Rebuilding Census After COVID-19 

Building and maintaining census are significant concerns for senior care providers that have been highlighted and made more urgent in light of COVID-19. While COVID is becoming more manageable, strategies can be implemented now to boost admissions and move-ins.  

Forum Extended Care Services February webinar, Rebuilding After COVID-19,  explores innovative approaches to regaining momentum, key consumer concerns providers should be addressing, and how to align marketing strategies with reimbursement strategies. Industry experts and webinar Speakers CC Andrews, Chief Strategist at Quantum Age Collaborative, and Lisa Thomson, Chief Strategy and Marketing Officer at Pathway Health, share best practices, cutting-edge strategies, and tips for bringing in new residents, strengthening partnerships and public trust, and rebuilding census post-COVID.  

Nursing Homes: Where Are We Now?  

As an industry with census challenges, COVID has made building and maintaining census even more challenging. By April of 2020, occupancy fell to 69% of the 2019 volume, according to CarePort. Occupancy bounced up to 97% by October, most of which accounted for home health care, and skilled nursing only rose to 83%. At the start of 2021, national median occupancy sat at 69%, down from 85% the year before.  

Even as the pandemic eases and everyone prepares for a sense of normalcy, the industry should stay vigilant and continue to confront trends and challenges that impact occupancy. A significant driver of decreased nursing home occupancy is referral trends. With COVID, elective procedures are being eliminated or cut in half, hospitals and physicians are sending patients home instead of SNFs, and nursing homes only see clinically complex patients or those with challenging dementia cases.  

Media coverage also plays a role in the census. COVID led to isolation and limited community activities to keep residents safe, which also means family members have limited or no contact with loved ones. The media portrayed these safety precautions with images of family members seeing loved ones through windows or distraught family members being denied access to ill loved ones. Ultimately, the media played a role in scarring consumers and referrers away from nursing homes and significantly impacted occupancy.  

Oversight has also been a challenge for the senior care industry, even before COVID. Citations and enforcement sanctions have already been imposed, and the sector is experiencing infection prevention and control surveys in skilled nursing and assisted living. When it comes to COVID and government oversight, there are more sitations, with a more extensive scope and severity and less leniency. Adjusting to new policy, implementing new quality measuring, and correcting situations have impacted providers and occupancy.  

Assisted Living: Where Are We Now?  

Assisted living facilities experienced a similar decrease in occupancy. In December 2020, occupancy was at 77.7%. Meanwhile, the number of senior living operators with occupancy rates below the market average grew. The move-ins that are happening have significantly more needs with higher acuity and more challenging dementia cases. Seniors with low to mild needs are finding alternative living and care arrangements.  

Drivers contributing to these low numbers include: 

• Self-imposed moratorium on movie-ins due to COVID 
• Visitation and activity restrictions  
• Fear created or exacerbated by media coverage 

• Regular attrition and COVID move-outs that weren’t replaced by new move-ins  

What Can We Do Now? 

The pandemic is a permanent game-changer that accelerated the drive for industry change. Things will not go back to the way they were before COVID—operators should expect these referral patterns, regulations, and media portrayals to remain a challenge.  

Despite downwards trends in occupancy, organizations and the industry can do much to build the census up and regain momentum. Webinar speakers suggest the industry starts with mindset and attitude. The industry should strive for transparency by sharing data with residents, referrers, and family members.  

Watch the February webinar for more information on how organizations and the senior care industry can rebuild the census after COVID. View the webinar here.