What Is Long Term Care Software?

When entering long term care as a provider, biller, or in management, you will need to understand what long term care software is and how it works.

Long term care software systems allow nursing homes, skilled nursing facilities, and other long term care (LTC) providers to store and manage a variety of data types.

There are four main components.

2. Business Finance Software helps a long term care facility track its income and outgoings from a business perspective. This type of software covers items such as accounts payable, payroll, materials management, and vendor management.
3. Resident Billing Software, or Revenue Cycle Management software, manages accounts receivables and reimbursements.
4. Operational Software, helps facilities track and manage data such as resources, funds, schedules. These systems often include data analytics dashboards to help track key performance indicators (KPIs) to help LTC facilities organize their business operations and ensure that they are remaining profitable.

Each of these components must include a wide variety of information and the software is often is built from multiple modules. We will discuss all of the long term care software options a facility may need in detail in this article.

Where is Long Term Care Software Used?

People often assume long term care software is only used in nursing homes. The truth is, these systems are used in a variety of long term care settings big and small.

Here of some examples of care settings that benefit from using long term care software.

Acute vs Post-Acute Care Software

Many people may be familiar with what happens in acute care, such as in a hospital. In acute care, the focus is often on the patient getting well and returning to the community. Post-acute, or long term care is focused on helping residents about live the best quality of life they can while still taking into account outcomes. Because of this difference, the software systems needed for caring for and documenting residents in long term care are different and in many ways more complex than those used in acute care.

What is Long Term Care Software Called?

Though long term care software is utilized by many care settings, it is often referred to as an EHR system, SNF software, or nursing home software. Regardless of what you call it, it has huge benefits for nurses, patients, residents, and management teams over outdated paper methods.

What Processes Does Long Term Care Software Help With?

The short answer is that software can help with just about every aspect of a facility on many levels. From financials to resident care, to process management, and everything in between, there are electronic systems to make things faster and easier.

The current processes and systems that a facility has in place will be a big factor in determining where software (or more robust software) is needed most.

Though software can help with all kinds of tasks in an SNF, there are a few areas that which it is especially crucial for every facility to find and maintain financial success.

The Patient Driven Payment Model (PDPM)

Since 2019, PDPM is the system by which long term care groups get reimbursed by Medicare. PDPM is dictated by the Centers For Medicare and Medicaid Services and is driven both by outcomes and level of patient care.

The “Per Patient Day” Model

With PDPM, facilities are paid on a “per patient day” model. That means that they are paid for every day the resident is in the facility. Thus they often measure costs on a per patient day basis.

The Minimum Data Set

This assessment is used to determine how much money each patient day is worth on a per-patient basis. The minimum data set must be completed within 48 hours of someone arriving at the facility.

Calculating PDPM Reimbursements

Calculating PDPM reimbursements is a little like doing your taxes. There are a lot of numbers to take into account, you have to carefully gather information and make calculations, and the government determines when it’s due and checks your work. Most importantly, if you make a mistake or leave something out, you could be missing out on a lot of money.

This is why it’s so important to use LTC software to achieve the highest possible PDPM functional score and ensure that your facility is getting the reimbursements it deserves.

MDS Surveys

Reimbursements are driven by PDPM, but also by government surveys. These are very important because they can greatly affect a facility’s reimbursements, or even eliminate them all together.

Here are the most important things to know about these surveys.

• They rate facilities on a 1 to 5 star rating system
• All groups across a state are rated against one another
• If facilities drop below a certain rating, they are not eligible for reimbursements from Medicare or Medicaid or their reimbursement level drops.
• Surveys are done randomly throughout the year
• A penalty is known as a F-Tag and these penalties are very often accompanied by a fine
• Getting high marks on surveys is a critical part of maintaining a financially viable long term care facility
• Very often, previously received F-tags are strongly monitored so they do not come up again

Long term care software helps with MDS surveys by importing and exporting various data so you can easily fetch information requested by surveyors. An electronic MDS system also lets you run reports and track current or potential issues to prevent F-tags and subsequent penalties.

What Long Term Care Staff Uses Nursing Home Software and How?

At first glance, it might seem like long term care software is for nurses and CNAs. Though this is true, there are multiple other areas of long term care software that other staff members utilize in a variety of ways.

Leadership

CEOs, CTOs, CNOs, CIOs, and Medical Directors use LTC software to

• Keep tabs on facility KPIs
• Identify the causes of facility issues
• Monitor financial success

Clinical Staff

Physicians, Nurses, CNAs, DONs, and therapists use LTC software in a variety of ways for example to

Revenue Cycle Management Staff

Billers, financial clerks, billing managers, and directors of revenue use LTC software to

• Produce invoices
• Maximize reimbursements
• Check eligibility for services
• Manage multiple payors

Financial Staff

Accountants, bookkeepers, financial managers, controllers, and CFOs use LTC software to

• Managing fixed assets
• Budgeting and projections
• PDPM calculations
• Generating financial reports

Read more about how the various members of a long term care team use long term care software below (“Who Uses LTC Software?”).

 

What To Know Before Using Nursing Home Software

Before understanding how to use long term care software, it is important to understand the process a person flows through to get into and out of a long term care facility.

Admittance Processes

Patients, or residents as they are most often referred to in long term care, are admitted to a facility in one of 3 ways.

1. From the hospital
2. From a physician referral
3. From a family member

After Being Admitted

There is a lot that happens after a patient or resident is admitted.

1. They must be assessed within 3 days, of being admitted to determine diagnoses, although additional diagnoses can be added later.
2. A care plan is created that outlines issues, how they will be addressed, and what the expected outcomes will be. Within Assisted Living facilities, these are known as Service Plans.
3. A physician will give Physician’s Orders which refer to treatments, often in the form of medications, to be given to the resident as well as when and how to meet the goals of the care plan.
4. Ongoing progress notes are made to note the progress of the resident.

Ongoing Care

From administering medications to checking vitals, to tracking infections, there is a lot that needs to be done to provide quality ongoing care to residents.

Gathering Clinical Data

1. Most residents will have their vitals taken regularly to ensure they are in line with expectations.
2. Daily or more often, every aspect of the resident’s nutritional intake, liquids, behavior, mood, cognitive abilities, skin condition, and much more are tracked using a Point of Care system that shows care providers and the administration how individuals and the facility overall are doing.

Assessments

Throughout giving care, many different assessments are necessary to keep track of the progress of the resident. These assessments have shared aspects across different types of facilities, but many facilities utilize their own assessments. These are called User Defined Assessments.

Administering Medications

When nurses distribute medications that the physician prescribed, they must track every medication, every dose, and every delivery of that medication. This is done with an Electronic Medication Administration Record (eMar)software, which is almost always built into the EHR.

Infection Control

Infection control within a long term care facility is critical and thus there is a separate Infection Control System and reporting system that tracks issues such as HAIs.

Discharge

Residents are often discharged from a facility. There are a few important things to know relating to discharges.

Medicare

Medicare will often pay for up to 20 days in a long term care facility for a resident. If the resident is on Medicare and not on a self-pay or private pay system such as insurance, they will be discharged after 20 days. Insurance and self-pay systems enable residents to stay much longer.

Discharge Paperwork

Once a resident is discharged, they are given a set of discharge paperwork which is meant to help them get the medications and equipment needed to live outside of the long term care facility.

How To Use Long Term Care Software

Long term care software is in growing demand, as the technology in healthcare itself continues to grow to better meet the needs of patients and residents. However, many healthcare providers are struggling to use these systems to optimize their daily workflow and improve health outcomes for their residents.

Facility managers have to manage residents’ medical and daily lifestyle needs (meals and indoor/outdoor activities). They also have to maintain a relationship with family members of residents and manage the complex health care system that ensures they get paid. This is why picking the best long term care software and learning how to use the software correctly and efficiently is so important.

Documentation

Surveyors will utilize the LTC software system to review documentation. They will ask questions if they cannot locate the information they need. Completing documentation regularly will help avoid a deficiency in records, which will save the facility a significant amount of money.

Documentation in a long term care EHR should be a professional, unbiased statement of facts. Subjective comments, like a resident being “too nosey,” should not be documented, as it is irrelevant. This applies even if a staff member thinks a resident follows them around too much. The resolution in this example might be to see if the resident wishes to participate in an activity, allowing the staff member to attend to other duties. It also should be noted that the nursing home software system is not a forum for airing staff grievances. There should be a completely separate system in place for such communications.

Reports

It is essential to ensure that up-to-date reports are available consistently, as they can reduce errors and misunderstandings. The more information that is input into the software system, the more it can generate positive outcomes. This attention to detail could be critical to determining a person’s future treatment, finding patterns of behavior or a “trigger” responsible for the behavior displayed, or identifying a decline in health. These reports also help ensure compliance with regulatory standards for nursing homes and other long term care facilities.

Training

Using long term care software effectively begins with training all staff on the best practices. Management may need to have discussions with staff members who are intimidated by the idea of moving from paper to electronic health records. This is of particular concern for nurses who have been in the industry for a long time.

Others may not be very tech-savvy or even understand the advantages of using such software. Do not be surprised if some CNAs or other direct caregivers have never learned how to use a computerized system.

