Integrating Healthcare Services into Seniors Housing Reduces ER Visits, Hospital Admissions

SAN DIEGO — Integrating healthcare services — such as primary care and nurse practitioners — into seniors housing can reduce costly emergency room (ER) visits and inpatient hospital stays, according to new data from ATI Advisory released Wednesday at the 2020 NIC Spring Conference.

Comparing an assisted living facility that incorporates healthcare services to facilities that do not provide healthcare, ATI researchers found utilization rates plummeted by more than 50 percent in the integrated care model.

“The data reveal a tremendous opportunity to reduce hospital-based healthcare services that put seniors’ health at risk and drive costs upward,” said Anne Tumlinson, founder and CEO of ATI Advisory. “Putting housing and healthcare under the same roof promises better coordination and results.” Tumlinson’s Washington, D.C.-based firm works to reform health and long-term care delivery and financing for the nation’s frail and vulnerable older adults.

Researchers found that incorporating a nurse practitioner and case manager into a senior living facility’s operation can reduce the number of inpatient hospital admissions per 1,000 residents from 430 to 300.

The data on utilization rates among assisted living facilities for hospitalization services comes from the 2017 Medicare Current Beneficiary Survey and was limited to traditional fee-for-service Medicare enrollees. The findings with regard to the integrated care model are based on results from Juniper Communities’ Connect 4 Life model. Bloomfield, New Jersey-based Juniper is an operator of senior living communities.

“This is a powerful message for the seniors housing community. If you aren’t considering how to engage insurers and hospital systems to integrate healthcare services into your housing model, owners and operators forgo an opportunity to improve care outcomes,” said Brian Jurutka, president and CEO of the National Investment Center for Seniors Housing & Care (NIC).

“Owners and operators need to take steps that support the improvements in health and healthcare spending that patients, taxpayers and governments continue to demand,” added Jurutka.

Real-life application

NIC provided a case study involving Presbyterian Homes & Services (PHS) that shows the benefits of the seniors housing and healthcare sectors working together. Based in St. Paul, Minnesota, PHS is a nonprofit, faith-based organization providing an array of housing choices, care and service options for older adults. Some 6,620 employees serve 27,000 older adults through 46 PHS-affiliated senior living communities in Minnesota, Wisconsin and Iowa, and through its Optage home and community services division.

According to Dan Lindh, president and CEO of PHS since 1996, integrating healthcare services into the organization’s senior living offerings was a goal of his several years ago. Today it is an example of holistic healthcare.

“Five years ago, we embarked on our healthcare partnership — first determining the pathways to care, then how to best share information, and finally, how to effectively implement healthcare services to address our residents’ social determinants of health,” said Lindh.

Once PHS made the decision to incorporate care services into its housing model, it purchased a 50 percent stake in care provider company Genevive, which offers mobile primary care to older adults with high acuity needs.

The model works by preparing teams of physicians and nurse practitioners to be available during set office hours and “off hours” through conference calls. These teams consult with PHS’ on-the-ground nurses and staff, who help triage the right care for the individual.

For example, a PHS resident experienced a negative reaction to medication and potentially needed acute care services. On-site staff placed a triage call with the care team. They jointly agreed that the patient did not require emergency room or hospital services. Instead the patient was transported at a much lower cost to a PHS-owned transitional care center.

In this case, according to Lindh, the intervention saved the healthcare system between $4,000 and $5,000, and both the resident and her family were happy with the result.

Lindh believes that both the seniors housing and healthcare sectors are providers. Together they can offer high-quality services and increase overall effectiveness, he argues. There is no blueprint on how to partner effectively, and synergy requires buy-in from all parties, according to Lindh.

“We are thankful for the opportunity to reimagine how healthcare is delivered in our communities. And while we don’t have all the answers, we are still taking meaningful steps forward to positively affect our residents’ lives,” said Lindh.

Actual Rates Initiative update

At Wednesday’s media briefing, NIC also announced a new partner to track actual rates at senior living communities. The NIC Actual Rates Initiative is driven by the need to increase transparency in the seniors housing sector and achieve greater parity to data that is available in other real estate property types.

NIC’s new partner on this front is Medtelligent, the Chicago-based maker of ALIS (pronounced “Alice”) software for assisted living, memory care and behavioral health communities. This marks the fourth software partnership for NIC in its mission to improve transparency in the senior housing industry.

The 2020 NIC Spring Conference runs through Friday, March 6 at the Marriott Marquis San Diego Marina. The day-one attendance was 1,550 people, a 4.4 percent increase over last year’s first day, according to NIC.

— Matt Valley