The vendors' view: roundtable of long-term care manufacturers and suppliers.

Welcome to Product Watch

Nursing Homes/Long Term Care Management is pleased to publish the second installment of Product Watch. Through periodic Product Watch supplements, readers will be offered insights straight from the vendors serving our ever-changing field. Within the pages of Product Watch, vendors will showcase "the best of the best" of their new products, offer market advice and observation, and review the challenges and opportunities facing long-term care providers, now and in the future.

In this installment of Product Watch, vendors respond to questions about the increasing intensity of resident care and how their products are being designed and used to accommodate this. In the coming months, Product Watch will examine such key areas as developments in information/communications technology, facility management products, and services offered the field. We hope that readers will enjoy and benefit from the unique perspective Product Watch will provide.

One significant group that is seldom heard from when people globally assess the long-term care field is the vendors who service that field every day. Certainly it is their business to know its operations at the grassroots level. Granted, their views are likely skewed by the products and services they offer--their business--but they nevertheless offer a valuable perspective on this ever-evolving, sometimes tumultuous profession. Recently, Nursing Homes/Long Term Care Management Editor-in-Chief Richard L. Peck asked an assorted group of resident care product/service provider C-level executives (CEO, COO, CFO, etc.) to offer their views on three questions: Are skilled nursing facilities providing more intense resident care these days and, if so, in what way? What impact are resident care trends having on your product's utilization and development? What are some advances in resident care technology that you see coming? Their responses follow.

Are skilled nursing facilities providing more intense resident care these days and, if so, in what way?

It will come as no surprise to experienced skilled nursing facility (SNF) operators that vendors do confirm the widely touted trend toward more intensified care in their facilities. What is interesting, however, are some of the explanations and perspectives that the vendors provide. Aside from such broadly acknowledged factors as the increasing options for residents who are less acutely ill and more independent and the sheer growth of the frail senior population, Steve Hoffman, PT, regional sales manager and loss prevention consultant for Medcare Products (lift equipment) notes a third factor: "The growing number of obese people in the United States has led to an increase in bariatric patients and residents who require intense physical exertion by nursing staff when providing cares."

An interesting historical perspective on the clinical trend was provided by John Richard Mach, Jr., CEO of Evercare, the pioneering provider of integrated clinical long-term care using the nurse practitioner as the basic provider. He recalled that "few SNFs did IVs or provided many skilled nursing services on site" when Evercare was founded 20 years ago. But added to earlier discharges by hospitals and that above-mentioned increase in lower-intensity options for relatively healthy elderly was Mach's own additional factor: the public health system's ongoing contraction of mental healthcare bed availability--in effect, pressuring SNFs to accept residents with severe behavioral issues. "All this has led to a nursing home population that is on average older, sicker, and with more complex issues than a generation ago," said Mach.

Finally, Connie Phillips-Jones, director of clinical support for Longport, Inc., vendor of high-frequency ultrasound diagnostic equipment called EPISCAN I-200, points to increased regulatory oversight and increased transparency for quality care leading to greater use of high-tech instruments in long-term care for assessment, care planning, and documentation. She does note countervailing factors, however, including financing and staff training difficulties, as well as the current bias in culture change circles toward "high-touch" rather than "high-tech" care.

What impact are resident care trends having on your product's utilization and development?

Again, no surprise--these market-savvy vendors have positioned their products and services to make sure that their answers are positive. Medcare's Hoffman saw an increasing need for lifting equipment, particularly bariatric oriented, in line with the trends he mentioned. The need for advanced wound prevention and care was prompting interest in use of ultrasound diagnostics, said Phillips-Jones of Longport. Tempur-Pedic North America's President Paul Coulis said that the comfort provided by his company's medical mattress was not only promoting resident health and well-being, but providing facilities with a strong marketing point on that score. "It takes less than a 1% increase in occupancy to justify having the mattresses best known for providing comfort and better sleep," said Coulis.

Reflecting the wellness trend starting to take hold in long-term care facilities, Peter Blumenthal, CEO of RSS Industries, noted that "fitness directors are requiring exercise and therapy equipment that all residents can easily access and use. Therefore, we are expanding our line of motorized equipment [Theracycle] for the specific needs of residents who do not have the strength, balance, or endurance to use traditional exercise equipment."

Evercare's Mach noted that his company's care delivery model, based on nurse practitioner collaboration with staff, was designed to accommodate growing clinical intensity. He added that Evercare's fixed payment reimbursement model encourages prevention and early intervention (with no three-day hospital stay, as per Medicare), rather than paying fee-for-service when residents get seriously ill--i.e., the good side of prepaid care.

What are some advances in resident care technology that you see coming?

Cindy Susienka, president and CEO of Golden Innovations, a major rehabilitation/hospice/home care provider, saw a number of technological advances in the field--"especially in areas such as geriatric-enhanced modalities and strength training. New specialized equipment is being developed for geriatric patients using the sports medicine model."

Eric Christ, president of the IT-based referral management system provider Patient Placement Systems, LLC, said there is growing acceptance of a technology creating "direct integration between referral management systems and the patient care system to speed up the process of bringing a new resident into the facility and getting all the data entered into the patient care system." Evercare has also taken significant steps toward IT, said CEO Mach, attempting to spur member facilities' progress toward the electronic health record (EHR) with its portable clinical information system CareOne. "EHRs give a patient's entire care team (with appropriate permissions) access to all the necessary information from anywhere, helping to ensure more effective integration of care and treatments, saving time, and reducing medical errors," said Mach. "We are encouraged by the progress being made in this area."

Meanwhile, Tempur-Pedic's Coulis pointed to recent studies indicating that use of his company's sleep surface promoted calmness, easier care, and reduced sleep medication prescriptions for residents suffering from dementia. "In an age of increasingly complexity," said Coulis, "sometimes the simplest solutions are the most powerful."

With thanks to:

John Richard Mach, Jr., CEO

Evercare

Cindy Susienka, President and CEO

Golden Innovations

Connie Phillips-Jones, Director of Clinical Support

Longport, Inc.

Steve Hoffman, PT, Regional Sales Manager/Loss Prevention Consultant

Medcare Products

Eric Christ, President

Patient Placement Systems, LLC

Peter Blumenthal, CEO

RSS Industries

Paul Coulis, President

Tempur-Pedic North America