These issues can be resolved with adequate training; a greater understanding and appreciation of the long term care software system will significantly reduce anxiety among staff members. Of course, not all staff members learn at the same pace. More training will be required for those who are not familiar with computers. Other experienced staff, or those known as “super users,” can assist new hires and those unfamiliar with information technology programs, inspiring teamwork and improving documentation standards.

All staff should become familiar with the software components they need for their roles within the facility. Fortunately, some LTC software providers offer free online EHR training that can help nurses and other team members improve a facility’s compliance significantly. In addition to training, it is crucial to explain to staff the importance of using the electronic system every shift to maintain optimal levels of documentation.

What Are The Components of Long Term Care Software?

Clinical

The clinical component within the electronic health record system includes a resident’s health information along with demographics and social history (if known). This builds a picture of the individual, which tells staff details such as food preferences, daily routines, alertness levels, diagnoses, and all activities of daily living.

Clinical data does more than provide an accurate electronic health record.

The clinical component can also include more personal information like if the resident loves playing bingo, is afraid of spiders, is a retired teacher, or likes westerns. This sort of information proves very valuable, especially when a new resident arrives at the facility or when new staff members are learning about resident preferences. The more information, the more staff can adequately meet the resident’s needs.

The Most Commonly Used Clinical Software in Long Term Care

In addition, staff should document and retrieve details from the system to perform their jobs to the best of their abilities. Some of the most commonly used modules in clinical software are:

Business Financials

-Clinical data can improve the health of residents. Financial data can improve the health of the business.

The financial component of nursing home software allows tracking and trending management for the financial assets of a facility through a General Ledger module with user-defined formats for financial statements. Here the user will be able to create per-patient-day budgets and track performance. One can also simplify budget creation and manage journal entries.

LTC financial software does more than provide an accurate financial picture for the business.

An Accounts Payable module will include advanced tools that allow a facility to maintain vendor information, process invoices, write checks, generate 1099s, and monitor cash requirements.

Some aspects of long term care business financial software include

• General ledger
• Accounts payable
• Fixed assets
• Payroll
• Materials management
• Financial reporting

Overall, LTC financial software enables management teams to see where money is being well spent and, more importantly, identify areas where the business is losing money and adjust accordingly.

LTC Resident Billing

This is another software component that surveyors review, particularly on annual surveys or complaint surveys about resident trust funds.

Accounts Receivable and Billing of long term care software helps keep track of payments made to the facility and any outgoing expenses. In addition, reports can be generated to determine any current or overdue bills. The emphasis is on consistent, accurate documentation to avoid future errors and issues.

Another aspect of resident billing is determining eligibility for services. Many LTC accounts receivables systems take this into consideration with integrated 270/271 messaging.

Additionally, updates must be made accordingly within the system when residents move in or out of the facility with details of where they went or where they came from. The facility also needs to detail if any medications were destroyed or surrendered and where belongings went if a resident passes away, transfers to another facility or returns to the community.

Facility Operations

Long term care facilities need to provide the best environment for residents while still making a profit in order to stay in operation. And that can’t be done without managing various areas of data. Money will be lost without keeping track of business operations, and data crucial to your team’s success will be missed.

There are several software areas that fall under operations such as

• Resident funds management
• Resident and resource scheduling
• KPIs management with data analytics dashboards
• Client relationship management (CRM)

The Advantages to Using a Long Term Care Software System

Talk to anyone who has switched from pen and paper to an electronic system and they are sure to have a long list of perks, and maybe a few gripes (more on those in the next section). Let’s start with the most obvious benefits.

More Bedside Time

Nurses and CNAs always have more to do than can get done. Typing is much faster than handwriting. Studies show that typing with just two fingers is faster than writing by hand. Once an LTC software system is in place, nurses have more time to provide the best possible care.

Less Paperwork

Moving away from the traditional pen and paper method of documenting allows facilities to reduce the amount of physical paperwork stored inside the facility. Not only can facilities save paper, records can be scanned into a system, which frees up storage space within a facility meaning more physical space for other things and no more expenses for off-site storage.

Safer For Facilities, Better For The Environment

In previous decades, paperwork would build up and take up so much space that it would become a potential fire hazard if not stored correctly. And the longer a facility has been around, the more paperwork they have, compounding the issue. Long term care software offers a safer alternative.

Another big driving force behind a facility’s upgrade to a paperless long term care EHR system is the environmental factors. Paper, ink, and filing cabinets are not the most environmentally friendly options, not to mention the cost of those supplies and managing them.

More Accurate LTC Charting and Records

With paper records, things can get lost, handwriting can be sloppy, and there was that time Maggie spilled her entire coffee on a stack of patient charts. When you use software for your nursing home management, you don’t have to worry about poor penmanship, or damaged or misplaced paperwork. What’s more, the best nursing home charting systems help avoid missing data by having a required field and reminders to complete all of the necessary information.

When charting is faster and correcting misspellings and errors is easier, nurses are able to provide more detailed notes. That means more accurate patient records and supplemental information becoming available that might have otherwise fallen by the wayside.

Important Notifications Via ADL Charting Alerts

ADL charting in long term care is safer and more efficient with an electronic system. By using an electronic Kardex, your team will receive alerts that must be acknowledged pertaining to the most pressing matters about your residents. With physical records, automatic and immediate notifications simply are not possible.

The Capability to Make Late Entries and Modifications to Electronic Records

With the hectic schedules of nurses, they not always be able to document everything on time, meaning some key information will need to be recorded after the fact. While late entries are not ideal, they are a better alternative than no documentation, which creates gaps in events and could cause confusion between staff as to what occurred on their watch.

Higher PDPM Functional Scores

The Patient-Driven Payment Model (PDPM), is a new way for facilities to calculate their reimbursements. A higher score typically means more in the way of reimbursements. Long term care software can help facilities to optimize the delivery of services and provide the best care to residents, allowing facilities to achieve a higher PDPM score..

Easier Financial Tracking

SNFs can better track their General Ledger and Accounts Payable, making the billing and reimbursement process easier and more straightforward. In fact, now it is even possible to track your depreciating assets automatically using a Fixed Assets module.

Better Surveys and Ratings

Long term care software makes it simple to collect and organize data and create reports for surveyors. It also gives facilities an easy way to monitor F-tags to avoid poor ratings and penalties.

Access Data Anywhere, Any Time

With nursing home software, data can be viewed, added, or updated from anywhere inside or outside a facility. This one is especially relevant due to the impact of Covid-19. For example, SNF leaders and care providers can access the EHR securely from home.

Reduce Billing Errors

A computerized system catches human errors meaning less money falling by the wayside. Electronic billing systems don’t just help with calculations, they make sure information is not missed. For example, electronic communication with pharmacies reduces billing errors by identifying incomplete fields on UB04

Other Advantages

Talk to the employees of a facility that has switched from pen and paper to electronic systems and you are likely to hear a wide variety of other advantages. The benefits you’ll hear about often depend on the system’s capabilities and the position of the person you’re talking to, but one thing is overwhelmingly clear, the benefits of an electronic system outweigh the challenges.

What To Look For In Long Term Care Software

Though there are countless benefits of using SNF software, choosing software that is a poor fit for your facility can cause a lot of headaches. Knowing what makes a great long term care software will give you the knowledge to pick the best option for you and your team.

Functionality

Of course, the most important aspect of an LTC software system is that it is able to do the things you need it to do. Make a list of everything you need your software to do and any special requirements your facility has that may not be standard.

Tip: In addition to “What can it do?” you might want to ask “What data does it connect to?” to determine if a system has the capabilities you need.

Usability

Next to necessary functionality, ease-of-use and ease of learning or onboarding is the most important aspect of long term care software. In an industry that has a lot of turn over it can be time-consuming and expensive to explain details of a software system to each staff member so it’s imperative that the software you choose be user-friendly and intuitive.

Tip: To determine a software’s usability, show some screenshots of a software to your staff and see if they can guess where they should click to complete various tasks.

Customer Support

It’s inevitable that your team is going to have questions or need help from time to time. Without good customer support, you’re going to be on your own to solve software issues. In fact, some of the biggest complaints LTC software users have is about poor customer support.

Tip: Don’t just look at reviews. Research the support team’s credentials and response rates to get a clear picture of the quality of support you can expect.

Implementation

The fact is it’s not easy to set up a long term care software system. There are a lot of moving parts so you’ll want to make sure you have a clear picture of who is responsible for what and when so there are no surprises.

One of the biggest, and most difficult aspects of implementation is training staff on using the new software. No matter what system you are using, there is a lot for everyone to learn so it’s critical that the software company has free online training available. The reason it needs to be free is that most facilities have a high turnover and paying for every new person to receive training gets expensive fast.

Tip: On-site technical know-how is important for a successful implementation. Many EHR companies have “a train the trainer” program where they can effectively train on-site technical knowledge to your most efficient team members.

Listens To And Understands Customers

If you go with a company that doesn’t understand the industry or listen to your team, you’ll end up with software that doesn’t meet your needs. It’s best to find a company that proactively asks their customers what they are struggling with at their facility and makes changes to the software to help resolve those issues.

