Staffing Challenges
How operational inefficiencies exacerbate the problem.
If you are unaware of the staffing crisis in Senior Living, please stop reading and refer to Google. Seriously, we are assuming that if you’re reading this, you’re in the same boat. Finding, training, keeping, and engaging staff in the Senior Living is challenging - to say at the very least.
Staffing and driving new revenue sources are truly intertwined, and focusing on one can drive the other. We hope to avoid or glance over the obvious aspects of this and dive deeper into how improving the staff experience is the key to driving more revenue in Senior Living.
Saving on operational costs creates “more revenue.” It’s also possible to redirect the money saved with efficiencies and increase your sales and marketing budget. These concepts apply to any industry. You could also argue that having a slick operation will demonstrate to prospective families that your community is more attractive than others. These are often “soft” operational benefits as they do not have a direct, measurable impact on revenue. Increased revenue is associated, but not clearly a result.
Lost revenue is the hidden result of the very obvious staffing problem. Often, we find that the concept of staffing is viewed outside the need for more revenue, but we have seen evidence that the staffing problem actually exacerbates the revenue problem.
The impact of the staffing crisis is that the day-to-day operations in most communities can be chaotic and unorganized. Accurate documentation outside of EHR accuracy seems a lost cause. Staff do not have time to execute all of the tasks on their plate, and as a result, they are forced to focus on the most immediate and important items.
This means management oversight, measurements, or repeatable processes become an afterthought. Staff do not have time to track their activities, track the activities of residents, or take the extra steps for data collection. In addition, they often miss the opportunities to engage with their workplace, which overall contributes to a sense of accomplishment and community.
Because of the chaotic environment, it is nearly impossible to have consistent data collection, training patterns, or processes. Many staff then only have institutional knowledge, which is also not scalable and leads to more inefficiencies.
This results in:
- A failure to collect valuable data
- The inability to track employee activity beyond hours
- Inconsistent services to residents
- A lack of performance-based incentives
- Less meaningful work for staff
- Redundant and inconsistent processes to address problems
It’s an ongoing cycle. The main takeaway is staff cannot capture chargeable services - they do not have an accessible, consistent manner. When staff interactions go untimed and additional services go undocumented, you lose revenue. The systemic inefficiency, the lack of data entry and the lack of insight, further compounds staffing issues with revenue loss.
Documentation
How time-consuming documentation creates dilemmas for compassionate care workers.
Think about the dilemma staff face across the Senior Living spectrum - do they take the time to document everything going on, or do they skip that step to get to the next person? Far too often, staff say they struggle with this, and in reality, they simply don’t have the time, so they end up documenting the bare minimum.
According to CIPD.org, employees with high-quality jobs and effective management are not only happier, healthier, and more fulfilled, but they also drive productivity, produce better products or services, and foster innovation. Giving up on these things because “it’s just too hard” is like giving up on your business. An engaged staff that believes management values their activities has incredible benefits, including consistent, valuable documentation and driving more revenue.
The Way Forward
How to optimize revenue and costs together.
Accurate task documentation can help in both retaining staff and optimizing revenue and costs.
Imagine a scenario where staff can document their tasks in the regular flow of their day without the need to open an app or sit at a desk.
We provide two scenarios below:
Scenario 1 - John is doing rounds and visits Mary in Apartment 202. He provides toileting and grooming as a part of his rounds. While present, Mary asks John if he can help with her hearing aids and with making a call to her friend. John is with Mary for two extra services and an additional 20 minutes. When John finishes with Mary, he moves on to his next resident, and at the end of his day, he updates the EHR that he has completed all of his tasks.
Scenario 2 - Jane moved into an AL community 6 months ago. She tells her daughter that nobody talks to her and that she never gets help when she asks. Jane’s daughter is angry and sets up a meeting with the community. The community ED checks their thorough documentation and discovers that Jane spends an additional 15-20 minutes interacting with staff after receiving her daily care. She also did two puzzles this month with the help of the activities team, attended three activities, and had staff sit with her several times in the library discussing some of her favorite books.
When Jane’s daughter comes in, the community shares this with her. It’s a difficult conversation but an honest one where the ED can provide actionable, relevant next steps.
Based on the above, are any of these statements true about your employees?
- The organization provides them with the tools to do their job.
- They are motivated to do a great job.
- Everyone charges for extra services.
- Residents and their families respect their valuable time.
- Staff recruits others to work in the community.
- Salary doesn’t matter.
Probably not.
