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Every decade, the American Census Bureau conducts a nationwide survey to count the people living in America and its territories. The census has been mandated since 1790 by the U.S. Constitution to gain an accurate understanding of who resides in America. For long term care facilities, there are two levels of nursing home census that impact operations and funding:

  • On a national level, the Census Bureau will request a count for every resident living in a facility, including both the long and short stay residents. The most recent survey was conducted in 2020, with facilities providing the Bureau with information on the resident’s name, sex, date of birth, age, race, and home address. To protect the privacy of the residents, there are also strict laws with confidentiality clauses for the responses.

It is particularly important for facilities to conduct accurate census counts because Medicare and Medicaid use these results to determine their funding distributions every ten years. Healthcare programs like Medicaid and Medicare impact low-income people who need financial assistance. Therefore, if they are misrepresented, this will affect the amount of funding that is allocated to these healthcare services. 

  • On an individual facility level, when it comes to nursing home census, the official census counts all residents that are admitted into a facility by midnight on a weekly basis. This data is then utilized by the Department of Health and Human Services to measure the resident’s quality of life and the quality of service within a facility. 

In some cases, long term care facilities will use their population statistics to decide whether or not they should expand. One example is Wesley Communities in Washington state, which chose to ensure that its growing number of residents had enough access to short-term rehab. “And of course, in the event that they would need more long term care services, a much higher level of care, they could receive that service here on campus,” said Greg Byrge, the Executive Director of Wesley. 

Byrge and Jamilyn Bloodworth, the Director of Marketing Admissions, recently appeared on the LTC Heroes podcast to discuss their experiences in nursing home marketing and the challenges they faced with marketing admissions and keeping a steady census level. Listen to their full podcast here: 

5 Strategies To Improve Nursing Home Admissions

Building a strong census comes down to nursing home admissions but involves other external factors. Facilities must delicately balance staffing, reimbursement, and regulatory requirements, while also providing excellent care to residents. Though maintaining a high nursing home census is not easy, it is essential for facilities to maintain and protect their reimbursement payments and Medicare funding. Facilities often struggle with the constant regulation changes and the current staffing crisis, both of which impact the quality of care. 

Despite certain factors being beyond a facility’s control, there are several strategies to adopt in order to improve a nursing home census, thus making the facility more appealing. Gross Mendelsohn provides these commonly used strategies that can be of great benefit:

Nurse placing hand on resident.
Nursing home census counts all residents in a facility.
  1. Determine the Decision-Maker – Residents in long term care facilities are rarely the decision makers. Their families, often adult children, are the ones who decide where and when their elderly parents move into a facility. When they realize that they cannot care for their aging parents, they are often racked with guilt. Therefore, when interacting with families, being compassionate, patient, and helpful will make the process easier. 
  2. First Impressions Count – When families visit a facility, they often look for a pleasant and homelike environment for their parents. “One of the benefits to [Wesley Communities] is that it’s aesthetically-pleasing,” said Bloodworth. “It’s a nice building and it has a warm feeling when you walk in. It doesn’t have some of the aesthetic challenges that other skilled nursing facilities have.” 

Families will take note of the small things, like cleanliness, hygiene, and atmosphere. With a few simple touches, facilities can make better first impressions by:

  • Acknowledging festive holidays with decorations
  • Creating a warm entrance area with indoor plants and flowers
  • Supplementing fluorescent lighting with natural and non-fluorescent lighting.
  • Playing relaxing music in the facility
  • Displaying fresh flowers and a welcome sign in the reception area
  1. Provide Sufficient Staff Training – Families will observe the behaviors and attitudes of staff. Therefore, facilities need to provide sufficient staff training to create a positive and warm atmosphere. Something as simple as acknowledging the family with a warm smile and a friendly greeting will create a positive first impression. Other things to think about include:
    • Making sure the admissions staff are well-versed with the important points of the tour
    • Monitoring staff behavior and attitudes with visitors 
    • Training exercises with anonymous calls to check staff are communicating properly with telephone enquiries 
    • Giving staff positive reinforcement with small gifts for good behavior and attitudes 
  2. Mutual Referrals – It is useful to foster positive relationships with other healthcare providers, like home healthcare, assisted living facilities, hospitals, and physical therapists. Residents will need different levels of care at different times. Therefore, it is mutually beneficial for healthcare providers to refer residents to each other as and when their services are needed
  3. Understanding Census – When facilities regularly monitor their census, it allows the administrator to spot potential problems in their facility. As we know, the long term care industry is currently facing a staffing shortage. This impacts the overall level of care and quality in facilities, consequently affecting a facility’s star rating. 

