Digging into the Details: Data Points Provide Nursing Homes Clarity to Plan For Future

As the financing, staffing and occupancy landscape continues to consistently change for the nursing home industry, delving into the data can better inform where operators should focus their resources moving ahead.

CliftonLarsonAllen (CLA) in a Wednesday webinar outlined different ways to “socialize” data points to identify opportunities for nursing home providers, decide which opportunities are most actionable and what might need to change to reach that opportunity.

In other words, socializing data takes facility-specific information and compares it to what’s going on in the local market and with direct peer groups.


“That’s really the power of it,” CLA Principal Stephen Taylor said. “Just looking at that data in isolation, you’re in essence limited on the insights you can really gather there. That socialization and triangulating those data points is extremely important, because then effectively that’s what creates those insights.”

CLA gathered data from a variety of different publicly available sources, including the Medicare Cost Report from Dec. 31, 2020 to Dec. 31, 2021; Nursing Home Compare; and 2020 Medicare standard analytic files (SAF).

Taylor said the seven to eight month old Medicare Cost Report data, while sometimes dismissed as being too old in what many consider a dynamic market, allows a strategic advantage in its “wide swath” of data pulled from any facility if executives are making a decision on increasing wages or looking at occupancy.


“It’s really a barometer of saying ‘alright, how do we compare to our local market? Was this an area of opportunity or not? Has anything changed in the past couple of months that would drastically impact that,’” Taylor said.

Operators must focus on the fundamentals first before pulling the trigger on an actionable item, according to CLA Principal Deb Emerson: occupancy, revenue optimization, expense efficiency and of course – staffing.

“If you’re struggling with occupancy, how does that relate to your referral sources? Are there things that you need to do differently related to that? With revenue optimization, that might be a matter of looking at your clinical information, looking at your payer mix,” she said.

A strategic look at referral sources and facility patient mix, with potential tweaks, could yield revenue opportunities, she said.

Meanwhile, workforce challenges continue to hinder operator ability to move forward and be successful, she said.

But pulling insights like paid hours per patient day, average hourly rates and the financial impact of potentially shifting hours per resident day – and looking at it all together against peer groups and the local market – can help leadership take a step toward improving staffing for their own unique situation.

“We really want to be able to understand what’s happening, what are the facts and circumstances and how it all comes together,” said Seth Wilson, data analyst manager for CLA.

Expense efficiency, added Emerson, is usually focused on the past, where a particular operator has spent money in prior years, rather than where money is spent compared to a peer group.

“We’re not only looking at opportunity from a financial perspective, we’re looking at it from a market share perspective, we’re looking at where you are spending dollars,” noted Emerson. “It’s not just about looking at your facility, but looking at how you compare to your peer group, looking at the market, looking at the state, and top performers.”

Not everyone is going to operate the same, or is going after the same market – each operator needs to look at these fundamentals in total and figure out what those opportunities are.

“We have the ability to look at a particular hospital as a referring source and say, ‘where in your market is that hospital sending patients, where are they discharging patients,’” said Emerson.

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