Tip: Ask if a company holds their version of virtual “Town Hall” meetings, how often they are, what is covered, and who on the software team will be present.

Maintenance

For any software system, but especially for long term care software, maintenance and reporting systems are critical aspects of finding the solution for your facility. In past decades, long term care facilities were required to maintain their own hardware. But these days, most long term care software providers offer hosted solutions in the cloud. This dramatically cuts costs for the long term care facility and is a crucial part of finding and maintaining an effective long term care software solution.

Tip: Ask how many times the software had to be offline in the last year due to maintenance or other factors.

The Challenges of Using Long Term Care Software

Still, the industry has been using the traditional pen and paper method for a long time. Thus, when long term care software vendors reach out to long term care facilities, they must take this into account if they are to win over staff who are resistant to change. Of course, if the nursing home software is easy to navigate, staff will be more inclined to adopt and use it. This is part of the reason why choosing the right long term care EHR and sufficient training are important parts of integrating a care plan software better into a facility.

Implementation

People, of course, learn at different paces, especially when it comes to technology in long term care. A facility will often have some staff members who are more tech-savvy than others. These “super users” will have an aptitude for picking up the new technology more quickly, so they can assist with the transition from paper to electronic by training others who need additional help using the EMAR software.

If the long term care software is overly complicated, these staff members may be resistant or too afraid to use the equipment, therefore increasing the likelihood of recording inconsistent documentation which can result in medical errors and high mortality rates. Therefore, it is imperative that nursing software programs are user-friendly, with accessible resident data that can be pulled up throughout the facility on multiple devices, easy-to-view charting, flexibility to move between resident charts with minimal scrolling, and useful pop-up notifications that warn nurses about pressing activities of daily living (ADLs). All of these features and more, need to be easily accessible so staff can accurately input resident data into the long term care EHR.

Required EHR Training

When a facility adopts a new nursing home software, they must allow for an implementation period to provide sufficient staff training. To maximize the full capabilities of long term care software, its users must be proficient in using it.

Of course, staff members will have different levels of computer literacy and will also use different functions of the nursing home software depending on their roles and responsibilities. Therefore, it is not necessary to train every feature and function of the software to every staff member. This free online EHR training resource has classes customized for each role in a long term care facility.

While “super users” may be ready for a great deal of information, it would be wise to avoid overloading the others with excessive software training initially. Instead, train them only on the core functions needed to perform their jobs. This will not only improve the facility’s efficiency, but it will make them less reluctant to accept the move to electronic records and give them more confidence when using the long term care software overall.

The Burden of Re-Training

Another reason why senior living software needs to be user-friendly is high staff turnover, a longstanding problem in long term care. When new recruits join a facility, they will need sufficient training to use the senior housing software in order to effectively carry out their duties. Therefore, the SNF software needs to be straightforward and easy to navigate so new hires can be immediately entered into the system. Meanwhile, previous staff must be removed from the system in a timely fashion. This will help facilities to maintain up-to-date and accurate records.

Providing adequate staff training is absolutely imperative for a smooth transition and for the nursing home management software to be fully and efficiently implemented into a facility. Improving internal workflow by moving from one module to another will significantly help facility staff to filter,  sort, and export information , saving a lot of time. This is especially the case when there are new updates to the long term care software.

Training Sessions

The training itself can be conducted online, in person, or using inservices. Some long term care software vendors offer personalized training, free training, or additional training when required. Because every facility is unique with its own needs and requirements, it would be beneficial to have a trainer from the long term care EMR software company visit the facility to walk staff through the various programs and functions.

Facilities should also utilize their tech-savvy staff who are more knowledgeable about using the nursing home EMR software. They can share their valuable insights with newer recruits passing on relevant software tips on its functionality.

Software Malfunction

In the past, facilities were generally responsible for maintaining their own systems. However, long term care software companies have now assumed part of that responsibility, working in unison with the facility. Experience Care’s user-friendly system allows for easy communication so that facilities can provide feedback and suggestions for software improvements. This can keep costs down by preventing any future issues

Long term care EHR may, at some point, experience a malfunction that prevents it from working properly. In the case of a power outage, an administrator will need to report the issue and access backup information. That means that the nursing home software will need to include an emergency access function. Another situation that could arise it that a nurse may be accidentally locked out of an account, preventing access to resident documentation. That is why the long term care software system will need to include password retrieval functions.

It is imperative that the long term care software vendor resolve the problem quickly. Contacting the software’s customer support department needs to be smooth, simple, and fast. If the user must wait for excessive periods of time to connect to an advisor and then repeatedly explain the issue to different customer service advisors, the process becomes inefficient and discouraging.

For some long term care software vendors, it can take up to three to four days to escalate problems to higher tiers, further exacerbating facility staff. Meanwhile, Experience Care, which emphasizes outstanding customer service, has an average response time for critical issues of sixty minutes, under four hours for high priority issues, six to eight hours for medium priority, and contacts users by the next business day for low priority issue

Facilities should also be wary of software companies that charge additional maintenance fees, as this drives up costs considerably. In such circumstances, facilities may want to consider one of the other long term care software vendors so that they can find one that better suits their needs.

The Role of Customer Service

At the heart of every company is efficient customer service that supports and delivers help as and when needed. For something as important as long term care software, it is imperative that the vendor connects users to advisors rather than pre-recorded messages. Experience Care has dedicated customer service representatives located throughout the U.S. working in all time zones, thus ensuring help is on hand when needed.

Long term care software vendors must provide facilities with customer service numbers that can be reached around the clock. These advisors should be on-hand to determine the problem, give prompt replies, and advise possible solutions. They must also have a reasonable understanding of the long term care industry, as well as their own nursing home EHR software, in order to provide real solutions. Still, there may be major glitches for which an immediate resolution is not possible. In such cases, it is imperative that the nursing home EHR software’s customer support has effective communication and can provide the facility with regular updates and temporary fixes, especially if the problem is prolonged.

Open Communication

Finally, in order to bolster a better working relationship between the long term care EHR software company and the facility, long term care software vendors should reach out from time to time to check on the facility, making sure the nursing home software is running as it should. The facility will appreciate the personal touch giving them a chance to highlight any problems or issues they are having with their long term care software. It is beneficial for both organizations to discuss the software functionality in order to open communication and promote a smoother service all around.

Clinical Long Term Care Software

Clinical software is what most people think of when they picture a software system for a post-acute care facility and for good reason. Nurses, CNAs, physicians, therapists, and other clinical staff rely on these systems for the majority of their daily tasks.

What Is Clinical Long Term Care Software?

Clinical Systems are healthcare information technology systems applied at the point of clinical care. Doctors, nurses, and other healthcare providers use them to manage patient or resident data to ensure regulatory compliance , improve care outcomes, and submit the correct reimbursements for services.

Information Tracked By Clinical LTC Software

There is a wide array of data that is tracked and managed by conical systems. Here are some of the most used aspects of clinical systems in long term care facilities.

Nursing Home Charting Systems

Clinical LTC software handles huge amounts of documentation. The capabilities of charting systems in nursing homes varies based factors such as the permission level of the user and the specialization of the facility.

Documentation

For charting software to be used in post-acute care setting, there are several standard pieces of data that need to be documented for a resident such as

• Identification cards (e.g. a driver’s license)
• Medical coverage details
• Family and emergency contacts
• Point of discharge documents for facility admission

Specific notes relevant to a resident—for example, power of attorney or the guardianship in place—will also be stored as part of the documentation

Charting software allows nursing home staff to document and store resident information, such as

Allergies

These must be easily accessible and highlighted in the system. All allergies must be recorded to prevent any potential life-threatening situations. These allergies may be certain foods, medications, and reactions to products or animals. It is also valuable for staff providing direct care. For example, staff would need to know not to use certain washing detergents for a particular resident due to allergy concerns.

Vital Signs

According to Caring Senior Service, vital signs indicate a resident or a patient’s most essential bodily functions. A clinical system can be set up to gather this information as required. Note that some residents may need their vital signs checked more frequently than others. Tasks often need to remain as incomplete until the member of staff records the assignment has been done. Vital Signs recorded include:

Diagnoses

A physician or qualified clinician determines a resident or patient’s diagnosis through the diagnostic process. These diagnoses can be recorded in the software and updated accordingly. This information drives the payment model for each resident. It may prove helpful to have regular meetings with the physician to ensure all diagnoses are adequately captured within the clinical system. Physicians are concerned with the care and treatment of residents hence they do not think about financial reimbursements to a facility. Meetings can enable information sharing and education to ensure all relevant diagnoses are recorded.

Immunizations Records

An immunization record shows past and recent immunizations for every resident. It can also record when a resident’s health declined or could not have a particular immunization due to health, medical, or religious reasons. These records have become of greater importance since the COVID-19 outbreak began. In addition, the system can create reports for local and state health agencies to review if needed.

Snapshots/Dashboards

Dashboards provide an easy-to-use and easy-to-locate option within the system. The dashboard offers immediate information quickly if required. This data is also helpful for physicians who need quick access to a resident’s medical information for review.

