Census Cures All: Or Does It?
"Census cures all." I've come across this phrase from a CEO and subsequent leaders for over two decades. In today's ever-unpredictable behavioral health market, the responsibility for maintaining a stable census primarily rests on the front-facing departments: Marketing, Business Development, Admissions, and now Alumni.
These four revenue-generating departments are well-acquainted with the fluctuations in census numbers. They receive accolades and recognition when the census is robust, with beds and chairs fully occupied, and clients well-served. However, it's important to note that census declines are not a matter of 'if' but 'when,' and during these downturns, they bear the brunt of scrutiny, pressure, and questions like, "Why aren't they working hard enough?"
Having spent two decades in leadership roles within both inpatient and outpatient programs at national and regional treatment facilities, I've gained valuable insights into this dynamic.
1. Business leaders need to set realistic expectations for census growth.
Census variations are an inherent aspect of the behavioral health field. We are dealing with individuals, not mere commodities. This isn't a mechanized production line business; it's a constantly evolving landscape built on relationships. Emotions like fear, shame, and uncertainty play a significant role in the decision-making process, particularly when addressing addiction, a condition that disrupts executive functioning and places families in turmoil. It's akin to navigating a ship through turbulent waters without a compass. To enhance your team's success, it's crucial to establish realistic monthly census targets that align with historical trends and treatment seasons.
2. Micro-tears in the organizational system are the biggest culprit in census growth and a healthy culture.
It’s not another pretty website or the rockstar business development professional that is going to get you to your census goals. They know their job. They understand the hustle. What we often see that prevents census growth are the micro-tears in the organizational system. Sometimes, they seem so small and insignificant that we wonder how they could impact the larger goals.
For Example:
What does training look like for your Business Development team? Are you recruiting people with limited to no experience in behavioral health knowledge? If so, what are you doing to train them to level up their performance and success?
Does your Business Development/Outreach team work collaboratively with your clinical and admissions teams?
Does the Business Development team receive the support they need in the field? Do they have the marketing assets or resource toolbox to effectively respond to the market they work with? Collateral/Company Credit Card/access to leadership for meetings.
Do you celebrate the wins of your teams without mentioning the numbers but instead focusing on their efforts only?
Does your digital marketing campaign tell the unique story of your program or is it written only for SEO and paid search?
How have you built your alumni program? Do you even have an alumni program?
Does social media have a part in your marketing and branding campaigns? What message are you pushing to share your unique story?
How does leadership effectively communicate the goals of the organization? Is there a month-over-month average daily census expectation that the teams can shoot for?
Do you provide communication dashboards to all front-facing departments that tell you who made the referral and is there a communication plan to follow up?
Yes, there are many other variables like financial forecasting, HR hiring practices, leadership training, and coaching, building strong evidence-based clinical programs with highly talented staff, insurance contracting, and billing that are vital to this dance of census growth.
Finding the micro-tears can be a challenge if you are too closely tied to a system that appears to be working okay. Discovering these small cracks sometimes requires an outsider. Someone who is not emotionally vested, someone who can look objectively and ask the hard questions.
If you want a unique approach and partner to elevate and improve best practices in census growth, I will work collaboratively with your team to empower them to identify these setbacks and provide proven solutions for success.
I can’t promise an ongoing stable census, but I can commit to helping you build a healthy servant leadership culture, that responds to the ever-changing world of treatment and gives your organization and staff the tools they need to help more individuals and families struggling with behavioral health issues find life in recovery.
