As if declining occupancy, new payment models, increasing labor costs and continued regulatory pressure weren’t enough, long-term care providers must learn to address the emerging demands from younger consumers. In this presentation, we look at why occupancy and utilization are declining, the characteristics of the emerging market and how best to engage them. We will also look at levels of efficiency, why efficiency is the new keyword in long term care, and ways to differentiate long term care services.

1. Not Yo Mamma’s
Retirement Home
Why Kroger’s Has Better
Technology Than Nursing
Homes and Why It Matters
presented by
Irving L. Stackpole

2. The Challenge of Occupancy
Why are occupancies poor?
What should be done?
What role can technology play?

3. Responding to a declining market
Defend, protect & fortify
• Manage to Loyalty
Increase Productivity / Efficiency
Innovate
Differentiate

4. Myths
The aging population is growing
A rising tide “floats all boats”
People always get sick

5. Myth Buster
Occupancies are poor because the age
qualified markets are declining
ALSO, occupancies are poor because of
• Increased options / choices
• Negative perception
• The economy
• “Intermediaries”
Kroger’s competes on ≤ 2% margins
• Can retirement centers & nursing homes?

6. Stackpole & Associates, Inc.6
Population myth - headlines are not bottom lines

7. ~6.4 mm @15%
~ 960,000

11. What’s the problem?
Why are occupancies
declining?
Is “Marketing” that bad?
Is “Sales” that bad?

12. Stackpole & Associates, Inc.
12
2014
Born 1928
85 yoa
2020
Born 1934
85 yoa
2017
Born 1931
85 yoa

13. Negativity
 Sector NOT thought of as the valuable
resource it is …
 They are seen as prisons – awful places
– The “F” word
– “Don’t want to put / place mom in a nursing
home.”
– “I’d rather be dead.”
 Deep metaphor of negativity
Stackpole & Associates, Inc.13

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15. Responding to a declining market
Defend, protect & fortify
• Manage to Loyalty
Increase Productivity / Efficiency
Innovate
Differentiate

16. Stackpole & Associates, Inc.16
Source of Efficiencies
Employees
– Key to  costs /  outputs
Are we getting more staff?
Staff produce “patient / family
experience”
Staff produce Quality & Value

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Productivity & Efficiency
Outputs for Inputs
– Productivity ≠ Staff Reductions
Simple Efficiency
– Purchase decision cycle – Time?
Pull through
Case Managers, Consumers, Doctors
“Actors”

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Efficiency
Technical, Productive, Allocative
–Technical
Maximum improvement from resources
–Productive
Best health outcome for given costs or
reduction in cost for the same outcome
–Allocative
Best outcomes for society

20. Stackpole & Associates, Inc.20
Innovate / Add Efficiencies
Post Acute Care Transitions
Hospitals
– Resident & Family satisfaction data
– Transactional efficiency
Pharmacy & Rehab
HCBS

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22. Facts of Life
The age qualified market is shrinking
Continued pressure on payments
Continued pressure on utilization
Efficiencies & productivity are the
keys to effective differentiation

23. Responding to a declining market
Defend, protect & fortify
• Manage to Loyalty
Increase Productivity / Efficiency
Innovate
Differentiate

25. Call or email Irving Stackpole
+1-617-739-5900, Ext. 11
istackpole@StackpoleAssociates.com
www.StackpoleAssociates.com
Stackpole & Associates, Inc.

26. Bibliography
26
Albrecht K. and Zemke, R. Service America. New York: Warner Books, Inc. 1985
Bruner II, G.C. , James, K.E., and Hansel, P.J. Marketing Scales Handbook: A
compilation of multi-item measures, volume iii. Chicago: American Marketing
Association. 2001
Chase, R & Dasu, S. Want to perfect your company’s services?: Use behavioral
science. Harvard Business Review June, 2001.
Cialdini, R. Influence: The psychology of persuasion. New York: Quill. 1993
Johnson, M & Gustafsson, A. Improving customer satisfaction, loyalty and profit: An
integrated measurement and management system. San Francisco: Jossey-Bass.
2000
Parasuraman, Zeithaml and Berry. A conceptual model of service quality and its
implications for future research. Journal of Marketing. 1985 Fall:41-50.

27. Bibliography
27
Palmer, S and Torgerson, DJ. Economic Notes: Definitions of efficiency. BMJ
VOLUME 318 24 APRIL 1999
Reichheld, F The Loyalty Effect: The hidden forces behind growth, profits, and lasting
value. Boston: Harvard University Press. 1996
Stackpole. I. & Ziemba, E. Make Your Marketing P-P-P-P-Perfect, Care Management
Matters, April 2008
Stackpole, I. & Ziemba, E. It’s Not What Your Say – It’s What People Hear!, Care
Management Matters, June, 2008
Zaltman, G, Zaltman, L, Marketing Metaphoria: What deep metaphors reveal about
the minds of consumers. Boston, Harvard Business Press 2008
Ziemba, E. Email Campaigns that Work. Care Management Matters, April, 2009
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