This document outlines a three-step marketing plan for skilled nursing facilities (SNFs) to address challenges from healthcare reform, Accountable Care Organizations (ACOs), and reducing hospital readmissions. First, SNFs must evaluate how they are perceived by referral sources and improve communications to be invited to join local ACOs. Second, SNFs must track and report their hospital readmission rates to referral sources. Third, if not included in a preferred ACO, SNFs should promote their quality care directly to consumers to maintain Medicare referrals and revenues. The plan advises proactive communications now to prepare for changes from healthcare reform and ACOs.

1. A Three-Step Marketing Plan to
Address the ACO, Medicare and
Re-hospitalization Challenge
Provided by
Experts in LTC marketing and consulting since 1983.
Providing marketing and consulting services to:
Skilled Nursing Facilities I CCRCs I Assisted Living Buildings
Independent Living Communities I Specialty Care Programs I Community-Based Programs
toll-free: 877.725.6774 I www.MarketingDynamics.net I ©2012 Marketing Dynamics All Rights Reserved

2. A Three-Step Marketing Plan to Address the
ACO, Medicare and Re-hospitalization Challenge
Health care reform and the era of accountability:
how SNFs can protect their Medicare revenues.
Although much remains to be finalized, today’s health care reform legislation will result in the
most significant changes in the way Medicare-funded services will be paid for and delivered since
the introduction of PPS in the early 1980s. What can a SNF do to maintain – and increase – its
Medicare referrals in this uncertain environment?
1 Accept the fact that reform will take place and that it will change referral
relationships. There is no question: the need to lower costs and improve outcomes through
better coordination of care will result in some form of Accountable Care Organizations (ACOs)
in your marketplace. What can SNF management do right now to get “invited” to join the ACO of
your choice and maintain or improve its referral relationships? Start by answering these questions:
• Are you perceived by referral sources as providing quality sub-acute and rehab care?
• Does every referral source know about your clinical capabilities?
• Do community physicians know how successful your rehab program is in returning short
term patients to their homes after a hospital stay?
If you’ve answered “no” or “don’t know” to any of the above questions, the very first thing you
should do to prepare for accountable care and protect your flow of Medicare referrals is to
re-look at the way you are projecting your image to referral sources and physicians.
This evaluation should include both what you are saying, and how you are communicating it.
For example:
• Make sure your building’s name and brand reflect that you are an expert in short term rehab
and ub-acute care. If it doesn’t, but instead sounds like that of a traditional nursing home,
s
consider changing the name or adding a tagline that highlights your rehabilitation capabilities.
• How often do you communicate with referral sources? It is not enough to be relying
entirely on your outreach people to personally inform discharge planners and physicians
about your clinical capabilities and outcomes. Consider developing a set of communications
pieces that provide powerful messages about who you are and what you can achieve
clinically. Then consistently distribute those materials to every referral source at least once
every month.
• In addition, begin reporting directly to referral sources about their referrals’ progress
via a simple “Patient Progress Report” to the discharge planner, case worker, surgeon,
specialist or primary care physician. Note that keeping referral sources appraised of their
patients’ progress will be required in the era of accountable care, so it is a good idea to
implement this important process ahead of your competitors.
toll-free: 877.725.6774 I www.MarketingDynamics.net I ©2012 Marketing Dynamics All Rights Reserved

3. A Three-Step Marketing Plan to Address the
ACO, Medicare and Re-hospitalization Challenge
2 Recognize that you will need to reduce re-hospitalizations – especially
for those Medicare Part A referrals that are within the “30 day window”
– starting right now.
Although many facilities have begun to focus on this area, simply reducing your rate of
re-hospitalizations isn’t enough; you must also track that performance and communicate
it to your referral sources. Begin protecting your Medicare revenues right now by asking
yourself the following questions:
• What is your re-hospitalization rate and how does it compare to published rates?
• Do you have the in-house clinical services necessary to treat Medicare referrals in your
building to avoid re-hospitalization?
• Do you have a process and communications programs in place to educate and focus
your staff on doing what’s necessary to achieve reduced re-hospitalizations?
• Did you know that as many as 50% of re-hospitalizations are at the urging of family
members? Do you have any educational materials to help reduce family members’
insistence on hospitalizing their loved ones?
If you’ve answered “no” to any of these questions, you should immediately:
• Begin tracking your re-hospitalization rate and then report those achievements to
referral sources.
• Assess your clinical capabilities to confirm that they are consistent with the needs of the
referrals you want to attract.
• Establish a process and communications program to educate and focus your staff
to do what’s necessary to reduce re-hospitalizations.
• Begin educating family members about your clinical capabilities and your ability to avoid the
risks that are associated with transfers to hospitals by providing much of the care their loved
one will need.
toll-free: 877.725.6774 I www.MarketingDynamics.net I ©2012 Marketing Dynamics All Rights Reserved

4. A Three-Step Marketing Plan to Address the
ACO, Medicare and Re-hospitalization Challenge
3 Not every SNF will be invited to participate in the ACO of their choice; some
may be left out. What are your options if you find yourself “outside” your
preferred system?
Keep in mind that consumer choice will play an important role in the era of accountable care. This
means that communicating with consumers now – to establish awareness of who you are and the
quality care you provide – can be essential to protecting your Medicare revenues.
Why? Because of two important reasons: First, consumers will have a choice of where they want
to receive post-hospital care, so you want to make sure they can ask for you by name. Second,
enhancing your image with consumers also helps to establish your image with referral sources.
By starting your awareness campaign now, it not only helps to establish your image as a quality
provider with consumers, but also with those health care decision-makers currently structuring the
ACOs in your market.
To help establish an image as an expert in senior care throughout your community, you may want
to consider the following:
• Implementing a senior health education initiative as a community service program
• Enhancing communications with family members and providing support groups – both of
which have been proven to increase satisfaction and to generate positive word-of-mouth
• Frequently communicating with discharged short term patients so that they are encouraged
to generate positive word-of-mouth
Summary
Although many details have yet to be finalized, there is no question that health care reform will
be implemented and will directly impact Medicare referral relationships. At the heart of health
care reform is the creation of Accountable Care Organizations (ACOs), which will be designed to
achieve improved integration and coordination of patient care to deliver both cost-savings and
improved outcomes.
To protect Medicare referrals, SNFs should start to implement communications and promotional
programs that will enhance their image and help to ensure they are perceived by referral sources,
physicians and consumers as a provider of superior short term rehabilitation and sub-acute care.
(continued on next page)
toll-free: 877.725.6774 I www.MarketingDynamics.net I ©2012 Marketing Dynamics All Rights Reserved

5. A Three-Step Marketing Plan to Address the
ACO, Medicare and Re-hospitalization Challenge
Communications will be more important than ever in attracting Medicare referrals. Whether to
establish your clinical credentials, educate and re-focus staff on retention, or generate positive
word-of-mouth, specialized communications and promotional programs should be implemented
now – before final agreements are reached regarding the formation of ACOs in your market.
Taking proactive steps is the best way to overcome the uncertainty of the future of health care
reform and to protect your Medicare revenues.
Not sure what to do next?
here or call our Help Line at 877-725-6774 to schedule a free consultation
Click
for the answers to these crucial questions:
• What can you do right now to help ensure that you are “invited” to join the
ACO of your choice?
• What is the single most important thing you must do immediately to protect
your Medicare referrals and revenue stream?
• How do you generate Medicare revenues if you are “left out” of the ACO
of your choice?
toll-free: 877.725.6774 I www.MarketingDynamics.net I ©2012 Marketing Dynamics All Rights Reserved