Investing in Skilled Nursing Tech Isn’t Worth Much Without Employee, Leadership Acceptance

Data continues to be the watchword in a skilled nursing marketplace where hospitals and other referral partners demand increasingly concrete information about post-acute outcomes.

In response, numerous tech companies have stepped into the fray to provide potential solutions — from data analytics tools that can identify serious health issues before they escalate to a hospitalization, to tracking software that alerts SNFs when one of their former residents shows up at a hospital.

But all of this flashy new technology doesn’t mean much if the frontline employees at a SNF don’t actually use it. For Scott Rifkin, founder and executive chairman of skilled nursing tech provider Real Time Medical Systems, this concept usually takes the form of an admonition from the operators to which he pitches his product.

“If you create more work for my staff, I’ll kill you,” Rifkin said, paraphrasing skeptical providers during a panel discussion at Zimmet Healthcare Services Group’s annual conference in Atlantic City, N.J. earlier this month.

Rifkin’s platform has seen rapid expansion in the last few months, with Real Time scoring a $10 million funding round in March and inking a deal to bring its platform to all of Creative Solutions in Healthcare’s more than 70 facilities in Texas earlier this month.

Real Time works by seeking to identify patterns in residents’ medical records and then using the information to intervene with treatments within the SNF — instead of waiting until the patient’s condition worsens to the point that a hospital transfer is necessary. So far, Rifkin — who developed the program during his time as a skilled nursing facility owner and operator — says the program has helped participating properties cut hospital readmissions by 40% to 50%, with 60,000 residents covered as of this past spring.

“If you create work for nursing staff, it’s not going to work. They’re not going to be able to do it,” Rifkin told SNN at the time of the $10 million funding round. “We understood that workflow. We built it for our own facilities.”

Reducing readmissions has long been a goal of tech providers; with the SNF Value-Based Purchasing (VBP) program penalizing operators for failing to reduce hospital admissions, and referral partners putting increasing pressure on SNFs to keep residents out of the hospital, the stat has proven to be a fruitful target for software innovation. But as the Patient-Driven Patient Model (PDPM) looms, there has been increasing focus on securing proper reimbursements under the new payment structure.

To that end, consulting firm Zimmet has positioned its new product, CORE Analytics, as a way to prevent missed PDPM reimbursement opportunities. Vincent Fedele, CORE’s chief operating officer, said the software has already located about $300 in lost payments per claim when used to analyze current data through a PDPM lens.

“A product that found a PDPM mistake could pay for it for the whole year,” Fedele said.

For Barry Munk, chief operating officer of the Brick, N.J.-based operator Marquis Health Services, ensuring that any tech solutions fit seamlessly into his buildings’ workflows is essential when he considers rolling out a new program.

While many technology and data providers throw around gaudy return-on-investment numbers when trying to pitch operators, Munk said he tends to view those figures as ephemeral; given the complex matrix of factors that go into a SNF’s bottom line, it can be incredibly difficult to pinpoint exactly how many dollars a given tech product saved.

“We like when the team embraces it and uses it,” Munk said. “And if there’s a software where we’re not really sure what the ROI is, but the team is using it, we’re going to keep it.”

That said, SNFs haven’t always had a choice when it comes to adopting data. Some hospital systems and referral partners, according to PointRight president and CEO Steve Scott, essentially have required skilled nursing operators to invest in data platforms in order to secure a spot in their preferred networks.

“They felt that since they were sending the referrals, that the operator should pay for that,” Scott said.

That isn’t necessarily a dealbreaker for operators, especially if the relationship with the referral partner is fruitful.

“You sign up with them, you’re in; you don’t sign up with them, you’re not in,” Munk said. “For us, it’s a price tag of being in a preferred network.”

Either way, the tide seems to be turning, with Scott — whose company offers a range of analytics services targeted at post-acute providers — noting that more and more acute networks and accountable care organizations (ACOs) are beginning to pick up the tab for rolling out tech platforms.

“We’re seeing more systems and ACOs and health plans now that are looking to provide that service as a value-add,” Scott said.

But no matter who eventually pays for the service, Munk emphasized that employee buy-in is the deciding factor in whether or not he elects to use a given program in his buildings.

“I must see utilization, with the team adopting it,” he said. “Scott promises a reduction in readmission rates; I think Scott agrees that it will only work if the team is using it.”