Before David Dunn joined Shannon Gray Rehabilitation & Recovery Center, he’d never worked in a senior community that used an institutional special needs plan, or I-SNP, to deliver extra levels of personalized care to residents suffering from complex and chronic conditions.

Now, after 10 years of working in partnership with the Optum care model, he says he never wants to “go back to a world without it.”

“I really can’t emphasize the benefits enough,” says Dunn, a former nurse who is now chief operating officer at Jamestown, North Carolina-based Shannon Gray. “We see really positive outcomes among the residents who are on the plan. The focus is on being proactive, preventing hospitalizations and preventing problems before they arise.”

In this post-pandemic era of tight staffing, Optum’s care model has been a “Godsend,” Dunn says. He lauds the model’s “extra set of eyes” that help identify the holes created by layers and levels of care, and the additional resources that deliver key advantages for patients, families and senior communities.

Patient-centric model “goes above and beyond”

One of the original innovators of I-SNPs, Optum has built its care model as patient-centric, bringing highly trained, experienced clinicians and care teams into communities to coordinate and oversee resident care.

The teams are led by advanced practice clinicians (APCs), who are either nurse practitioners or physician assistants. They make regular visits to member communities, coordinating and reviewing resident care across what are often multiple doctors and therapists.

But it’s not just the extra in-community care that makes the plan so valuable.

“It’s the people Optum puts on its teams,” Dunn says. “They go above and beyond. It’s the caring — the corporate support they provide. They’re very important members of our team.”

As nursing communities are struggling to find qualified caregivers, that extra level of support is more important than ever. Indeed, data from Optum shows that 92% of members are satisfied with the plan, and 95% of stay on the plan for life.

“Happy 100th birthday”: Optum’s human touch through personal connections

Among the key benefits of the partnership are the personal relationships the Optum teams forge with residents, families and even staff.

“I’ve seen how the Optum nurse practitioners will sit in the room or sit at the nurses’ station and talk with them — not just as residents, but as friends,” Dunn says. “They’ll ask how their grandkids are doing. They’re involved in their life.”

Dunn recalls one family that was particularly stressed during the pandemic shutdown because their mother wanted to reach her 100th birthday, and they were intent on helping her achieve that goal. The Optum APC was instrumental in keeping both the resident and her family connected and educated about the aging process and what to expect.

“She would not have made it to 100 if not for that APC,” Dunn says. “Managing that family, meeting their expectations, we could not have done that without the Optum support.”

Better surveys, better ratings

That in-depth care and the nurse practitioners’ personal connections and thorough case notes have been invaluable in helping Shannon Gray respond to surveys and boost its ratings, which Dunn says are very strong compared to state, even national, averages.

The Optum team takes ownership and accountability for its members, Dunn says.

“We’ve had situations that maybe could have been considered deficient practice, if not for that Optum person who has that medical credential and that respect and that knowledge, and who’s very adept at speaking without talking in circles,” Dunn says. “They answer the questions very honestly and they’re not afraid to defend the facility or what they did.”

Happy residents, happy families — and better outcomes

According to Optum data, communities in the plan have 40% fewer hospital admissions. Dunn says that tracks with his observations at Shannon Gray, because the proactive care helps identify problems early.

“Early identification and referrals are so important,” he says. “Let’s be honest, what’s easier? Preventing decline or treating and having to deal with it?”

And that equals happier, healthier residents, and happy families.

What family members want is simple, he says: knowing that their loved one is doing better.

“I try to put myself in their shoes,” Dunn says. “If it was my loved one, this is the question: Would I sign them up for Optum? Yes, I would do it in a heartbeat.”

This article is sponsored by Optum and is adapted from a new Optum case study. To read the full study and learn more about the Optum care model, visit optum.com/shannongray.