New Perspectives, Processes, and Solutions: How Brookdale Senior Living Digitized Document Management

I grew up around the value of servant leadership. My mom was a healthcare administrator, and our life revolved around the skilled nursing facility where she worked. She was selfless, and her job was a 24/7 commitment—and a lifestyle. I wanted something different for myself, so I went into teaching instead. But sometimes, our callings find us.

I left teaching and an opportunity at a skilled nursing facility came my way and I fell madly in love with the residents. I realized that being in this environment merged my passion and my education. I love to teach, and I get joy out of watching people succeed and spread their wings. Doing so within a healthcare environment was a great way to both serve and lead. As a result, I pursued my Healthcare Administrators License. One of the best decisions I ever made. 

Finding My People at Brookdale Senior Living

I spent many years in skilled nursing, and then I decided that I wanted a chance to understand the rest of the continuum. I landed at American Retirement Corporation, which was acquired by Brookdale Senior Living. The company culture and servant leadership mentality at Brookdale resonated with me, and when I got offered the job, I called my mom and told her, "I found my people."

I’ve been with Brookdale for about 18 years and I’ve stayed because it’s never boring. I started in assisted living, and then gained exposure to the other service lines, including independent living, memory care, skilled nursing, home health, and hospice. Today, as VP of Sales, Skilled Nursing, my ultimate responsibility is driving occupancy and revenue.

This involves partnering across divisional lines and collaborating with hospital teams, business development teams, and our operational, clinical, therapy and finance departments. Everyone shares ideas and challenges to identify urgent needs and opportunities, and these insights allow us to introduce new skills and programs.

Identifying Process Gaps, Risks, and Inefficiencies

PointClickCare has been our electronic health record platform since 2013. We started with intake referral management and integrating our referrals in the system. Over time, however, I realized there were different modules within the platform that could help us gain insight into our operations.

At a company the size of Brookdale, data collection is vital, and important to gain visibility into existing processes. Without visibility, it’s hard to form a strategy. We also needed to automate data collection—everything from referral trending to conversion ratios. This is particularly important within skilled nursing, where you're working with a variety of integrated systems.

Although Brookdale is a senior living company, assisted living is our core business. In skilled nursing, the resident admission process was manual and paper-based, which caused huge issues. Paperwork would stack up in my colleagues’ offices, which increased the risk of HIPAA violations and created internal billing issues. Some skilled nursing facilities process more than 100 admissions a month—that’s a lot of paper and a lot of room for error when entering everything manually.

In any business, if you have tried-and-true processes for data collection, your data can stay pretty clean. Consistent processes can save a lot of time and build efficiencies. If an issue arises, it’s because there’s usually been a failure somewhere in your process.

We needed a new process. I didn’t want us to have to print copies of admission packets or see them piled up in offices anymore. I wanted to overhaul and digitize our process, from pre-admission through to billing.

Streamlining Our Admission Process with PointClickCare

I had this in mind, but the real catalyst for our project was my mom's health. She underwent heart surgery, after which she was in ICU for 11 days, followed by a move to skilled nursing. At that point, I was aware of PointClickCare’s Document Manager, but I had not seen a full demo. I found myself as an end user during my mom’s admission process and experienced it from a completely different perspective. Viewing from the lens of a family member I essentially "walked a mile" in the shoes of our residents and their families and it made me realize the value of Document Manager.

There are always lots of forms to fill out in healthcare, both for patients and staff. Document Manager reduces the manual effort it takes to create and complete personalized documentation by automating the process. It’s faster, more accurate, more secure, and enhances standardization. PointClickCare Document Manager is digital first, so it also allows for HIPAA-compliant eSignatures.

Seeing it in action convinced me this was the solution we needed across Brookdale. I started banging the drum, engaging different people and asking them how Document Manager would be beneficial to their work. The big push came from our finance team, because some of the billing issues were due to poor paperwork management.

With PointClickCare’s Document Manager, we ultimately wanted to:

• Increase efficiencies in our current admissions workflow using eSignature functionality and automation
• Decrease the number of write-offs due to late or incomplete admission documents using the audit functionality
• Eliminate admission documentation errors that result from manually completing forms with the ability to pre-populate the electronic admissions forms directly from the electronic health record (EHR)
• Standardize the admission process using templates 

Ultimately, I assembled a team of seven key stakeholders from finance, IT, legal, and operations. We identified rock stars within different departments who knew the fail points in the existing process and everyone worked together to build a new process that filled in those gaps. They also graciously agreed to participate in the strategy and rollout of Document Manager, with the help of nine additional super users who could assist with the training and implementation. 

No User Left Behind

As anyone who’s implemented a new technology within an organization knows, there’s always some groans about a new process. I minimized the groans by hosting a lot of one-on-one sessions, as did our superusers, and spending time with individual users. I also provided a variety of tools for users in the field, including creating Zoom tutorials and Quick Reference Guides (QRGs). 

Implementing Document Manager during the pandemic brought on some additional challenges. All of these individual sessions had to be done remotely, and I couldn’t always go on site to address issues that arose. I leaned heavily on our super users and department rock stars for ongoing peer support in the field. That peer-to-peer training made all the difference. It encouraged everyone to have ownership of, and engagement with, the solution. It also flagged areas that weren’t going as smoothly as they should’ve been and people who needed extra attention.

Taking on this project allowed me to step back into my roots and assume a teaching role. I was committed to the success of our communities and got to mold their learning of the new system. No one was left behind and all our communities successfully onboarded to the new platform.

Building a Next-Level Admissions Process

We were well-coordinated and organized, so the rollout happened very fast—about two months. Once we finished the planning phase, we launched PointClickCare Document Manager in October 2020 and officially finished implementing our 36 communities by mid-December.

The biggest impact of rolling out PointClickCare Document Manager so far is visibility into our processes. It’s been invaluable to have insight into the daily business to see what is working, to make sure that these processes are complete, and to establish a solid baseline of results. We’ve identified areas where we can make admissions more efficient. It also revealed our broken spots and showed us some best practices. We’ve made adjustments to our billing components and can more easily review data.

Our rollout was successful, but there's no way you can ever plan for every scenario that's going to come up. I'm very grateful to the PointClickCare team—Harley and Mary Jane in particular—who are always so responsive when I reach out with questions or need support or help with troubleshooting. I start calls by saying, "Hello, it's me again," and they don’t miss a beat. They’ve been so patient, encouraging, and knowledgeable every step of the way. 

Preparing for Post-Pandemic Processes

Our rollout of PointClickCare Document Manager is especially meaningful because launching a new solution during the height of the pandemic was a big risk. Everyone was exhausted and my team and I hadn’t been able to get into certain communities for almost a year. But it also highlighted the need and the importance of a digital process, where you don’t need to pass pens for signatures or shift through papers to find information. 

This new process has forced us to become better partners and communicators. When you have freestanding skilled nursing communities, you often have every player sitting in the same building. At Brookdale, due to our communities being CCRC campuses, you may have a business office in a completely different building than skilled nursing. We needed to find a way to ensure everyone was on the same page, and PointClickCare helps us do that.

This was a “go big or go home” situation. We went big, and we’re now prepared for the post-pandemic rebuild process. When admissions return to normal levels, we’ll be ready with a more streamlined process, knowing that we can invoice and collect appropriately. I fully expect us to reap the long-term benefits of PointClickCare Document Manager, namely solving our collection issues, continuing to improve process efficiencies, and finally making a complete shift away from the archaic world of paper.