Can Nursing Facilities Keep All Services In-House?

Can Nursing Facilities Keep All Services In-House?

If you operate, or are part of the administration, at a long term or skilled nursing facility ⏤ you’ve likely asked yourself this question at some point.

How do other healthcare organizations do it all?

Dealing with administration, pharmacy, billing, customer relations, housekeeping, restocking supplies etc., in addition to handling the actual nursing, therapy and other care for residents – all under one roof.

I’ll let you in on the secret right now:

They don’t do it all.

Nobody does it all.

They’re outsourcing some (or a lot) of it.

In fact, a huge range of companies, including hotels and airlines, outsource, too.

After all, isn’t a nursing facility just that – outsourced skilled nursing and/or rehab for patients and their families?

Outsourcing Perks

Aside from the obvious reasons to outsource, which include:

  •       Upgraded patient services
  •       Increased employee retention rates
  •       Access to additional resources
  •       Increased cost savings,
  •       Hazard mitigation
  •       Access to funds for further improvement

Outsourcing includes an additional perk: doing away with the hassle of legal regulations. This is especially valuable in the face of rapidly changing rules in the healthcare industry.

For instance, during the migration to PDPM, many facilities solved compliance issues by outsourcing their therapy to a third party. In many cases this resulted in excellent therapy for patients, ensured compliance, and no decrease on the facility’s bottom line.

Outsource With Care

Although it is commonly accepted at face value that outsourcing completely saves facility administration and operators from the hassle of constantly evolving industry regulations and its repercussions, this idea is, in fact, not as straightforward as it seems.

In the recent article, $3.8 million Settlement Shows Nursing Homes Must Oversee Their Therapy Providers, Feds Say, nursing homes were hit with enormous penalties after outsourcing therapy services without ensuring the provider adhered to all legal guidelines.

The below is a quote from U.S. Attorney Carmen M. Ortiz:
“Settlements like this one show that, when a facility contracts with an outside rehabilitation therapy provider, the facility has a continuing responsibility to ensure that the provider is not engaged in conduct that causes the submission of false claims to Medicare.”

Therefore, though many LTC facilities and SNFs assume that staying current and in compliance with regulations and industry practices is a headache for the hired contract therapy – or any other – service provider, this settlement proves otherwise.

When a third-party company is contracted, care should be taken to collaborate with an ethical and transparent company, and contracts and liabilities meticulously reviewed by the legal team.

Outsourcing Questions to Ask:
Outsourcing often repeated tasks like housekeeping and billing will save you the time, hassle, and money of hiring and maintaining your own staff, and services like resident therapy and pharmaceuticals will spare your administration headaches and possible penalties of compliance regulations.

Yet, when all is said and done, it’s about improving the patient experience at your facility, and that warrants a very unique calculation.

According to Dr. Travis Good, CEO and co-founder of Datica, the below questions should be evaluated when determining whether to outsource tasks or services within your facility.

  • Employee satisfaction
    Does it make our staff happier and make their life easier collectively?
  • Patient experience
    Will outsourcing this responsibility provide more time to focus on your company’s core values and improving the customer experience your residents receive?
  • Cost-effective value
    Will this effect in increased cost efficiency and/or restructuring of resources to focus on positive company development?
  • Competitive advantage
    Take a look at other organizations and question whether they are providing a better service due to outsourcing tasks and responsibilities.
    Can further outsourcing lend a competitive edge to your facility?
  • Resource allocation
    Does outsourcing deliver reliable quality and even better quality than the organization can produce? Does the core competency of the outsourcing partner offset, outweigh and/or complement our organization’s core competencies? Do they have more experience than our staff? Can they do it faster, better, less expensive and realize more revenue? What are the costs of keeping things internal? Do we pay less for outsourcing than we do in salaries, benefits and time for internal employees?

Dr. Good said, “The key to survival lies in leveraging organizational attributes while enacting continuous incremental improvements in effectiveness and efficiency—more often than not by using third-party vendors.”

We all know that where there is less stress, there is more quality, productivity, and positivity. This is the recipe for satisfied employees, and results in decreased turnover rates, improves quality of patient care, and increases revenue.

Advantages Versus Risks

Despite the risks involved, the answer to the question of “should we outsource?” is in many cases, “yes.” The time, skill, knowledge, and resources demanded from administrative staff in order to successfully complete the tasks in question are usually enough of a reason to outsource them.

That being said, the key to successful outsourcing lies in the ability to gauge the services weighing down the staff and resources at your specific facility, and finding the right service provider to ease that burden.