How Exceptional Living Centers turned faster referral review into 32% more admissions

Introduction

"Even when I've got quite a few referrals stacked up, I have the comfort of knowing exacare ai is working for me. I can have that laser focus on what I need to drill down on."

Exceptional Living Centers operates 10 skilled nursing facilities across Indiana, Ohio, and Tennessee. By the time the team started working with exacare ai, they had already done much of the hard operational work: moving more facilities into a centralized intake process, standardizing referral categories, and establishing disciplined reporting habits to track performance across the portfolio. The process worked, but it still left room to move faster.

A single referral could move through various referral portals, PointClickCare (PCC), email, Teams, eFax, and hospital systems before a decision was made. Intake leaders had to read through the full packet, extract relevant clinical details, verify insurance, complete sex offender checks, write a summary for the facility, update PCC, respond in the referral portal, and manually track what happened next. For straightforward referrals, the team had learned to move quickly. For longer, more complex packets, sometimes 300 or 400 pages, the work left real room for duplicate effort and missed details.

Exacare ai gave Exceptional Living Centers a more centralized way to manage that work. Instead of building the story from a blank packet, intake and facility teams could start from an organized referral summary, a clearer activity history, and better visibility into what needed attention, helping them move faster, review with more confidence, and turn more of the right referrals into admissions.

Key Results

• 26% increase in accepted referrals
• 32% increase in conversion rate
• 17% increase in win rate
• 50% reduction in referral review time for familiar green referrals
• 40% referral growth after implementing exacare ai
• 31% growth in average daily census across the 10 centers

The Customer

Exceptional Living Centers is a skilled nursing operator with facilities across Indiana, Ohio, and Tennessee. Its admissions process is built around a central intake team that helps coordinate referral review across most of the portfolio, while a few long-standing facilities continue to manage parts of the process locally.

That hybrid approach gives Exceptional Living Centers a practical balance: central intake can move quickly on referrals that are clearly a fit, while facility teams stay closely involved in clinical decisions that need local review. Green referrals can be accepted centrally, clear non-fits can be removed quickly, and more complex yellow referrals can be packaged for building-level review.

The organization is also highly data-driven. Before exacare ai, leaders had already invested in consistent referral tracking and reporting through PCC, using thoughtful manual workflows to understand referral volume, denial reasons, acceptance trends, and facility-level performance. That discipline made the team a strong fit for exacare ai: they were not looking to replace judgment or rebuild admissions from scratch. They were looking for a faster, more visible way to run the process they had already built.

The Stakeholders

Nicolle Meade, Senior Vice President of Business Development
Nicolle Meade is a senior leader and key advocate for exacare ai at Exceptional Living Centers. She has been with the organization since 2019 and now serves as Senior Vice President of Business Development. During her time at ELC, she has also served as Vice President of Operations and Vice President of Strategic Initiatives. Her background spans business development, operations, facility administration, and clinical nutrition, giving her a practical view of what admissions teams need to move quickly while still making responsible decisions.

Kimberly McCombs, Central Intake Director
Kimberly McCombs leads central intake at Exceptional Living Centers and is one of the team's primary exacare ai power users. She has been with the organization since 2022, after more than a decade at Trilogy Health Services in customer service, community relations, and referral development roles. Her background in admissions, marketing, referral relationships, and customer communication gives her a practical view into the day-to-day work exacare ai supports: reviewing referrals quickly, coordinating across teams, and keeping the admissions process moving.

Jean Marcelli, Regional Care Coordinator
Jean Marcelli is a Regional Care Coordinator at Exceptional Living Centers and an active user of exacare ai in the referral review process. She joined the organization in 2023 after more than six years as a Nurse Link Manager at Diversicare. Her background gives her a strong operational lens on referral review, team coordination, and the clinical details that can affect whether a referral is a good fit.

The Challenge: A Strong Intake Process With Too Much Manual Work

Starting in 2022, Exceptional Living Centers worked to centralize referral review across most of the organization, standardize referral categories, and capture the data leadership needed to understand performance across buildings.

That discipline gave the team a stronger process, and made the limits of the old workflow easier to see. Even with central intake in place, the process still involved a lot of moving parts. Kimberly described it as "a lot of ping-pong" across different sites, portals, documents, and people. The time added up.

"By the time I finished reviewing the referral, documenting it, and responding back, it was probably 20–25 minutes of my time per referral."

For more complex referrals, the challenge was not just speed. It was the pressure of knowing one missed detail could change the decision.

"There were times when we would get a 300- or 400-page referral faxed in. It took time to go through all of that information, and there was always that anxiety of, 'Am I going to miss something?'"

Reporting added yet another layer to that burden. Kimberly had built a process for tracking referral outcomes in PCC, but turning that data into insight still meant downloading itemized reports, cleaning the data, and building pivot tables. Turnaround time was even harder to measure. PCC didn't give the team clean timestamps at every step, and weekend referrals or minor status updates could skew the numbers.

Exceptional Living Centers had the people, process, and discipline. What they needed was a way to reduce the clerical burden around each referral, so their teams could spend less time stitching information together and more time making fast, accurate admissions decisions.