What if there was a way to have all staff activities documented, with time stamps and enough detail, so everyone has complete insight into the care each resident receives?
For John and his fellow staff in Scenario 1, they could then be confident that:
- Management sees extra work and potentially charges for it, increasing the value of their services.
- Families see all the work provided, and instead of complaining, express gratitude and offer assistance.
- Because residents and families have more insight, a support system can evolve, improving the community and staff morale.
- Because recognition and rewards are more frequent, they are motivated to engage further and do even more.
- They know their contributions are valued and help the community make more money.
- Their community is a positive environment to work in (which is hard to find) and worth referring other workers to.
- Increased satisfaction and higher pay mean they do not have to look for a position in another community.
In Scenario 1, John cannot easily document his tasks, meaning no one knows about extra services provided.
In Scenario 2, interactions with resident Jane are all documented, facilitating meaningful conversations about her care and enabling proper billing.
Revenue Increase
How to charge for all the work being done!
Now let’s address the more significant, impactful, and measurable topic: more revenue.
When we talk about services within Senior Living, we are (too often) met with a quizzical look. “We provide care” or “we have activities and transportation” are common responses. Many will even say dining is the number 1 driver of satisfaction. But aren’t all of these things services? What services do you provide your residents and family? And how do you charge for them?
While many “services” are provided in a scheduled manner, such as care visits, meals, or regular housekeeping, many of these services have additional components that are unbilled or provided for free with the thought of “We’ll just do this, too.”
In our Scenario 1 example above, John provided two additional billable services (helping a resident with a hearing aid and making a call). When someone visits a room, typically, they perform more than a single care item. They tend to help with multiple things on top of talking and being a friend.
You may think these things are just part of the overall experience and you can’t charge for every interaction - but let’s look a bit more closely.
In a community with 100 residents, imagine each resident receives one extra billable service daily. This equates to 100 additional services daily or 3,000 additional services monthly. If each of these services costs $300 per month for each resident, the potential missed revenue for the community is $30,000 monthly.
If these numbers look probable, isn't it worth the effort to enable your staff to record all of their tasks?
How family access helps increase revenue.
Further to this point, usually, families don’t have access to viewing volumes or ordering services. Transparency and accessibility help them appreciate process and cost. The benefit of offering an easy way for them to order services is clear - it can increase revenue and become a differentiator, lowering the risk of resident attrition.
Traditional Solutions and Their Pitfalls
Why time-tracking and engagement software leads to poor results.
It’s time to get over “engagement platforms.” Adoption of traditional engagement platforms is low. Residents may or may not use an app or website to see what’s on the calendar. Taking attendance will give you valuable data, but the ROI is difficult. Yes, your events and schedules are important; they drive wellness, and they really matter, but paying for a website/app to manage this is a rear-view mirror proposition.
In fact, using these platforms is likely taking valuable dollars out of your budget for the sake of a few people checking a calendar and your staff doing a ton of data entry. The vast majority of communities we speak with admit that they use a small portion of their existing platform and rarely take advantage of the proposed data they provide.
How Point of Sales standalone systems provide a narrow focus.
You can certainly collect more money with a traditional POS solution, and most are focused on dining, which makes sense. Consider that dining POS and the emerging class of “Senior Living POS” still require an app or other interface that has already proven to have low adoption.
In-dining apps for staff can provide measurable efficiencies, but the systems rarely, if ever, integrate with the overall experience in a community. Not to mention, POS are expensive on their own, driving down ROI.
Innovating Revenue Capture
The benefits of a fully accessible interface!
The solution is a fully integrated services catalog with a simple concept and interface that combines staff efficiency with the ability to collect more revenue.
First, providing a user interface usable by all acuity levels is a must. Yes, apps and web portals are a given, but the use of voice technology and multi-modal devices (voice, touchscreen, visuals) enables all levels of residents access to services, status, and content.
Second, a robust services catalog, which tracks all services across all disciplines, can be accessible to all parties. And finally, the ability for staff to do data entry during the regular flow of their day, using voice and multi-modal technology, connects staff, services, and residents and their families to drive more revenue and improve the experience for the entire ecosystem.
Reducing Costs Through Labor Transparency
How a lack of documentation leads to indirect costs associated with inefficient staffing.
Tracking Residents
How much time is spent at the front desk/concierge manually tracking where residents might be? Often, a front desk or similar employee signs community members in and out, tracks where residents are on request, and contacts staff/housekeeping for residents' schedules. That "on-the-ground" knowledge is hidden in people and not leveraged easily, creating word of mouth and informal processes that are not consistent or repeatable. It is impossible to train people or scale that approach.
