Rebuilding Census: What Your Plans Could Be Missing

 In Getting Earlier Referrals

When the dawn of 2021 unveiled skilled nursing census trends between 56-80% capacity in 48 states, the charge to rebuild census was cemented as a top strategic priority for this year.

Our research and client growth work has revealed several opportunities and challenges that may remain in the shadows of your attention. Let’s bring them forward and review five areas to assess in your census rebuilding plans.


1. Understand and honor mindsets. Your financial reality is a byproduct of perception. Have you mastered mindsets that drive choice, which fuels your census and revenue? Do your plans reflect an understanding of family caregivers, for example, who are often the linchpin in patient/resident choice and potentially a referral influencer?

Our growing body of research illuminates that heads in beds starts with minds at peace in choice – in the minds of your referrers, your patients/residents’ caregivers, your patients/residents and your employees. COVID-19 has created or cemented barriers to choosing your organization. In our 2020 survey of 1,000 family caregivers:

  • 68% don’t agree that quality care can be provided in healthcare facilities.
  • 60% are more confident that quality care can be provided in the home, and nearly half reported they are less likely or “definitely won’t use” in-facility care.
  • The majority (78%) are afraid of resident infection and 52% would remove residents from a facility if the option existed to do so.

Leverage your surveys, social media listening, Transcend’s research and other tools to understand the mindsets that may be impacting your census.


2. Assess areas of opportunity to overcome the barriers that are holding back referrals. What are the roadblocks to choosing your organization? What is creating undue resistance in choice, referrals and patient/resident retention?

Our research insights revealed barriers of trust, safety and security that may be diverting family caregiver decisions or recommendations away from providers:

  • Trust: Respondents are more than three times as likely to be satisfied with overall quality of care if they’re also happy with the quality of open, honest communication received about COVID-19 cases.
  • Confidence in Safety: Respondents are nearly twice as likely to believe resident is safer from viruses in a facility vs. in-home if they’re satisfied staff provides compassionate care when family can’t visit.
  • Security: 70% are more likely to believe their loved one is getting better care in a facility than they could at home if they are satisfied with access to information to help monitor their loved one’s health.

These insights can help you assess how your census rebuilding plans leverage the following barrier-breaking opportunities by providing:

  1. Quality of communication
  2. Compassionate care of staff
  3. Immediate access to information and updates about their loved one

Technology has enabled a cocooning in the home where people feel more safe and secure. Fear is holding individuals back from entering facilities unless they have no other option, but the increasing comfort with technology presents an opportunity.

How are you using technology to rebuild and retain your census? 62% of family caregivers agree telehealth provides an attractive alternative and families say they’re more likely to use telehealth in the future. We found that 28% of family caregivers have used video conferencing or telehealth in place of in-person visit by care providers.

Look for opportunities to meaningfully engage prospective residents/patients throughout their journey to choosing you, and while they are under your care.


3. Transform referrer relationships to indispensable partnerships.                                       

The call for more referral transactions as quickly as possible has never been louder or clearer. But urgency alone is not the siren call for growth that will resonate with referrers.

Step back and ensure strategic plans will evolve your referrer relationships from a transactional mindset to becoming an indispensable partner in the continuum of care. For example:

  • Reframe and quantify your value to signal business opportunities to referrers.
  • Expand your approach to embrace collaboration over competition. Take a fresh look to ensure you communicate “indispensable partner” in every word and action.
  • Complement the value you deliver to your patients/residents in what you deliver to your referral partners. When your culture and operations dovetail with your external growth strategies, trust and preference will be emboldened.
  • Laser-target your messaging to your most promising referral prospects using tools such as account-based marketing.

When you have a moment, take a listen to our Transcending Podcast Episode 14 “Breaking Down Barriers to Earlier Referrals” for applicable insights from home-based care providers.


4. Innovate with insight and rebuild through your constellation of essential elements.

Catalyze your census building through essential elements that fall into five growth engine categories:

  • Brand – The differentiation and distinct value of your organization realized in your culture.
  • Experience – Enriching social, physical, emotional, life-affirming experiences under your care.
  • Messaging – Capturing authentic personal stories that engender trust.
  • Technology – Relationship-enabling tools to grow your referrals and reach.
  • Actionable data – Consistent data cadence from surveys, social listening to QAPI dashboards

Prioritize these elements based on your data insights and resources in concert with the following assessment area.


5. Power up with proven practitioners rather than rebuilding alone.

It takes more than a stiff upper lip and Keep Calm Carry On at this critical juncture. What is holding you back from securing additional strategic support for growth?

Senior care providers who applied Transcend’s strategies have experienced increases in topline revenue of 100 to 400% during the first three years alone.

Do these assessment areas reveal opportunities to rebuild census more quickly? Where do you see gaps in your strategic planning and implementation?  Email me at to ascertain why now is the time to take First Steps with Transcend to fuel your business development and marketing efforts in today’s business environment.

Related Posts