Preparing for payment reform is daunting. With necessary operational changes and reduced state and Medicaid funding, many senior living communities are asking, “If we can’t survive long enough to see the new payment reform, what’s the point in preparing?”

Financial concerns were made clear during BKD’s second Lounge Chat, “Harnessing Payment Reform to Improve Care Outcomes,” led by BKD Partners Camille Lockhart and Chris Murphy. We were joined by a nursing home administrator from a rural senior living community. Like many others, her community is predominantly funded by Medicaid but faces significant challenges as her state works to reduce the number of Medicaid beds. How can communities prepare for advancement payment models, provide better care and reduce readmissions without sacrificing short-term profitability? Consider these questions and key points from the Lounge Chat.

Is your clinical staffing pattern addressing your risks and opportunities?

Most admissions from acute care hospitals are on Thursday, Friday and Saturday. Statistically, the most preventable readmissions occur Friday, Saturday and Sunday. Rebuilding and reassessing your staffing model to get a stronger weekend staff can increase confidence, ensure better weekend care and ultimately reduce preventable readmissions.

How will you deal with shorter, skilled lengths of stay without sacrificing your margin?

Reducing lengths of stay means having to increase admissions to make up the difference. You can boost admissions by communicating with hospitals to know what criteria they’re using to select post-acute care providers, identify mutual concerns and commonalities and inform them of your clinical capabilities. Be sure you’re prepared for increased admissions, as clinical competencies must expand to accommodate additional care, billing and paperwork.

Are you starting the admission process early enough?

Start the admission process earlier while patients are still in the hospital. Work with the hospital to allow your admissions coordinator to meet with the patient and provide information about your organization and staff. This can reduce readmissions by boosting the patient’s confidence in your organization and easing anxiety about transitioning to post-acute care.