placement. Staff Key Results Area’s were created to clearly define the expectations of their role and create buy-in for them to succeed
Targeting the lowest rates first started the trend of increased revenue. We compared each resident’s care needs against the daily rate provided using medical necessity definitions and activity of daily living categories. Staff was educated on how to chart note properly to justify care needs and possible increases. Staff was educated on how to communicate with case managers properly when asked “how is_____ doing”. For private pay individuals, a calculator was created to identify the cost of care based on the individual’s needs.
Case Managers were contacted for an addendum to increase the daily rate of the resident using Medical Necessity information and activity of daily living categories specific to each agency. If appeals were denied, residents were converted to agencies that were reimbursed at a higher daily rate.
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