Optimize Resident Care & Business Performance by Controlling “Acuity Creep”

Optimize Resident Care & Business Performance by Controlling “Acuity Creep”

Five or ten years ago, if seniors needed skilled nursing care, they went to a skilled nursing facility. Today, however, seniors who need higher levels of care are increasingly able to receive such care in other residential settings, including independent living and assisted living communities. As a result, the senior living industry is experiencing a convergence of senior housing and healthcare.

In many ways, this is a logical progression. Since morbidity increases with age, seniors will naturally need more complex healthcare services as they get older. Yet seniors don’t want to keep moving as their needs change; they want to “age in place.” For their part, senior living providers don’t want a lot of resident turnover; they want to increase average length of stay.

Shifting towards more clinical models of care makes sense, both to better meet resident needs and to optimize business performance. But it also presents a significant challenge: controlling and managing “acuity creep.”

Acuity creep occurs when a resident’s acuity level increases over time but the change in condition is not captured in an ongoing care analysis and reassessment loop. The resident’s plan of care based on assessed needs does not align with the actual services delivered at the point-of-care (Figure 1).

Uncontrolled acuity creep can lead to a host of problems that make it difficult, if not impossible, to optimize resident care and business performance, especially when compounded over dozens or potentially hundreds of residents:

  1. Planned care tasks and service levels based on resident assessments do not match the services actually delivered at the point of care.
  2. Inability for facilities to quickly recognize, document, and adapt to changes in a resident’s condition or care needs will adversely affect the resident’s quality of life.
  3. More staff time is spent on care tasks not in the care plan (as well as more time spent tracking and documenting care), resulting in higher job stress and inefficient allocation of staff resources. Conversely, needed care may not be delivered, resulting in sub-optimal health outcomes and greater liability risk exposure.
  4. Average length of stay decreases because residents move to facilities better equipped to meet their changing acuity needs, negatively impacting occupancy rates and profitability.
  5. Billing for all services rendered is not captured; there is a disconnect between service rates for planned care and actual care and revenue opportunities are lost.
  6. Communication/engagement with residents and families suffers because of lack of information and coordination; conversations around changing care needs, service levels, and costs are based more on highly charged emotions rather than documented facts, further increasing liability risk.

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What causes acuity creep? Primarily, it’s a lack of interoperability between resident care systems. “Interoperability” means that two or more systems are able to work together to communicate, share data, and effectively use the data shared to improve outcomes without the need for any additional work or extra steps in the overall process.

Lack of interoperability can exist between detached systems (senior living and point-of-care software from different providers) and can also exist between separate software modules from the same provider. Without interoperability, extra manual steps are required to gather, compare, and assess the data generated in each system. These manual efforts are time-consuming and labor-intensive, leading to acuity creep and all its associated problems.

With the power of interoperability, however, it’s much easier to stay on top of resident care needs. Data generated by each system is automatically shared and can be analyzed in real time, creating a “closed loop” process of continuous learning and improvement that optimizes both resident health outcomes and overall business performance by effectively controlling acuity creep (Figure 2).

If you’re a senior living provider managing increasingly complex resident health care needs, controlling acuity creep should be a strategic priority. That means working with software providers who understand the importance of interoperability to your business and your residents, who can partner to provide seamless integration and combined functionality between their systems, and who can collaborate to meet all of your business requirements.

Robert Mann is CEO and Founder of Vitals Software, a complete, web-based software suite designed specifically to meet the unique business needs of senior living operators. Learn more »

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