The Solution: A Faster, More Centralized Referral Review Process

Exceptional Living Centers chose exacare ai to make referral review faster, easier, and more consistent across its portfolio, while keeping experienced admissions and clinical teams at the center of every decision.

The team saw value across five areas, each building on the next. AI-generated summaries gave intake teams a structured starting point instead of a blank packet. That clearer starting point made it easier to centralize review, reducing time spent bouncing between portals, documents, and email. Faster, more organized review meant central intake could move quickly on clear green referrals, escalate yellow referrals to the right people, and help clinical leaders see a complete picture without manually working through hundreds of pages first. And with cleaner intake data flowing through the platform, the team could begin replacing manual reporting work with real dashboard visibility and scheduled reports.

The summary report was especially important for clinical buy-in. Nicolle knew exacare ai would only work if clinical leaders trusted what they were seeing. The platform needed to support the organization's review process, not shortcut it.

"Our chief nursing officer said the summary report alone was a game changer. It gave the team a much better clinical picture than going through 300 pages manually."

For Exceptional Living Centers, exacare ai fit the way the organization wanted to work. Admissions and clinical teams would stay in the loop on each decision, while AI helped organize information, reduce clerical work, and give experienced teams a faster, clearer starting point.

The Implementation: Early Buy-In and Practical Team Adoption

Exceptional Living Centers started conversations early and worked to build buy-in across senior leadership, operations, and clinical teams.

The change had to be introduced carefully. Admissions decisions were shared across central intake and facility teams, and facility leaders needed to trust that exacare ai was organizing information consistently and applying referral statuses they could rely on. That meant bringing people along gradually.

Jean supported adoption through daily calls, giving users time to get comfortable with the platform instead of overwhelming them all at once.

"Each day, I would show them something new in exacare ai. I didn't try to do it all at once, just little bits at a time. Even people who were resistant to change started to see the value."

The Impact

Referral review time decreased by 50% for familiar green referrals

Before exacare ai, even a familiar, straightforward referral could take Kimberly 20–25 minutes to review, summarize, document, and respond to. With exacare ai, that same referral could be reviewed in under 10 minutes.

Exacare ai shortened the steps around each referral, helping the team move from review to response with less manual preparation.

Accepted referrals increased 26%, conversion rate increased 32%, and win rate increased 17%

Comparing the team's first month on exacare ai with a recent 30-day period, accepted referrals increased from 391 to 494 (26%) and conversion rate increased from 146 to 192 (32%). Win rate also improved by 17%.

Together, those metrics show that Exceptional Living Centers was not just reviewing referrals faster. The team was identifying more of the right referrals, accepting more of them, and moving more opportunities through to admission.

“We used to offer beds on about 40% of our non-denied referrals. Now we’re up to 65–70%. It’s been amazing.”

Average daily census grew 31% across the 10 centers

One of the clearest outcomes came as a surprise to the team. Rather than showing up primarily in admission volume, exacare ai's impact showed up in census. Buildings were filling more consistently, and some locations soon faced a new challenge: more qualified referrals than available beds.

That shift helped the team look at performance more completely. Admissions growth mattered, but it was not the whole story. As occupancy improved, Exceptional Living Centers also needed to understand where capacity was tightening, why referrals were being denied, and how bed availability was shaping future admissions opportunities.

Referral volume grew 40%

Exceptional Living Centers also reported 40% referral growth after implementing exacare ai. Nicolle attributed that growth to stronger hospital relationships, more liaison capacity, and faster response times, with exacare ai helping the team respond more quickly and consistently in the referral channels hospitals already used.

"We're responding so much faster in the CarePort portals. The hospital sees us now as a valuable partner."

Complex referrals became clearer, faster

One of the biggest qualitative improvements was confidence. For Jean, that was especially clear on busy days or when long referral packets came in. Instead of opening a large packet cold and trying to find every important detail manually, the team could start from a clearer, more organized view of the referral.

Exacare ai gave the team a clearer starting point for review. Admissions and clinical teams could spend less time searching through the packet and more time focusing on the barriers, risks, payer considerations, and facility-fit questions that needed attention.

Reporting became easier and more actionable

Exceptional Living Centers was already serious about referral data before exacare ai. Kimberly had built a careful manual reporting process in PCC to track referral statuses, denial reasons, acceptance trends, and facility-level performance. But getting to those insights took work: itemized exports, data cleanup, and pivot tables.

With exacare ai, the team gained a more direct view into referral activity through the Data Center, scheduled reports, and clearer intake data across the portfolio. Better visibility helps Exceptional Living Centers spot bottlenecks earlier, manage facility performance more consistently, and make smarter decisions about clinical capabilities, specialty programs, and market strategy.

What’s Next

For Exceptional Living Centers, the work isn't done; it's expanding. The team sees opportunities to deepen exacare ai's role across the admissions process, including managed care support, Bed Board visibility, specialty referral tracking, and post-acceptance engagement with residents and responsible parties.

"As census and managed care volume continue to grow, we know we will need a more scalable way to manage authorization work."

Exacare ai helped a strong foundation scale. With faster review, clearer information, and better visibility, Exceptional Living Centers is identifying more of the right referrals, moving them through to admission, and building toward what comes next.

"Our team loves exacare ai. It has made their world a lot easier. They have embraced it."