A patient sent to a skilled nursing facility for rehabilitation usually comes from the hospital, but as the health care system changes, more and more patients will be making choices outside of the acute care setting.
That includes decisions about rehab, and with that in mind, Centers Health Care recently launched a concierge rehab program designed to target short-term rehab residents who can preselect their rehab provider. The Good Outcomes (GO) program has been launched at five of Centers’ 50 owned facilities to date; the most recent was launched on January 16 at Centers’ Bannister Center in Providence, R.I.
“We know that the patients that can go home are going home,” Steve Carr, director of sales at Centers Health Care, told Skilled Nursing News. “And the patients that are being referred to SNFs are true rehab candidates. I think it’s important to show them that yes, we’ve got very comfortable facilities with great amenities, but we’ve also got the outcomes.”
Clinical capabilities and patient experience
Patient expectations for their skilled stay have changed rapidly, and the new baseline includes things like Wi-Fi and streaming services. Centers began seeing lots of requests related to video streaming and access to social media, Carr said, which led the Bronx, N.Y.-based post-acute chain to re-examine the rehab and recovery experience.
Centers targets select facilities for the GO program, which involves retrofitting the existing plants, adding new tools to track patient outcomes, and hiring new positions. The units range in size from 20 to 40 beds.
“It all starts with the renovation project, where we’re doing everything we can to make the physical surroundings better,” Carr said. “That includes the rooms, the gyms, and the common areas. What we didn’t want to do with GO is renovate a unit and say, ‘We have a brand new rehab unit, come to this Centers location!’ We really focused on the criteria we thought would drive the outcomes, those two being clinical and experience.”
On the clinical side, the GO program features an attending physician available five days per week and a registered nurse available 24 hours a day, according to Centers. The program also has specialists available for individual cases.
“The first thing we focused on was RN coverage around the clock in all our GO programs,” Carr told SNN. “The second thing we really targeted was the therapy departments and what we could give our therapy teams in terms of technology.”
Those include the Jintronix biofeedback system and Uniform Data System for Medical Rehabilitation software, both of which facilitate tracking the functioning and outcomes of rehab patients, Carr said.
“We want to benchmark not only against skilled nursing, but against the top inpatient rehab facilities in the country,” he said. “So as patients are confronted with the reality that care is being pushed to a lower cost-setting … we want to be able to show them in the end that outcomes are comparable to what you’re able to receive at the top rehabilitation hospitals in the country.”
To make sure patient expectations for the stay experience are met, the program also provides enhanced menus and higher-end coffee — which in most markets is Starbucks — Netflix in all patient rooms, Chromebooks and tablets available for patients in the GO program, and social hours each night.
“There’s a movement to say SNFs are some type of resort or hotel, and that’s not accurate,” Carr said. “That’s not who we are. We as SNFs are in the business of helping people get better, but that doesn’t mean that we couldn’t implement amenities that are in hotels and resorts.”
Investing in a changing world
Centers isn’t the only company seeking to weather the changes in the skilled nursing world through higher-end rehab services: Companies like Plum Healthcare and Ignite Medical Resorts have made pushes in recent months to build new, resort-style facilities for Medicare-eligible patients, which bring in higher per-day reimbursements than their long-term Medicaid counterparts.
But unlike those operators, Centers has focused on converting its existing physical plants. Adding the GO program at a facility first entails filling RN positions if necessary, potentially boosting the building’s staffing budget. The program also includes a dedicated concierge, which is a new position for Centers, Carr said. The dietary department is also affected, because of the enhanced menu — from which anyone at the GO location can order, even if they aren’t in the unit.
“We found ourselves really having to evaluate the talent in our kitchens to make sure we had the talent to produce the menu,” he said.
Without counting the the costs of the therapy technology and the nursing, getting a GO program off the ground at a Centers facility can be done for roughly $25,000 to $30,000, Carr said. But the services such as Netflix, Starbucks coffee and Chromebooks and tablets aren’t free either, he added.
When Centers’ management identifies a property — through examining such metrics as current outcomes and ratings — as a location for the GO program, it takes about 90 days to prepare for an internal launch and then another 30 days to make sure the logistics of the program are in place. Once any hitches in the program are smoothed over, Centers starts introducing it to hospitals, physicians and payors.
Centers assesses the program’s success by net admission volume, which is up 8% at the facilities where the program has been implemented. Management hopes to have 10 to 12 locations with GO offerings by the end of 2019, Carr said.
And though it’s not clear how the reimbursement world will shake out as the Patient-Driven Payment Model is implemented, he is confident that the program will serve to set Centers apart from competitors in the area.
“To show patients concretely that with patients similar to them, this is what we’ve been able to do – it will lead to more people choosing us than not,” Carr said.