Security and Permissions Management

With many types of employees, long term care facilities need multiple user types for their software systems. This allows each staff member to have access to all the information they need, and nothing they don’t.

For example, nurses and other medical professionals can access the information they need for resident care but not other confidential information, like finances and payroll information. The system administrator will only grant access to the financial information of the nursing home to financial officers. Financial officers, though, will not be able to view any details of residents’ ongoing care.

Even the clinical systems administrator—the only person that has access to all the information in the clinical system—is limited in terms of emergency access, grant delegation, and interdomain access control based on  role-based access control, according to the National Library of Medicine.

Admit Discharge Transfer (ADT)

ADT tracks a residents’ known movements. Facilities record this information for all residents, not only for reimbursement but also in cases of emergency. Some of the information that falls under ADT is:

• New admissions
• Resident facility transfers
• Resident admissions to a hospital, nursing home, or other inpatient facilities
• Resident re-admissions
• Resident discharges (death or return to the community)
• Resident location changes within the facility
• Changes in levels of care

Assessments

The Minimum Data Set (MDS) determines from the documentation recorded the monetary amount the facility is reimbursed for services provided to residents. User-Defined Assessments are a part of the clinical system that allows facilities to build their own assessments.

Physician’s Orders

Physician’s Orders is a specific section that lists each resident’s treatments and medications as ordered by the physician overseeing the resident’s care. This is a complex system that covers all aspects that can be medicated or treated. The physician or qualified person will include documentation to support the decision for the order

Orders can be linked to the ePrescribing system that automatically gives alerts to send medication orders to the pharmacy. This is sometimes known as a monthly order cycle. This feature can save staff time by being automatically generated, as long as the information is kept current in the system.

Controlled Substances

A separate system is required for controlled substances. The Prescription Controlled Substances system (ePCS) is used when there are government-enforced limitations for prescriptions. The system can also provide prescribing alerts, dispensing alerts, basic drug information, and possible drug contraindications.

Care Conference Letters/Facility Notifications

Facilities will issue periodic letters to residents’ families or appointed personnel regarding the resident’s care. They will also give families and personnel opportunities to attend care plan meetings. In addition, facilities may decide to distribute information such as Covid 19 updates, upcoming facility-based events, and marketing materials. All notifications can be set up in the system to be generated for distribution and updated as required.

Care Plans

Here are the main steps of a care plan with practical examples:

• Identify the concern – Take the example of a resident who consumes less than 50 percent at mealtimes.
• Have an attainable goal – This could be that the resident will consume 50 percent or more at mealtimes with snack choices offered between meals.
• Interventions – There is more than one way to intervene.
  • The resident might be offered her preferred meal choices (cereal, grilled cheese, minestrone soup) daily in addition to the daily menu choices to encourage intake.
  • The resident could also be offered snacks of her choice (blueberry yogurt, fruit salad with no peaches, cheese crackers) a minimum of three times a day between meals.
  • The resident is weighed daily to track progress for 30 days.
  • The resident is encouraged to socially dine with other residents every mealtime for 30 days to improve well-being and food consumption.
• Resolutions – The resident will be weighed weekly to monitor weight loss or weight gain. A care plan is arranged with the family, and they are updated with relevant information so that they can provide support. If the resident declines all of the meal options above, family members will be informed. Still, staff will continue to offer the resident’s preferred choices alongside daily menu options and arrange weekly management meetings to discuss the resident’s progress.

Interdisciplinary Progress Notes

Interdisciplinary Progress Notes are detailed documentation regarding an identified issue and include the steps being taken to resolve it. These are similar to SOAP (Subjective, Objective, Assessment, Plan) notes used in acute care settings. Such documentation shows where the facility is making reasonable attempts to increase the resident’s food consumption and continue doing so

We can use the example above of a resident who consumes less than 50 percent of her meals to see what progress notes look like:

• August 2, 2020, 10 A.M. – Resident refused all breakfast choices offered except a glass of milk. Family informed as per request of meal refusals. Resident offered 10 A.M. snack and chose blueberry yogurt, 100% intake.
• 12:30 P.M. – Resident chose to eat lunch in her room with roommate. Resident ate minestrone soup, 80% intake. Resident declined dessert.
• 3:35 P.M. – Resident declined to attend bingo with snacks activity. Resident ate two cheese crackers, 100% intake.
• 5:30 P.M. – Resident declined all supper choices. Family was notified.
• 6:30 P.M. – Resident ate a fruit salad bowl, glass of milk, and a bag of chips, 80% intake. Daughter visited and brought her a variety bag of chips.
• 8:30 P.M. – Resident declined any snacks and requested to go to bed.

This documentation shows how and when the facility continually made sincere attempts to increase the resident’s food consumption.

As the example demonstrates, there are times when an intervention is attempted and is not successful, or the outcome was not as productive as anticipated. It should be known that there is a certain degree of flexibility to make relevant changes and put in place another intervention when necessary. Consistent documentation can explain what worked and what may still need a resolution.

eMAR (electronic Medication Administration Record) and eTAR (electronic Treatment Administration Record)

The physician gives orders for facility staff to follow and implement. Nurses and other specialty trained staff will track types of medication, dosage, time, method of administering, and any medication refusals. The eMAR system assists in ensuring residents receive their medications correctly. here for an eMAR cheat sheet.

In System Tasks

Also referred to as “e-Assignments” or “Assignments,” Task Management involves overseeing the whole cycle of a task process, from planning to conclusion. The system allows users to be able to assign tasks to others, including requirements and deadlines.

eResults (Also Referred to as “Labs and Rads”)

Residents will require diagnostic tests from time to time or when there is the need to investigate a health concern. Standard tests, such as blood work or an MRI (Magnetic Resonance Imaging) would be considered both a Lab (Laboratory test) and a Rad (Radiography test). Before, results had to be issued manually. But with the invention of long term care EHR, the eResults system can communicate the results back from the external testing facility. This saves the facility time as staff does not have to scan information into the system.

Messages (DSM)

A nursing home software system can provide DSM (Direct Secure Messaging), also known as “Direct Messaging” and “Direct Project,” to enable communication between staff and families of patients or residents. The system uses HISP (Health Information Service Provider), an accredited network service operator that enables clinical data exchange nationwide.

Incident Reporting

The clinical system in long term care software can track incidents and accidents reports. This documentation will track falls (with and without injuries) and unusual events. The incident should be well documented to include the following:

• Date
• Time of the incident
• Details of the event
• Any witness statements
• What the resident could tell staff and
• What was implemented to resolve it.

The incident report should be signed by staff documenting the incident, and witnesses should sign and record the date of their statements. Incidents should be tracked in the long term care EHR.

Infection Control Tracking

Infection prevention has become more of a focus since the outbreak of COVID-19. Health Acquired Infections (HAIs) have been a long-standing issue within facilities. Some infections, such as SARS-CoV-2, are highly contagious and can quickly spread in a long term care setting. Therefore, facilities must ensure they have the proper protocols in place to reduce the chances of acquiring and spreading any infections.

Infection Control tracking is designed to monitor the number of residents with infections or diseases in the facility and the treatment steps implemented. The clinical system in long term care software can monitor signs and symptoms, test results, treatment, and recoveries or health declines. Documentation must be kept current, and staff is required to sign their reports.

Quality Assurance and Process Improvement (QAPI)

QAPI has emerged in more recent years and is used for continuous assessment to strive for better quality of care outcomes. Facilities often have quarterly QAPI meetings with various facility department heads and management. By way of these discussions, areas of concern can be identified before the problem becomes more significant. Ideas to resolve the situation can be documented, implemented, and then updated at the next meeting. In addition, facilities will use PIPs (Performance Improvement Projects) to track their progress.

Reporting

Long term care involves continuously reporting, documenting, and monitoring. The clinical system in nursing home software can be set up to pull reports on all system areas and review specific timeframes. New advanced systems come standard with over a thousand reports that can be generated.

Transfer Information

Facilities usually deal with a resident transferring from one facility to another on an individual basis. Reasons for this transfer include:

• A request made by the resident or his/her family
• The need for a higher level of care
• Financial issues

n cases of an emergency or facility closure, many residents will suddenly need to find placement. Facilities located in the same area will often have documents that state where residents should be transferred, whether a sister facility or a separate business.

Clinical systems in long term care software can store important transfer information and keep it relevant and up to date. In addition, the system can be set up so that the transfer facility can access all of the resident’s information.

Point Of Care Systems

Point of care enables facility staff to easily access a system for the purpose of documenting various aspects of each resident’s life during their stay. The point of care system will include areas of care with tasks to complete, such as:

• Care Plan Interventions- This includes medication reviews with changes, physical therapy referrals, fall prevention mats in place, dietary recommendations, and provide medical assistive devices
• Activities of Daily Living (ADLs)- This includes bathing and dressing, eating, sleep patterns, activities participation, ambulation and locomotion, toileting and incontinence, cognitive behaviors, transfers, and bed mobility
• Functional Abilities – Participation in hobbies and activities, independence levels
• Meals – Food preferences and choices, feeding assistance levels, use of adaptive devices for eating, preferred locations to dine within a facility
• Toileting – Continence abilities and assistance levels, continence training programs
• Bathing and Hygiene – Levels of assistance, shower/bathing schedule, care compliance
• Cognitive Abilities – Behavior patterns, alertness, and orientation

In point of care systems, management alerts can allow checks to be made on care performance progress and to show areas not as yet completed.

