Critical Conditions

Edition: July 2006 - Vol 14 Number 07
Article#: 2445
Author: Repertoire

PONTE VEDRA BEACH, FLA — Residents of nursing homes are more acutely ill than ever before. And that’s changing the needs of Repertoire readers’ long-term-care customers.

In the past, many nursing home residents were admitted to facilities after lengthy (two- to four-week) hospital stays, said Bryan Jones, director of operations for Crown Management LLC, a privately owned nursing-home and assisted-living chain of 25 facilities in Alabama. Today, the typical resident might check in after spending just a few days in the hospital. “They have a higher acuity level,” said Jones, who participated on a long-term-care panel at the recent IMCO National Convention. Nursing homes are responding by providing more sophisticated services, such as advanced wound care. Their risk management procedures are more sophisticated too. Distributors must respond to their customers’ changing needs.

Ironically, not only are residents being admitted sicker, but chances are, they’re staying in the long-term-care facility for shorter periods of time, said Joe Brinker, executive VP, Bethesda Group, a non-profit provider of senior living and skilled nursing care residences, with seven locations in metropolitan St. Louis. “A year and a half is our average length of stay today. [In the past], it was not uncommon to have [residents] for six, eight or 10 years.” One reason is, people have more choices about where they can receive care. Rather than go to a long-term-care facility, many opt to stay at home and receive care there, while others buy into independent- or assisted-living units.

Another change brewing among long-term-care facilities is a greater load of rehab patients, due in part to the fact that hospitals — citing diminishing reimbursement from the federal government — are shedding their rehabilitation departments, added Brinker. “[Rehab] is a good business for nursing homes, because as length-of-stay shortens and acuity is higher, we see more churning of beds. Occupancy is a big issue.”

The occupancy issue

Indeed, occupancy isn’t what it used to be. In Alabama, for example, the occupancy rate in long-term-care facilities is about 91 percent, said Jones. That sounds high, but it used to be more like 98 percent, he said.

Consequently, long-term-care facilities and chains are marketing their services as never before. But they face an uphill battle. Today’s long-term-care patients want better accommodations, such as private rooms, said Jones. However, nursing-home operators are finding it difficult to come up with the money needed to upgrade or replace aging facilities.

Some long-term-care providers are getting serious about bringing their services to people in their homes. “Nobody wants to be in a nursing home,” said Brinker. “They want to stay at home and age in place. They want people to bring services to them. So we’re undertaking a study to identify home- and community-based services that can add to our profitability.” That’s particularly important as Medicare and Medicaid continue to trim reimbursement.

One trend that shows no sign of abating are clampdowns by a myriad of regulators overseeing the long-term-care industry, said the panelists. “Regulations have become much stricter,” said Jones. Surveyors camp out at facilities for three or four days, looking for problems, he said. Chances are, they’ll find some, and then return for a follow-up check several weeks or months later.

Distributor’s role

Distributors can help their long-term-care customers meet these challenges through creativity and hard work, said Kelly Hart, director of long-term care for Earth City, Mo.-based MMS, a medical supply company; and Duke Ropa, a sales rep with MMS. And their customers agree.

Distributors who take the time to get to know their customers will win the business, said Brinker. “MMS knows our company and our business practices, and they can identify opportunities that may help both of us. That has happened multiple times.”

Field sales support still counts for a lot, according to all the panelists. Yes, mail-order houses can offer a wide range of products and services, said the long-term-care operators. But the real winner is “the rep who comes in and gets to know us, our people and our practices, and who can tell us, ‘Here’s why you should or shouldn’t do this,’” said Brinker.

As part of their value-added approach, some distributors are marketing group purchasing programs to their long-term-care customers, offering savings not only on medical supplies, but on food, office supplies and other products and services, said the two distributors.

In the end, it’s all pretty simple, said Brinker. To be successful, distributors need to keep a few things in mind: “Just identifying opportunities for us; knowing who to contact in our organization, putting us in touch with the right folks, and providing quality products at reasonable prices. That always catches our eye.”