According to a McKnights news report, approximately 1,400 nursing homes have lost star ratings due to inadequate staffing levels. Invariably, when families research facilities, the star rating will impact their decision. “Most people want to know what your star rating is,” said Bloodworth. “Buildings that are under five stars have to talk about their outcomes and focus on specific outcomes and quality measures.” Therefore, it is important for an administrator to monitor the real-time situation, to understand the census and staffing levels so they can plan appropriately to ensure the facility maintains a high star rating. 

Having an efficient nursing home software system in place will help a facility monitor census by managing the clinical and billing reports. This, in turn, will allow a facility to create a single resident repository with real-time data sharing so staff can save time and manage census.

Contact us here if you would like to test drive our user-friendly software.

Misconceptions in Nursing Home Marketing 

Marketing is recognized as an essential business function across all industries, and healthcare is no exception. In the past two decades, as competition in nursing homes has increased, so has the impact on nursing home marketing. A recent study suggests there is a heightened emphasis on communication, with marketing practices shifting towards better customer relationship management. 

Nursing home residents looking at computer.
Building a strong nursing home census comes down to nursing home admissions.

Nursing homes are placing more and more emphasis on building meaningful relationships with residents and their families and being more accessible. “You have to be willing to answer your phone all the time, even on the weekends. The hospitals don’t close on the weekends, so neither do I,” said Bloodworth. “I have to find a way to be helpful to them. And then, at the end of the day, they appreciate that and they’ll remember that.”

Bloodworth mentioned common misconceptions in nursing home marketing. She opined that the best method for nursing home marketing is to take a slow and steady approach rather than being aggressive. “People who are super aggressive and going into places where they shouldn’t and doing it anyway. That type of marketing does not work in this industry, specifically in skilled nursing. Her approach to nursing home marketing is more respectful, favoring lasting relationships that will continue for many years to come.  

Another misconception in nursing home marketing is about nursing home census and the notion that it is easier to market, fill, and manage a smaller building. “That is one hundred percent, not the case,” said Bloodworth. “It’s actually harder and more challenging,” as one must be concerned with bed availability. Wesley Communities, with only thirty-six beds, manages its nursing home census by working with hospital case managers and “manipulating the schedule and the bed availability so we don’t lose the admissions,” said Bloodworth. 

Determining a proper marketing strategy impacts nursing home admissions and census, which affects a facility’s profitability. “If you have two discharges, that’s a big percentage of what you’re losing in a day. If you have three discharges, now you’re at 10%, so you really have to manage that,” said Byrge. “It’s hard to keep it full because one, two, or three discharges can change a lot of what you’re doing.” Therefore, it is advisable for the administrator to review the nursing home admissions checklist regularly to track admissions. 

How To Overcome Nursing Home Census Challenges

While many nursing homes struggle to manage their nursing home census, there are several effective nursing home marketing strategies that ensure a facility stands out from others. Building trust with families creates meaningful relationships that foster open communication. “They’re looking for a quick response and options,” said Bloodworth. “By answering your phone and returning phone calls almost immediately, you make them your absolute priority.”

Nursing home marketing uses similar principles to other marketing strategies.
Effective nursing home marketing requires a slow and steady approach.

Another marketing strategy used to improve nursing home census is maximizing reach by building followers. Developing a strong website, displaying reviews, and expanding on social media will increase the facility’s online presence and following. Facilities need to be consistent with their social media while providing relevant information on their services, knowledge, skills, and benefits to put themselves forward as an industry leader. With over 4.55 billion social media users in October 2021, long term care facilities must adapt to the times or risk being left behind.

If facilities have a steady flow of admissions, the nursing home census will naturally be consistent and the facility will typically be full most of the time. “If you do it the right way and you take the right people, you can have good outcomes,” said Byrge. “Your reputation is nearly everything.”

For more on recent trends in long term care, read our blog and subscribe to the LTC Heroes podcast

Cindy Wong