Kardex

The Kardex provides a list of all the day-to-day resident needs. In recent decades, it has become a quick “go-to” for finding and documenting information, such as:

Interoperability

This refers to the ability of computer systems or software to exchange and make use of information. Information is transmitted via the Health Level 7 Protocol, a set of international standards regarding the receiving and sending of health information. In addition, the industry is moving towards using APIs (Advanced Programming Interfaces) FHIR (Fast Healthcare Interoperability Resources). These systems are proving to be critical to the continuity of the long term care industry.

State-Specific Systems

States vary regarding their specific requirements for documentation and provision of long term care services. Clinical systems must consider both state protocol and federal regulations and be customized accordingly. The U.S. government’s code of federal regulations provides a list of the regulations and requirements for states and long term care facilities. It includes:

• The requirements for long term care facilities
• Preadmission screening and annual review of mentally challenged individuals
• Requirements that must be met by states and state agencies for nurse aide training, competency evaluation, and paid feeding assistants
• Requirements that states and state agencies must meet for resident assessment

The different state requirements often concern standards put in place to ensure a higher level of care. For example, California passed a nurse-to-patient ratio staffing law that specifies the required nurse-to-patient ratios in long term care facilities. Texas, however, does not have such a law.

Long Term Care RCM and Resident Billing Software

LTC resident billing software often referred to as revenue revenue cycle management software , does more than send out invoices. It manages revenue cycles so facilities can maximize their reimbursements, optimize their workflows, and have more time to focus on residents.

Benefits of Revenue Cycle Management in LTC

Revenue Cycle Management (RCM) software allows care providers to create customized workflows specific to their organizations by connecting to other systems in the long term care software system.

It is more than a general accounts receivable software. RCM has industry-specific methods that long term care facilities use to manage the financial and billing processes for a facility. Some of the benefits of an RCM system are:

Save Hours Every Week

With accurate and automatic billing you can eliminate hours of work every week. Here’s our case study on exactly how LTC billing software saved a financial accounting supervisor hundreds of hours a year.

An efficient long term care software can

• Connect directly to clinical data so you don’t have to worry about wasted time and potential errors finding and moving data
• Set up billing profiles so you don’t have to start from scratch each time
• Automatically calculate charges
• Set up your own rules for everything from bill cycles, pro-rated charges, to plan requirements
• Set plan requirements, such as whether it pays for the day of discharge or admit
• Set up billing criteria for hospital leaves

Eliminate Repetitive Tasks

There’s no reason your team’s valuable time needs to be wasted doing the same tasks again and again.

A wise man once said

If it has to be done more than once, it can be automated.

Resident billing software helps to eliminate tedious repetitive tasks since you can

Maximize Reimbursements and Optimize Cash Flow

If you’re not using an electronic billing system, you’re losing money, plain and simple. LTC billing software will catch all of the areas you would have missed or spent hours trying to sort out.

For example, resident billing software allows you to

• Set limits or minimums on specific ancillary items
• Smoothly handle retroactivity and rebills
• Automatically track Medicare for 100 days including hospital leaves and stays
• Send real-time queries about a beneficiary’s eligibility in 270 format to CMS

Nothing Falls Off The Radar

If you’re dealing with RCM manually, you’re inevitably going to end up with dates that pass and items that were forgotten. LTC billing software helps facilities keep up through features that let you

• Allow multiple viewers simultaneously without disrupting one another
• Generate custom billing reports on demand so you can see everything you need at a glance and print as needed
• Get reminders for upcoming events with up to date status reviews on credits, costs, and account balances
• Flag areas that need to be addressed or seen through

The Main Billing Components of Nursing Home Software Systems

Manually entering financial accounts is both time-consuming and inefficient. Here are the main components and functions of long term care accounts receivable and billing systems:

Accounts

Accounts is a general term for a software feature set that has several functions including

• Charge Orders – generate and review charge orders
• Receipts – enter a cash receipt or negative remittance from a payor
• PDPM – review and approve assessments
• Statuses – understand account balances, costs, and credits

Billing

Creating, sending, and tracking invoices is a real challenge without the right software for the job. Long term care software is specialized in the industry and help with a variety of tasks such as

• Raise and send invoices
• Process invoices that are sent out and received by the provider
• Track a paper trail for facilities to keep records
• Act as an inventory tracker
• Help facilities remain legally compliant

Account Receivable

Using RCM software to manage money in and access the data in a meaningful way will keep you from digging through piles of paper or messy spreadsheets to find the numbers you need. RCM software can help

• Document all facility purchases for services and outstanding payments
• Maintain logs for all money received or due to be received from services rendered
• Enter invoices and calculate the depreciating assets at the end of the year
• Attach invoice details to each transaction and enter the relevant information
• Record and collect any debt step-by-step

Patient-Driven Payment Model

PDPM is the current method for reimbursing skilled nursing facilities (SNFs) for their residents’ stays at the facility. It was introduced by Medicare in 2019 and calculates the payment to a facility based on clinical characteristics, patient assessments, diagnosis, and the resources needed for coordinated team-based care during a patient’s stay. Facilities must know how to classify a resident for payment and how to calculate the per diem payment as stipulated by PDPM.

The Patient-Driven Payment Model (PDPM) feature in the care plan software will enable the user to review and approve PDPM-based MDS (minimum data set requirements) assessments.
These assessments record each resident’s health journey by using a code system that is submitted for reimbursements to Medicare and Medicaid. Facilities operating on paper will have to look through paper reports and diagnoses to code for PDPM, and this can be very time-consuming.

Resident care is classified into one group of the five case-mix adjusted components, these being:

• Physical Therapy (PT)
• Occupational Therapy (OT)
• Speech-Language Pathology (SLP)
• Non-Therapy Ancillary (NTA)
• Nursing

Each case-mix group has several sub-groups based on the relevant MDS 3.0 data. PDPM classifies residents according to the case-mix component group, each of which has its own case-mix indexes and per diem rates. Therefore, PDPM can apply variables per diem payments and the resources used during a resident’s stay. This information should be submitted by staff who are experienced with coding to ensure billing accuracy and payment.
A system can alert staff to any changes to the coding process. All of this is entered into the long term care software by the MDS nurse, the driver of PDPM reimbursements.

While it can be confusing for facilities to calculate their PDPM rates, especially if they are not familiar with residents’ case-mix classifications, these PDPM resources can make the process easier.

Long Term Care Financial Management

The financial success of any long term care organization relies on its financial management systems. These are extensive accounting systems that help SNFs keep track of everything the business spends money on from payroll to materials costs to maintenance and more.

What Does a Financial Management System Do For a SNF?

These systems encompass a variety of areas and some facilities will have more specialized account needs than others. Here are some of the items that almost every facility will require from their financial management system.

• Accounts payable
• Invoice entry
• Printing checks
• Managing vendors
• Check reconciliation
• Voiding checks
• General ledger
• Journal entries
• Cash entries
• Account inquiry
• Financial inquiry
• Bank reconciliation
• Closing a financial period
• Fixed assets management
• Materials management
• Payroll
• Dashboards and KPIs

LTC Financial Management Terminology

• Accounts Payable (AP)represents a facility’s obligation to pay off a short-term debt to its creditors or suppliers.
• Invoice Entry is a time-stamped document that itemizes and records a specific transaction. Invoices can include a paper receipt, a bill of sale, a debit note, a sales invoice, or an online electronic record.
• Printing Checks, Check Recognition, Check Voids help prevent fraud. A certified check is one that guarantees enough cash is available in the holder’s account when the recipient decides to use the check. It is advisable to verify the authenticity of a check with the account holder’s signature.
• Managing Vendor is the company or business that supplies a product or service to the facility. It is advisable to shop around for different vendors to find the one that offers the best quality and prices for their products.
• General Ledger is a record-keeping system that houses a facility’s financial data. It provides a record of every financial transaction and is used to prepare the facility’s financial statements. There are many useful tools facilities can use to organize their general ledger, like Experience Care’s innovative general ledger tool that offers flexible and user-defined formats for financial statements. Key features include giving facilities adequate tools for budgeting, entering journals, and writing customized reports
• Journal Entriesare used to record all the transaction dates and amounts of a facility. It is a double-entry bookkeeping method that tracks all the financial transactions by recording financial information in a detailed account. Facilities usually have a number of financial transactions, like vendor information, processing invoices, and writing checks that need monitoring. Therefore, it is beneficial to invest in an efficient nursing computer software that can incorporate all this data.
• Cash Entries record transactions received or refunded in the form of cash or a check. It is important for facilities to document all cash entries so that they can keep accurate records and balance their books. Many long term care EMR software programs will include this function.
• Financial or Account Inquiries allow a facility to research its balance of payments covering all financial assets.
• Bank Reconciliation is a statement with a summary of a facility’s banking and business activities. This typically outlines a facility’s deposits, withdrawals, and other financial activities for a specific period.
• Closing a Financial Period comes at the end of a period of 355 days, between April 1st to March 31st.
• Fixed Assets (Materials Management) tracks property or equipment owned by a facility that helps generate an income and depreciates annually. Fixed assets are seen as a long term investment that can be converted into cash after a year. By using a Fixed Assets module, you will automatically see the depreciating value of these items and thus save on taxes and CPA wages.
• Payrollis the compensation a facility must pay to its employees for a set period or on a given date. This is managed by the accounting department.
• KPIs (Key Performance Indicators) are a set of quantitative measures that are used to track a facility’s overall long term performance.
• Dashboards show a facility’s KPIs to determine their strategic, financial, and operational achievements.Clinical dashboards , like Experience Care’s, document everything from KPIs to resident care plans and allow users to view them at a glance so that facilities can track and implement their KPIs better.

