Lowering Hospital Readmission with Coordinated Care

As hospitals look to curb rates of readmission, Erickson Living has some practical solutions

Certain clichés abound about post-retirement life: there isn’t a lot to do; it’s lonely; it takes a while to seek proper medical care. Erickson Living is a stark contrast to that outdated image. At one of its many retirement communities, it’s not uncommon to see a group of seniors swimming, enjoying a stroll outdoors, or taking a yoga class. You might find a resident using a tablet or cellphone to access the company’s recently launched app.

Erickson Living manages 18 senior living communities around the country. The company opened its first property in Catonsville, Massachusetts, in 1983. Its properties range in capacity from about 400 residents to 2,200. Currently, there are 23,000 residents across 10 states. It has 8,500 full-time employees and partners with numerous physicians, nutritionists, and specialists to attend to the needs of residents.

John Lessner is the vice president and associate general counsel of Erickson. In addition to overseeing compliance with the various regulated health-care entities Erickson manages, Lessner is also responsible for managing the contracting process with third-party vendors. On any given day, he is working on issues involving state and local health licensure, Medicare compliance, and privacy issues connected to the federal Health Insurance Portability and Accountability Act of 1996. Risk management is also a major focus for Lessner and his team.

Lessner previously worked as assistant attorney general for the State of Maryland and counsel to the Department of Health and Mental Hygiene. While there, he realized long-term care would become a major growth area for the country. As the current baby boom generation approaches retirement, facilities like Erickson’s are becoming increasingly popular for senior citizens. Though he acknowledges there will always be seniors who prefer to live independently, he believes many in retirement would like to keep an active lifestyle but deal with less upkeep in taking care of a home. He cites the particularly harsh winter of 2014–15 as a likely factor for some seniors to seek out communities like Erickson Living.

One of Lessner’s initiatives with Erickson has been to work with company leadership and local hospitals to comply with the Affordable Care Act (ACA), which recently celebrated its fifth anniversary. When the ACA was enacted, one of its goals was to reduce the rate of hospital readmissions for Medicare beneficiaries because readmissions had become a strain on Medicare expenditures.

Readmission refers to when a patient treated for one medical issue later seeks further medical attention due to an infection, improper care, or stagnated healing process. The ACA looked to curb readmissions and to penalize hospitals for not working with long-term-care facilities. Several policies and expected readmission algorithms were applied to effectively outline the ACA’s goal of reducing the readmission.

Hospital readmission rates drop when care coordination becomes a priority. According to Lessner, Erickson Living has enjoyed “good relationships” with local hospitals, and the readmission rates for its residents are much lower than the national average.

Lessner says Erickson Living is focused on medical monitoring, physician and nurse practitioner oversight, and providing appropriate therapy and ancillary services to help reduce readmissions. Erickson Living communities are unique in that each has an on-site medical center with geriatricians and internists who practice solely at their communities and care only for community residents. These Erickson physicians devote more time to each patient than the norm, at about 25 minutes per appointment; the national average is just nine.

Compliance goes beyond coordinated care, though, and Erickson Living works to reduce readmission by ensuring preventive services are provided. These include nutrition, exercise, wellness, and memory fitness options.

In a cost-benefit model, preventive care is not only ethically advantageous; it makes obvious financial sense. “It not only provides a better quality of life for our residents; it’s more cost-effective in the long run to prevent problems than to pay for them after they happen,” says Lessner.

Lessner believes residents of Erickson Living are benefiting immensely from this enhanced care coordination. Naturally, this translates to a healthier and more fulfilled life for these residents. As the ACA continues to affect long-term-care options for seniors, Lessner believes more places like Erickson Living communities will become attractive postretirement homes for many.