CEOs See Long-Term Care Occupancy, Staffing As Top Post-Pandemic Challenges

While occupancy numbers are enjoying a modest upward trend, skilled nursing operators face an uphill battle to strengthen long-term care metrics into the next year.

And, staffing issues also loom large and are commanding attention from SNF operators.

These were among the big topics under discussion at Tuesday’s Synergy Summit, where leaders with providers Marquis Limited, Plum Healthcare, Ignite Medical Resorts and Ensign affiliate Bandera weighed in on how their organizations are navigating the challenging — but improving — market.

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Driving long-term care occupancy

Norman Rokeach, founder and president of Marquis Limited in New Jersey, said during a live virtual event that their facilities have gotten creative in an increasingly competitive landscape to attract new residents — reassurance after more than a year of bad press will help with occupancy too, he said.

“It’s the long-term care sector that we’re really going to be struggling with, to get people back in our facilities,” Rokeach said at Tuesday’s Synergy Summit. “A lot of facilities have been hit hard in the long-term care sector. What is going to differentiate your long-term care model versus your competitors? We’ve focused a lot on, believe it or not, special ethnicity programs.”

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Aiming for a hyper local market, the folks at Marquis have developed programs specific to a large Korean population in South New Jersey, a Spanish program for communities in Missoula, Mass., and an Indian program at its Pennsylvania SNFs.

Pre-pandemic occupancy was 93% before dropping to 79% at the height of COVID-19; currently, occupancy has crept up to 88%, Rokeach said.

Long-term care makes up 50% of the patient mix for his SNF operators, fellow panelist Forrest Peterson said. Peterson is president of Bandera Healthcare in Phoenix, Ariz. Bandera is an affiliate of Ensign Group (Nasdaq: ENSG).

“We’re hoping that we can see a steady climb in long-term care,” noted Peterson. “Seeing that climb, even if it’s slow and steady, we’re okay with that.”

Honing ops and culture for staffing

Staffing challenges will require major in-house investment and HR changes to boost retention and recruitment, panelists said.

Ignite Medical Resorts Chief Executive and panelist Tim Fields said their team took the technical and operational aspects out of human resources so employees in that department could focus more on recruitment, orientation and retention. The operator’s corporate office took on the more traditional HR functions, he said.

Different hours that better fit staff needs, Rokeach added, will help retain staff.

“A lot of these folks are single moms … it’s perhaps a six hour shift versus an eight hour shift, perhaps it’s a 12 hour shift twice a week versus the traditional 40 hour,” said Rokeach.

Listening to staff, whether it’s for a change in hours or changes to the break room, is the first step toward improving workplace culture, and in turn retention and recruitment, Rokeach said.

When asked if there were metrics to determine if these staffing methods were working, Marquis’ Rokeach noted that weekly indications were favorable, but not at the pace they would like.

A stronger culture will keep the right people taking care of residents and help with occupancy numbers too, according to panelist Cory Christensen, CEO of Plum Healthcare.

“Creating a stronger culture is also related to the same issue of how do we build our occupancy back … folks that would opt out to collect an unemployment check rather than serve, I don’t want them. They’re not about what we need to be about,” Christensen said.

Operators can more often accept residents with higher acuity, or behaviorally difficult patients if staff have a strong, supportive company culture behind them.

“Getting to where we say ‘yes’ more often will be attractive not only to our discharging partners and drive our census, but it will be attractive to the caregivers out there that want to become the best,” added Christensen.

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