Stand-alone and rural senior living and care communities typically have three things in common: They are starving to find the labor pool needed for those entrusted to their care; in many cases, they are battling insufficient reimbursement to cover the cost of high-quality care that their residents deserve; and they struggle to operate in a world of ever-changing regulations.

With the growing reliance on Medicaid waiver reimbursement for many senior living providers, it is often not easy to formulate a strategy of quality and financial viability. Operating in an environment that mandates a very narrow expense profile requires ingenuity—finding ways to make more with less. Not easy! For those that struggle with this dilemma, there is a viable path forward.

Solutions for Stand-Alone or Rural Senior Living Communities

Partner Up: Many times, solutions are not staring us in the face. This is where providers need to think about unconventional approaches. For instance, Health Dimensions Group® (HDG®) has worked with dozens of senior living operators throughout the country to develop comprehensive recruitment and retention strategies that serve to bolster the inbound talent pipeline, as well as create innovative retention approaches to keep the “back door” closed (or at least optimally secure from competitive threats).

Recruit Rapidly: Speed is life when it comes to recruiting and onboarding new team members. All too often, we encounter organizations with recruitment processes that extend the candidate’s first touch over several weeks. Success relies on getting all those involved in recruitment and onboarding working with the utmost urgency. Many rural communities lacking the internal talent or time to focus on recruitment, along with organizations managing multiple locations that seek to streamline their hiring processes, have turned to HDG’s centralized recruiting services to take the reigns and improve their recruitment results.

Mix It Up: Operating in a rural environment may require a bit of creativity with respect to the traditional roles each team member plays. This can actually be a huge incentive for executive directors who perhaps wish to exercise their business acumen by taking a more direct role in finance and accounting or the social services director who has a flare for life enrichment. Helping team members expand their capabilities builds stability and a commitment to collective success.

Watch the Clock: Obviously, the workforce represents the largest expense profile for any operator. Managing minutes of labor can mean all the difference in making or missing targets. A former mentor of mine, responsible for hundreds of U.S. facilities, would often comment that missing labor by as much as .01 hours per patient day on his roll-up would result in tens of thousands of dollars of excess labor costs. Fractions count—big time!

Consider Compensation: Purging reliance on agency staffing and managing pay practices to drive desired results must be a daily focus. Re-evaluating wage scales once a year to remain competitive doesn’t work anymore. The current environment is much too dynamic. Successful operators are touching compensation competitiveness no less than quarterly. Find a partner that can assist you if you lack the resources to do this work.

Quality is Key: Keeping the house in order supersedes all. It is nearly impossible to manage most operational challenges during a regulatory flare-up. Study your metrics, drive your Quality Assurance and Performance Improvement (QAPI), and success will follow. QAPI represents an ongoing, organized method of doing business to achieve optimum results, involving all levels of an organization. These are key areas of focus:

  • Continuously monitor care and services through multiple systems.
  • Metrics/data from multiple sources—including Quality Indicators (QIs) and Quality Measures (QMs), the CMS Five-Star Quality Rating System, and labor tracking—should be part of daily operations and reported to QAPI.
  • A robust Risk Management Program is imperative to keeping order in the house. It helps the facility develop performance improvement projects to focus on problem areas.
  • Resident, family, and employee surveys provide a type of feedback that should be incorporated into the facility’s QAPI processes, supported by the facility’s grievance program and customer service initiatives.
  • Standalone communities without a corporate support system must stay current with regulatory rule changes.

To help your community stay in compliance, HDG can complete a mock survey, giving you a second set of eyes to identify areas of weakness. A mock survey is recommended to be completed approximately eight months after the annual survey or three to four months prior to the opening of the survey window.

In Your Corner

If you find yourself struggling to maintain regulatory compliance or recruit necessary team members, HDG can help. To learn more about our operational consulting and workforce solutions services, please contact us at info@hdgi1.com or 763.537.5700.