Non-emergency Calls
How often does care staff visit an apartment that is better serviced by another department? Often, care staff is called to an apartment via pendant/pull cord only to find out it is not an emergency or doesn't require care staff. Many pendant requests are not emergencies. MANY!
Video calling and voice-driven requests that offer context allow the scheduling of non-emergency tasks, enable residents to check their status, and let care staff prioritize more pressing matters. The benefits of context-based requests are self-evident.
Unscheduled and Unbilled Time
How often does a staff member interact with a resident in an unscheduled manner? Your non-care staff is interacting with residents far more than acknowledged or measured, which impacts your entire ecosystem.
Families undervalue the community, evaluators do not assess staff based on true merit, and audits lack data support. There are reasons to do this: family reporting and value of service, marketing on transparency and provable data on the value of community, transparency, staff engagement drives less attrition, motivation, empower management to incentivize, data drives decisions on resident needs and staff allocation - lessens costs.
People understandably cling to this way of working, but most industries have gone digital. It is common knowledge that digitization provides efficiencies and insights unachievable using paper and memory. What happens when that person becomes unavailable? If there is a need to replace, new processes and levels of success are introduced.
Apply this mentality across multiple communities, meaning you have no reasonable way to manage all of the natural day-to-day flow of activity. Further, the ability to save that role time is so simple and adaptable that it just takes a commitment to change and accept the benefits.
Task Transparency for Resource Allocation
How improved data entry enables efficient staffing, potentially reducing labor costs.
How much time do people spend daily/monthly searching for individuals to administer medicine? By establishing routines to track a resident's current or last location, you reduce dependence on inconsistent, hero-driven methods and instead foster a consistent, repeatable pattern that residents and staff can adopt across communities.
You also get valuable data that can drive better behaviors and enable the use of digital and automated reminders, announcements, or other technologies that can help track where a resident is to ensure a more efficient process.
How many meals do residents miss because of delayed or anticipated medication that conflicts with meals? Situations where someone needs to tell the kitchen to put a meal aside for a resident because they haven't taken their medicine yet or cannot eat until a specific time after taking their medicine. The burden lies with the Med Tech and Dining Teams.
How often do families call the front desk to ask if a relative attended an activity or meal? By all reports, this is a commonplace occurrence. Busy front desk staff answering phones to address simple questions that are easily automated is, at minimum, a distraction. There are also benefits of automating such data, as it enables you to capture and analyze such things as resident tasks, meals, staff time, and other ancillary items that can help you make proactive decisions and keep families informed in a modernized way.
The Efficiency Dividend
A solution designed for better resource allocation.
The solution's simplicity stems from using the appropriate technology at the right moment and investing time upfront to ensure success. In a fast-paced care environment, the best method for documentation is using secure, hands-free, voice-enabled devices. It is really very simple.
When staff engage with residents in an apartment or common area, they speak about their activities and let an AI engine categorize and store the interaction. In parallel, creating a services database that can match those services with a billing code can automatically update the resident record, and the staff that is speaking closes the loop with two significant, immediate benefits:
- Staff is free to do their jobs without interruption while still capturing data, freeing up valuable staff time
- Services are captured and aligned with measurable business goals
It's straightforward for your staff: use voice commands in a hands-free setting, utilize an app for on-the-go tasks when you can tap and swipe, and access the web for report viewing and automated billing through APIs.
How effective task documentation improves staff retention, revenue, and costs.
So, are documenting day-to-day tasks really that important? Aren’t there bigger issues to tackle? Big things start with small steps. It IS a big deal. Simple task documentation costs money, impacts resident satisfaction, and changes the culture. In this time of a staffing crisis, the impact on staff reverberates throughout your business.
Empower your staff with modern tools that take their needs into account. Define your services and the costs, and be more proactive while driving revenue with operational data. Your staff is more satisfied, so they deliver better services, they recruit, they believe, and your residents feel the benefits. And all the while, you’re capturing more services, have more transparency, and are better able to scale because you have repeatable processes. Saving staff time and driving more revenue are intrinsically connected.
Explore innovative solutions for task documentation.
Start by reaching out to us to take our ROI survey and ask yourself the questions that will challenge your view of the importance of the change we are enabling. Survey your staff, walk the halls, and measure the impact that is possible. Define your services, apply scalable processes, and adopt technology that empowers your staff to do more of what they are good at with less data entry while capturing more revenue.