The long-term care (LTC) industry is at a crossroads. Senior populations are living longer, and fewer people are able to take care of them.
Seven in 10 seniors reaching 65 years of age are expected to need some type of long-term care (LTC) including hospice care before the end of their life. However, the challenges presented by the COVID-19 pandemic have led to essential worker fatigue, staffing shortages, and now “The Great Resignation.”
With the current pandemic-strained status of the industry and the rising need for LTC, partnering with the right certified hospice agency is now more essential than ever. It’s also necessary as Medicare only covers hospice services for SNF residents as long as the SNF has a contract with a Medicare-certified hospice agency.
For 12 years, Constellation Health Services—an award-winning home health and hospice agency based in the Northeast—has partnered with SNFs to deliver hospice care. Below, Constellation provides insights into how the right agency can make all of the difference in delivering quality hospice services that lead to long-term success for operators, staff, and patients.
No. 1 Improve Staffing Support
In 2013, the Centers for Medicare and Medicaid Services (CMS) prepared a report (pg. 17) which suggests time with residents and facility ratings could be highly correlated.Time with patients is so important and can drastically make a difference in patient outcomes and satisfaction at their facilities.
Additionally, an average size SNF in the U.S. is 120 beds often with an RN-to-patient ratio of over 20-to-1, and it can be even higher on nights and weekends. Considering the increasing acuity of patient populations, being responsible for such a high number is a large burden to shoulder.
If time equates to better patient experience, how are facilities going to be able to increase time spent with residents in light of a staffing shortage? (Consider that 94 percent of operators said they are experiencing a staffing shortage.)
According to the American Hospice Foundation, hospice agencies help staff by offsetting care in many ways, including:
- Regular visits to the nursing home by a hospice Registered Nurse and care team.
- Consultations by a specialized hospice physician as needed.
- Expert management of pain and other symptoms, such as problems breathing or swallowing.
- Education for nursing home staff, patients, and families about patients’ condition, symptoms, medications, and how to best care for patients’ medical needs during this phase of their illness.
- Emotional and spiritual support for patients, families, and caregivers during this phase of life. This includes help for the family before and after the patient dies.
- Provide medications and supplies related to the patient’s terminal illness.
- Coordinate the patient’s care and medications across all of the patient’s medical providers including the SNF’s medical director and staff.
This all equates to the increased time spent with patients and better outcomes for everyone.
Contracting with the right hospice agency can result in widespread support and availability of staff resources throughout a facility. Hospice agencies take the burden off in-house care teams that are typically spread thin, and have limited time and training to provide many of the hospice benefits covered by Medicare. Most significantly, agencies provide “knowledge transfer” surrounding end-of-life issues that arm SNF staff with additional tools for success. Support can come in different forms including access to a full complement of services including hospice aides and volunteers when appropriate who can help with tasks such as hair brushing, reading, playing cards, or being a comforting presence.
In certain areas, it can be difficult for operators to find highly skilled employees. Contracting with the right hospice agency that values its healthcare workers could ultimately improve retention and increase productivity and satisfaction for staff and patients. With the additional layer of resources, more time can be spent with patients, which ultimately increases their quality of life.
No. 2 Increase Hospice Awareness
The No. 1 complaint of families is that they didn’t put their loved one on hospice sooner.
In 2017, the average length of stay for Medicare patients enrolled in hospice was 76.1 days. But individuals and families can request hospice at any point as long as the person requesting it has been diagnosed with a terminal illness and a life expectancy of 6 months or less.
A recent study shows that 89 percent of Americans have little to no knowledge about palliative care—the philosophy of care also incorporated into hospice care.
Awareness around palliative and hospice services are not only needed but necessary.
Experienced agencies have recognized this knowledge gap and have incorporated education initiatives into their business and marketing programs. Examples include advertising campaigns designed to inform the public about options for end-of-life care—necessary services often covered by Medicare—or outreach to provider networks to alert them about innovative ways they are serving patients better under the Medicare benefit.
Through marketing efforts, hospice agencies can educate the general public and aging populations on options for end-of-life. They are trained in the sensitive conversations around end-of-life, but more importantly, they can identify when someone may need hospice and help them get on hospice sooner.
No. 3 Connect through Technology Utilization
Maintaining high standards of health care during an unpredictable pandemic has never been so important. Telehealth and virtual visits have become a widely accepted tool to enhance ongoing in-person care, and connect patients to their loved ones, despite the ebbs and flows of COVID-19 and its variants.
Some experts say the pandemic accelerated U.S. digital health by a decade. It quickly became apparent that telehealth in the long-term care industry was no different in evolving with the times. For residents in SNFs, technology has opened the door to more customizable care plans that can include a combination of in-person and virtual visits. But perhaps a more meaningful utilization during the pandemic—especially among hospice patients—has been access to technology like Zoom or FaceTime to connect with loved ones during periods of isolation.
For SNF operators who partner with tech-savvy hospice agencies, patients and their families truly benefit.
No. 4 Make a Difference with Culture
In an article with Skilled Nursing News, Betsy Rust—partner at Plante & Moran—expressed that “It’s just much harder for larger companies to build a ‘we care’ kind of attitude company-wide compared to small or even some mid-sized operators.”
With Constellation, that is not the case. Constellation has worked diligently to create a culture that values its employees and the individuals they care for, which can transfer to improving cultures at small-to-large SNFs. Year after year, Constellation has been voted a best place to work because the employees feel valued.
“I feel valued at Constellation because I don’t get treated just as a CNA, but as a human being,” says Breanna Pinto. “My inputs are heard. I’m not just the little pebble on the floor, they listen to me, they actually listen. They take my input. I really feel valued in that aspect.”
As a hospice agency that specializes in SNF partnerships, Constellation goes above and beyond to provide any and all benefits a patient can receive on Medicare. The benefits of finding the right hospice partner are widespread. Constellation can support SNF staff, increase hospice awareness throughout the facility, and connect patients and their loved ones through innovative technology. Additionally, Constellation provides veterans recognition and integrative services that can provide comfort and joy.
A company culture that values respect internally is able to mirror that same respect onto their partners and patients externally. Spending time with those nearing end-of-life, giving them the dignity they deserve—this is the most precious gift a hospice company can offer. When people and relationships are valued, a feeling of worth and contribution manifests into the care given to patients.
“You have to have a heart and compassion for seniors to work at our company,” says Christine Herting, The Arbors Assisted Living, NY. “We interview a lot of people that may have 20 years experience in assisted living, but we find people who treat our residents as if they were their own family members. And that’s what we see with the Constellation team—we see that same resident-centered approach, and we appreciate that.”
If you’re interested in learning more about Constellation’s hospice services for SNFs, we will happily connect you with a care expert in your location.
Constellation is a family-owned, family-centered organization that has remained true to our commitment to providing the best patient experience and the highest quality outcomes. We believe this is accomplished by ensuring that everyone we connect with feels valued, trusted, and heard. Learn more about our hospice services.