For additional information, refer to this useful and learn about the objectives and functions of financial management. Another resource is our financial management module page, which demonstrates how facilities can gain an upper hand by incorporating long term care EMR software into their financial management planning.

Why Use LTC-Specific Financial Management Software?

Most facilities use some kind of software to monitor their finances, but there are many reasons why a system designed specifically for long term care is ideal. For example, it would be very difficult to keep up with per-patient-day statistics using general accounting software or spreadsheets.

Main Elements of LTC Financial Management Software

There are a few main elements of financial management software for a nursing home. They are

1. General Ledger
2. Accounts Payable
3. Fixed Assets
4. Payroll
5. Materials Management
6. Financial Reporting

Let’s dive into how software helps in each of these areas.

General Ledger

The general ledger is the main accounting record for the business. The data in the general ledger must be viewed in a variety of ways for an even wider variety of uses.

How Can a General Ledger System Help a SNF?

General ledger software helps with this by creating a way to

Per-Patient-Day (PPD) Statistics

Per-patient-day statistics help facilities determine how much they are spending, on average, for each resident on a day-by-day basis. Financial management software helps break down PPD statistics by nursing hours, food costs, laundry costs, or the total cost and can pull in data such as census or payroll.

Budgeting With LTC Financial Management Software

With general ledger software, long term care centers can create multiple types of budgets based on monthly or per-patient-day amounts.

A robust general ledger system will have budgeting options like

• Variable budgeting
• Budget maintenance
• Budget inquiry

Journal Entry Tools

A good general ledger system will have a variety of journal entry tools to meet a facility’s needs such as

• Self-balancing with alerts when accounts are not lining up
• Prior period adjustments so you can make changes to a prior period and automatically bring changes forward
• Trial balance reports showing detailed information or a summary

Month-End or Year-End Processing

Using software that automatically imports transactions saves a ton of time when it comes to month-end or year-end finances. Being able to reverse entries, calculate retained earnings, and print reports before finalizing them will also simplify month or year-end processing.

Accounts Payable

A long term care accounts payable software system is a centralized way to manage vendor information, process invoices, write checks, generate 1099s, and monitor cash requirements. Accounts payable software should be fully integrated with the general ledger.

How Can an Accounts Payable System Help a SNF?

An accounts payable system will allow you to complete tasks like

• Set up an account
• Generate charges for orders and receipts
• Modify for changes
• Review costs and credits
• Manage Payment Driven Payment Model (PDPM) assessments

Manage Vendor Information

Accounts Payable software will house all of your vendor information. Most systems can pull this information automatically when needed for accounts payable.

Setting Up Codes

Codes act as tags or rules in an accounts payable system. Here are some examples of ways codes are used in LTC software.

1. If a vendor has multiple addresses, assigning pay-to codes will help keep you organized.
2. Set up discount terms for each vendor to encourage them to pay quickly.

Cash Flow Management

In an accounts payable system you can manage your cash flow by controlling exactly when payments are made and how a payment will affect your numbers at any given time.

• Set invoices to pay manually or automatically
• See how paying an invoice on various dates affects cashflow

Multi-Facility Organizations

If you are part of a multi-facility LTC organization it’s important that your accounts payable software supports centralized processing of multiple facilities and inter-company accounting.

Tip: For multi-facility organizations, it’s important to use software that allows vendor information to be shared across facilities.

Check Processing

If you’ve been processing checks by hand, you are losing time and risking errors. An LTC Accounts payable system can print checks, process electronic signatures, and give you a lot more options than traditional methods such as

• Positive Pay file for the bank to deter check fraud
• Generates preliminary check register and a cash requirement report before printing checks
• Handles stop-payment of check with auto reversal
• Generates detail and summary-level check registers by payment cycle and month-end

Tip: Make sure your software allows you to easily reprint checks with new numbers if the original checks are not usable.

Check Status Inquiry

Software makes searching for checks easy with search filters like

• Check number
• Amount
• Date written
• Vendor same
• Status (open, reconciled, canceled, etc.)
• Date of last change
• User who last changed the status

AP Reports

LTC financial management requires a lot of reports and a good AP system should give you dozens of on-demand and month-end options. Here are a few examples fo reports facilities frequently use.

• 1099 Record Listing
• Aging Analysis Report
• Contra Analysis
• Distribution vs. Budget
• Invoices Paid But Not Expensed
• Purchase Journal
• Resolved Discrepancies

Financial managers must remain vigilant and review reports to identify areas of improvement to reduce additional expenditures and potential financial penalties. These reports are beneficial in determining the areas in which a facility is financially viable. The more systematic and time-efficient this reporting is, the better an organization will operate. That is why investing in a long term care software system is a smart investment for most facilities.

By tracking employees’ workable hours through an efficient nursing home EHR, a facility will better be able to maintain accurate payroll and time records, which include any overtime hours incurred. Facility staff are often asked to cover additional shifts, therefore, it is important for the facility to record any changes to staff schedules and overtime hours in their assisted living software program. Another advantage of using long term care software is that it helps facilities avoid making payroll mistakes and ensure that staff members are compensated fairly for their work.

Further, accurate documentation of finances will help organizations remain in compliance with federal regulations as imposed by the Internal Revenue Service (IRS) and the U.S. Department of Labor (DOL).

Long term care facilities are asked to keep time records for a minimum of two years, and payroll records for three years or more. It is far easier to do so electronically than on paper.

Fixed Assets

Long term care facilities have a lot of fixed assets that depreciate over time. From hospital beds to kitchen equipment, to ice makers, there is a lot to take into account, and without fixed asset management software to handle everything, it’s almost impossible to keep track.

Why Use Fixed Asset Software Instead of Spreadsheets

Spreadsheets can get messy and even for the most seasoned users, one error can throw everything off. Fixed asset software is ideal because it means

Bigger Tax Breaks For Your Depreciating Assets

When you have hundreds of assets to manage it’s almost certain that you’re missing out on some tax breaks if you’re using traditional methods. Fixed asset management software keeps track of everything automatically so you know you’re not missing out on deductions. Managing your nursing home’s fixed assets with software also means that everything will be tidy if you get audited.

Tip: Some fixed asset software allows you to deactivate an asset to suspend depreciation for the following year while recording the asset’s inactive dates.

Automatically Add Journal Entries

Fixed asset software lets you post accumulated depreciation and associated expenses automatically to the general ledger. You can also link new assets to master groups with general ledger account codes and depreciation types which makes setting up new assets easy.

Less Time Managing Your Fixed Assets

Time is money and managing assets with spreadsheets is time-consuming even for a seasoned user. The more complex your fixed asset management process it, the more time it will take to train someone new to use it too.

Easily Filter Data

Fixed asset software helps you find things easily with search options like

• Location (building, floor, room, etc.)
• Code
• Description
• Tag ID
• Depreciation schedule
• Free-form comments

Generate Meaningful Reports

Again, reports are key to the financial success of a post-acute care organization. Fixed Asset software gives you report options like

• Depreciation schedule for an asset
• Depreciation forecast
• Asset tracking information
• Assets by location

Payroll

Long term care payroll software is used to maintain employee information and streamline the payroll process. Most payroll systems have the following steps

• Timecard Processing – calculate timecards, show totals, and the number of completed and missing timecards by department
• Benefit/Deduction Processing – calculate benefit accruals and employee deductions, then deliver a preliminary check register
• Check Processing – with the option to view before printing
• Update Files – update employee accumulators and add data to files for benefit accrual, earnings history, deduction history, payroll master, and summary of earnings
• Payroll Reports – for management data, such as Labor Distribution and YTD summaries, as well as for local, state, and federal government reporting

Better Hiring and Staff Retention Options

In an industry that has a high turnover rate, the right payroll software can give a facility a big advantage, especially with features like

• Global pay rate changesand the option to simulate changes show the financial impact
• Job applicant tracking maintains hiring information for new employees

Why Use an LTC Payroll Software Instead of Other Payroll Software

In many ways, a long term care payroll system functions similarly to non-industry-specific payroll software. However, it connects to other parts of the long term care software system such as the general ledger to calculate per-patient-day statistic

What to Look For in Nursing Home Payroll Software

• Interface with time clock software
• Support direct deposit for multiple accounts
• Accept tax rate changes in advance
• Handle simple and complex shift differentials with hours and earnings codes
• Retain a history of prior quarters and years
• Support hundreds of Hours/Earnings codes
• Unlimited number of deduction codes, for items such as 401(K) and union dues
• Add functions to deduction codes such as a priority order for deductions, using percentage or fixed dollar amount, tracking missed deductions, and assigning taxes
• Calculate overtime pay per FSLA regulations
• Comply with EEOC reporting rules and calculates an annual report automatically
• Support hundreds of Benefit Accrual rates for different classes of employees and benefits
• Provide security and confidentiality in which access to data can be assigned for each employee or group
• Offer user-defined fields for optional data
• Provide magnetic media for state-specific quarterly requirements and federal regulations

Payroll Reports

Payroll reports can help the management team in several ways. Here are examples of types of reports often run using payroll software.

