As Consumer Clout Grows, Providers Need to Bust Long-Term Care ‘Myths’

In a world where ratings and reviews help shape consumer choice, long-term care has a major perception problem.

“When we go out and just talk to consumers, perception-wise, about long-term care, only about 24% trust or have confidence in long-term care or nursing homes,” Ryan Donohue, strategic adviser at the the research firm NRC Health (Nasdaq: NRC), told Skilled Nursing News in a conversation on the sidelines of the American Health Care Association’s annual conference and expo in San Diego last month.

That matches the findings of an informal survey conducted at the start of 2018 by Skilled Nursing News that found randomly selected consumers in a Chicago grocery store associated “nursing home” with “dismal,” “sad,” and “bad food.”


But when consumers actually get inside the walls of a nursing home, the picture changes, Donohue said. In fact, 88% of people who have actually been residents would recommend the experience, he said, compared with the people outside the walls of a nursing home.

That makes that negative perception something that long-term care providers have to address, according to Pat Cokingtin,* senior vice president of sales and marketing at Americare Senior Living, which is based in Sikeston, Mo.

Th provider has 23 skilled nursing and rehabilitation facilities — in addition to assisted living, memory care and independent living communities — across Kansas, Missouri, Mississippi, Tennessee, and Illinois.


Americare’s residents have high satisfaction rates when they’re actually experiencing the care, she said, making it crucial to let others know.

“I think that [negative perception] is a myth we have to turn around by sharing information about what our current customers think,” she told SNN at the AHCA conference. “That’s some of the things we’re concentrating on, really leveraging our reputation as a company … I need to find a way to leverage that in the community, because what other people are saying about me is more important than what I’m saying about me.”

One of the other obstacles is that most people age 65 and older don’t think they’ll need skilled nursing or long-term care of any sort for at least 10 years, Donohue added. But educating them and giving them the tools to make plans generally leads them to feeling better about the possibility, he said. And even though it’s a common idea that people prefer to be in their homes, that doesn’t always apply to the people Cokingtin sees.

“Most of the people who have come to us have already explored that avenue,” she said. “And it’s not working. Even with the means, there’s social isolation … Home care is great when your care needs can be scheduled. When it becomes care on demand, then living in a congregate care community makes better sense.”

The industry has to battle more than bad individual or even family perceptions, though. Towards the end of 2017 and the end of 2018, nursing homes had to contend a wave of bad press in the wake of deadly disasters, which caused even further damage to the perception of nursing homes in the U.S.

When it comes to educating consumers, though, there are some options. Donohue has seen clients build apps that allow potential residents to take a virtual tour of a facility. And even though patients about to go into a nursing facility are in some cases constricted by narrow networks, they still have choices about where they’ll go, Cokingtin noted.

“I think that’s another big myth, that everyone who’s in skilled nursing had zero choice to be there,” Donohue said, adding that consumers have actually started to push back on narrow networks as more and more information becomes available to them.

That information has taken consumers to some interesting places, such as Yelp, which began as a site for food reviews. But both she and Donohue see this as a kind of opportunity.

“When we saw the Yelp information coming out, we thought, ‘What an interesting and reaffirming sign that consumers are desperate for information in health care,'” Donohue said. “What we’ve done is encouraged our clients to be your own source of information. Don’t just let consumers wander the wilderness of the internet and try to find that information. They really want to know how you’re doing … and they want to hear from other consumers.”

But reviews from Google and Facebook can be unreliable, and so one of the steps Americare has taken is to partner with NRC Health to gather verified resident and family feedback and convert it into star ratings and reviews.** To get people to trust its information, Americare makes sure to include both positive and negative remarks and explains the survey process that it uses to get customer feedback, which includes using an independent third party and benchmarking Americare against others in the industry.

“You have to have some balance and authenticity in the comments that you’re posting for [consumers] to trust you,” Cokingtin said.

Donohue agreed.

“We find the authenticity rises if you have a high number of reviews, and you have actual comments they can read about other people like themselves,” he said.

Written by Maggie Flynn

*Updated to correct the spelling of Pat Cokingtin’s name; it is Cokingtin, not Cokington. 

**Updated to clarify what Americare is converting to star ratings; it is consumer feedback, not CMS ratings. SNN regrets the errors.

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