Despite Ongoing Operational Challenges, Brookdale Rebuilding Home Health Census

Brookdale Senior Living Inc. (NYSE: BKD) has performed over 100,000 COVID-19 tests across 44 states since the public health emergency began. It has been doing that while rebuilding its home health patient census, which took a substantial hit due to elective surgeries shutting down in spring.

Brentwood, Tennessee-based Brookdale operates and manages more than 730 independent living, assisted living, memory care and continuing care retirement communities nationwide, serving over 65,000 residents. Along with its senior living segment, Brookdale offers a range of home health, hospice and outpatient therapy services to thousands of additional patients.

To protect itself against potential spread and identify possible COVID-19 exposure, Brookdale has proactively implemented a resident and associate baseline testing program. This has allowed the company to identify and quarantine individuals who may have been asymptomatic, according to leadership.

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To date, its testing efforts have resulted in positive outcomes for the company. As of the end of July, less than 1% of Brookdale’s residents had COVID-19-positive results.

“Baseline testing at all our communities allows us to … minimize the duration and impact a community experiences with a COVID-19 exposure,” Brookdale President and CEO Cindy Baier said Tuesday during the company’s second-quarter earnings call. “One of the pleasant surprises we experienced was that all those residents who tested positive for COVID-19, many passed through the full exposure period without becoming symptomatic.”

On top of testing, Brookdale has also leaned on technology to allow prospective residents to tour its communities virtually.

“Virtual visits are not as effective as in-person visits, but they have been much more effective than not being able to do a visit at all,” Baier said.

Rebuilding home health volume

Similar to most home health companies, Brookdale’s average daily census began to decrease in March due to coronavirus complications, ultimately resulting in an 18.7% decline in census during the second quarter.

“Lower occupancy in our communities combined with the acute care health systems that shut down — or severely limited — all elective procedures and limited access to care had a negative impact on our home health revenue,” Baier said. “But we are starting to rebuild our census.”

Brookdale’s census began to show recovery in June 2020, returning to levels attained in January 2020, according to the company.

“Our associates started educating patients and referral sources about our strong screening [policies] and protocols in order to continue to provide vital services,” Baier said.

Overall, Brookdale posted revenues of $865.9 million for the quarter, down from $1.02 billion in Q2 2019. The company’s home health revenue checked in at $60.9 million for the quarter, down from $85.2 million in Q2 2019.

Brookdale’s Q2 home health average daily census fell to 12,980, compared to 15,966 in the second quarter of 2019.

Recovering lost revenue

Brookdale leadership estimates that COVID-19 resulted in $15 million in lost revenue for the second quarter, specifically looking at its health care services segment, which includes home health and hospice care.

Company-wide, Brookdale has spent $71 million fighting the COVID-19 virus year to date, with the bulk of that going to fund personal protective equipment (PPE) and medical supplies.

To help offset those and future coronavirus-related costs in its health care services segment, Brookdale recognized several million dollars of federal support.

“In the second quarter, we recognized $27 million of grants income,” Steve Swain, executive vice president and CFO, said during the call. “The majority of the grants were related to our Medicare business, which is largely in our health care services segment and a small skilled nursing section in senior housing.”

The company also received $85 million in Medicare advance payments, a Centers for Medicare & Medicaid Services (CMS) program that provides emergency funding in response to a disruption in claims submission or claims processing.

Nationally, federal aid for senior living providers has been an advocacy mission for industry groups. Brookdale has been active on this front.

“Brookdale played a leadership role in emphasizing to [the U.S. Department of Health and Human Services], the administration and Congressional members the importance of providing financial relief to the senior housing industry to help protect our nation’s seniors against COVID-19,” Baier said.

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