• Allocation of employer’s payroll taxes
• Benefit accrual, salary accrual
• Check register
• Compensation rates
• Deductions, by employee, deduction, missed deduction
• Distribution expense
• Earnings/deduction history

Materials Management

The Materials Management module allows you to create purchase orders by selecting from a list of vendors and items that you use often. You can submit orders to vendors or your warehouse. After they are delivered, you scan them and confirm you received them. You can also manage your warehouse by taking inventory and printing item and shelf labels.

So how does Materials Management work? It connects to General Ledger and is integrated with Accounts Payable. Staff members communicate what they need to the facility’s warehouse or vendor. A catalog of items that are regularly purchased appears, and nurses can select the ones they want and hit send. The items are delivered and distributed. The payment is recorded in General Ledger. After the purchase, the amount, the date, and the purchase number will automatically appear in the long term care software. Bills can be checked in Accounts Payable to ensure that all items billed were actually received.

Long Term Care Operational Software

LTC operations include everything that needs to be managed in the business to keep it running. Here are some examples of areas that are included in operations at long term care facilities

• Managing resident funds
• Resident and resource scheduling
• Managing KPIs
• Client relationship management (CRM)

Though these areas are not a direct branch of clinical, billing, or financial software, each one plays a crucial role in how successful a long term care facility can be. We will cover each in detail.

Managing Resident Funds

Managing residents’ trusts or funds is not a task to be taken lightly. It’s an area that is specific to long term care and therefore requires specialized methods and software to be done effectively. Here’s how it works.

The Basics of Long Term Care Trust Management Systems

Managing resident trusts in long term care is a lot like managing your bank account. Except you’re managing the bank account for almost every person in the facility. Without a system to keep up with everything, it’s easy to run into problems, but fortunately, there are plenty of ways to simplify the process. Let’s start with the basics.

What is a Resident Trust?

A resident trust is a fund that a long term care organization is responsible for managing in the resident’s name.

Technically speaking a trust is a legal agreement that outlines how assets are to be treated, managed, and distributed. A trust fund on the other hand is a legal entity. Despite the subtle differences, the terms are often used interchangeably. In general, the terms “trust” and “fund” are used interchangeably in long term care settings as well.

Which LTC Residents Have a Trust?

The short answer is, a lot of residents have trusts. In fact, federal law requires facilities to provide a trust fund for any Medicaid resident that requests one. In many long term care facilities, the majority of residents have a trust or several funds that the facility manages for them.

What Type of Funds Do Residents Have?

There are several types of funds that a resident might have and it is common for a resident to have multiple types. Some of the most common include

• Burial funds
• Savings funds
• Security deposit accounts

Why Would Residents Want a Facility to Manage Their Trust?

Residents may choose to use this service, or families with legal responsibility of the resident may request to use it. This can be very helpful when dealing with residents who do not recall where they have saved their money.

How to Manage Long Term Care Resident Trusts

There are a variety of tasks a long term care facility may need to perform relating to resident trusts such as

• Adding fund information such as who owns the fund, how much money is in the fund, and what it can be used for
• Adding transactions to a single fund or all funds at the same time
• Importing deposits and withdrawals into the fund one at a time or as a batch
• Correcting or transferring transactions from one person to another when transactions are added incorrectly
• Noting paymentsfrom the fund for particular items
• Fund sweeps or recurring batch transfers from several resident funds of the same type into another target fund
• Maintain bank withdrawals and deposits and associate a check written from the bank account with all the individual withdrawal and payment transactions from the funds
• Fund account maintenanc to perform transactions directly associated with a fund type rather than a specific fund
• Exporting to the General Ledger – If you’re using a long term care Financial system that is a part of the ERP, such as in the Experience Care platform and not a separate system, then very often you can directly export fund transactions directly into your general ledger.

Resident and Resource Scheduling

LTC resident and resource planning software gives facilities a quick and effective way to schedule residents’ appointments and activities and the corresponding staff needed for those events. Scheduling software also handles related resources such as equipment and rooms. Nursing home scheduling software displays information with calendars and reports so staff can keep up to date with events.

What Can Nursing Home Scheduling Software Do That Other Electronic Calendars Cannot?

Facilities may attempt to use a standard electronic calendar system, such as Google Calendars, but they will quickly realize they do not have the functions they need, such as the ability to

• Schedule appointments for multiple residents simultaneously
• Pair staff members, residents, and resources to a single event
• View each staff member’s real-time work schedule
• Ensure that staff members are not double-booked
• Filter calendars by staff member, activity, resident, and other factors
• Generate reports

Though scheduling software is important to any long term care facility to manage appointments, it’ is especially important for facilities that plan activities and outings for residents.

Transportation Scheduling

Facilities are often required to transport residents for medical appointments or outings. Nursing home scheduling software can be set up so that one can view, at a glance, the individuals on transport duty and the scheduled appointments for that day.

The clinical system can also list all staff trained to transport residents, staff contact information, and highlight those currently working. This can be useful in the event of necessary, but unplanned, transport of a patient or resident.

Managing Key Performance Indicators in Long Term Care

Key Performance Indicators (KPIs) are metrics that post-acute care facilities use to understand how they are doing in a variety of areas such as

• Census
• Vitals
• Care delivery
• Documentation
• Diagnoses

Managing KPIs in post-acute care settings is very important to the success of the business as well as the ability of staff members to perform their job duties effectively. KPIs help management keep up with facility trends and help staff stay informed about events such as a new resident’s arrival.

KPI Dashboards

KPIs are displayed using a dashboard to make it easy to view important information at a glance.

KPIs will differ from facility to facility, or even between staff members within a facility so no two dashboards will look the same.

Configuring KPIs Dashboards

Configuring your KPIs dashboards to display the right information to the right people is crucial to individuals and the business as a whole. Most long term care software systems will have a default dashboard to use as a starting point. Additionally, many will assist you in making requested changes to your dashboard so you’re not stuck doing the heavy lifting.

Tip: Ask your software provider who on their team can consult with you to determine which KPIs are the best fit for your dashboard before setting it up.

Customer Relationship Management (CRM) in Long Term Care

Long Term Care Customer Relationship Management (CRM) software organizes a facility’s interactions with prospects, sales activities, and referrals and it provides data for evaluation. A CRM system is the core of all of a post-acute care facility’s marketing and sales and handles areas such as

• Lead generation and follow up
• Referral source tracking
• Inquiry and prospect management
• Marketing programs and campaigns
• Management of sales process activity
• Waitlist management
• Initiation of customer contracts
• Sales forecasts and analysis
• Customer experience, service, and retention
• Donor development

Managing Referrals

A CRM will help manage a facility’s interactions with current and potential customers, as well as referrals from various sources such as

• Medical clinics
• Phone calls
• Email inquiries
• Geropsych facilities
• Home health agencies
• Community centers
• Facility transfers

Nursing Home CRM Dashboards

Like KPIs, CRM data is displayed on a dashboard that can be tailored to the needs of the facility. A post-acute CRM dashboard can include data such as opportunities by referral type or by payor, as well as sales, and trends.

How Can a CRM Help Sales and Marketing?

A CRM system can help a long term care center’s sales and marketing team to

• Organize appointments with prospects
• Create and manage custom to-do lists and records of each marketing activity performed
• Maintain waitlists with preferences
• Standardize best practices using document template libraries
• Send and track emails to prospects
• Export customer data to the EHR so nothing is missing when they arrive at the facility
• Measure their success with on-demand reports

Who Uses LTC Software?

Owner or Owner-Operator

All long term care facilities have leaders in upper management roles, though the titles may vary. Leaders in long term care must be effective communicators, capable of resolving conflict, skilled in people management, and adaptable. They must also be able to make important decisions, including deciding when and how to make the move to electronic documentation and which long term care software to implement. The owner or operator will also review census reports, receivables, and payables in the financial suite of the software. They can also take advantage of analytics tools, like CareMetrics, to get a bird’s eye view of their organization and determine which payors or buildings deserve immediate attention.

Non-profit ownership organizations will need to keep an eye on Fixed Assets, or, the depreciating value of equipment, hardware, supplies, and other assets. This is because non-profit organizations must consistently reinvest into the organization as opposed to pocketing excess profits, which is the case for owners in for-profit organizations.

An owner-operator also functions as the administrator, which means that he or she will need to use the long term care software to view day-to-day operations to ensure they are in compliance with federal regulations and that standards of care meet the appropriate requirements. This will be discussed further below.

CEO (Chief Executive Officer)

The CEO will look at every aspect of the organization, including operations, finances, policies, procedures, and other regulatory matters. So this individual will use an analytics tool, like CareMetrics, to look at KPI dashboards, census numbers, AR, receipts, and the overall financial health of facilities and compliance.

COO (Chief Operations Officer)

The COO, meanwhile, will be concerned only with operations, like census numbers, and will work with others on a regional level. The COO will look at the analytics and reports in the long term care software in order to devise a plan for issues like staffing.

CIO (Chief Information Officer)

The CIO takes the lead on the implementation of digital technology, including long term care software systems. So he or she will need to determine whether or not the software is compatible with the facility’s hardware. The CIO will also manage the IT team and ensure that they are receiving the support that they need to best use the long term care EHR and prevent data violations.

CNO (Chief Nursing Officer)

A CNO is primarily concerned with updating policies and procedures, staying up to date with regulatory changes to ensure compliance, and determining best nursing practices. So the CNO will look at KPI dashboards and rehospitalization rates in the long term care software to see if the facility is meeting the appropriate metrics and getting satisfactory reviews.

here to learn more about how executive leadership can use a long term care EHR system.

Administrator/Executive Director/Facility Manager

The administrator keeps tabs on his or her building and ensures that it is making a profit. So the administrator uses the long term care software to view the census on a daily basis as well as the receivables and the turnaround on reimbursements. The administrator will also manage costs, which means he or she will look at staffing numbers, agency fees, and overtime expenses and decide if finances are being wasted or not. The administrator looks at balance and net income statements on a monthly basis and observes trends. This is made easier by way of an analytics tool in the financial suite. For instance, if AR Aging for private pay residents is more than 30 days out, this will become a focal point.

The administrator is responsible for ensuring that CNAs and nurses provide sufficient support for ADLs and incontinence care, administer medication on time, and give residents showers as needed. So the administrator will hold a CQI (clinical quality improvement) meeting and review the documentation of these matters with the DON. If there is an issue, the administrator will have to address it.

Medical Director

A medical director makes recommendations for procedures at a facility and participates in QAPI, which usually must be recorded twice a year in incident and infection report controlling in the clinical modules of a long term care EHR. QAPI is a data-driven approach to improvement, so a care team will look at the number of falls and infections in order to determine a common source, like the outbreak of flu, to develop a strategy to reduce reoccurrence. For instance, a nurse may not be following handwashing protocol before or after coming in close contact with residents. This could be determined by contact tracing in the long term care software and observing a trend.

Regional Director/Regional Nurse Consultant/Regional Director of Operations

While they do not oversee day-to-day operations, they will receive reports from administrators and directors of nursing, who will seek the regional director’s advice on how to proceed. A regional nurse consultant will look at care plans and Kardex checklists to make sure that everything from the former is included in the latter. They will also look at physician orders to ensure that there is an appropriate diagnosis available for the medications administered. These individuals can use the software to log in at any point and look into the history of a resident’s stay to investigate and resolve compliance issues.

Facility Level Management

This encompasses administrator, DON, ADON (assistant director of nursing), MDS nurse, social services, admissions director/coordinator, dietary manager, housekeeping manager, maintenance manager, and medical records.

Director of Nursing (DON)

The DON will manage the day-to-day operations of the nursing staff’s interactions with residents, so they will review progress notes every day as well as point of care compliance and ensure that CNAs are providing adequate documentation. Thus, the DON is responsible for ensuring that the care plan and electronic Kardex
are kept up to date and accurate. This can all be viewed in reports pulled from the progress notes module. They will also view the eInteract module to check stop and watch reporting. And they will check the modules for infection control, incident reporting, and UDAs (user-defined assessments) on a daily basis in the long term care software. here to learn more about how nursing leadership uses long term care software

Licensed Practical Nurse (LPN)

They will create progress notes and update eMAR and eTAR based on the treatment given to residents. The LPN will also review eResults for lab and radiology and utilize the physician orders module to add and remove orders for x-rays, labs, and medication. here to learn more about how LPNs can benefit from a long term care software system.

Minimum Data Set (MDS) Coordinator

They utilize all the documentation created by the direct caregivers to complete the resident assessment, which will, in turn, provide a HIPPS code that the MDS coordinator uses for PDPM reimbursements in the resident assessments module. Read more about how an MDS nurse or MDS coordinator can help maximize PDPM reimbursements here. The MDS nurse will also be responsible for updating the care plan in the care plan module. Click here to read more about how an MDS coordinator uses long term care software.

Social Services Director

They are active participants in completing admission assessments in the resident assessment module. That means they must collect historical data (like employment background). The SSD is also responsible for discharge planning and ensuring that a resident has a safe environment at home before discharge. This discharge summary is stored as a UDA. Click here to learn more about how a social services director uses a long term care EHR.

Marketing Director / Admissions Director

They are primarily responsible for receiving referrals from case managers at various organizations to determine whether a patient should or should not be admitted. The marketing director will receive referrals in the referral portal in the long term care software. The reporting capabilities in the referral portal will also help the marketing or admissions director determine a better marketing strategy. In many cases, the admissions director will use the ADT (admit discharge transfer) module to build a new resident’s profile. The marketing director can use the RCM dashboardto track admissions and get overall census numbers and year-to-date variances for the previous year.

Business Office Manager

They will utilize ADT to ensure correct admission and discharge and transfer, such as location, time, and payor source. They will also be responsible for the billing and collections module, eligibility verification module, and managing the resident funds module. All of these can be found in the RCM dashboard.

Activities Director or Life Enrichment Coordinator

They will be involved in care planning in the long term care software. They will meet with the resident and the family to determine what the resident likes and does not like, like bingo or craft time. They will then use an electronic Kardexto document the activities in which a resident participates. They also fill out the portion of the resident assessment module related to activities. Click here to read more about how an activities director uses a long term care EHR.

Dietary Manager

They will look at the physician orders module to check if a resident has a specific diet order, like a low sodium diet or diabetic diet. They will also look for any allergies recorded in the long term care software to see if, for instance, they must avoid shellfish. Click here to read more about how a dietary manager uses long term care software.

Maintenance Director

The maintenance director does not directly use long term care software. However, if an incident occurs on account of a maintenance issue, like not cleaning up a wet spot, this will be documented in incident reporting and the infection control module.

Housekeeping Manager

The housekeeper will need to enact the care plan recorded by the housekeeping manager in the care plan module or allergy module.

Housekeeper

The housekeeper will need to enact the care plan recorded by the housekeeping manager in the care plan module or allergy module.

Laundry

Like a housekeeper, laundry is merely tasked with enacting the care plan recorded by the housekeeping manager in the care plan module or allergy module.

Staffing Supervisor/CNA (certified nurse assistant) Supervisor

The CNA supervisor documents care in the long term care EHR and also manages issues that arise for CNAs, who are tasked with recording all care administered in the point of care module of the long term care software. If a CNA has an issue with administering care, such as a combative resident, they will ask the CNA supervisor for assistance.

CNA (Certified Nurse Assistant/Aide) / DCA. (Direct Care Aide)

A CNA predominantly uses the electronic Kardex and the point of care module to document all care, including assistance with ADLs like bathing, transferring, passing trays, providing water, and toileting. Click here to learn more about how CNAs use long term care software

Physician

They provide prescriptions that are entered into the physician orders module. They can make an ePrescription in the ePrescribing module for opioids or other controlled substances. Physicians provide diagnoses that are then entered into the diagnosis module by nurses. They also use (UDAs) to complete history and physical assessments. Click here to learn more about how physicians, nurse phractiioners, and physicians’ assistants use long term care software.

Registered Dietician

A registered dietician will use the long term care software to review physician orders ( physician orders module), wound assessments ( (UDAs)), diagnoses (diagnoses module), allergies (allergy module), and weight tracking to recommend changes to be made to a resident’s diet, like by reducing carbs or adding supplements.

Physical/Occupational Therapy (PT/OT) /Speech Therapy (Speech Language Pathologist SLP)

They will use a third-party system, like Therapute, that is interfaced with the long term care software. This allows therapists to enter therapy hours into the long term care EHR, which then facilitates reimbursements under PDPM.

Hospice

While they do not use the long term care software themselves, they provide the organization with summaries of their findings and activities that are then uploaded to the eDocument manager
in the long term care software.

Dentist and Podiatrist

They provide summaries of visits and procedures that are uploaded to the eDocument manager .

Home Health Services

They will receive documentation recorded in the long term care software from the facility for the purpose of discharge planning in order to ensure the continuity of care.

Hair Stylist/Beautician

The facility can care plan for the preferences of residents. Residents can then pay for beautician services from their resident fund account, which is managed by the business office manager in the resident funds module

Pastor/Religious Personnel

Religious preferences are captured in care plans and specific requests outside the facilities are organized by the activity director and then potentially recorded in the point of care module

Ombudsman

When a resident makes a complaint, the facility can provide documentation from the long term care software in order to resolve the complaint. The ombudsman will then review diagnoses, care plans, progress notes, assessments, and incident reporting stored in the long term care EHR.